Menopause and the years preceding it have a significant impact on the health and well-being of a majority of women, but more than one-third never discuss their concerns with their health care provider (HCP), and even fewer discuss the issues that worry or impact them the most, according to a new report from HealthyWomen and WebMD.
More than 3,100 U.S. women aged 18 and older from various ethnic and racial backgrounds and life stages responded to the report, Aging Smart, Aging Well: A National Dialogue on Women's Health Attitudes and Behaviors which assessed how women experience their physical, mental and sexual health as they age and their attitudes about healthy aging.
The results will be announced at 9 AM Eastern Time today at the National Press Club in Washington, DC.
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While the majority embrace the concept of healthy aging and say they pro-actively discuss their health concerns with their provider, the report found that most women have never had a dialogue about specific health issues, including menopausal symptoms, mental health concerns and sexual health. Additionally, most women have never discussed the health concerns that worry them the most, notably cancer, stroke, dementia and heart disease.
"Our report with WebMD shows that the majority of women are experiencing a variety of symptoms and health concerns as they move through perimenopause, menopause and post-menopause," said Beth Battaglino, RN-C, CEO of HealthyWomen. "While our survey did uncover knowledge gaps, it also identified teachable moments and opportunities for women and their HCPs to engage in meaningful conversations so that women can experience midlife and beyond with the best quality of life possible."
Menopausal Symptoms and Well-Being
The majority (75%) reported experiencing at least six symptoms of perimenopause and menopause.
- The most common symptoms include hot flashes, (69%), fatigue and sleep problems (64%), mood swings/irritability (62%), brain fog (60%), night sweats (60%) and weight gain (54%).
- Nearly half of all women experience irregular periods (45%), more than a third reported thinning hair, urinary urgency and vaginal dryness, and one in five experience painful intercourse.
Women in perimenopause and menopause reported lower rates of physical and emotional well-being compared to post-menopausal women.
- Only 25% of perimenopausal and menopausal women rate their physical health favorably, and 37% rate their mental health either excellent or very good.
- Once past menopause, however, women say their physical and mental health improve, with 40% of post-menopausal women rating their physical health as very good or excellent, and 60% rating their mental health similarly.
The report found differences with respect to race.
- Black women in menopause rated their physical health more highly (47% compared to 28% for White women) as well as their mental health (60% compared to 38%).
- Nearly 40% of Hispanic women in menopause described their physical health as fair or poor compared to 25% of Black women. Overall, Hispanic women are least likely to talk about health risks unless they are experiencing symptoms.
Health insurance independently plays a significant role in ratings of health. Lack of insurance is associated with a greater proportion of fair or poor ratings of physical and mental health among all women. Indeed, women without health insurance have greater concern over developing mental illnesses associated with aging, such as anxiety and depression, as compared to women with coverage.
Despite the documented value of health screenings, work remains to be done in improving knowledge and access. With the exception of cervical cancer, women ages 65 years and older typically responded more often than younger women that they have been screened for various diseases, although considerable numbers of both groups have not. This includes breast cancer, diabetes, hypertension, mental health and osteoporosis.
Little Discussion of Top Health Concerns
Women rank cancer, dementia, heart disease and stroke as among the top health concerns of aging, but most have never brought them up with a health care provider.
- Only 11% discuss concerns about cancer, 18% heart disease, and 9% stroke.
- More than 60% over the age of 65 have not been screened for colon cancer despite clinical guidelines advising that screening begin at age 50. Half said they didn't know they had reached the recommended age, and 30% said their doctor did not bring it up.
Conditions impacting mental health had the greatest negative impact on quality of life.
- Nearly three-quarters of women with anxiety said the condition has a moderate to severe impact on their daily lives, versus only 36% of women diagnosed with cancer, but only 16% of women with anxiety discuss the issue with their provider.
- Anxiety is another significant concern for many women, with more than 25% reporting anxiety or depression. This number increases for women with less education and less household income.
- In addition, 41% of premenopausal women believe that anxiety is a natural part of aging and there's nothing one can do to stop it.
Significant Declines in Sexual Health
While more than half of all premenopausal women report their sexual health as very good to excellent, that percentage declines to about one-third for women in perimenopause, menopause and post-menopause. Yet, only 10% of women discussed the issue with their provider.
- More than half (54%) say their level of sexual activity decreased beginning in perimenopause, with the majority (86%) noting a lower sex drive, 57% implicating weight gain and being uncomfortable with their appearance; 54% vaginal dryness; and 53% fatigue from lack of sleep. Fewer than 1 in 10 have been diagnosed with vaginal atrophy, contrary to clinical data citing a 50-60% prevalence in post-menopausal women. This may reflect lack of awareness of treatment strategies, or a reluctance to bring the matter up with their health care provider.
Women Self-Manage with Lifestyle Changes
Women are more likely to try lifestyle changes and supplements to manage their menopausal symptoms versus prescription treatments such as hormone therapy or vaginal estrogen. This may be partly due to lack of awareness, or because they believe their symptoms are not severe enough for treatment. One-third prefer to treat without medication, while 25% say they are fearful of side effects or increased risk of cancer, heart attack or stroke.
"Despite a general shift in our culture promoting more discussion of health concerns and healthy living, our report shows that there is still a lack of openness when it comes to the health issues and changes of women as they age," said John Whyte, MD, Chief Medical Officer of WebMD. "Easy access to relevant and reliable health information can foster greater dialogue around the issues that women are concerned about though every life stage, and can support them in their goals for healthy aging."
For more information about Aging Smart, Aging Well and to view the full survey report, please visit
HealthyWomen is the nation's leading independent, nonprofit health information source for women. Its mission is to educate women to make informed health choices for themselves and for their families, providing objective, research-based health information to its audience. For 30+ years, millions of women have turned to HealthyWomen for answers to their most personal health care questions. To learn more, please visit www.HealthyWomen.org.
Nothing is more important to our health than access to competent and affordable care and the safety of our medications and health care delivery practices. HealthyWomen works to educate women about health policy issues in these and other areas. It recognizes the importance of clinical trials in improving women's health and supports women's health research, particularly where sex may make a difference in research results. HealthyWomen advocates on behalf of women to ensure that women's health is a primary focus of policy makers and advocacy groups. Its investment in developing science-based information and its effort to incorporate perspectives reflected by advances in research and technology will further its mission to provide women with relevant and accurate health resources. To learn more, please visit www.HealthyWomen.org. Follow HealthyWomen on Facebook, Twitter, Instagram and LinkedIn.
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