Perimenopause is one of the most misunderstood and under-supported stages of a woman’s life. Despite affecting millions of American women for up to a decade before menopause, new research from TENA reveals a striking reality: those in perimenopause are among the least likely to seek medical help despite experiencing a wide range of disruptive symptoms. This disconnect isn’t just a knowledge gap, it’s a systemic issue shaped by misinterpretation, low awareness, and a lack of accessible guidance.
Flying Blind Through a Major Life Transition
A striking 50% of women report they don’t even know what stage of menopause they’re in. One in four (25%) say they weren’t prepared for perimenopause at all.
Without clear education on what to expect, many women are left trying to figure out changes in their own bodies on their own, misattributing hormonal symptoms to stress, aging, or simply being overworked.

The consequences are significant. More than half (55%) of perimenopausal women never seek medical support, believing their symptoms aren’t serious enough to warrant attention. This normalization of discomfort reflects a broader cultural tendency to minimize women’s health concerns, particularly when tied to hormonal changes.
Suffering in Silence Has Become the Default
Fatigue (51%), brain fog (36%), and low mood (36%) are among the most reported perimenopausal symptoms, also some of the easiest to ignore.
Women balancing careers, caregiving, and family responsibilities often normalize these experiences, pushing through exhaustion and mental fog rather than seeking answers. Without clear medical framing, symptoms get endured rather than addressed.

When the Body Speaks a Language No One Taught Her
Beyond the more recognized signs, many perimenopausal symptoms are widely misunderstood. Joint pain affects 35% of women, heart palpitations impact 18%, urinary urgency affects 25%, and hair loss impacts nearly three in ten (29%).
Yet these are rarely connected to hormonal changes in mainstream conversations, leaving women to assume they are unrelated health issues or simply part of aging.
Regional data reveals further inconsistency. In Minnesota, 47% of women report hair loss, yet awareness is only slightly higher at 54%. Massachusetts leads in urinary urgency reports (26%) and also ranks as the most knowledgeable state overall, with 83% of women reporting a strong understanding of menopause stages compared to just 42% in Missouri.
Together, these lesser-known and misunderstood symptoms create a fragmented picture of perimenopause, where women experience multiple physical and cognitive changes without connecting them to a single underlying cause.

