The change is coming — and it starts with the seemingly endless reverse puberty of perimenopause

Five years ago, when Emily McDowell was about 40 years old, she started to feel different.

Anxiety, insomnia, migraine headaches.

McDowell's doctor told her she something she'd never heard before. What she was experiencing was "puberty in reverse" — also known as "perimenopause."

In layman's terms that means "around menopause," the time during which a woman's body makes the natural transition to menopause, marking the end of the reproductive years. And it's so much more than hot flashes.

"I had an image in my head of an angry lady," McDowell says. "When I was growing up, you heard about it was mostly from the perspective of unfunny male comedians comparing it to PMS."

So McDowell, the founder of a stationery brand called Em & Friends, started talking about it on Instagram and thousands of women said they were going through the same thing.

Many of them said they felt their doctors were dismissing their symptoms and no one else in their lives was talking about it.

So McDowell, who is an artist by trade, decided to put words to what she and millions of others experience by creating "perimenopausal greeting cards." They offer uplifting and hilarious messages to women going through the change:

"To have the knowledge that this is normal and this is something that happens to everybody born female is so important," she says, "because so much of the fear and the confusion comes from feeling like you're alone in it and feeling like somethings happening to me. Am I making this up? Am I crazy? And knowing that no, you're not."

Em & Friends is known for creating greeting cards as a way to help normalize things we all go through, like grief, cancer and even the pandemic.

Right now, she's thinking about how hard we can sometimes be on ourselves — especially during the holidays.

Her new motto this year is, "Hey, it's OK to adjust our expectations," which means even a greeting card maker like herself has yet to send out holiday cards this year. And as of a few days ago, the McDowell family still hadn't bought a Christmas tree.

"I'm applying that thought of just skip it to so much right now and I'm really kinda moving through life doing the bare minimum and really taking care of myself like going for long walks and I am getting extra sleep and I am having long phone calls with my friends," she says. "And I'm doing things that care for myself and care for others in a way that feels nourishing."