That figure is real but narrower than it sounds: it measures how often a specific diagnosis code was entered in medical records, not how many women actually experienced symptoms, and not necessarily how much care they received.
In Israeli health records, only 8 percent of women aged 45-54 accumulated a documented menopause-symptom diagnosis over a six-year period, against self-report literature suggesting 50 to 75 percent of women experience symptoms. Similar US claims data found only about 7 percent of women aged 45-51 carried a perimenopause or menopause diagnosis code over five years, and even among women whose records showed a recognizable pattern of symptoms, only 19 to 28 percent ever got the specific label. The safest reading is: this measures documentation, not the true rate of symptoms or the true rate of care.
The core disagreement is whether a missing diagnosis code proves missing care, or is mainly an artifact of how records are coded.
What the research shows, and which source each finding rests on
Maccabi Healthcare Services (Israel), 2010-2015: 17,046 women aged 45-54 accumulated a documented menopause-symptom diagnosis, a cumulative incidence of only 8% over the study period, against self-report literature of 50-75% symptom prevalence; the authors state the figure 'is suggestive of a large degree of under-diagnosis.'
The diagnosis code family used in that study (ICD-9 627.x) mixes peri- and postmenopausal states, so the 8% is a mixed symptomatic peri-plus-post cohort, not a perimenopause-specific rate; first code came at mean age 49.4; the 8% is study-period cumulative incidence, not a lifetime rate.
ICD-9-CM, still used in Israeli community care, has no code for perimenopause as its own state, so the transition is literally uncodeable as such in Israeli community records.
Where the real disagreement is
Each position is shown with its own sources. A position listed here is not necessarily the accepted view.
Low coding rates measure a real clinical failure
the study authors themselves
The Israeli study's own authors read the 8% figure as suggestive of substantial under-diagnosis, and treatment rates in the same population (12.6% ever using hormone therapy) are about as low as the coding rate, suggesting the record reflects a real gap rather than just a coding habit.
Coding is partly an administrative artifact
a counterargument preserved for balance
A clinician may manage menopause symptoms well while coding the visit under insomnia, hot flashes, or a general encounter code, especially where, as in Israeli ICD-9-CM records, no perimenopause code exists to use at all - a missing code is not automatic proof of missing care.
What would settle it: Chart-review studies that link coded versus uncoded symptomatic women to the actual treatment they were offered, to see whether the coding gap tracks a real care gap or mainly a documentation habit.
What is really going on here
- Does a diagnosis-code rate measure how many women have symptoms, how many sought care, or how often a clinician wrote down a specific label - which of these am I actually being told about?
- Is the statistic I'm hearing specific to perimenopause, or does it include postmenopausal states too?
Questions for your doctor
- Is there a specific diagnosis code for what I'm experiencing being entered in my chart, and does that matter for my care or my records?
- If my symptoms haven't been formally coded before, does that mean they weren't being treated, or just not labeled?
- Would it help my future care if this were documented more specifically as perimenopause-related rather than under a general symptom code?
Questions with no answer yet
Is the low diagnosis-code rate mainly an artifact of coding systems that literally have no code for perimenopause, such as the one used in Israeli community care, or does it hold up even in systems with a proper code available?
Partly studiedWhat is known: In the Israeli system studied, the diagnosis code family used mixes peri- and postmenopausal states, and the coding system has no code for perimenopause as its own state at all, meaning the transition is literally uncodeable as such in that specific record system. Whether similarly low rates persist in health systems that do have a dedicated perimenopause code has not been directly compared.
What would test it: A comparable documentation-rate study conducted in a health system using a coding standard that does include a specific perimenopause code, to see whether the rate is meaningfully higher.
Does a missing diagnosis code mean the visit's actual care was inadequate, or could a clinician be managing the symptoms competently while coding the visit under a different, more specific complaint like insomnia or hot flashes?
Not directly studied yetNo research does not mean it does not work, and it does not mean it works. It means nobody has tested it yet.
What is known: This is explicitly identified as an open question in the source material: the study authors read the low rate as suggestive of under-diagnosis, and treatment rates in the same population are similarly low, which supports a real gap, but no chart-review study has directly linked coded versus uncoded symptomatic women to the actual treatment they received.
What would test it: Chart-review studies that link coded versus uncoded symptomatic women to the actual treatment they were offered, to see whether the coding gap tracks a real care gap or mainly a documentation habit.
Sources
- 1.Healthcare Utilization and Prevalence of Symptoms in Women with Menopause: A Real-World Analysis.Sharman Moser S, Chodick G, Bar-On S, Shalev V. Healthcare utilization and prevalence of symptoms in women with menopause: a real-world analysis. Int J Womens Health 2020;12:445-54. · Comparative or small study
- 2.Komodo Health. Lost in Transition: despite growing awareness, perimenopause remains vastly underrecognized and undertreated. March 2025.Review, opinion or mechanism
The letter grades the type of study behind a claim, not the answer itself.
This page is general information based on published research and public sources. It is not medical advice and not a personal assessment, and it does not replace a conversation with your doctor. Peritale is a wellness product, not a medical device, and is not intended to diagnose, treat, cure or prevent any disease. For any medical question, speak with a licensed clinician.
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Start Free MappingRelated questions
- Is there a test for perimenopause?
- Why did my doctor say my hormones are normal, when I feel terrible?
- How many doctors do women typically see before someone finally tells them it's perimenopause?
- I read that most women with menopause symptoms never seek help - is that really true?
- If there's no blood test, how is perimenopause actually diagnosed?
- What about AMH testing - can that tell me when I'll hit menopause?
- Back to topic: Spotting perimenopause, hormone testing and the care gap