Winona analyzed data from more than 100,000 patients to create The State of Menopause, the most comprehensive look at what menopause actually feels like for women and the surprising ways it impacts daily life. The State of Menopause was built around data from real women ages 35–60 across every stage of the menopause journey.
This report serves as a much-needed update to how modern menopause is understood and discussed as a whole. New data will help women across every stage of the transition, whether they are uncertain if the changes they notice are hormonal, are just starting to ask questions, or have been searching for a real solution to their menopause symptoms for years.
The State of Menopause Requires a New Conversation
Menopausal changes aren’t psychosomatic, they’re hormonal.
What women feel in this phase of life has a name, and it’s more complex than you might have been led to believe.
Most women are told to look out for hot flashes and night sweats. No one mentions the many changes that occur far sooner. The menopause transition often announces itself through exhaustion, weight gain, anxiety, brain fog, and a slow erosion of a daily life that feels manageable.
77.5%
Waited over a yearto find care that worked
76%
Were managing 6+ symptoms at once
ON ANY GIVEN DAY
9symptoms experienced simultaneously, on average
AT THEIR WORST
16symptoms happening all at once
According to data in The State of Menopause:
77.5% of patients surveyed lived with symptoms for over a year before finding care that worked.
76% of them were managing 6+ symptoms at once.
Women reported experiencing an average of 9 symptoms at any given time.
At maximum, women reported experiencing 16 symptoms at once.
These women didn’t experience a dramatic, unmistakable switch. They began to feel a gradual accumulation of changes that didn't add up, until they did.
Menopause symptoms impact entire body systems and lead to more widespread, impactful changes than most women have been educated to recognize. To learn more, explore the full report:
Menopause symptoms don’t happen the way women are told.
Hormonal changes lead to clusters of related symptoms most women aren’t prepared to manage.
After analyzing the data of more than 100,000 Winona patients, it was clear their top concerns weren’t the most well-known symptoms that usually dominate the menopause conversation.
Symptom frequency in The State of Menopause:
Energy loss— 79% of women
Weight gain— 75% of women
Fatigue— 71% of women
Brain fog— 70% of women
Sleep disruption— 69% of women
Hot flashes — 44% of women
These symptoms are what quietly dismantle daily life. Women reported an inability to think clearly, sustain energy, and remain emotionally grounded. These symptoms are often mistaken for stress, aging, or unrelated conditions. If you’ve overlooked these changes in your own life, this data is a signal. You may have been in perimenopause or menopause longer than you realized.
What was equally surprising? One of the most significant findings in The State of Menopause is that symptoms don't arrive independently.
Cognitive-Energy Burden
Fatigue and brain fog consistently co-occur, creating a reinforcing cycle where reduced energy compounds cognitive difficulty, and cognitive difficulty makes everything feel more exhausting. Many women describe this like moving through fog, even after a full night's rest.
Sleep-Metabolic Burden
Sleep disruption and weight gain frequently appear together, suggesting a connected physiological pathway that, when left untreated, perpetuates itself. Poor sleep affects metabolism. Metabolic changes affect sleep quality. The cycle continues.
The State of Menopause maps these patterns in full, with direct implications for how menopause should be treated and what women should ask for.
Finally, the data matches what women have always known.
According to The State of Menopause, 77.5% of Winona patients reported living with menopause symptoms for at least one year before discovering personalized HRT treatment.
The menopause conversation has been shaped for decades by small studies, clinical assumptions, and a cultural tendency to minimize what women report about their own bodies. The State of Menopause is here to change that, with a scale that makes dismissal impossible.
Inside the State of Menopause
A data-rich guide to understanding menopause symptoms and what comes next
The State of Menopause connects the symptoms many women have been living with to the science behind them and makes the case for treatment that addresses the full picture, not just the most visible parts.
Inside, you'll find:
The complete symptom frequency breakdown across 100,000+ women — including the ones rarely discussed
The symptom clusters that appear repeatedly — and what they reveal about how menopause works in the body
Analysis of the care gap: how long women wait, why partial treatment falls short, and what that costs them
The case for earlier, more comprehensive HRT as a response to the full scope of what the data shows
What this means for women at every stage, from newly symptomatic to mid-journey and still searching for answers
The State of Menopause gives a voice to women who were told their symptoms aren't that serious, those who spent years wondering if their feelings were "normal,” and those just beginning to connect the dots. Finally, the data is in writing and clearly on the side of women.
The State of Menopause is published by Winona, a telehealth platform specializing in evidence-based hormone replacement therapy for women. Data collected from 100,000+ patients between May 2025 and February 2026. Full methodology available in the whitepaper.