When women post about perimenopause on social media, hot flashes aren’t what comes up most—at least according to new research from Wisp, a women’s telehealth provider that serves more than 2 million patients in the U.S.
The study was conducted independently by researcher Dr. Emily Pfender and funded by Wisp. It analyzed 269 TikTok and Instagram videos about perimenopause and menopause. Mental health issues were the most discussed symptom, appearing in 40.6 percent of the videos. Next came sleep issues (28.2 percent), weight gain (21.2 percent) and brain fog (20.7 percent). Hot flashes, the symptom most associated with menopause, ranked fifth at 18.9 percent.
Ahead, how women talk themselves out of their symptoms and the early signs of perimenopause to watch for.
Women Are Second-Guessing Themselves
The researchers also looked at what they called “disenfranchised talk,” meaning content in which women’s health experiences are invalidated. Among the posts that contained it, 56 percent included discrediting, a category that covers self-gaslighting: women questioning, minimizing or dismissing their own symptoms.
“Research on medical disenfranchisement typically focuses on interpersonal interaction, such as conversations with family members or healthcare providers, that invalidate women’s health experiences. In this study, my team found that women question or dismiss their own symptoms related to peri/menopause through self-gaslighting,” Dr. Pfender says. “These findings underscore the need for greater support and education around women’s health to validate women’s experiences and strengthen their confidence when something feels off.”
Symptoms That Are Easy to Explain Away
Perimenopause, the transition years before menopause, often doesn’t look like the stereotype. Early signs can include waking at 3 a.m., more anxiety than usual, losing your train of thought or changes to your period or body. All of these are easy to blame on stress, screens or age.
“For so many women, perimenopause doesn’t start with a dramatic hot flash. It starts with sleep disturbances, mood changes and brain fog—symptoms that are incredibly easy to explain away as stress, a busy schedule or just getting older,” says Andrea Sleeth, WHNP-BC, associate medical director at Wisp. “None of these symptoms automatically mean you’re in perimenopause, but women should feel empowered to start connecting the dots instead of dismissing what they’re experiencing. Understanding how this transition can actually show up can help women recognize when something has changed and start asking the right questions.”
The study also found that videos about basic symptoms drew the highest engagement. The researchers read that as a sign that many women online are trying to answer one question: Is this happening to me?
What’s Next
Wisp, which offers virtual perimenopause and menopause care, says it plans to use the findings to help women recognize changes earlier and seek care sooner, instead of waiting until symptoms become hard to ignore.
The study is a preprint and is still undergoing peer review. Wisp funded Pfender Consulting, LLC to conduct the research. According to Wisp, it was not involved in the study’s design, analysis or write-up, and Dr. Pfender kept complete oversight of the research.
