How Common Are Perimenopause Misdiagnoses?

Around 1.3 million women enter menopause each year in the United States, but only a fraction receive confirmation that they’ve officially entered this life stage, let alone acquire the proper medical guidance necessary to help them navigate the transition.¹ This can often lead to symptoms being misdiagnosed or blamed on other causes, such as anxiety or stress, when really, they’re related to the common hormonal fluctuations experienced during this time.

So, why exactly are menopause and perimenopause misdiagnoses so common, and how is menopause actually diagnosed? Let’s dive in.

How is Menopause Diagnosed?

A healthcare provider may consider a diagnosis of menopause if you’ve been without your period for 12 consecutive months.²

The problem is that the stage before menopause—called perimenopause— begins much earlier, causing symptoms that women or their healthcare provider may or may not contribute to this natural, hormonal transition. While perimenopause typically begins between the ages of 40-44, some women may experience it starting as early as in their mid-30s.³

While the media has reported a lack of menopause education within the medical community,⁴ some research also points to a lack of proper understanding of the experience among women themselves, as another variable leading to a misunderstanding of these symptoms and their relationship to perimenopause or menopause.

One study revealed that more than 80% of women surveyed had little to no knowledge of menopause symptoms,⁵ while another found that more than 94% had never been taught about the hormonal transition in school.⁶ Thus, women who don’t realize their symptoms could be associated with perimenopause or menopause, may not bring them up to a healthcare provider for diagnosis or treatment.

So, why are these barriers to diagnoses important? The delay in a proper perimenopause diagnosis can cause other potential conditions to be missed or ignored. For example, once menopause nears, a woman's risk for heart disease, diabetes, osteoporosis, and changes in mental health increase markedly^{7, 8, 9, 10}— all conditions that are somewhat manageable if and when they’re diagnosed and treated early.

Lesser-Known Menopause Symptoms

Hot flashes, night sweats, and mood swings are often among some of the most commonly cited menopause symptoms.¹¹ But as women transition into perimenopause, lesser known symptoms may creep up that evade awareness of physicians who may not have a specific background in this area of women’s health.

Examples of less commonly discussed menopause symptoms that may go undiagnosed include:^{12, 13}

• Sleep Issues
• Joint and Muscle Pain, Aches, or Stiffness
• Painful Sex
• Vaginal Dryness
• Heart Palpitations
• Brain Fog
• Dry Mouth
• Body Odor
• Thinning Hair
• Dry Skin
• Brittle Nails

Women experiencing any of these less discussed menopause symptoms may not realize they’re experiencing the natural hormonal transition, and physicians without adequate training or experience may misdiagnose or potentially dismiss them altogether.

Can Cancer Be Mistaken for Menopause?

Unfortunately, some cancer symptoms can be mistaken for menopause symptoms and vice versa.¹⁴

Symptoms of both menopause and certain types of cancer can sometimes overlap. Abnormal bleeding cycles, for example, is a frequent symptom of perimenopause, as well as one of the most common symptoms of certain gynecologic cancers, such as cervical cancer, uterine cancer, or ovarian cancer.^{15, 16}

In many cases, the only definitive way to determine whether symptoms are due to menopause or another medical condition, such as cancer, is with a biopsy.¹⁷ For this reason, it’s important to discuss any changes or new symptoms you’re experiencing with a qualified healthcare provider who can help decipher whether your symptoms are those typical of menopause or something else.

What Can Be Mistaken for Hot Flashes?

If you’re nearing 40 and experiencing episodes of sudden warmth throughout your body, you may be diagnosed with menopause or perimenopause hot flashes.

However, hot flashes can occur as a result of other underlying conditions, as well. Examples of these can include:¹⁸

• Certain prescription medications, such as SSRIs or opioids
• Thyroid problems
• Hormonal imbalances, unrelated to menopause
• Anxiety
• Certain cancer treatments/cancer
• Fevers from infection
• Some neurological disorders
• Alcohol use
• Food intolerances

Always be sure to check with your healthcare provider if you’re experiencing hot flashes and are not quite sure why – just as a precaution and to rule out any of these potential other causes.

Find a Healthcare Provider Who Can Guide You Through Perimenopause

The transition from perimenopause through menopause and beyond can feel overwhelming, but you don’t have to manage it alone.

Consider looking into a specialized healthcare practitioner, such as a Certified Menopause Provider, in your area who focuses on menopause diagnosis and symptom management. A gynecologist or another type of healthcare provider with expertise in women’s health can also help to not only determine the root of your symptoms, but also the best course of treatment; and if necessary – they can also recommend you to a specialist if they feel it would be beneficial for your care.

It’s estimated that as many as 1 in 3 women may receive a misdiagnosis when it comes to menopause and its symptoms.¹⁹ This is why it’s important to consider proactively educating yourself about the symptoms, so you know what to expect, and can feel empowered to better advocate for yourself to your healthcare provider to get the treatment you need to feel like your best self again.

Resources

1. https://www.ncbi.nlm.nih.gov/books/NBK507826/
2. https://my.clevelandclinic.org/health/diseases/21841-menopause
3. https://www.mountsinai.org/health-library/report/menopause
4. https://www.aarp.org/health/conditions-treatments/info-2018/menopause-symptoms-doctors-relief-treatment.html
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9772977/
6. https://pubmed.ncbi.nlm.nih.gov/36994487/
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10074318/
8. https://newsnetwork.mayoclinic.org/discussion/consumer-health-diabetes-and-menopause/
9. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menopause-and-osteoporosis
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088347/
11. https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397
12. https://nyulangone.org/news/more-just-hot-flashes-other-menopause-symptoms-can-also-impact-your-quality-life
13. https://www.everydayhealth.com/menopause-pictures/menopause-symptoms-that-may-surprise-you.aspx
14. https://www.moffitt.org/taking-care-of-your-health/taking-care-of-your-health-story-archive/gynecologic-cancers-and-menopause
15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9140476/
16. https://www.verywellhealth.com/cancer-symptoms-abnormal-vaginal-bleeding-513761
17. https://womenshealthresearch.ubc.ca/blog/spot-difference-menopause-or-endometrial-cancer
18. https://www.verywellhealth.com/what-causes-hot-flashes-other-than-menopause-5186829
19. https://www.theflowspace.com/reproductive-health/menopause/menopause-symptoms-misdiagnosis-2938300/