AUSTRALIA, July 25, 2025 – Nearly 40% of women navigating perimenopause suffer from moderate to severe hot flashes and night sweats, yet lack effective treatment options, according to new research.
## Perimenopause: Almost 40% of women lack treatments for severe hot flashes
New findings reveal a significant gap in care for women experiencing disruptive perimenopausal symptoms.
- Almost 40% of women in perimenopause experience moderate to severe hot flashes and night sweats.
- These symptoms are the most defining characteristic of perimenopause, more so than irregular periods.
- Currently, there are no specifically designed or approved treatments for these symptoms in perimenopausal women.
- Research suggests a symptom-based approach could lead to earlier recognition and care.
The study, published in The Lancet Diabetes & Endocrinology, delved into symptom prevalence across different menopausal stages among women aged 40 to 69.
More than 8,000 participants who identified as women contributed to the Australian midlife women’s study. Researchers at Monash University analyzed data from 5,509 women, excluding those on hormonal medications or who had undergone procedures affecting their hormones.
Hot Flashes Define Perimenopause
Professor Susan Davis, the study’s senior author, highlighted that while hot flashes and night sweats (vasomotor symptoms, or VMS) are known menopause hallmarks, the research found moderate to severe VMS to be the most distinctive symptom of perimenopause, the transitional phase before the final menstrual period.
The study found that 37.3% of women in late perimenopause experienced bothersome hot flashes, making them five times more common than in pre-menopausal women. Severe vaginal dryness was also 2.5 times more prevalent in perimenopausal women.
While menopausal hormonal therapy (MHT) effectively treats VMS in menopause, researchers noted the absence of specific interventions for perimenopausal women. Treating perimenopause differs from post-menopause, as ovulation is still irregular, requiring contraception considerations. MHT can also exacerbate bleeding and progesterone may worsen premenstrual syndrome (PMS).
The study also questioned the long-held belief that menstrual irregularity is the earliest sign of perimenopause. Researchers found that pre-menopausal women experiencing VMS with subtle period changes (lighter or heavier flow) showed similar symptom prevalence to those with VMS and altered cycle frequency.
“So we’re really saying ignoring hot flashes and night sweats is wrong,” Davis stated.
Rethinking Perimenopause Diagnosis
Dr. Rakib Islam, another study author, pointed out that defining perimenopause by menstrual cycles overlooks women with regular cycles, those who have undergone procedures like endometrial ablation or hysterectomy, and users of hormonal contraception.
“Our findings support a more symptom-based approach, enabling earlier recognition of perimenopause and more timely care,” Islam said.
Davis emphasized the importance of recruiting participants without mentioning menopause to avoid bias.
Professor Martha Hickey, chair of obstetrics and gynaecology at the University of Melbourne and lead author of a previous Lancet series on menopause, called the study significant.
“The study reached quite a large number of women and provided deeper insight into perimenopause, an area traditionally overlooked in menopause research,” Hickey commented.
She explained that pharmaceutical companies often exclude perimenopausal women from research because their fluctuating hormone levels don’t fit traditional study designs.
Hickey noted the study’s primary limitation: it’s a cross-sectional survey, offering a snapshot of symptoms at a given stage but not detailing how these symptoms evolve throughout menopause.
