Key takeaways:
- Nearly 40% of women seeking care for perimenopause symptoms reported feeling misdiagnosed.
- Only 42% of clinicians initiated discussions about perimenopause, and just 15% of women felt adequately informed at symptom onset, reflecting a lack of menopause education in medical training.
- Many women turned to Google or family members (42% each) for information, while only 26% learned about perimenopause from their primary care provider or ob-gyn.
- Respondents wished they had known earlier about the timing, severity, and mental health effects of perimenopause, as well as how to advocate for care and available treatment options.
- Cognitive behavioral therapy can reduce the frequency and severity of hot flashes, night sweats, and anxiety, offering a valuable treatment option when perimenopause is accurately diagnosed.
Nearly 40% of women seeking care for perimenopause symptoms have reported feeling misdiagnosed, according to a new survey by Biote.2
Of survey respondents, over 50% were provided treatment for anxiety, depression, panic attacks, or mood swings, with 33% receiving an anxiety diagnosis. However, 39% of women diagnosed with depression expressed a belief they were not given the correct diagnosis.
“This data highlights a critical gap in how we approach women’s healthcare during perimenopause,” said Bruce Dorr, senior medical advisor at Biote. “We are seeing anxiety and depression being treated as isolated conditions when providers should be addressing the hormonal imbalance at the root of the problem.”
Limited provider engagement and knowledge
Only 42% of patients had their primary care provider or ob-gyn initiate discussions about perimenopause symptoms. Additionally, 18% expressed their concerns were not fully addressed during a conversation with their provider about perimenopause, and only 15% felt adequately informed about perimenopause at symptom onset.
According to investigators, the lack of a menopause curriculum in the United States, identified in only 31% of ob-gyn residency programs, may be a source of many health care providers feeling unprepared to support their patients during this period. Dorr noted that despite legislative efforts to address these gaps, many women are in need of immediate care.
Forty-two percent of patients reported relying on Google for additional information about perimenopause, while another 42% turned to family members. In comparison, only 26% learned more about perimenopause from their ob-gyn or primary care provider.
What women wish they knew sooner
A lack of preparation for hormonal fluctuation during perimenopause was reported among respondents. Many wished to know certain facts ahead of time, including:
- That symptoms can start earlier than previously affected by 56%
- About available treatment methods for perimenopause and associated symptoms by 41%
- About the potential severity and disruptive nature of symptoms by 37%
- How perimenopause can impact mental health by 35%
- How to advocate for themselves with doctors by 25%
This survey follows a 2022 survey from Biote that discovered 17% of women have quit their job or considered quitting because of menopause symptoms. Investigators concluded this indicates a gap in the health care system, adversely impacting women during a significant life transition.
“The timing of this survey data alongside the FDA's recent decision to remove the black box warning from hormone therapies is striking and demonstrates exactly why this regulatory change matters so much,” said Dorr.
How cognitive behavioral therapy can manage symptoms
When patients are properly diagnosed, they may receive effective treatment such as cognitive behavioral therapy (CBT) to manage symptoms, as discussed by Danette Conklin, PhD, director of Behavioral Health Services for Bariatric Surgery and Weight Management at University Hospitals, in an interview with Contemporary OB/GYN.2
According to Conklin, CBT has been associated with significant reductions in both the severity and frequency of hot flashes and night sweats during menopause. Additionally, positive effects on mood and anxiety have been reported. As anxiety can exasperate symptoms such as insomnia in perimenopausal women, this highlights the value of CBT techniques.
"The education about menopause and the possible length of menopause, the variations between women, I think that’s a big deal, and it helps women to know they’re not alone," said Conklin.
References
- Nearly 40% of women say they were misdiagnosed during perimenopause, national survey reveals. Business Wire. November 13, 2025. Accessed November 13, 2025. https://www.businesswire.com/news/home/20251113649089/en/Nearly-40-of-Women-Say-They-were-Misdiagnosed-During-Perimenopause-National-Survey-Reveals
- Conklin D. Danette Conklin, PhD, discusses cognitive behavioral therapy for menopausal symptom relief. Contemporary OB/GYN. October 24, 2025. Accessed November 13, 2025. https://www.contemporaryobgyn.net/view/danette-conklin-phd-discusses-cognitive-behavioral-therapy-for-menopausal-symptom-relief.
