Perimenopause is constantly overlooked and dismissed: experts say this must change

For many women, the first recognition of perimenopause comes not from clinics, but from social media feeds and online searches. While this surge in digital awareness has opened up conversations about the phenomenon, clinicians caution that it has also led to confusion, delayed diagnosis, and the spread of misinformation.

Diagnostic gaps

Perimenopause remains poorly defined in everyday clinical conversations. While menopause marked by 12 months without menstruation has better awareness and is understood, the transition leading up to it receives far less attention.

P.M. Gopinath, director, reproductive medicine, Kauvery Hospital, Chennai, says nearly 70% of women are unaware of perimenopausal symptoms. “They tend to focus on childbirth and ignore their own health thereafter. This creates a major gap in seeking timely care,” he explains.

Doctors emphasise that symptoms can begin as early as 35. However, because they appear irregularly and vary widely, they are often misattributed to stress or general hormonal imbalance. Limited emphasis on perimenopause in medical training further contributes to missed or delayed diagnoses.

There is also increasing evidence that Indian women experience menopause earlier than their Western counterparts often by nearly five years, which means symptoms begin earlier as well. Pavithra Ramakrishnan, consultant obstetrician and gynaecologist, Apollo Speciality Hospitals, OMR, Chennai, says this happens due to multiple factors, including poor nutrition, lifestyle changes, environmental toxins, and genetic predisposition. She notes that many women may not have access to adequate nutrition due to socio-economic constraints, fasting practices, or underlying health conditions.

Experts add that poor sleep, sedentary lifestyles, metabolic conditions such as insulin resistance, and stress further contribute to earlier onset.

Symptoms present, but not recognised

Women rarely identify perimenopause as the cause of their discomfort. Instead, they present with mixed concerns such as irregular or scanty periods, fatigue, anxiety, sleep disturbances, or unexplained weight gain.

Dr. Ramakrishnan notes that while online platforms have improved awareness, they have also created a paradox. “People are being misled by false information, even though social media and search engines have helped in disseminating useful health knowledge too,” she says.

Common symptoms include hot flushes where women feel intense heat even in cool environments, mood swings, hair loss, facial puffiness, and difficulty losing weight. Increased appetite, fatigue, and sleep disturbances are also seen.

K. Kanaga Lakshmi, consultant obstetrician and gynaecologist, MGM Malar Hospital, Chennai, points out that women often “brush off” symptoms such as poor sleep, constant fatigue, and mood changes as due to stress or ageing. Symptoms like brain fog, joint pain, palpitations, and anxiety are rarely linked to hormonal changes.

She adds that this phase is often the most demanding period in a woman’s life, when she is balancing career, caregiving, and family responsibilities, leaving little time to focus on her own health.

Need for systemic support

Dr. Ramakrishnan recalls a woman in her mid-40s who had been treated for anxiety and insomnia for years. Only after perimenopause was identified did she experience significant improvement with hormone therapy and lifestyle changes.

Dr. Gopinath recounts the tale of a patient who ignored symptoms for two years after menopause. Following treatment, her concentration and professional performance improved markedly. However, he cautions that hormone therapy is most effective when initiated within two to three years of menopause and is less beneficial if delayed beyond eight years.

Doctors stress that addressing perimenopause requires changes across healthcare systems, workplaces, and families.

This includes integrating menopause education into medical curricula, strengthening awareness during routine health check-ups, and creating dedicated menopausal clinics. Dr. Gopinath suggests that workplaces with women across age groups conduct regular awareness sessions and provide access to specialised care.

Dr. Kanaga Lakshmi emphasises the need for open conversations at home and work. “Women should not feel the need to adjust silently. Early recognition and support can significantly improve quality of life,” she says.

She also highlights practical steps such as regular exercise, balanced nutrition, calcium and vitamin D intake, stress management, and seeking medical advice for symptoms including sleep issues or vaginal dryness. The challenge lies not just in recognising perimenopause, but in responding to it with timely medical care, informed awareness, and sustained support.

Published – March 28, 2026 03:18 pm IST