Almost half of the world’s population has experienced menopause, yet many of its emotional, cognitive, and social effects are never discussed during a medical appointment. New research published today JAMA network open A research team led by UMD professor Yulin Hswen highlights these “silent symptoms” by comparing clinical notes containing symptoms of menopause with top Reddit posts on menopause forums.
We found that the more emotional and cognitive symptoms associated with menopause, such as cognitive impairment, were about three to four times more likely to be discussed in online forums than in a doctor’s consultation. These symptoms of menopause are much more pronounced in women’s own conversations than in traditional clinical records, and are not captured by our health care system. ”
Yulin Hswen, Associate Professor, Department of Epidemiology and Biostatistics, UMD School of Public Health and Maryland Interdisciplinary Institute for Artificial Intelligence
Hswen and her team used AI to screen more than 2 million electronic health records (EHRs) at the University of California, San Francisco and the top 999 posts of all time on Reddit’s Menopause Channel (r/menopause), identifying 646 clinical notes and 577 Reddit posts containing menopause-related personal discussions for analysis.
Reddit posts were several times more likely to discuss symptoms of cognitive impairment, mental health, and weight change than EHR clinical notes. For example, about 20% of posts on Reddit mentioned cognitive impairment, but the condition was present in only about 5% of clinic visits, a difference of almost four times.
Clinical notes increasingly mentioned physical symptoms such as hot flashes and night sweats, as well as hormone replacement therapy (HRT) treatments, lifestyle changes, sexual health, non-HRT treatments, and herbal medicine. The data showed no statistically significant differences between Reddit posts and EHR notes when it came to symptoms such as sleep disturbances, skin and hair changes, and bone and joint health.
Hswen points out that the absence of symptoms in the medical record should never be mistaken for the absence of symptoms themselves. Changes in mental health, memory loss, anxiety and cognition can have a significant impact on quality of life, work, relationships and daily life.
“If we don’t recognize and document these symptoms, we can’t effectively study them or improve their care. That’s why social forums are so important. Electronic medical records tell us what medicine knows. Online communities tell us how patients are living.”
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Reference magazines:
Mehta, T. Others. (2026). Differences in narratives of menopausal symptoms between online and clinical settings. JAMA network open. DOI: 10.1001/jamanetworkopen.2026.23217. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2851616
