Abstract Study question What do women know and think about the menopause? Summary answer Women reported a lack of their own and their health professional's knowledge of the menopause. Overall they had negative attitudes. What is known already Female fertility decline is strongly linked to the age a woman will go through the menopause. The menopause is defined as having been for one year without a period. The menopause causes the end of fertility. But women start to lose their fertility approximately 8-10 years before the menopause. Studies have shown that women are not educated about the menopause, and neither are their health professionals. This lack of education may result in infertility, childlessness, misdiagnosis of symptoms and seriously affect wellbeing and treatment. It is time to find out what women of all ages feel about the menopause. Study design, size, duration We conducted a mixed methods study: two anonymous, online surveys using multiple choice and open-ended questions on Qualtrics. One survey was designed for women under 40 years old and the other for women over 40. Both surveys were promoted using the social media of some of the authors (Twitter, Instagram, Facebook and Linkedin). The under 40s survey was live between 8/2/2022 to 15/3/2022 and the over 40s survey was live between 19/5/2021 and 26/5/2021. Participants/materials, setting, methods The study had ethical approval from UCL Research Ethics Committee ID no: 9831/005. The qualitative data was analysed thematically. 738 participants completed the under 40s survey. 2933 completed the over 40s survey and the data was analysed in three groups: 950 perimenopausal women, 934 postmenopausal women and 1049 who classed themselves as other which included those who were neither peri or post menopausal. Main results and the role of chance We asked women how informed they were about the menopause. Approximately 45% of women under 40 reported that they were not informed at all. For women over 40, we asked how informed they felt they had been before the age 40; 57.6% of the perimenopausal and 53.5% of the other group answered ‘Not informed at all,’ which was significantly greater than the post menopause group; 45.2% (422/934) (p<.05). Most women were happy about no longer menstruating, although some expressed sadness regarding fertility loss. Most women thought that the menopause should be taught at school, but over 80% in both surveys had received no menopause education at school themselves. The perimenopause group was significantly more likely to select ‘School’ (79.2%, 752/950) and ‘Apps such as period trackers and fertility apps’ (50%, 475/950) than the other two groups (p<.05). In the free text question, across both surveys the main themes were lack of education of the women, and of their health professionals and the negative narrative of the menopause. Women over 40 said that their lack of knowledge had caused many issues as they were often unaware that they were in the perimenopause. They felt their health professionals did not support them. Limitations, reasons for caution As the surveys were online and promoted using social media, only certain women in the population had access. The women were mostly highly educated. Women who did not have internet access, social media or did not know English to an adequate level would not have had access to the survey. Wider implications of the findings Most women had limited knowledge and negative attitudes towards menopause, leaving them unprepared. Improved menopause education is required to ensure women understand their fertility, to improve perimenopause quality of life and present a more positive narrative of life postmenopause. Health professionals training needs to incorporate education of the menopause. Trial registration number NA