Women experience perimenopause symptoms much earlier than expected

More than half of women ages 30 to 35 are already suffering moderate to severe symptoms associated with menopause, yet most women are waiting decades before seeking treatment, new research from UVA Health and the Flo women's health app reveals.

The research sheds important light on "perimenopause," the transition period leading to menopause. Many women in perimenopause assume they're too young to be suffering symptoms related to menopause, believing that symptoms won't appear until they reach their 50s. But this mistaken belief, the researchers say, only causes women to suffer in silence.

Physical and emotional symptoms associated with perimenopause are understudied and often dismissed by physicians. This research is important in order to more fully understand how common these symptoms are, their impact on women and to raise awareness amongst physicians as well as the general public. Knowing this type of progression of perimenopause-associated symptoms can help both women and their doctors know what to expect as women enter the perimenopausal portion of their lives."

Jennifer Payne, MD, study co-author, expert in reproductive psychiatry at UVA Health and the University of Virginia School of Medicine

Understanding perimenopause

The new study analyzes symptoms self-reported by more than 4,400 American women ages 30 and older who responded to a survey conducted online and in the Flo app. Among women 30 to 35, 55.4% reported symptoms that meet the criteria for "moderate" or "severe" on the widely used Menopause Rating Scale (MRS). This number increased to 64.3% among women 36 to 40. Yet most women don't seek treatment for menopause symptoms until they are 56 or older.

"We had a significant number of women who are typically thought to be too young for perimenopause tell us that they have high levels of perimenopause-related symptoms," said Liudmila Zhaunova, PhD, director of science at Flo. "It's important that we keep doing research to understand better what is happening with these women so that they can get the care they need."

The researchers found that psychological symptoms, such as anxiety, depression and irritability, took hold long before physical symptoms. These symptoms reached their peak among women ages 41-45, then ebbed to their lowest in women ages 56 and over.

Physical problems such as sexual problems, bladder issues and vaginal dryness peaked in women 51 and older. These types of problems were lowest in women ages 30 to 35. 

Some of the symptoms most classically associated with menopause, such as hot flashes and sweating, peaked at ages 51 to 55 and were lowest among women 30 to 35.

The researchers hope their results will help fill what they call an "alarming gap" in our understanding of perimenopause, improving care and support for women approaching menopause.

"This study is important because it plots a trajectory of perimenopausal symptoms that tells us what symptoms we can expect when and alerts us to the fact that women are experiencing perimenopausal symptoms earlier than we expected," Payne said.

Findings published

The researchers have detailed their findings in npjWomen's Health. The research team consisted of Adam C. Cunningham, Yella Hewings-Martin, Aidan P Wickham, Carley Prentice, Payne and Zhaunova. Payne is a consultant for Flo Health.