Perimenopause is one of the most misunderstood and under-supported times in a woman’s life. Despite affecting millions of American women, new research* shows a striking reality: those in perimenopause are among the least likely to seek medical help, even while experiencing a wide range of disruptive symptoms.

This disconnect between symptoms and support isn’t just a knowledge gap; it’s a systemic issue shaped by misinterpretation, low awareness, and a lack of accessible guidance.

A Stage Women Aren’t Prepared For

For many women, perimenopause arrives without warning. One in four (25%) say they weren’t prepared for this phase at all, and this lack of preparation sets the tone for everything that comes next, as without clear education on what to expect, many women are left trying to figure out changes in their bodies on their own.

This confusion has real consequences. Over half (55%) of perimenopausal women report don’t get medical support because they think their symptoms are caused by something else. Instead of recognizing hormonal fluctuations, they often think they are simply stressed, overworked, or experiencing the natural effects of aging.

The “Just Put Up with It” Mindset

Part of the issue lies in how symptoms are perceived. Fatigue (51%), brain fog (36%), and low mood (36%) are among the most common things people say they experience, but they are also some of the easiest to ignore.

These symptoms are often normalized or internalized. Women may believe they are expected to “push through” exhaustion or mental fog, particularly during midlife when many are balancing careers, caregiving, and family responsibilities.

Because of this way of thinking, and the lack of clear medical framing, people put up with their symptoms instead of dealing with them.

The Overlooked Symptoms Driving the Disconnect

Beyond the commonly recognized signs, many perimenopausal symptoms are still widely misunderstood, making women even less likely to ask for help.

For example, joint pain affects 35% of women, heart palpitations impact 18%, and a quarter (25%) experience urinary urgency. However, these symptoms are rarely linked to hormonal changes in mainstream conversations, leaving many women to assume they are unrelated health issues or just part of aging.

Hair loss is another key symptom shaping the perimenopausal experience, affecting nearly three in ten women (29%). Yet despite its prevalence, it often goes unaddressed as part of hormonal change, leaving many women without the context or support needed to manage it effectively.

Regional differences reinforce this inconsistency. In Minnesota, 47% of women report hair loss, yet awareness is only slightly higher at 54%. Meanwhile, New Hampshire has the highest awareness at 64%, but only 14% report experiencing hair loss.

Together, these lesser-known and misunderstood symptoms create a fragmented picture of perimenopause, one where women are experiencing multiple physical and cognitive changes without connecting them to a single underlying cause.

A Clear Demand for Support

Despite the lack of awareness and low engagement with healthcare providers, the demand for support is clear. More than half of women (56%) say that expert advice from a healthcare professional would help them feel more supported. Meanwhile, 45% are looking for recommendations on products to manage symptoms, and 41% want access to online tools to track their health.

This signals a crucial opportunity: women aren’t unwilling to ask for help, they simply don’t know where to find the right kind of support, or how to interpret what they’re experiencing.

Bridging the Gap with Better Resources

This is where initiatives like TENA’s American Menopause Guide play an important role. By providing accessible information, it highlights how menopause support and access can differ across the US, helping women better understand what care looks like depending on where they live. The need for support is clear; the challenge now is ensuring women know where to turn and how to access it.

Reframing Perimenopause as a Health Priority

Ultimately, the issue isn’t that women don’t care about their health, it’s that perimenopause hasn’t been positioned as a life stage that requires attention and care.

When symptoms are misunderstood, normalized, or dismissed, women are less likely to seek help. But when they are equipped with the right information and resources, the picture changes.

Perimenopause should be reframed not as a phase to merely accept, but as a critical window for proactive health management. By closing the gap between symptoms and support through education, accessible tools, and open conversations, we can ensure that fewer women feel they have to navigate this stage alone.

*The research was conducted by Censuswide on behalf of TENA, surveying a sample of 2,000 women aged 18 and over across the US.