Menopause
The many faces of menopause: Why it is a unique stage for each woman
While the symptoms may be similar, women go through menopause differently

No one told me that hot flashes could start in your mid-30s and continue into your 60s, says Cindy Moy Carr, founder of mySysters app. She tells FemTech World how menopause can affect women in different ways at different ages.
The menopause is a natural time of ageing when a woman’s periods stop and the ovaries lose their reproductive function. Usually, this occurs between the ages of 45 and 55, but as Cindy Moy Carr found out, this is not the case for everyone.
“After I turned 40, I started having these horrendous migraines which I had never had before,” she remembers. “For a year and a half, they would just come and go. I went to the hospital, I had an MRI and I was told that it was all in my head.”
Her case is not singular. A Yale University review of insurance claims from more than 500,000 women in various stages of menopause states that while 60 per cent of women with significant menopausal symptoms seek medical attention, nearly three-quarters of them are left untreated.
Moy Carr had not been told about menopause until she turned 50. “I was talking to a nurse practitioner and she said ‘Well, this is all menopause-related’. And that was the first light bulb moment when I asked myself, ‘Why didn’t anybody tell me that?’
“I lived in Minneapolis – the home of big medical device companies – and if I couldn’t get any help, what chance do other women have? When I saw that none of my friends seemed to talk about it, I realised how taboo menopause was.”
Cindy’s app, mySysters, was launched as a social and self-care platform to help women manage perimenopause and menopause, helping them to track symptoms, recognise patterns and share advice in discussion forums.
“At the time there were no period trackers for women of my age,” the founder says. “That’s why we decided to launch mySysters. We made a little beta version, and after it became available in the AppStore, women from different countries started using it and about 5,000 of them still use it today.
“The app is that validation that women need to understand that they are not alone in this.”

But launching it was far from easy. “I got laughed at by men who thought it was the stupidest thing ever,” Moy Carr confesses. “Talking to the people who are making decisions about these things can be very frustrating.
“With the app, it was that community feeling that we wanted to create because most women find us after they no longer trust the medical community. Once people feel connected, life becomes easier, clearer and it feels easier to make decisions and advocate for yourself.
“We don’t know what the other person is going through, so let’s ask questions, find some information, share it and ultimately, support each other in whatever decision we make. It’s easier to feel empowered this way.”
Actively tracking symptoms has been repeatedly shown to result in greater symptom reporting and better understanding and recovery. A report from the British Psychological Society has found that a greater proportion of people were classified as high period symptom reporters after using a symptom-tracking app.
Moy Carr says that taking five minutes to check in with yourself is key. “After a few weeks, you get a checkerboard that shows the severity of your symptoms and over time, you can notice patters or triggers that influence how you feel.
“What is it that you did on Sunday that worsen your headaches on Monday? So often we say, ‘This came out of nowhere’. In fact, it didn’t. It was building up to that, but we just didn’t notice it because we weren’t paying attention to it.
“Tracking what’s happening in your body means becoming more aware of how you’re feeling. Then when something goes wonky, you will be able to recognise it quicker.”
The recent US Supreme Court’s decision to overturn Roe v Wade may have serious consequences on tracking apps like mySysters. If there is a warrant, court order, or subpoena for the release of certain medical records, then a clinic could be required to hand them over, leaving patients and providers legally vulnerable.
“As a UK-based company, I’d like to think that our data is completely safe, but I worry about women in the US and what the current climate means for them,” Moy Carr says. “We found out that HIPAA – the US regulator providing data privacy and security provisions – will not protect women’s data.
“Roe v Wade is a step backwards for women’s health, not just for abortion, but for women’s health in general. The fact that data protection is not guaranteed can have huge consequences that we’re not even aware of.”
While the situation remains uncertain across half of the states, Cindy hopes that women will have autonomy over their bodies. “I’m hoping that at some point we can get away from these labels of menopause, perimenopause, post-menopause, fertility, age, puberty and focus on hormonal health.
“Not everybody goes through menopause at 50. Sometimes they’re 30. It’s our hormonal health and there’s no need for labels.”
For more info, visit mysysters.com.
Menopause
More research needed to understand link between brain fog and menopause, expert says

Brain fog in menopause is common but still poorly understood, with researchers calling for more work to explain the link and how best to support women.
For a new perspective article published in The Lancet Obstetrics, Gynaecology, & Women’s Health, researchers based in the UK and Australia reviewed the evidence on menopause-related cognitive symptoms. They found that symptoms such as forgetfulness, reduced concentration and brain fog are common during the menopause transition, but are still poorly recognised and under-researched.
More than two-thirds of women report difficulties with memory or concentration over the menopause transition. Multiple factors may contribute to these cognitive symptoms, including hormonal changes, sleep disturbances and psychological and psychosocial stress. Yet, because cognitive symptoms are not widely discussed, they can cause considerable worry, with some fearing they are signs of dementia or undiagnosed neurodevelopmental conditions.
The review paper emphasises that overall cognitive performance for women experiencing menopause-related brain fog typically remains within expected ranges and, importantly, that cognitive symptoms are not linked to an increased risk of dementia.
Professor Aimee Spector of UCL Division of Psychology and Language Sciences, co-author on the paper, said: “Cognitive symptoms such as forgetfulness and ‘brain fog’ are incredibly common during menopause, yet they are often overlooked. Our findings highlight just how complex menopause-related cognitive symptoms are, and how much we still don’t know about what drives them. More targeted research is essential if we are to identify which biological, psychological or lifestyle factors contribute most, and what types of support or treatment are likely to be effective.”
The authors argue that clinicians can play a key role in understanding and validating women’s experiences by asking about the duration of cognitive symptoms, impacts on day-to-day functioning and any other medical or psychosocial factors that could be contributing to cognitive symptoms.
The review also discusses a range of approaches that may ease cognitive symptoms, such as improving sleep quality, engaging in regular aerobic exercise and eating a balanced diet. There is also little but promising research into the impact of psychological therapies targeting cognitive symptoms, with a recent meta-analysis of three cognitive behavioural therapy-based studies showing significant improvements in memory and concentration. The evidence is more mixed for the benefits of hormone therapy on cognitive symptoms during menopause.
The authors identify cognitive symptoms as a major area of unmet need in menopause research. They call for a unified definition of menopause-related cognitive changes and for prospective, longitudinal studies that can track women from pre- to post-menopause. Better understanding of the biological, psychological and social factors that contribute to cognitive symptoms will be crucial for developing effective treatments.
Lead researcher Dr Caroline Gurvich of Monash University said: “There’s a lot of pressure to use objective measures of cognitive decline, like a memory test, for example, in a clinical trial, but the key symptom of brain fog is a subjective experience. So having a definition that acknowledges the key cognitive symptom is critical.”
This is not without precedent – we already use subjective or self-report measures for depression, anxiety and other mental health conditions with great success.
Dr Gurvich said the proposed definition would also validate women’s individual experiences while empowering them through the reassurance that any objective decline in their cognitive ability is subtle.
She added: “This is a decrease in cognitive or learning efficiency, not functionality or capacity. For many women, the perception they are losing capacity is what drives them to stop work or lose the confidence to live fulfilling lives during and after menopause. I hear all the time from women who have gone through menopause that validation would have made a significant difference to their resilience and the approach they took to living with menopause.”
Co-author Professor Martha Hickey of the University of Melbourne and Royal Women’s Hospital said: “Our analysis of the best available research shows that many women experience some degree of cognitive symptoms, such as brain fog, during the menopause transition.”
“But there’s a lack of long-term data, which means that there’s a gap in our knowledge about how the brain fog symptom develops and changes from peri-menopause to after menopause ends. It’s a real gap in our understanding.”
Professor Spector added: “We increasingly see women, typically at the peak of their careers, losing confidence in the workplace, often translating to leaving work or reducing work hours. Having simple strategies to support and retain them at work is also a broader economic issue.”
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