the state of (peri)menopause 2026

The hidden emotional reality of perimenopause

Bonafide's sixth annual State of Menopause Survey identified a critical shift in how women are experiencing the menopause transition. While physical symptoms remain disruptive, women are increasingly reporting that the emotional, cognitive, and social impacts of perimenopause are having a greater negative effect on their lives.

This Year's Topics:
  • It's not just about hot flashes
  • A lonely cycle
  • Seek validation vs. solutions
  • A more holistic approach
Three women smiling

This year's findings highlight an opportunity to expand the conversation beyond physical symptom management-toward helping women feel understood, supported, and empowered. This year Bonafide surveyed 2,000+ women, aged 40-64, who are experiencing perimenopause and menopause symptoms.

1. It's Not Just About Hot Flashes

It's about the emotional impacts.

While conversations about menopause are becoming more normalized, they've been limited to physical symptoms for years. But women are reporting perimenopause and menopause impacting their emotional and mental health more than their physical comfort. They are citing that symptoms of anxiety, sleep disruption, and brain fog, affect them more so than the hallmark hot flashes. Instead of telling women how they feel, taking the time to listen reveals nuance about what kinds of symptoms are most distressing-and right now, it's not the physical ones.

  • 60%

    say symptoms affect their emotional or mental health.

  • 50%

    say symptoms affect their mind and cognitive health.

  • 77%

    report cognitive changes.

Anxiety/depression is the #1 most cited impactful symptom, ahead of hot flashes.

Woman looking out window Woman looking out window

2. A Lonely Cycle: Self-isolation and a loss of identity

Women are expressing increased feelings of isolation and demotivation.

Perimenopause changes how women feel about themselves, their relationships, and the world around them. This year we found that women are feeling more overwhelmed, disconnected, and alone–but counterintuitively,  they also want to be alone more often. This creates a cycle that is hard to stop. Women are retreating because they don’t know where to turn and, historically, there have been a lack of safe spaces to talk about aging.

  • 69%

    69% say they want to be alone more often.

  • 74%

    74% of respondents report being annoyed by things that didn't annoy them before.

65% feel overwhelmed by everyday life vs. 70% specifically in women 40-49.

65%
All women
70%
40-49

Women 40-49 report their experience with peri/menopause has caused them to feel hopeless, at 30% higher levels than women 50-64.

30%
50-64
+30% 39%
40-49

And when it comes to work, 56% of all women said motivation is the #1 casualty of peri/meno symptoms—with this jumping to 62% in women 40-49.

56%
All women
62%
40-49
Woman looking out window

How women describe the experience:

"I feel like I'm on the
outside looking in."

3.Seeking validation vs. solutions

Women want to hear: “You're not imagining this.”

When women talk to each other about peri/menopause, they're not initially looking for treatments. They're looking for reassurance that what they're experiencing is real and shared.

  • 71%

    of women don't recognize their first peri/meno symptom as a peri/meno symptom-so talking about it can help lead to validation.

  • 62%

    say the biggest benefit of conversation is realizing they're not imagining it.

  • 39%

    say affirmation is the single most valuable outcome of talking about it.

  • 12%

    Only a small percent say information from the conversations they're having is the most valuable outcome.

Woman talking with health care practitioner Woman talking with healthcare practitioner

Conversation validates, reduces feelings of isolation and creates confidence. But the conversation and culture still need to shift to a new norm.

  • +5PP

    45% of women still say there's still enough stigma about menopause that they don't feel comfortable talking about it freely (this is up 5PP from 2024).

  • +21%

    And many say they've continued to have a hard time finding a healthcare professional who understands how disruptive their symptoms are (this is 40% in women 40-49, 21% higher than 50-64).
  • 85%

    Leaving 85% of women to continue to feel that the best way to navigate peri/menopause is to educate herself—this was cited at significantly higher levels compared to 2024.

Women smiling together Women smiling

4. Holistic Perimenopause Care Starts with Understanding

The future of perimenopause may be as much about emotional support as physical symptom management.

Women don't just want physical symptom relief. They need and deserve support for their emotions, relationships, and mental wellbeing. The conversation around perimenopause needs to evolve from simply managing symptoms to more holistic support.

Menopause literacy is increasing. This year 21% of women could correctly define menopause as a moment in time – this is the highest rate we’ve ever recorded! When women can identify their symptoms, they can articulate the help they need.

But there’s still work to be done:

80% say transparency around menopause is still low (this number has no year over year change).

80%
2025
80%
2026

72% say menopause symptoms are more disruptive than expected than in 2023 (14% increase over 4 years).

58%
2023
72%
2026

52% of all women feel they don’t have the tools to thrive (which jumps to 56% in women 40-49).

52%
All women
56%
40-49
Woman smiling and holding coffee cup

Women deserve comprehensive care; including mental and physical support.

Six years of State of Menopause research reveal a broader story: women are struggling just as much—if not more—with the hidden emotional, cognitive, and social impacts of this transition.

And as the conversation around perimenopause and menopause continues to evolve, there’s a growing need to no longer just manage the physical symptoms—but to help women feel understood, validated, and less alone.