CLEVELAND, Ohio (Jan 28, 2026)—Although perimenopause is experienced by all women regardless of race or nationality, it is not always experienced similarly. Studies comparing perimenopause symptoms across diverse cultures and geographic settings are lacking. A new study based on data from Flo, an international mobile health application, demonstrated inconsistency between perimenopause knowledge and actual symptoms experienced across diverse global populations. Study results are published online today in Menopause, the journal of The Menopause Society.
Perimenopause is the transition period leading up to a woman's last menstrual cycle and includes the 12 months afterward, after which menopause is established. Typically occurring in women aged in their mid-40s and lasting an average of 6 years, symptoms may begin as early as their 30s and persist for a decade. The menstrual cycle irregularity and fluctuating hormone concentrations that are typical of this time frame often cause a wide range of symptoms, including hot flashes and night sweats, sleep disruption, mood disturbances, and cognitive complaints.
Despite its clinical significance, perimenopause remains underrecognized and is less extensively studied compared with menopause. As a result, women might not realize that their symptoms may be attributable to perimenopause, which can lead to delays in seeking care and managing symptoms.
Because symptoms may be shaped by cultural norms, societal attitudes, and access to healthcare, a global perspective is valuable in understanding how perimenopause symptoms vary across regions. A recent review of 17 international studies found that women's experiences of perimenopause and menopause vary widely by country and are strongly influenced by sociocultural factors. However, there is a paucity of research that compares perimenopause symptoms across diverse cultural and geographic settings.
A new study based on data from more than 17,000 women aged older than 18 years from 158 countries sought to assess global knowledge and symptom experiences. It used Flo, a globally utilized mobile health app, to collect data from a broad and diverse user base. The primary endpoints were knowledge of perimenopause symptoms from all survey participants and self-reported perimenopause symptoms for survey participants aged 35 years and above.
Commonly recognized perimenopause symptoms included hot flashes (71%), sleep problems (68%), and weight gain (65%). Of the participants, 12,681 were aged 35 years and older, with the most common self-reported symptoms being fatigue (83%), physical and mental exhaustion (83%), irritability (80%), depressive mood (77%), sleep problems (76%), digestive issues (76%), and anxiety (75%). International variation in perimenopause symptoms knowledge and symptoms experienced was noted.
Future research should explore how demographic and lifestyle factors, social determinants of health, attitudes toward perimenopause and menopause, and knowledge-seeking behaviors influence these differences. Understanding these drivers will facilitate the development of tailored educational initiatives for both patients and clinicians.
Study results are published in the article " Global perspectives on perimenopause: a digital survey of knowledge and symptoms using the Flo application. "
"This study highlights a discordance between knowledge of perimenopause and actual symptoms experienced across global populations. Although hot flashes were the most widely recognized symptom, women most reported experiencing fatigue, physical and mental exhaustion, and irritability. Better understanding of the diverse experiences of women approaching menopause will help inform development of education for women and healthcare professionals across the globe," says Dr. Stephanie Faubion, medical director for The Menopause Society and one of the authors of the study.
