| Hello Rulers and happy Menopause Awareness Month! In light of this, we will be talking about all things menopause. Today’s newsletter is dedicated to my mom. Menopause is a fact of life for women. Over one million women enter menopause each year in the U.S. So why does access to information and treatment for menopause remain a struggle for many midlife women? In recent years, conversations around menopause have gained more momentum. A new docuseries, “The M Factor: Shredding the Silence on Menopause,” set to release on Oct. 17, explores how menopause impacts midlife women. And earlier this spring, Dr. Sharon Malone, a certified menopause practitioner, released her New York Times bestselling book “Grown Women Talk.” Menopause has become mainstream — not to mention profitable. Celebrities, such as Oprah Winfrey and Naomi Watts, are discussing it more openly. Watts launched a skincare and wellness line focused on menopause care. Actress Halle Berry made a trip to Capitol Hill last year to discuss her experience with menopause, and there are now a host of new sites offering information, treatment options and virtual care. “I love the loudness of the famous women saying ‘this is an unacceptable situation,’” Dr. Andrea LaCroix, a professor at the University of California, San Diego who specializes in postmenopausal health and the health of midlife women, tells Women Rule. As discussions around menopause build, women are demanding more action. In May, a bipartisan group of women senators introduced the Advancing Menopause Care and Mid-Life Women’s Health Act, which would authorize $275 million over five years to expand federal research, increase public awareness and improve training for health care providers on menopause and midlife women’s health. Last month, a handful of male senators, Sens. Cory Booker (D-N.J.), Jack Reed (D-R.I.) and John Hickenlooper (D-Colo.) signed on as co-sponsors. “It makes no sense that even though this is something every woman goes through, it is not something every health care provider has strong training on — the result is that too many women seeking answers just cannot find them easily,” Sen. Patty Murray (D-Wash.), one of the senators who introduced the legislation, says in a statement to Women Rule. The lack of sufficient health care access, along with the wide variety of over 30 symptoms one can have, complicates the process of diagnosing and treating menopause. A majority of medical training programs in the U.S. don’t have a dedicated menopause curriculum. One study conducted by Biote found that 25 percent of women ages 50 to 65 were never told by their doctor that they were experiencing menopause or perimenopause, despite 92 percent of them experiencing one or more symptoms in the past year. If enacted, the legislation would authorize $10 million per year over five fiscal years to improve training resources for health care providers. The bill, which has bipartisan support, is currently being reviewed by the Senate Committee on Health, Education, Labor, and Pensions. Claire Gill founded the National Menopause Foundation in 2019, which was the first nonprofit advocacy group dedicated solely to menopause. “It's kind of mind boggling that we haven't addressed it, but it's very, very symptomatic of how we treat women and women's health once we're past reproductive usefulness,” Gill tells Women Rule. NMF launched the Women’s Midlife Health Policy Institute in fall 2023, hosting their first summit in March of this year. To mark the beginning of Menopause Awareness Month, they released a report and action plan on Oct. 1. Actions include creating workgroups to recommend messaging on midlife women’s health and menopause, as well as collaborating with the Department of Health and Human Services Office of Research on Women’s Health and other federal agencies to create a central hub to access relevant information. Gill says that she often speaks with women who say when they share their symptoms with their doctors, they’re either dismissed and left to deal with it on their own or are forced to undergo tests for unrelated health care issues such as cancer. In order to address this, Gill says, health care needs to go beyond addressing common symptoms such as hot flashes. “There are many more symptoms of menopause that both clinicians and women aren’t aware of,” Gill says. The conversation has also shifted generationally. A new study found that 70 percent of millennials would consider reducing hours, changing jobs or retiring early to combat menopause symptoms. For women in the workforce, 40 percent of women reported missing work for a few days a week each month due to menopause symptoms. And 26 percent said that their workplace adequately addressed menopause. A large component of improving health care resources lies in increased funding for research related to menopause and midlife women’s health. In 99 percent of studies related to the biology of aging, menopause wasn’t considered in the research. LaCroix worked on the 2002 Women’s Health Initiative report, which highlighted concerns about hormone replacement therapy in relation to specific cancers. The report led to a strong decline in usage among women. Subsequent reports have debunked these claims. A new analysis released this year by medical journal JAMA found that the benefits of hormone replacement therapy far outweigh the dangers, citing it as an appropriate way to treat menopause symptoms, which can range from hot flashes to brain fog to weight gain to stiff and achy joints. But despite this, public opinion on hormone replacement therapy has remained largely unchanged. While the debate surrounding hormone therapy usage remains a controversial one, LaCroix says the conversation needs to move past the debate. “I would like for women to have a menu of choices that they can choose from to relieve whatever menopause symptoms they’re having,” LaCroix tells Women Rule. She helped create My Menoplan, an NIH-funded site that helps women in menopause explore treatment options based on their symptoms. Gill says research is extremely important given the wide variety of symptoms women can experience, and how factors such as age, socioeconomic status and race can impact how these symptoms manifest. Public opinion on hormone replacement theory is just one example of how gaps in general knowledge impact women seeking a treatment. “Women start to change and have these symptoms and are really worried. And since we are never told that these are common symptoms … it pushes the panic button for many women. And that impacts us in every aspect of our lives,” Gill says. Before the age of 40, a majority of women have little to no knowledge of menopause, and 80 percent of women weren’t educated about it at school. LaCroix and Gill both say that menopause education should be included in schools at an early age in addition to conversations about puberty. “It shouldn’t be so mysterious. It should just be one of those other things that happens in life, so that we don’t have to keep denying its presence and pretending it doesn’t exist,” LaCroix says. Gill says today’s public conversations give her hope that the stigma surrounding menopause is diminishing. “It’s not going to solve everything, but I do think it absolutely matters that they’re willing to step up and say something,” Gill says. However, for Gill, the most important next step is getting menopause-related legislation enacted into law. “I think we’re just at the start of this movement … but we have a lot of work ahead of us,” Gill says.
| 
