The Evernow
Menopause Study

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

1.

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.

A 10-20 year journey with
constantly changing symptoms

Menopause is life-changing

2.
(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

1
Weight changes
2
Sleep disruption
3
Fatigue
4
Brain fog

MOST SEVERE SYMPTOMS

1
Sleep disruption
2
Painful sex
3
Fatigue
4
Weight changes

EVERNOW SURVEY OVERVIEW

3.2
The average severity score across
all symptoms on a scale of 0-4
0
1
2
3
4

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)

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

3.
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
Over 80% reported severe
anxiety & depression

HOW COMMON ARE MY SYMPTOMS?

Are you experiencing any symptoms?

Start health profile

WOMEN RATED THEIR SYMPTOMS ON A SEVERITY SCALE OF 0-4

3.2 out of 4

average symptom
severity score

70%

rated symptoms
either a 3 or 4

Over 80%

reported severe
anxiety & depression

Nearly 1/3rd

reported heart
palpitations

PERCENTAGE OF RESPONDENTS WHO RATED
THESE SYMPTOMS A 4 (HIGHEST SCORE)

60%
+ Weight changes
+ Painful sex
0%
50%
100%
50%
+ Fatigue/low energy
+ Sleep disruptions
0%
50%
100%
40%
+ Joint/muscular discomfort
+ Skin/hair changes
+ Hot flashes
+ Night sweats
0%
50%
100%
30%
+ Hot flashes
+ Night sweats
+ Bladder issues
+ Unusual period
+ Skin changes
+ Joint muscular discomfort
0%
50%
100%

Perimenopause

4.
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.

Hot flashes may be a telltale sign—but they're not always an early one: While hot flashes are the canonical indicator of menopause, reported by nearly 75% of women in the menopausal transition, only half of perimenopausal women experience any hot flashes.

These are the actual signs that menopause is beginning:

PERImenopause in your 40’s: worst symptoms
1
Weight changes
2
Fatigue
3
Sleep disruption
ACTUAL SIGNS THAT MENoPAUSE IS BEGINNING
85%
of women in perimenopause experience fatigue/low energy
NEARLY
80%
of women in perimenopause experience sleep disruption, brain fog, or weight changes
>70%
of women in perimenopause report anxiety/depression or mood swings
NEW FINDING

Most symptoms differ by race

5.

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.

For the full finding, contact press@evernow.com

After Evernow treatment

6.

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.
Hot Flashes
90%
Night Sweats
81%
Mood Swings
77%
Anxiety/Depression
68%
Weight Changes
63%
Sleep Disruption
58%
75%
avg. improvement
at 4 months
Average improvement across all reported symptoms at 3 months for patients on transdermal Hormone Therapy.
Hot Flashes
82%
Night Sweats
88%
Mood Swings
82%
Anxiety/Depression
84%
Weight Changes
67%
Sleep Disruption
67%
Awareness is a key step toward
getting effective treatment

Smoking and menopause

7.

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
35.2%
of heavy smokers
have had a hysterectomy
vs
29.2%
of non-smokers
have had a hysterectomy

BMI and menopause

8.

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.

BMI
<19
42.6%
19-24
42.3%
25-29
46.7%
30-39
50.5%
40-49
53.8%
>50
55.7%

% Percent rating their symptoms a 4 on a 0-4 severity scale

Our data show that Hormone Therapy
is extremely effective at treating
nearly every major menopause symptom

About our research

9.

We use a validated questionnaire used in menopause research to measure symptoms. (This is not different than other peer-reviewed studies but different than other private companies that use their own scales.) 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

10.

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.

To read the full report, contact press@evernow.com