Menopause
Perimenopause misinformation ‘putting women at risk’
Perimenopause misinformation on social media is putting women at risk of unintended pregnancies, unnecessary medication and missed diagnoses, experts have said.
Awareness of menopause and treatments such as hormone replacement therapy, or HRT, has been raised by efforts including a prominent documentary by Davina McCall.
But as a growing number of women encounter misleading information on social media, there are concerns that some could be led to false conclusions that can obscure real underlying health difficulties.
“Everyone thinks they’re menopausal,” said Dr Paula Briggs, a consultant in sexual and reproductive health.
“So we are seeing younger and younger women asking for HRT when what they need is hormonal contraception, as they’re still fertile.
“I work in an abortion service and we’re seeing more women over 35 now who believe themselves to be menopausal and are gobsmacked when they become pregnant.”
According to the British Menopause Society, more than 80 per cent of women will be menopausal by the age of 54, meaning they have not had a period for 12 months or more, with about 5 per cent reaching menopause before the age of 45.
But menopause is not a sudden stop. Instead, women go through a transition known as perimenopause over months or years.
During this time, hormone levels fluctuate and can cause symptoms such as changes in menstrual patterns, hot flushes and difficulty sleeping.
Briggs said misinformation around perimenopause is concerning.
“I look at things like Instagram to see what they are exposed to and I am horrified,” she said, citing examples of women in their 30s being told to demand HRT if they are unable to sleep or are struggling with migraines, and to switch GPs if denied.
Or women being told they should seek testosterone treatment.
“I’m not anti any of these things in the right person, but females produce their own testosterone lifelong, even women without ovaries, so the idea that everybody has to demand testosterone is bonkers,” Briggs said.
Dr Channa Jayasena, an expert in reproductive endocrinology at Imperial College London, also raised concerns.
“It’s great that there’s better [public] awareness [about perimenopause]. And I think many doctors are completely unaware about how debilitating the symptoms of perimenopause can be,” he said.
“But the flipside of that, I think there’s a risk that some women are being mislabelled as having perimenopause when they have other things that are wrong.”
Prof Janice Rymer, chair of the British Menopause Society, agreed.
“[If you are] having regular periods naturally, then you’re not perimenopausal, end of story. You’ve got good hormone levels,” she said.
Rymer added that there is a perception that any symptom affecting women between the ages of 40 and 60 is due to perimenopause or menopause and that HRT is required.
“I think HRT is completely wonderful,” Rymer said. But, she added, “it’s not for women who don’t need it,” noting that in such situations it can cause heavy bleeding.
Briggs said a key concern arising from misinformation around perimenopause is that women are stopping contraception, thinking it is no longer needed.
Jayasena suggested that could be because of messaging around how fertility declines with age.
“I think we’ve got a real awareness about the timelines for optimum fertility and optimum response for IVF. IVF stops working well beyond the age of 42. It’s easy to translate that to an assumption that you can’t get pregnant naturally, when actually you can,” he said.
Experts have also raised concerns over a pushback against hormonal contraception, something that is particularly acute among younger women, even though demand for HRT is growing.
While they stress contraception is not a one-size-fits-all issue, Briggs noted there are many progestogen-only contraceptives, which use a synthetic version of the hormone progesterone, that can be used alongside HRT to protect against pregnancy while managing symptoms associated with perimenopause.
In addition, she said, there are modern forms of the combined pill that are safer for use in women experiencing perimenopause than traditional combined pills, as they contain a natural form of oestrogen.
Essentially, said Jayasena, “it’s a mini pill plus a bit of HRT.”
Dr Zara Haider, president of the College of Sexual and Reproductive Healthcare, said misinformation is a significant issue, particularly around fertility and hormone use.
She said: “We still see women stopping contraception too early because they assume they can’t get pregnant, when in reality contraception is needed until menopause is confirmed or until age 55.
“There’s also been a lasting impact from outdated or flawed studies around risks like breast cancer, which has understandably made some women cautious about hormones.
“At the same time, it’s positive that public conversations, including high-profile campaigns, have helped bring menopause into the mainstream.
“The challenge now is making sure women are getting accurate, evidence-based information to make informed decisions.”
One in three US women older than 35 are no sure whether they are in perimenopause, new research has revealed.
The findings suggest uncertainty remains common, largely because of knowledge gaps, symptom confusion and difficulty getting confirmation or care.
Perimenopause is the transitional stage before a woman’s final period, when hormone levels fluctuate and symptoms can change over time.
It usually begins in the mid-40s, although timing varies widely, and can last for around four to eight years.
Symptoms can include hot flushes, psychological symptoms and urogenital symptoms, which affect the urinary and genital areas.
Dr Stephanie Faubion, medical director for The Menopause Society and one of the study authors, said: “This large study showed that one in three US women aged older than 35 years are not sure whether they are in perimenopause.
“Further, the study highlights that symptom confusion, misconceptions, and barriers to care are leaving many women without the clarity and support they need during the menopause transition.
“Recognising perimenopause uncertainty as a common experience can help shift the conversation from searching for a diagnosis to providing women with the information, validation, and support they need to navigate this natural life transition with confidence.”
More than 7,600 US women aged 35 and older took part in the study, which looked at how common uncertainty around perimenopause is and what may be driving it.
Overall, 34 per cent of participants said they were unsure of their reproductive stage.
Uncertainty varied by age and symptom burden, reaching 42 per cent among women aged 40 to 44 and 37 per cent among those with severe symptoms.
Symptom confusion was the most common factor, cited in 56 per cent of responses.
This included difficulty making sense of bodily changes and telling perimenopause apart from other possible causes, such as premenstrual syndrome, thyroid disease or mental health conditions.
Knowledge gaps and information-seeking made up 28 per cent of responses, reflecting limited awareness, age-based assumptions and attempts to find reliable information.
Barriers to confirmation and care made up 16 per cent, including dismissive healthcare encounters and reluctance to acknowledge perimenopause.
Younger women aged 35 to 39 were more likely to cite knowledge gaps, while healthcare barriers were most common among women aged 40 to 44.
The researchers said clinicians should take a more flexible approach to recognising the emotional, cognitive and physical symptoms that can occur during perimenopause.
They said healthcare professionals should not rely too heavily on irregular periods as the main sign, because some women have symptoms before major cycle changes.
A new menopause drug has been approved for NHS use in Scotland, offering a non-hormonal option for women who cannot take HRT.
The Scottish Medicines Consortium has recommended that women can now be prescribed fezolinetant, also known as Veoza, for symptoms such as hot flushes and night sweats.
Some women cannot take HRT, leaving them with limited treatment options for symptoms that can be severe and long-lasting.
Dr Timir Patel, medical director of Astellas UK, said the company was “pleased that this important additional treatment option will be available to women in Scotland, helping to support more personalised care for those experiencing hot flushes and night sweats”.
Fezolinetant works by selectively blocking a neurotransmitter in the brain involved in triggering hot flushes.
Clinical trials have shown the drug can reduce both the frequency and severity of hot flushes and night sweats.
About 400,000 women in Scotland are said to be of menopausal age, with manufacturer Astellas Pharma Ltd saying up to 48,000 could benefit from the treatment.
Dr Rob Peel, chair of the Scottish Medicines Consortium, said: “We know that menopausal hot flushes and night sweats can substantially affect quality of life.
“For those who cannot take HRT, effective treatment options are limited. Fezolinetant provides a non-hormonal treatment option, and we know our decision will be welcomed.”
Dr Kay McAllister, consultant gynaecologist and clinical lead for menopause services at NHS Glasgow and Greater Clyde, said: “Today’s decision marks a positive development for the wellbeing of Scottish women.
“In clinical practice, I see how hot flushes and night sweats impact sleep and overall quality of life in my patients.
“The availability of this targeted treatment offers a welcome choice and further options for patients.”
Avni Wellness has secured Rs 4 crore, around US$470,000, in seed funding to expand its products and digital commerce capabilities.
The Mumbai-based women’s health start-up plans to strengthen its online retail operations and increase its presence across digital marketplaces.
It will also expand its cycle nutrition product range and grow its women-led network of micro-entrepreneurs.
Founded in 2021 by Sujata Pawar and Apurv Agarwal, Avni Wellness offers science-backed, toxin-free products spanning adolescence, reproductive years and menopause.
Its portfolio includes a patented antimicrobial reusable sanitary pad and a liposomal iron supplement designed to address iron deficiency among women in India.
Liposomal supplements encase nutrients in tiny fat-like particles intended to support absorption.
The company also offers products for polycystic ovary syndrome, or PCOS, calcium supplementation, urinary and vaginal health and seed-based hormonal nutrition. PCOS is a condition that can affect hormone levels, periods and fertility.
Proteus Partners led the funding round, with participation from angel investors Puru Gupta, Sreejith Moolayil, A. Velumani and Somya Nigam.
Avni Wellness said it aims to address gaps in women’s healthcare in India by focusing on hormonal health, nutrition and long-term wellbeing while incorporating livelihood generation and sustainability into its model.
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