What Perimenopause Support Reveals About Consumer Relationships in Healthcare

By Michelle Silva, M.A., Content Strategist, Thought Leadership, NRC Health

Perimenopause – the often years-long transition before menopause, marked by changing hormone levels and a wide range of symptoms – has become one of healthcare’s fastest-growing consumer conversations. 

Across social media, podcasts, online communities, bestselling books and national television, millions of women are openly discussing symptoms, comparing physicians, debating hormone therapy, sharing research and helping one another navigate a life stage that traditional healthcare has not always addressed consistently. NRC Health data shows these conversations are not a fad: Concern for menopausal wellness increased from 13% in 2023 to 22% in 2025.¹

The conversation has expanded well beyond individual experiences. Philanthropist Melinda French Gates recently committed $215 million to women’s reproductive and midlife health. State legislatures are advancing perimenopause-related policies, while investors continue pouring billions into women’s health innovation and new models of care designed around this life transition. 

For traditional care systems, the significance of this moment lies in what it reveals about middle-aged women as healthcare consumers.  

NRC Health has previously described women at midlife as healthcare’s “super consumers.” They not only are navigating their own healthcare journeys but also selecting health plans, comparing providers, coordinating care for spouses, children and aging parents, and influencing healthcare decisions across entire households. Few consumer groups have greater influence over healthcare utilization. 

That makes perimenopause more than a women’s health issue – it is a valuable lens through which health systems can better understand how one of healthcare’s most powerful consumer groups evaluates trust, expertise, convenience, partnership and – perhaps most significantly – loyalty. 

Want to continue the conversation? Join the pre-conference workshop at NRC Health’s Human Understanding Beyond | HUB26 healthcare conference this September in Nashville.

Trust Is Strong – But Loyalty Is Becoming More Conditional 

Perimenopause is not only one of the most significant biological transitions in a woman’s life, it also is one of healthcare’s most complex consumer journeys. Symptoms vary widely and often evolve over several years, requiring women to navigate primary care, gynecology, behavioral health, endocrinology, and other specialties. At the same time, clinical guidance continues to evolve, leaving many women searching for answers that feel credible, personalized, and actionable. 

Women also are navigating this journey with unprecedented access to information and an expanding marketplace of care options. They learn from medical experts, social media communities, friends and family, podcasts, advocacy organizations, virtual care platforms and specialty clinics – often long before they schedule an appointment. Increasingly, they – and a growing number of consumers in general – are willing to assemble care across multiple sources when those options better meet their needs.

To better understand how perimenopause care may be reshaping healthcare decisions, NRC Health surveyed 2,000 women between the ages of 35 and 59 about their experiences seeking support for their symptoms.  

Despite widespread traditional and social media attention highlighting women’s frustrations, the findings paint a more nuanced picture: Most women reported feeling supported by their healthcare providers, and trust in traditional healthcare remains strong.  

However, the research also suggests that loyalty is becoming increasingly conditional, as consumers continue evaluating which organization can better meet their needs. 

Survey results show that overall, 52% of respondents identified their OB/GYN as the healthcare provider they trust most for women’s health, while another 33% selected their primary care physician.² Together, 85% place their greatest trust in traditional healthcare providers – great news for health systems. 

Support clearly matters. Women who felt mostly or extremely supported were overwhelmingly likely to continue using their current organization for future care, while the likelihood of remaining with the organization dropped sharply among women who felt unsupported. 

Yet the data also reveal something significant about today’s healthcare marketplace: feeling supported does not eliminate consumers’ willingness to consider alternatives. Among women who described their perimenopause symptom care as extremely supportive, 39% said they would still be very or extremely likely to consider switching if another healthcare organization offered stronger perimenopause support.

Why Are Younger Women More Willing to Switch Providers? 

The pattern was even more pronounced among younger women. Nearly two-thirds (64%) of women ages 35 to 39 said they would be very or extremely likely to consider switching for stronger perimenopause support, compared with 29% of women ages 55 to 59. 

Women also are exploring perimenopause care beyond traditional settings. NRC Health found that 23% have considered virtual care for mood support, 22% for hot flashes, 18% for sleep support, 18% for weight management and 13% for hormone management. 

Taken together, these findings suggest women are not abandoning traditional healthcare outright. Rather, they are continually evaluating whether another organization could better meet their needs. For health systems, this means that maintaining trust remains essential, but sustaining long-term relationships increasingly depends on continuing to demonstrate value as consumer expectations evolve. 

What Is Relationship Leakage and Why Should Health System Leaders Care? 

This also reveals a largely hidden form of competitive vulnerability: Every consumer who chooses another provider, virtual platform or healthcare organization represents more than a single lost encounter – it can represent years of future healthcare utilization, referrals and household influence that gradually migrate elsewhere.  

As consumers become increasingly willing to re-evaluate long-standing healthcare relationships, reducing relationship leakage becomes an important strategic challenge for health system leaders.  

Loyalty is increasingly earned through an organization’s ability to remain relevant as consumer needs and expectations evolve. For CEOs, this is both a growth challenge and experience challenge. 

Organizations that recognize early signs of relationship leakage will be better positioned to strengthen long-term loyalty before consumers quietly begin shifting pieces of their healthcare journey elsewhere. 

Middle-aged women are not simply exploring whether a health system offers a perimenopause program, but are evaluating whether that organization understands their needs, expectations, and goals well enough to remain their healthcare partner. 

Below are five actions health system leaders can take to strengthen long-term loyalty with their super-consumers: 

1. Start by understanding what female consumers at midlife are trying to accomplish – not just what symptoms they have. 

Traditional healthcare often begins the relationship by asking what symptoms a patient is experiencing. Consumer-centered organizations also ask what the patient hopes to achieve now and over the long term. For one woman, the goal may be sleeping through the night, while for another it may be maintaining energy at work, feeling like herself again, understanding treatment options or having confidence in the decisions she is making about her health. Desired consumer outcomes should be explored and leveraged to shape how care is designed and delivered. Loyalty grows when consumers feel healthcare understands what matters most to them – not just the condition being treated and the clinical outcome. 

2. Understand consumers before they become patients. 

Many women spend months or even years researching perimenopause before scheduling an appointment. They are gathering information, comparing options and forming expectations long before they enter a health system. Organizations that want to build trust earlier should engage these consumers before the point of care through research, advisory panels, digital communities and expectation-based surveys. The goal is not simply to ask whether the experience met expectations after the visit, it also is to understand expectations before care begins. The organizations that listen earlier will be better positioned to design patient experiences that feel relevant when consumers are ready to seek care. 

3. Design around the journey consumers experience – not processes or the organizational chart. 

Consumers in general do not experience healthcare as a collection of departments or processes. They do not think, First I schedule primary care, then obtain a referral, then complete intake forms, then see a specialist. They think, I have a concern. Help me solve it. Consumers do not evaluate each interaction in isolation; they remember how the entire experience made them feel. Every step should help them move from uncertainty to confidence with greater clarity, coordination and support. 

4. Accept that consumers are building their own care ecosystems and compete through trusted relationships. 

Healthcare consumers increasingly combine traditional healthcare with virtual platforms, specialty services, wellness resources and other sources of support. This behavior reflects a broader shift toward more personalized, self-directed healthcare. For health systems, loyalty will increasingly depend less on controlling every touchpoint and more on creating outstanding experiences that make the organization the trusted partner consumers choose for guidance, coordination and expertise throughout their healthcare journey. 

5. Move beyond satisfaction to understand what earns consumer loyalty. 

A positive, supportive visit is important, but it may not be sufficient to secure a lasting relationship in an increasingly competitive healthcare environment. Health systems should continue measuring experience at the point of care while also understanding the broader factors that influence loyalty: whether consumers feel understood, whether they believe the organization supports their goals, whether they intend to return, and what might cause them to seek care elsewhere. Understanding consumer expectations before care begins enables health systems to strengthen trust, deepen loyalty and identify emerging relationship leakage before it becomes lost market share.

This research will be explored in greater depth at NRC Health’s Human Understanding Beyond | HUB26 during a dedicated workshop. The hands-on session will examine how perimenopause care is reshaping women’s healthcare choice, trust, and retention. 

Join healthcare leaders to discuss the consumer behaviors behind provider switching, the growth of alternative care options, and strategies for building lasting healthcare relationships with midlife women.  

Save your spot and register today to join us in Nashville, Sept 2-4. 

NRC Health Research Associate Heather Costa-Greger, M.A., provided research and writing support for this article.

¹ NRC Health Market Insights Maternity/OB/Midwifery Service Line report

² A female patient’s trust in an OB/GYN may be forged and strengthened if they had a previous and/or long-term relationship during pregnancy, childbirth and postpartum care – a unique time in which many people form close bonds with their care providers, particularly if there are multiple pregnancies and childbirth over time. More research is needed to determine the levels of trust that women have in an OB/GYN for perimenopause/menopause symptom support if they do not have a previous relationship related to pregnancy, childbirth and postpartum care.