'The M Factor' Makers Create A Perimenopause Film: 'Before The Pause'

Forbes

4 days ago

The creators of The M Factor are working on a follow up documentary about perimenopause The M Factor
Menopause got a dose of long-overdue attention with the hit documentary The M Factor: Shredding The Silence On Menopause , which revolutionized how women (and doctors) think and talk about menopause. It was screened in 700 cities around the world, including at the World Economic Forum in Davos.
But, as so many millennial and Gen X women know, the story doesn't start with menopause, which usually happens around 51 years-old. Hormonal changes can start as young as 35, which is a transition called perimenopause that's even less well-understood than menopause.
The team who made The M Factor are on the case—they're planning a March 2026 release of Before the Pause , a documentary that will focus specifically on perimenopause. Jacoba Atlas will be the director, and Joanne LaMarca Mathison, a former executive producer of the Today show as well as The M Factor, will be a co-producer.
'This film is going to focus on what women can do beforehand to start prepping for the next 30 years of their lives,' says Tamsen Fadal, an executive producer on both documentaries, a former news anchor, and author of the New York Times bestselling book How To Menopause .
Following screenings of The M Factor , women lined up to talk to the filmmakers, wanting to know 'When's the next film?'
So they put their heads together and realized the logical next step would be to start the story earlier in the timeline with perimenopause.
'We're going to start this conversation earlier—like at 35,' says Denise Pines, another executive producer of The M Factor and Before the Pause, and president of the Osteopathic Medical Board of California. 'Symptoms actually start to emerge then. Women know something's going on, their body is starting to change, but they're not thinking these are early perimenopause symptoms.'
That's why Before the Pause will focus on women in their 30s and 40s, who, when they report hormonal symptoms, are often dismissed by doctors.
'Women are still coming to us confused and scared, and honestly there's no area of your life that's untouched by this season of life, whether it's perimenopause or menopause,' Fadal says. Doctors Aren't Ready And Women Are Paying The Price
Despite her proximity to the medical profession, Pines says she was unprepared for her own perimenopausal symptoms.
'Not once did a doctor say—not my OB/GYN, not my general practitioner—'You know, Denise, you're 48 and you might start to see some of these things show up ... there are solutions and we can talk about some options,'' she said. 'Never, not once, never ever.
Countless women have similar stories, including Fadal, who said she thought she was too young for menopause symptoms in her late 40s. 'I was 49 when I hit menopause,' she says.
That disconnect between life experience and medical practice became the core of The M Factor , and continues to drive the new film. The documentary makers want women to understand that the health system isn't set up to usher women through this transition.
General practitioners have little time to spend with each patient, so they refer them to an OB/GYN. But, as The M Factor made clear, even OB/GYNs have surprisingly little training in menopause or perimenopause care.
'I'm tired of seeing smart, capable women feel blindsided by a stage of life that nobody warned them about,' Fadal says. Data Gaps, Misinformation, And The Legacy Of The Women's Health Initiative Study
When the filmmakers searched for data on how many women use hormone therapy, they were shocked by what they found.
Data showed that just 4.7% of women were taking hormone replacement therapy, also known as HRT, to treat their menopausal symptoms, which includes hot flashes, brain fog, depression, and a long list of many more. That number had plummeted from almost 27% in 1999.
But what was really shocking was data released just days before delivering final cut of the film. A new report put the number at just 1.8%. 'In some age groups it was even lower than that,' Pines says.
The steep decline is a direct result of lingering fear sparked by a 2002 blockbuster study released by the Women's Health Initiative. It linked hormone therapy to serious health risks, including breast cancer.
But the study was flawed in many ways—for example, the researchers recruited patients over 60 (about a decade older than the typical patient starting HRT).
A quarter of a century later—despite research showing that HRT is not only safe for most patients but also protective against other complications including cardiovascular disease and osteoporosis—a lingering fear of HRT remains among both patients and doctors.
'You still have doctors who will not prescribe HRT,' Pines said. 'They will tell you they don't believe in it.'
The M Factor began to mitigate that fear, and the filmmakers hope After the Pause will continue the trend by helping women begin a conversation about HRT with their doctors even earlier. Measuring The Power of Media
Despite systemic resistance, The M Factor proved that education can move the needle—and a new report shows just how widespread and impactful the film was.
'We were told there was no audience for this kind of topic,' Fadal says. 'That it was 'niche.' A niche topic that affects half the population of the world."
Following screenings in all 50 states and 50 countries around the world world, the filmmakers conducted pre- and post-screening surveys and found that a significant number of women who were not already taking HRT did a 180.
'It was crazy—around a 400% increase (in interest in trying HRT) from watching a 60-minute film,' Pines says.
They're hoping for a similar impact with the new documentary. 'If we start talking at 35 instead of 50, we change everything,' she says.