She was 37. She brought a plastic bag of hair to her appointment — collected from the shower drain over four days, because she was afraid I wouldn't believe her. Her previous visit had lasted eleven minutes and ended with "everyone sheds, it's probably stress, try to relax." That is not a diagnosis. That is a scheduling constraint wearing a lab coat. I want to name something clinicians often skip. Hair loss is not cosmetic. For women in midlife, hair is bound up with identity, professional presence, sexual confidence, and the private terror of visibly aging faster than you expected. Women describe hair loss with language they reserve for grief. When a woman is told to relax about it, she hears that her distress is the problem — rather than the shedding.

A patient came into my office a few months ago, opened a folder on her phone, and showed me a long list of skincare products she had been cycling through for the past two years. Retinol. Vitamin C. Bakuchiol. Three different growth factor serums. A peptide moisturizer. A red light mask. She was 46. She told me she felt like she was "throwing money at her face" without understanding any of it. She had just heard about copper peptides on a podcast and wanted to know if it was the next thing to try or the next thing to ignore. Here is what I actually think about GHK-Cu in perimenopause: where the data is strongest, where it is weaker, and how I think about it in my own practice.