Written by Susan Sly, Founder and CEO of The Pause Technologies, Inc.
For many women, midlife is not just a season of change. It is a season of confusion, frustration, and, too often, silence.
A woman in perimenopause or menopause may walk into a medical appointment with sleep disruption, anxiety, brain fog, weight changes, irregular bleeding, low libido, hot flashes, joint pain, or heart palpitations — and walk out with no real answers. Not because her practitioner does not care, but because the system itself has not consistently trained clinicians to recognize the hormonal shifts of midlife.
This is an important distinction.
The goal is not to shame healthcare practitioners. Most are doing their best in overstretched systems with limited time and broad responsibilities. The deeper issue is that menopause, hormones, and the health needs of women in midlife have historically received far too little attention in medical education and clinical training.
Many Women Do Not Feel Supported in Midlife Healthcare
Women’s stories about feeling dismissed in midlife are not isolated.
In the UK government’s Women’s Health Strategy survey , based on nearly 100,000 responses, 84% of women said there had been times when they were not listened to by healthcare professionals, and only 64% said they felt comfortable talking to healthcare professionals about menopause.
That matters. When women do not feel heard, symptoms go unspoken, concerns get minimized, and treatment is often delayed.
A separate U.S. survey conducted by The Harris Poll on behalf of Bayer found that 34% of women in menopause or postmenopause do not discuss their symptoms with their provider, even though 93% report experiencing symptoms:report
In other words, many women are experiencing symptoms, but a significant number are not bringing them into the clinical conversation at all.
Why This Happens: The Menopause Training Gap Is Real
If women feel unseen or unheard, part of the reason may be that many clinicians were never adequately trained in menopause care in the first place.
A Mayo Clinic Proceedings study found that only 6.8% of family medicine, internal medicine, and OB-GYN residents felt adequately prepared to manage women experiencing menopause, and 20.3% reported receiving no menopause lectures at all during residency.
That is a striking statistic. It suggests that the training gap begins early and can follow clinicians into practice.
A 2023 survey highlighted by The Menopause Society found that only 31.3% of OB-GYN residency program directors reported having any menopause curriculum in their program. Among those that did, all reported five or fewer menopause lectures per year, and 71% reported two or fewer lectures per year.
Even among practitioners already in the field, confidence is mixed. In a UK survey of general practitioners, 77.5% said menopause training should be improved in medical school and GP training, and only 60.7% said they felt comfortable managing patients with menopause-related health problems and offering HRT or non-HRT treatment options.
Taken together, these numbers tell an important story: many women are not imagining the gap. The gap is real.
This Is Not About Blame — It Is About Better Preparation
Most practitioners were not intentionally taught to dismiss women in midlife. Many were simply not given enough education in hormones, perimenopause, menopause, or the broad range of symptoms that can emerge during these years.
And menopause is not just hot flashes.
It can affect sleep, mood, memory, anxiety, metabolism, libido, cardiovascular health, bone health, and overall quality of life. Yet menopause training has often been treated as a niche issue instead of a core component of women’s health.
That leaves both patients and practitioners in a difficult position: one searching for answers, and the other trying to help without enough specialized training, time, or support.
Why Symptom Tracking Matters So Much in Midlife
One of the hardest parts of perimenopause and menopause is that symptoms can feel random, inconsistent, and easy to dismiss — even by the woman experiencing them.
A woman may have insomnia for several nights in a row, then sleep normally. Anxiety may spike unexpectedly. Cycles may shorten, lengthen, disappear, and return. Brain fog may come and go. When an appointment is only 10 to 15 minutes, it can be difficult to explain what is really happening.
That is why symptom tracking matters.
When symptoms are tracked over time, patterns become clearer. Women can walk into appointments with specifics instead of vague recollections. Practitioners can see trends more easily. Conversations become more grounded, collaborative, and productive.
This is one reason why thePause® App is so valuable. It helps women track changes, identify patterns, and better communicate what is happening in their bodies.
5 Tips for Women Who Feel Unseen or Unheard in Midlife Healthcare
1. Track your symptoms consistently
Do not rely on memory alone. Track sleep, mood, cycle changes, hot flashes, night sweats, libido, anxiety, energy, and brain fog. Using thePause® App can help you spot patterns over time and walk into your appointment with clear, useful information.
2. Prepare for your appointment before you go
Write down your top three concerns, how long they have been happening, and how they are affecting your daily life. “I’m waking up drenched three nights a week” is much easier for a practitioner to assess than “I’m not feeling like myself.”
3. Ask directly about menopause and hormone expertise
You do not need to be confrontational. A simple question like, “How comfortable are you treating perimenopause or menopause symptoms?” can help you understand whether your provider has the right background for your needs.
4. Bring data, not just distress
Your experience is valid either way, but symptom logs and patterns can help turn frustration into a more actionable clinical conversation. This is another reason thePause® App can be so helpful because it gives you a practical way to track what is changing and when.
5. Seek trained care when you need more support
If you leave an appointment feeling dismissed, unheard, or told that it is “just aging” without a meaningful discussion, it is okay to seek a second opinion.
That is also why we are building Amsara Health , a telehealth company focused on supporting women in perimenopause and menopause with trained providers. If you are looking for care that understands the hormonal realities of midlife, you can join the waiting list here: https://www.amsarahealth.com
The Bottom Line
If you have felt unseen or unheard in midlife healthcare, you are not alone.
The data suggests that many clinicians have had limited training in menopause care, hormone therapy, and the full complexity of midlife women’s health. That does not make practitioners the enemy. It makes better menopause education an urgent opportunity.
Women deserve to be heard.
Practitioners deserve better training.
And the path forward is not to blame. It is better education, better communication, better tracking, and better access to trained care.
At The Pause, we believe women should not have to guess their way through midlife. ThePause® App helps women track symptoms, recognize patterns, and advocate for themselves with more clarity and confidence. And through Amsara Health, we are working to expand access to telehealth care for women in perimenopause and menopause from trained providers.
Because being heard should not be the exception. It should be the standard.
