Flo Health Study Finds One in Three U.S. Women Over 35 Unsure About Perimenopause Stage

A new Flo Health study says 34 percent of U.S. women aged 35 and older were unsure of their reproductive stage, including whether symptoms they were experiencing indicated they had entered perimenopause. The women's health app announced the findings on 14 July in a Business Wire release syndicated by Yahoo Finance, saying the research was conducted with the Center for Women's Health at the Mayo Clinic and published in Menopause: The Journal of the Menopause Society.

The study included 7,640 U.S. women aged 35 and older and used the Menopause Rating Scale as well as open responses. Flo said uncertainty was especially high among women aged 40 to 44, the age range when many women are approaching perimenopause and often experiencing stronger symptoms. In that group, 42 percent said they did not know if they were perimenopausal.

That finding matters because perimenopause is not a niche health topic. It can affect sleep, mood, bleeding patterns, weight, concentration, work, relationships and long-term health decisions. Yet the study points to a large knowledge gap at precisely the stage when women may be trying to decide whether symptoms are hormonal, stress-related, connected to another condition, or simply part of life.

Flo's open-response analysis identified three main drivers of uncertainty. The first was symptom confusion and attribution, representing 56 percent of responses. Many women described severe physical or mental symptoms but doubted they were in perimenopause because their menstrual cycles remained largely regular. Others struggled to separate perimenopause from existing conditions or life events such as endometriosis, postpartum weaning or stopping hormonal birth control.

The second driver was knowledge gaps and conflicting information, cited in 28 percent of responses. Participants said they did not know what perimenopause meant, which symptoms counted, or how to interpret what was happening in their own bodies. That is a communication failure as much as a clinical issue. If women do not have reliable, plain-language information before symptoms become disruptive, they are more likely to delay care or normalize discomfort.

The third driver involved uncertainty around menstrual-cycle patterns and reproductive transitions. That is a common problem because perimenopause does not usually arrive as a clean before-and-after moment. Cycles can continue while symptoms change. Hormonal patterns can vary. Some people may still be using contraception, recovering from pregnancy, or managing conditions that overlap with menopause symptoms.

For SheMeansNews readers, the work and careers angle is also practical. Perimenopause often arrives during peak responsibility years, when women may be managing senior roles, caregiving, parenting, entrepreneurship or financial pressure. If symptoms are misunderstood, the result can be more than private discomfort. It can affect performance, confidence, health spending and whether women feel able to ask for support at work or in healthcare settings.

The study does not mean every symptom after 35 is perimenopause, and it should not replace clinical advice. Its value is clearer: many women do not have enough information to know what questions to ask. A health system, employer or app that wants to support women at midlife has to begin there, with medically backed education that reduces guessing rather than adding another vague wellness message.