More than 55% of women aged 30 to 35 reported moderate to severe perimenopause symptoms, indicating a notable symptom burden in younger age groups, according to a recent study. 

Researchers conducted an observational study based on a survey to assess perimenopause symptom severity and health care-seeking behaviors among U.S. women. Published in njp women’s health, the study included 4,432 participants aged 30 years and older. Recruitment occurred through the Prolific platform and the Flo app between November 2023 and March 2024. The researchers, led by Adam C. Cunningham of Flo Health, Inc. in London, UK, noted that eligible participants completed an electronic questionnaire that assessed perimenopause symptoms and severity using the Menopause Rating Scale (MRS). Logistic regression models and Kruskal-Wallis tests were used to examine the association between symptom burden, age, and perimenopause status as confirmed by a health care provider.

Out of 5,136 participants who accessed the survey, 4,432 fully completed it and were included in the final analysis. The mean age of participants was 42.6 years (standard deviation = 9.4), and most (60.3%) identified as White, European American, or Caucasian. A total of 908 respondents (20.7%) reported consulting a health care professional regarding perimenopause. Among those, 30.3% were under 46 years of age. Of the women who sought medical advice, 70.8% received a diagnosis of perimenopause. The highest confirmation rates were observed in the 51 to 55 years age group (42.6%; χ² = 227.79, P < .001). Consultation rates increased significantly with age: 51.5% of women aged 56 years and older reported physician visits for perimenopausal concerns (χ² = 803.98, P < .001).

Logistic regression analysis identified eight symptoms that were significantly associated with confirmed perimenopause:

• absence of menstruation for 12 months (log odds = 1.85; 95% confidence interval [CI] = 1.38–2.38; P < .001)
• absence for 60 days in the last year (log odds = 1.58; 95% CI = 1.19–1.98; P < .001)
• hot flashes (log odds = 0.81; 95% CI = 0.45–1.17; P < .001)
• vaginal dryness (log odds = 0.61; 95% CI = 0.25–0.97; P < .001)
• pain during initial sexual penetration (log odds = 0.60; 95% CI = 0.23–0.98; P < .001)
• irregular cycles (log odds = 0.49; 95% CI = 0.11–0.87; P = .012)
• heart palpitations (log odds = 0.45; 95% CI = 0.06–0.85; P = .028)
• frequent urination (log odds = 0.44; 95% CI = 0.08–0.82; P = .019)

Symptom severity, as measured by the MRS, varied significantly by age group. The median total MRS score and subdomain scores for urogenital (H = 177.17, P < .001, η² = .04), psychological (H = 55.70, P < .001, η² = .01), and somatovegetative symptoms (H = 209.07, P < .001, η² = .05) were highest in women aged 51 to 55 years. Notably, over half (55.4%) of women aged 30 to 35 years reported moderate to severe symptoms.

The analysis also revealed that symptom severity differed by perimenopause status. MRS total scores were significantly higher in participants with confirmed perimenopause (H = 190.46, P < .001, η² = .04) compared with those who did not have a diagnosis. Among participants experiencing cycle irregularities indicative of early or late perimenopause, higher symptom severity was observed, particularly in the urogenital and somatovegetative domains.

These findings suggest that women as young as 30 years old may experience symptoms associated with perimenopause, though a clinical diagnosis is necessary to confirm early onset. The researchers noted the need for greater clinical awareness and earlier recognition because timely interventions and broader diagnostic considerations could improve patient outcomes and address underdiagnosis in younger populations.

Full disclosures can be found in the published study.