Is this menopause? Why so many women are left guessing, and what to do next

Hot flashes may be the symptom most people associate with menopause, but for many women, the first signs are less obvious – and easier to dismiss.

It can start with waking up at 3 a.m. and not being able to fall back asleep. Or suddenly feeling more anxious than usual. Maybe you’re forgetting words in the middle of a conversation, struggling to focus at work, or noticing your periods have become less predictable.

Symptoms aren’t always obvious, and, as a result, many women spend years wondering what’s happening to their bodies before realizing the answer may be perimenopause or menopause.

Could this be menopause? 

Menopause is officially defined as 12 consecutive months without a period, and it typically occurs between ages 45-55 though it can sometimes occur earlier in life for a certain proportion of women. The transition time leading up to menopause, known as perimenopause, can begin years earlier — sometimes as early as your late 30s or early 40s. During this time, changing hormone levels can affect nearly every system in the body, and symptoms can include:

• Trouble concentrating, brain fog, or difficulty finding words 

• Anxiety, irritability, or depression 

• Difficulty sleeping, insomnia, or waking up in the middle of the night 

• Joint pain or body aches 

• Irregular periods or changes in your cycle 

• Hot flashes or night sweats 

• Vaginal dryness or discomfort 

• Heart palpitations or a racing feeling in your chest 

Many women don’t realize these symptoms may be connected. Instead, they can seem unrelated, and they’re treated that way.

Why so many women are left guessing 

Women often seek help symptom by symptom and specialist by specialist, spending months – or years – trying to get answers. Brain fog may lead to a neurologist. Anxiety or mood changes may lead to a therapist or psychiatrist. Sleep problems may lead to a sleep study. Irregular periods may lead to repeated OB-GYN visits. And heart palpitations may result in a visit to a cardiologist or even the emergency room.

The problem isn’t that these symptoms aren’t taken seriously – it’s that they’re rarely looked at together as one whole picture. Progyny refers to this as fragmented care, and it can create unnecessary costs, frustration, and delayed treatment.

Why menopause care often falls short 

One reason so many women struggle to get answers is that the healthcare system isn’t designed to support menopause care well. Despite affecting more than 50 million women in the U.S., most providers have very little training on how to diagnose and treat it. In fact, only 6.8% of primary care providers (including ob/gyn; internal and family medicine physicians) feel adequately prepared to help women manage menopause symptoms.

As a result, women are often told they’re simply experiencing stress, anxiety, burnout, or aging, and they’re offered treatment one symptom at a time. When care is provided through a system of trial and error, women often pay the price in time, cost, and quality of life.

Menopause doesn’t stay outside of work 

When menopause symptoms go unsupported, the effects don’t stay at home. Sleep disruption, anxiety, brain fog, and difficulty concentrating can make it harder to stay focused, participate confidently in meetings, or keep up with the demands of work.

Nearly 11% of women report missing work due to symptoms, and nearly 1 in 5 women have considered leaving their jobs entirely because of the impact menopause has had on their lives and careers.

Menopause isn’t just a health issue — it’s a workplace issue.  

What good menopause care looks like 

Good menopause care should help you understand what’s happening, connect you with providers who are trained in evidence-based best practice menopause care, and give you support between visits. It should include:  

• Access to menopause-trained providers who understand the full range of symptoms 

• A coordinated care plan that addresses both physical and emotional health 

• Coaching and support between appointments 

• Education that helps you recognize symptoms earlier 

• Treatment options that may include hormone therapy, non-hormonal medications, nutrition support, sleep support, and mental health care 

• Help navigating next steps 

Progyny’s Menopause and Midlife Care solution is designed around this comprehensive approach. Members have access to menopause-trained providers, ongoing clinical coaching, and personalized treatment plans that address the root cause of symptoms, not just the symptoms themselves. This holistic approach, combining education, access, and integrated care, results in faster recognition of symptoms, fewer misdiagnoses, and better outcomes.

You don’t have to figure this out alone 

If you’ve been wondering whether what you’re experiencing could be menopause, trust yourself. You’re not imagining it, you’re not alone, and you deserve care that supports you during this stage of life and helps you feel like yourself again.

Better menopause care may already be available through your employer benefits. Talk to your HR or benefits team to learn whether your organization offers Progyny’s Menopause and Midlife Care benefit.

Start the conversation in your workplace with these resources:

• Menopause support in the workplace: A guide for employers 

• Menopause: Frequently asked questions  

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