Lancet landmark Commission reports on global female health: takes lifespan approach to menstruation and bleeding disorders
Columbia Mailman School of Public Health’s Marni Sommer is a co-author of the Commission
July 16, 2026 — The Lancet Haematology today published its Commission on Global Female Health and Haematology, a multidisciplinary international collaboration that examines the unique hematologic health challenges faced by women and girls around the world and outlines recommendations for improving outcomes. Marni Sommer, DrPh, RN, professor of Sociomedical Sciences at Columbia University Mailman School of Public Health, is a co-author of the report by the Commission.
The Commission focuses on hematologic health across multiple stages of life, addressing issues ranging from menstruation, reproductive health, pregnancy and aging. It also explores socioeconomic disparities, such as poverty, access to care and social determinants of health influence outcomes for women around the world.
“The Commission highlights how under-recognized, underdiagnosed, and stigmatized heavy menstrual bleeding is around the world, leaving many people with inadequate support and care, and with negative impacts for their health and quality of life,” said Dr. Sommer.
The Commission launches in conjunction with the International Society on Thrombosis and Haemostasis (ISTH) 2026 Congress in Paris, where more than 6,000 experts from around the world gathered to advance research and clinical care in thrombosis and hemostasis.
The Lancet Commission on Global Female Health and Haematology arrives at a pivotal moment for women's health, according to the authors, as growing recognition of longstanding disparities in the diagnosis, treatment and research of bleeding and thrombotic disorders drives global calls for action.
The launch also coincides with the ISTH's expanding commitment to women's health through the newly established ISTH Women's Health Hub, a comprehensive global initiative dedicated to advancing education, collaboration, research and advocacy for bleeding and clotting disorders across every stage of a woman's life. This commitment is also reflected at the ISTH 2026 Congress through the Society's first-ever regulatory session, convening international regulatory leaders to explore collaborative approaches to strengthening evidence generation and improving care for women worldwide.
"This Commission is driven by a recognition that women's hematologic health deserves greater visibility, investment and action," said Bethany Samuelson-Bannow, MD, lead author of the Commission and a member of the ISTH. President of the ISTH Pantep Angchaisuksiri, MD, noted, “The publication of this Commission represents an important milestone for women's health and hematology. Women experience unique challenges related to bleeding and clotting disorders throughout their lives, yet many aspects of their care remain underrecognized or understudied. This Commission provides an important resource for clinicians, researchers, policymakers and advocates to improve outcomes globally."
In a separate, accompanying Commentary by Dr. Sommer in the The Lancet Haematology, she says, "Until menstrual health is recognized as a fundamental aspect of population health, meaningful progress in improving access worldwide will remain out of reach. We need to recognize the menstrual cycle as a lifelong health issue—that also means ensuring people who menstruate, and those who support them, have access to accurate information and evidence-based care," noted Sommer.
Columbia University Mailman School of Public Health
Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the fourth largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master’s and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu.
Journal
The Lancet Haematology
Article Title
Reducing mortality, improving outcomes, and establishing equity for women with classical haematological disease: a Lancet Haematology Commission
Article Publication Date
13-Jul-2026
Many women still confused about perimenopause
New large-scale study estimates that roughly one-third of women experience perimenopause uncertainty
CLEVELAND, Ohio (July 15, 2026)—Perimenopause is an underrecognized life stage that is often accompanied by complex and fluctuating symptoms. A new study sought to quantify the prevalence of perimenopause uncertainty and identify the primary causes. It found that perimenopause uncertainty is prevalent and largely because of knowledge gaps and barriers to confirmation and care. Results of the study are published online today in Menopause, the journal of The Menopause Society.
Perimenopause is the transitional period leading up to the final menstrual period. Known as a time of considerable hormone changes, it usually begins when women are aged in their mid-40s, although onset can vary widely. It is estimated that approximately two million women begin perimenopause each year in the United States and remain in this phase for roughly 4 to 8 years.
Perimenopause symptoms can significantly affect women’s well-being, with more than half (59%-65%) experiencing hot flashes as well as psychological or urogenital symptoms that can impair daily functioning, diminish quality of life, and reduce work productivity. Despite its prevalence, recognizing perimenopause remains a challenge for both women and clinicians. A key reason is that there is no laboratory test or biomarker to definitively determine the perimenopause stage. Complicating a clear diagnosis is the fact that perimenopause symptoms vary widely and evolve over time. These symptoms also overlap with a wide range of other conditions, including premenstrual syndrome, thyroid disease, and mental health conditions.
Limited public awareness and inconsistent clinical recognition further compound this uncertainty. Many women report little prior knowledge about perimenopause, and clinicians typically receive inadequate training and education on perimenopause and menopause care. In addition, there has been a propagation of misinformation about menopause and symptom management in recent years.
Prior studies have described elements of perimenopause uncertainty, such as confusion about symptoms, misconceptions about the age at which symptoms might occur, and invalidating healthcare encounters, but most were small, focused only on women aged older than 40 years and were rarely US based. In addition, there is no known study to have quantified how common perimenopause uncertainty is, what its common drivers are, and whether those drivers differ across age groups or levels of symptom burden.
In this new study involving more than 7,600 US women aged 35 years and older, researchers sought to estimate the prevalence of perimenopause uncertainty and examine subgroup differences by age and symptom severity. Overall, 34% of participants reported being unsure of their reproductive stage. Uncertainty varied by age and symptom severity, peaking at 42% in those aged 40 to 44 years, and 37% in those with severe symptom burden.
Symptom confusion and attribution were the most common (56%), reflecting difficulties interpreting bodily changes and distinguishing perimenopause from other causes. Knowledge gaps and information-seeking accounted for 28% of responses, highlighting limited health literacy, age-based assumptions, and active searches for evidence. Barriers to confirmation and care (16%) described dismissive healthcare encounters and reluctance to acknowledge perimenopause. Younger women (aged 35-39 y) were more likely to cite knowledge gaps, whereas healthcare barriers peaked in the 40 to 44-year-old age group.
Based on these results, the researchers recommend that clinicians should be more open and flexible to consider the multidimensional symptom profiles of perimenopause and normalize cognitive, emotional, and physical changes that can occur earlier rather than over-relying on menstrual irregularity as the principal indicator. Although cycle irregularity is characteristic of perimenopause, many women have symptoms before they experience significant cycle changes.
Survey results are published in the article “Exploring prevalence and drivers of perimenopause uncertainty among US Women: a mixed-methods study.”
“This large study showed that one in three US women aged older than 35 years are not sure whether they are in perimenopause. Further, the study highlights that symptom confusion, misconceptions, and barriers to care are leaving many women without the clarity and support they need during the menopause transition. Recognizing perimenopause uncertainty as a common experience can help shift the conversation from searching for a diagnosis to providing women with the information, validation, and support they need to navigate this natural life transition with confidence,” says Dr. Stephanie Faubion, medical director for The Menopause Society and one of the authors of the study.
For more information about menopause and healthy aging, visit www.menopause.org.
The Menopause Society is dedicated to empowering healthcare professionals and providing them with the tools and resources to improve the health of women during the menopause transition and beyond. As the leading authority on menopause since 1989, the nonprofit, multidisciplinary organization serves as the independent, evidence-based resource for healthcare professionals, researchers, the media, and the public and leads the conversation about improving women’s health and healthcare experiences. To learn more, visit menopause.org.
Journal
Menopause
Method of Research
Survey
Subject of Research
People
Article Title
exploring prevalence and drivers of perimenopause uncertainty among US Women: a mixed-methods study
Article Publication Date
15-Jul-2026
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