Symptoms on the Path to Menopause: Research

The lived experience on the path to menopause is not well-researched. Our 2020 WLB Survey aimed to change that.

Key contributions

A better characterization of the symptom experience before and after noticeable menstrual cycle changes.
Establishing the phrase “Not Feeling Like Myself” as part of perimenopause and linking it to associated symptoms.
Describing women’s experiences seeking healthcare during perimenopause.
Exploring associations between life stressors and perimenopausal symptoms.
Determining the impact of expectations about the timing of perimenopause and the symptom experience.

Survey design

Data collection: March 2020 to August 2020

Participants: 3000+

Languages: English and Spanish-language versions

Topics covered: menstrual cycle characteristics, 61 symptoms (frequency and bother), interference of symptoms, sources of stress, satisfaction with life, health ratings and behaviors.

Read the published research

We don’t expect changes to happen as early as they do.

Think back to when you were 30. In which of the following age ranges did you assume the changes associated with the lead up to menopause would begin?

Top 4 findings from our first paper

Symptoms begin before very noticeable menstrual cycle changes (i.e. skipped periods or irregular cycles).
59% of respondents expected changes associated with menopause to begin at 50 or later. (see chart above)
Similar symptoms occur before and after periods become irregular.
The symptom experience is much broader than expected (considerably more than hot flashes and vaginal dryness)

Symptoms Reported: Regular Periods w/ subtle changes*

% reporting

I am more forgetful

I am irritable (e.g. short tempered, impatient with others)

I have sore breasts, breast tenderness

I have a harder time concentrating

I am less interested in sexual activities

I am experiencing new fatigue, tiredness

I have feelings of anxiety (e.g. more nervous)

My skin is drier than it used to be

I wake in the middle of the night (for 1+ hour)

I feel easily overwhelmed, less able to cope

I have urinary leakage w/ sneeze or cough

I have night or cold sweats

Defining the groups that were compared

Monthly periods w/ subtle changes to menstrual cycles

Respondents had 3 or 4 periods in the past 3 months.
They also reported a change to either cycle length, amount of flow (heavier or lighter) or days of flow (greater or fewer).
According to a framework used by healthcare providers and scientists this group is in the Late Reproductive Stage.
There were 945 respondents in this group.

Skipped periods, much longer cycles

These respondents had skipped a period.
They reported 2 or fewer periods in the past 3 months.
According to the framework used by the research and healthcare community, this group is in the Menopausal Transition.
There were 491 respondents in this group.

Symptoms Reported: Irregular (green) vs Regular w/subtle changes (navy)

% reported

I am more forgetful (irregular)

I am more forgetful (regular)

I am irritable (irregular)

I am irritable (regular)

I have sore breasts, breast tenderness (irregular)

I have sore breasts, breast tenderness (regular)

I have a harder time concentrating (irregular)

I have a harder time concentrating (regular)

I am less interested in sexual activities (irregular)

I am less interested in sexual activities (regular)

I am experiencing new fatigue, tiredness (irregular)

I am experiencing new fatigue, tiredness (regular)

I have feelings of anxiety (irregular)

I have feelings of anxiety (regular)

My skin is drier than it used to be (irregular)

My skin is drier than it used to be (regular)

I wake in the middle of the night (for 1+ hour) (irregular)

I wake in the middle of the night (for 1+ hour)(regular)

I feel easily overwhelmed, less able to cope (irregular)

I feel easily overwhelmed, less able to cope (regular)

I have urinary leakage w/ sneeze or cough (irregular)

I have urinary leakage w/ sneeze or cough (regular)

I have new facial hairs (irregular)

I have new facial hairs (regular)

I have night or cold sweats (irregular)

I have night or cold sweats(regular)

I have low feelings (irregular)

I have low feelings (regular)

My eyes are drier (irregular)

My eyes are drier (regular)

I have hot flashes (irregular)

I have hot flashes (regular)

Update May 2024

Thanks to the generosity of the Women Living Better community through GoFundMe campaigns, we were able to make three of our papers open access so that they can be read by everyone, not just academics with institutional access. You can find all of our published research and links to the articles here.

The 2020 WLB Survey: Symptoms on the Path to Menopause — Key Findings