According to Bonafide Health’s 6th Annual State of Menopause Survey, women are increasingly describing anxiety, brain fog, sleep disruption, and declining motivation rather than hot flashes as the symptoms having the greatest impact on their daily lives.
“These findings reinforce that women experience menopause holistically, not as a collection of individual symptoms,” said Kate Jamieson, vice president of marketing and e-commerce at Bonafide. “Mood, cognition, sleep and physical symptoms are all connected, and we need to think about supporting women that way. It reinforces our focus on better understanding the unique needs of women in perimenopause and identifying opportunities to develop clinically studied solutions that address some of the biggest unmet needs during that stage of the transition.”
The survey included over 2,000 U.S. women ages 40 to 64 experiencing perimenopause or menopause symptoms.
- 60% say symptoms negatively affect their emotional or mental health, jumping to 65% in women 40 to 49.
- 50% say symptoms affect their cognitive health, jumping to 56% in women 40 to 49.
- 77% report cognitive changes.
- Anxiety, panic attacks and depression surpassed hot flashes as the most impactful symptom.
Bonafide said supporting women through perimenopause and menopause requires acknowledgement that disruptive cognitive, emotional, workplace and social challenges can significantly alter a woman’s quality of life.
For example, perimenopause can disrupt a woman’s career and income.
- More than half (56%) of women surveyed say declining motivation is the biggest way symptoms affect their work. This increases to 62% among women ages 40–49.
- Nearly half (48%) say symptoms have negatively affected their income, with 23% reporting losing at least $10,000 because of menopause symptoms.
- 27% have hidden their symptoms for fear of workplace discrimination (this is 30% in women 40 to 49).
- And only 7% of working women report being aware of menopause accommodations at work, down from 2025.
Seeking the comfort of peers
The survey also found that women are seeking affirmation that what they are experiencing in both perimenopause and menopause is not “in their heads.”
“Women have more language today to describe what they’re experiencing, and conversations around both menopause and mental health have become more common,” Jamieson said.
According to Bonafide, conversations with peers help reduce feelings of isolation.
- 62% say talking with other women helps them realize they are not imagining their symptoms.
- 39% report feeling affirmation is the most valuable outcome of conversations with other women – with 34% of women 40 to 49 stating others “don’t understand how hard this is.”
- 71% did not recognize their first symptom as being related to perimenopause or menopause.
- Women ages 40 to 49 are significantly more likely to report difficulty finding healthcare professionals who understand how disruptive their symptoms can be.
- 85% believe educating themselves remains the best way to navigate menopause, about a 5% year-over-year increase.
The survey results can also help inform product development within the supplement industry, Jamieson noted.
“I hope the industry sees [the survey] as a reminder to start with women’s real experiences rather than individual ingredients or trends,” she said. “They should also recognize that women do not experience menopause as a series of disconnected symptoms. Sleep, mood, cognition, energy, sexual health, and physical comfort can influence one another. That creates an opportunity to develop more thoughtful solutions and regimens, but it also raises the standard for evidence, transparency and responsible claims.”
