Two-thirds of American women between 38 and 50 say they felt better prepared to go through puberty than perimenopause. The statistic, from a nationally representative survey commissioned by Flo Health and conducted by Wakefield Research, captures something that decades of public health messaging have failed to fix: most women arrive at one of the most disruptive hormonal transitions of their lives with less reliable information than they had as teenagers.

Flo Health, the period-tracking app that has grown into the largest women’s health platform in the world with 80 million monthly active users, is attempting to close that gap with a new suite of perimenopause tools launching this month for its premium subscribers. The features,  a symptom checker, a perimenopause severity score, a menopause timeline tracker, and a medically verified relief-options guide,  represent the company’s most significant product expansion since it achieved unicorn status in 2024.

The knowledge gap

The scale of the problem Flo is targeting is not in dispute. More than a billion women globally will experience perimenopause or menopause, yet a recent Flo study found that one in three American women aged 35 and over still do not know whether they are in perimenopause. It is part of a persistent gender gap in health data that femtech companies have been working to close. The confusion is compounded by an information environment that has swung from silence to noise: doctors are increasingly warning patients to be sceptical of the unverified advice that has flooded social media and wellness platforms as the menopause conversation has entered the mainstream.

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The consequences of that confusion are measurable, if self-reported. In Flo’s Wakefield Research survey, 52% of women in relationships said perimenopause had affected their romantic partnerships. Forty-eight per cent said it had impaired their ability to exercise. These are not abstractions. They describe a population navigating a medical reality with inadequate tools, and they explain why Flo sees perimenopause not as a feature addition but as a market.

What the tools do

The new suite comprises four products, all available to Flo Premium users. The Perimenopause Symptom Checker is a self-assessment that maps a user’s reported symptoms against known perimenopause indicators. The Perimenopause Score, which Flo describes as the first scientifically validated digital assessment tool specifically designed for perimenopause, assigns a severity rating and tracks changes over time. The Menopause Timeline estimates where a user sits in the broader hormonal transition. And Relief Options provides a medically verified comparison of treatments, from medication to lifestyle changes, matched to specific symptoms.

The tools are built on content developed with Flo’s network of more than 100 medical experts. Anna Klepchukova, Flo’s chief medical officer, framed the launch as a response to an information crisis rather than a feature gap. The problem, she said, is not that women lack access to perimenopause content. It is that they cannot distinguish verified medical guidance from the flood of conflicting narratives that has accompanied the topic’s rise in public discourse.

The research behind it

Flo has been building toward this launch for more than a year. Its science team published a study in the Nature portfolio journal npj Women’s Health that found perimenopause symptoms often begin earlier than previously assumed, a finding that complicates the already imprecise timelines most women receive from their doctors. Separately, a collaboration with Mayo Clinic produced what both organisations described as the first global digital study of perimenopause awareness, drawing on data from more than 17,000 Flo users across 158 countries.

The Mayo Clinic study found that perimenopause knowledge varied dramatically by geography, with higher scores in the United Kingdom, Ireland, and Australia and lower scores in Nigeria, France, and parts of Latin America. But the overall finding was consistent: knowledge was low everywhere. The most commonly reported symptoms were not the hot flushes that dominate popular understanding but fatigue, mental exhaustion, and irritability, a mismatch between expectation and experience that may itself be contributing to delayed recognition.

The business case

Flo is not the first app to target perimenopause. Clue, the Berlin-based cycle tracker, introduced a perimenopause mode in 2023. But Flo’s scale gives it a different kind of leverage. The app has been downloaded more than 420 million times. It became the first European femtech unicorn in July 2024 after a $200 million Series C investment from General Atlantic, and its gross bookings were expected to exceed $200 million that same year. Perimenopause represents a natural extension of its existing user base: millions of women who began tracking their cycles in their twenties and thirties are now entering the age range where those cycles become unpredictable.

The commercial logic is straightforward. Perimenopause features are available only to premium subscribers, which means every woman who moves from free cycle tracking to paid perimenopause support increases Flo’s average revenue per user. The company’s bet is that the same trust it built by being the most-downloaded period tracker in the world transfers to a life stage where trust in information sources is both more scarce and more consequential. That bet comes with a caveat: experts have called for stricter femtech data laws, and Flo itself settled with the FTC in 2021 over allegations that it shared sensitive health data with third parties, a history that makes the trust question more than theoretical.

Whether that bet pays off depends on something harder to measure than downloads or revenue: whether women who have learned to distrust perimenopause advice will treat an app’s medical content differently from the social media posts and wellness influencers that have defined the conversation so far. Flo’s answer is clinical validation, the Mayo Clinic study, the Nature publication, the network of named medical experts. It is a more rigorous foundation than most competitors offer. But the 66% of women who felt more prepared for puberty than perimenopause did not arrive at that state because of a lack of apps. They arrived there because the medical system, the education system, and the culture failed to tell them what was coming. An app, however well-designed, is a patch on a structural problem. Flo’s implicit argument is that a good patch, applied at scale, can still change outcomes. Eighty million monthly users is the scale at which that argument gets tested.