This year approximately 60 million American women between the ages of thirty-nine and fifty-three will be perimenopausal. Nearly half will evidence clinical depression and anxiety disorders associated with the onset of perimenopause. "The Fifth Decade" offers women and their families a lucid, accessible guide to the phases that define the turbulent years of perimenopause, as well as seasoned insight to navigate the intense, unpredictable emotional swings that define ‘The Change.’ Dr. Wagner brings the discussion home with clear and factual explanations for changing sexuality, depleted energy, lack of focus, and even women’s’ changing capacity to empathize with the people around them. . .peppering her narrative with sanity-affirming stories of keys lost in the fridge and women discovering they’ve poured orange juice into their coffee.    Dismissing the one-size-fits-all approach, Dr. Wagner provides, unbiased information on treatment approaches, including the most current medical insights into hormonal changes (for example, estrogen levels actually rise during perimenopause!) and hormone therapy options. She also explains how every woman’s own personality, history, hormonal mix, health (especially thyroid health) as well as her current social situation will shape her experience and her approaches for managing her wellbeing. Perhaps most inspiring is Dr. Wagner’s reminder that the volatile years of perimenopause do, ultimately, resolve into Quietude, when the storm ends, and women are able to look forward to the calm after the storm. With warm and conversational chapters dedicated to spouses and children, as well as an intuitive real-world discussion of the added stressors that define daily life for women in the new millennium, "The Fifth Decade" is a welcome and indispensable guide for 40-something and 50-something women coping with the poignant growth, and the most intense life, body and identity shifts they will experience since their teen years.