Most Women Face 9 Menopause Symptoms at Once and Wait Over a Year for Care
A 100,000-patient study reveals the staggering symptom burden of menopause and the care gaps leaving women undertreated for years.
Summary
A new analysis of over 100,000 menopause patient assessments found that women seeking care report an average of nine simultaneous symptoms, with three in four experiencing six or more at once. The most common complaints include energy loss, weight gain, fatigue, brain fog, and sleep disruption. Notably, 77.5% of women lived with symptoms for at least a year before receiving any care. The study, conducted by telehealth provider Winona, also found that genitourinary symptoms affect over 70% of patients — a frequently overlooked aspect of menopause. While the data reflects a self-selected patient population, the scale of the dataset offers a rare large-sample look at the real-world menopause experience and the significant delays in diagnosis and treatment that women currently face.
Detailed Summary
Menopause is widely underestimated as a multisystem health event, and a large new dataset from telehealth provider Winona puts hard numbers on the burden. Analyzing over 100,000 de-identified patient intake forms collected between May 2025 and February 2026, the study found that women arriving for menopause care report an average of nine concurrent symptoms, with some reporting as many as 16 at once.
The most commonly reported symptoms were energy loss (79%), weight gain (75%), fatigue (71%), brain fog (nearly 70%), sleep disruption (69%), and hot flashes (44%). These findings challenge the popular notion that hot flashes are the defining or most prevalent symptom of menopause. Cognitive and metabolic symptoms appear to be far more widespread and may carry greater long-term health consequences, particularly for brain health and metabolic aging.
A striking 56% of patients showed a combined brain fog and fatigue pattern, suggesting a distinct symptom cluster that may warrant targeted therapeutic approaches. Additionally, 71% reported genitourinary syndrome of menopause — a condition involving vaginal dryness, urinary urgency, and related discomfort — which is frequently underdiscussed and undertreated in clinical settings.
Perhaps the most actionable finding is the care gap: 77.5% of women endured symptoms for at least one year before accessing treatment. This delay represents a significant lost window for intervention, especially given that hormonal changes during perimenopause and menopause are now linked to increased risks of cardiovascular disease, osteoporosis, and cognitive decline. Regarding treatment preferences, 67.5% preferred oral medications, 25.8% creams, and 6.5% patches.
Caveats are important here. This is a self-selected sample of women who actively sought telehealth menopause care, meaning it likely overrepresents symptomatic individuals. The data comes from a commercial provider, which introduces potential bias. Independent peer-reviewed replication would strengthen these conclusions.
Key Findings
- Women seeking menopause care report an average of 9 simultaneous symptoms, with a max of 16.
- Energy loss (79%), weight gain (75%), and fatigue (71%) outrank hot flashes (44%) in prevalence.
- 77.5% of women waited over one year before receiving any menopause-related care.
- 71% report genitourinary syndrome of menopause, a commonly overlooked symptom cluster.
- 56% show a combined brain fog and fatigue pattern that may benefit from targeted treatment.
Methodology
This is a news report summarizing proprietary research from Winona, a commercial telehealth provider. The dataset is large (100,000+ patients) but self-selected and not peer-reviewed. Evidence basis is observational intake data, not a controlled clinical study.
Study Limitations
The sample is self-selected women actively seeking care, likely overrepresenting severe symptom burden relative to the general population. Data comes from a commercial entity with a financial interest in menopause treatment uptake. No peer review or independent replication has been reported for this dataset.
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