Perimenopause symptoms more common than hot flashes, study finds

A survey of 17,494 women across 158 countries found that ten perimenopause symptoms were reported more often than hot flashes, with examples including headaches, sleep problems, skin and hair changes, fatigue and sexual issues; researchers say this gap between expectations and experience can delay recognition and care.

Researchers analyzed responses from more than 17,000 users of a period-tracking app to compare which symptoms people associate with or experience during perimenopause. The study focused on people across 158 countries and grouped respondents by age to measure both knowledge and lived symptoms. Perimenopause refers to the years before menopause and often begins in the mid-40s, though it can start earlier. The authors note that past public discussion has emphasized hot flashes and aimed to document a broader symptom profile. Key findings: - The survey included 17,494 participants from 158 countries; those aged 18–34 were asked about their knowledge of 26 listed symptoms, while participants 35 and older were asked whether they were experiencing them. - Among 12,680 respondents aged 35 and older, 21% reported being in perimenopause, and within that group ten symptoms were reported more often than hot flashes. - Examples of commonly reported symptoms include headaches, sleep problems, skin and hair changes, fatigue (including exhaustion), irritability, and sexual problems. - Younger respondents most often identified hot flashes as a common symptom; only about 65% recognized sleep problems, fatigue, exhaustion, and irritability as perimenopause-related. - Study authors and quoted clinicians said that lack of awareness can lead to confusion and delays in evaluation, and they noted there is no single reliable at-home test for menopause because hormones such as FSH can fluctuate during perimenopause. Summary: The study broadens the set of symptoms linked to perimenopause and highlights a mismatch between which symptoms people expect and which they report experiencing. The authors report that this gap can delay recognition and care, and they note that clinician training and specialty services for midlife women are expanding in some settings. Undetermined at this time.