The Evernow Menopause Study

The most up-to-date study on menopause symptoms, with data shared by over 100,000 women.

Study Overview

Every woman will go through menopause. It will affect her health, her longevity, and her life. Yet this is one of the most overlooked areas of women’s health. To help move the science forward and to better understand the lived experience of menopause, we surveyed women at all stages of the journey.

To date, the gold standard menopause study has been the SWAN study, which followed 3,302 patients. Evernow has more than 100,000 clinically validated health profiles and a subset of thousands of patients who we are following longitudinally to learn from and support. To our knowledge, this is also the largest cohort study looking at the type and severity of symptoms by ethnicity.

Menopause is life-changing

(It's more than hot flashes)

Every year, 2 million American women will reach menopause, and the symptoms can be uncomfortable or even debilitating: Over 70% of women who completed Evernow's health profile rated a symptom a 3 or 4 on a severity scale of 0 - 4 (with 4 being “very severe symptoms”).

Most common symptoms:

• Weight changes
• Sleep disruption
• Fatigue
• Brain fog

Most Severe symptoms:

• Sleep disruption
• Painful sex
• Fatigue
• Weight changes

A 10-20 year journey with constantly changing symptoms

The frequency and severity of different symptoms shift as hormone levels change. For example, brain fog is typically most severe during perimenopause. These distinctions are important to understand. Because perimenopause symptoms don’t typically include symptoms like hot flashes, they can be easily misattributed, delaying the path to care—and relief.

Menopausal Transition

Common symptoms by menopause stage

• 40's (Perimenopause):

  • Sleep disruption
  • Brain fog
  • Fatigue
  • Weight changes
  • Mood swings
  • Anxiety / depression

• 50's (Menopause):

  • Hot flashes
  • Night sweats
  • Sleep disruption
  • Joint pain
  • Brain fog

• 60's+ (Late Menopause):

  • Painful sex
  • Urinary issues
  • Vaginal dryness
  • Brain fog

Symptoms deep dive: frequency and severity

Our data show that menopause symptoms are ubiquitous

Nearly 80% reported:

• Brain fog
• Weight changes
• Sleep disruption
• Fatigue

Over 60% reported:

• Anxiety or depression
• Joint or muscular pain
• Night sweats
• Hot flashes

Over 50% reported:

• Skin and hair changes
• Vaginal dryness
• Mood swings

How common are my symptoms?

Fatigue & low energy: 81.5% experience this symptom
Sleep disruption: 78.6% experience this symptom
Weight changes: 78.1% experience this symptom
Brain fog: 75.7% experience this symptom
Hot flashes: 70.0% experience this symptom
Night sweats: 66.5% experience this symptom
Joint/muscle discomfort: 63.6% experience this symptom
Anxiety/depression: 61.8% experience this symptom
Mood swings: 59.5% experience this symptom
Vaginal dryness: 57.4% experience this symptom
Skin & hair changes: 57.3% experience this symptom
Painful sex: 41.5% experience this symptom
Heart discomfort: 31.8% experience this symptom
Facial hair/acne: 33.0% experience this symptom
Urgent bathroom trips: 30.0% experience this symptom
Unusual period: 17.7% experience this symptom

Perimenopause

It's a different experience than menopause. Most women start perimenopause in their 40's, but our data show that for some, skipped cycles and period irregularities (like a heavier flow, or “tsunami period,” which affects nearly 1/3 of those in perimenopause) can begin as early as age 39. Symptoms and their severity differ (sometimes greatly) from what women experience in menopause, so awareness is key to getting effective treatment.

These are the actual signs that menopause is beginning:

• 85% of women in perimenopause experience fatigue/low energy.
• Nearly 80% experience sleep disruption, brain fog, or weight changes.
• And most (>70%) report anxiety, depression, or mood swings.

Most symptoms differ by race

Black women have reported experiencing longer and more severe menopause symptoms, but this has typically been attributed to higher rates of obesity. In our study, we controlled for obesity and other factors, and the higher rates and more severe experiences persisted. We are submitting a paper for publication that covers this topic specifically.

After Evernow treatment

Evernow is currently collecting follow-up data from more than 200 of our members about how their symptoms changed in severity after they began taking hormone therapy (HT). Our data shows that HT is extremely effective at treating nearly every major menopause symptom. These findings suggest that estrogen may play a bigger role in more conditions than is currently understood.

Significant improvement of most menopause symptoms within a month of starting hormone therapy

68% avg. improvement at 3 months
Women reported symptom relief down to 1.03 on a 1–4 severity scale across all symptoms for patients on transdermal Hormone Therapy.

Awareness is a key step toward getting effective treatment

Hysterectomies & menopause

Nearly a third of all American women 50 or older have had a hysterectomy. Hysterectomies are the second most common surgery performed on women in America. 600,000 women will get one every year, and many report feeling unprepared for the symptoms that follow. Our data indicates a direct link between hysterectomies and an increase in frequency of menopause symptoms.

Smoking & menopause

In the U.S., 1 in 8 women is a smoker. Smoking rates are highest among those aged 45-64, prime time for menopause. Our data show some clear trends:

• 1 in 8 women in the U.S. is a smoker
• Smokers experience more severe menopause symptoms
• Heavy smokers reach menopause on average one year earlier than non-smokers

BMI & menopause

Our survey data showed a direct positive correlation between Body Mass Index (BMI) and menopause symptom severity: The higher the BMI, the more severe the symptoms.

About our research

We use a validated questionnaire used in menopause research to measure symptoms. Our study was carried out rigorously so we can pass the peer review process when we publish, and we will continue to share our findings so that all providers can better serve women over 40.

Knowledge is power

Everyone should be able to keep living their best lives throughout menopause. Recognizing the symptoms and understanding their severity is a significant step toward treatment.