A new national survey from Biote reveals widespread frustration and misdiagnosis among women experiencing perimenopause, highlighting persistent gaps in training, communication and treatment across the healthcare system. The 2025 “Perimenopause Focus” survey collected responses from more than 1,000 U.S. women between the ages of 30 and 60, and the findings suggest that many are left navigating one of life’s major hormonal transitions with limited guidance and, in many cases, incorrect treatment.
Misdiagnosis and Mismatched Treatment
More than half of survey participants said they had been treated for depression, anxiety, mood swings or panic attacks after entering perimenopause. One in three respondents reported being diagnosed with anxiety. Yet nearly 40 percent of the women who were prescribed medication for these mental health conditions said they believed their diagnosis was wrong.
Dr. Bruce Dorr, Senior Medical Advisor at Biote, said the data shows how often hormonal imbalance is overlooked when women seek help for new or worsening symptoms. He explained that the emotional and cognitive shifts tied to fluctuating estrogen and progesterone levels are frequently mistaken for standalone psychiatric disorders. “We are seeing anxiety and depression being treated as isolated conditions when providers should be addressing the hormonal imbalance at the root of the problem,” he said. “Many of these women know something isn’t right with their diagnosis, but they don’t know where to turn for better care.”
A Communication Breakdown in Routine Care
The survey revealed that conversations about hormonal changes are not happening early enough, or in some cases, at all. Only 42 percent of women said their primary care physician or OB/GYN proactively initiated discussions about perimenopause. Close to one in five reported that even when they did talk with their provider, their concerns weren’t taken seriously or were quickly dismissed.
These missed conversations leave many women without a clear understanding of the range of symptoms that can appear during perimenopause, which may include sleep disturbances, brain fog, weight changes, cycle irregularity, temperature dysregulation and mood fluctuations. Without proper context, many women assume something more serious is wrong or accept diagnoses that don’t fully match their experience.
Gaps in Medical Training
Part of the issue, according to Biote, is tied to outdated or limited clinical education. Only 31 percent of OB/GYN residency programs in the United States include a menopause curriculum. As a result, many providers lack exposure to the latest science on hormonal transitions, diagnostic criteria and treatment options.
“We’ve created a system where the onus is on women to search for that rare provider with specialized perimenopause knowledge,” Dr. Dorr said. He noted that even as efforts are underway to improve training, many women need help now, not years down the road.
Women Seek Answers Outside the Exam Room
Because of the lack of clear guidance from healthcare professionals, many women turn to non-medical sources for information. Only 15 percent of respondents said they felt reasonably informed about perimenopause when their symptoms began. To learn more, almost half sought answers online and another 42 percent turned to family members, often relying on generational anecdotes rather than medical expertise. Only 26 percent said they learned about perimenopause from a primary care provider or OB/GYN.
When asked what they wished they had known earlier, women pointed to several issues:
• 56 percent wished they had known symptoms can begin earlier than expected.
• 41 percent wished they had known that treatment options are available.
• 37 percent wished they had known symptoms can be severe or disruptive.
• 35 percent wished they had known how significantly perimenopause can affect mental health.
• 25 percent wished they had known how to advocate for themselves in medical settings.
A Pivotal Moment After FDA Changes
Dr. Dorr said the survey’s timing is significant given the FDA’s recent decision to remove the black box warning from hormone therapies. For years, those warnings discouraged both physicians and patients from considering hormone-based treatments, even when symptoms pointed to hormonal imbalance. “Nearly 40 percent of women felt misdiagnosed, and now we know that the very treatments that could have addressed their root hormonal issues carried warnings that scared away both patients and providers,” he said.
He added that the FDA’s shift reflects updated science and opens the door for providers to reconsider hormone optimization as a safe and effective option. “This regulatory change aligns directly with what women in this survey are telling us. They need informed, comprehensive care today.”
Biote says it plans to use the survey findings to expand educational outreach to healthcare providers and to improve public understanding of what perimenopause is, how early symptoms can appear and what treatment choices exist.
About the Survey:
“Perimenopause Focus” is the second national survey from Irving-based Biote and follows the landmark “Women in the Workplace” 2022 survey which revealed 17% of women have actually quit a job or considered quitting due to menopause symptoms. Biote commissioned the Perimenopause Focus survey through a third-party research firm to examine how healthcare gaps affect women in perimenopause in support of legislative efforts across 15 states aiming to enhance clinician training and education on menopause.
