Reddit posts reveal silent symptoms of menopause

Nearly half the world’s population experiences menopause, yet many of its emotional, cognitive and social impacts may never be discussed during medical appointments. New research published today in JAMA Network Open, led by UMD Professor Yulin Hswen, highlights these “silent symptoms” by comparing clinical notes that include menopause symptoms with the top Reddit posts in menopause forums.

“We found that emotional and cognitive symptoms of menopause, such as cognitive impairment, were 3–4 times more likely to come up in online forums than during doctor visits. These menopause symptoms are far more visible in women’s own conversations than in traditional clinical records and are not being captured by our health care system,” said Hswen, associate professor in the UMD School of Public Health’s Department of Epidemiology and Biostatistics and the Artificial Intelligence Interdisciplinary Institute at Maryland.

Hswen and her team used AI to screen more than 2 million electronic health records (EHRs) from the University of California, San Francisco, and Reddit’s top 999 all-time posts in menopause channels (r/menopause), identifying 646 clinical notes and 577 Reddit posts that contained menopause-related personal discussions for analysis.

In the Reddit posts, symptoms of cognitive impairment, emotional well-being and weight change were several times more likely to be discussed than in EHR clinical notes. For example, cognitive impairment came up in about 20% of Reddit posts but was noted in only about 5% of clinic visits—almost a fourfold difference.

Clinical notes more often mentioned physical symptoms such as hot flashes and night sweats, as well as hormone replacement therapy (HRT), lifestyle changes, sexual health, non-HRT treatment and herbal remedies. The data showed no statistically significant difference between Reddit posts and EHR notes for symptoms such as sleep disturbances, skin and hair changes, and bone and joint health.

Hswen notes that the absence of a symptom in the medical record should never be mistaken for the absence of the symptom itself. Emotional health, memory loss, anxiety and cognitive changes can have a profound impact on quality of life, work, relationships and daily functioning.

“If we don’t recognize and document these symptoms, we can’t effectively study them or improve care. This is why social forums can be so important for better understanding stigmatized or poorly understood conditions like perimenopause and menopause. Electronic health records tell us what medicine sees. Online communities tell us what patients experience. We need both.”

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Swati Mestri

Swati Mestri holds a bachelor’s degree in Electronics Engineering and has worked as a content editor since 2019. She has experience editing research documents across technology, health care, and materials science, and has a particular interest in technology and space.

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Andrew Zinin

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