How it’s affecting women trying to get care.
There’s a hidden tax that’s creating a significant financial burden on the roughly two million women who go through menopause each year — and many have no choice but to shoulder the cost.
You might’ve heard of the “pink tax” — which isn’t actually a government tax, but a form of discriminatory pricing toward women that makes certain essential products and services (from razors to deodorant to haircuts) more expensive. Since there’s no federal law that expressly prohibits businesses from charging different prices for similar goods targeted to men and women, retailers often mark up costs on women’s products. In recent years, some companies — including online retailer Boxed.com and the women’s shaving brand Billie — have taken a stand against this gender bias, and reduced their prices on common items, like razors and pads.
Even though we commonly think of the pink tax in relation to menstrual products, the inflated costs don’t stop once you cease menstruating: There’s also what’s known as the “menopause pink tax,” and it results in staggering discrepancies.
On average, medical costs for menopausal women ages 45 to 54 are 47 percent higher than they are for women of the same age who don’t exhibit menopause symptoms, according to recent findings by the consulting firm, Milliman.
This study was commissioned by the women’s telehealth clinic Gennev, which is trying to raise awareness about this disparity. “These are staggering costs,” says the company’s president Jill Angelo. “We need to be providing women with the right menopause care at the right time.”
How much more do menopausal women pay — and why does it matter?
The study found that monthly expenses for women going through menopause average $1,243, compared to $848 for the general population of women. And this has some far-reaching effects: More than 2 million Americans hit menopause each year, an estimated 6,000 people daily, according to the Mayo Clinic.
While you may think of menopause as a pretty run-of-the-mill experience (albeit, an inconvenient and confusing one), it’s not without serious complications. Angelo says one of the main drivers of these sky-high costs is ER visits. Some women with hot flashes may experience heart palpitations due to fluctuating hormones, which can require urgent care.
The other major expense is behavioral care, like mental-health treatment. After all, going through menopause can be incredibly stressful, especially since we’ve been conditioned to perceive menopause as a negative experience. “We know mental health issues are a growing concern within the United States, but women in menopause exhibit them at a higher rate because of the hormonal shifts happening within them,” Angelo tells us.
There are also some larger systemic issues at play — such as the cost of medicine. Wen Shen, M.D., tells us that certain hormone-related therapies like progesterone, which is often combined with estrogen to treat menopause symptoms, can cost consumers thousands of dollars every couple of months. Luckily, she points out that many of these pricey drugs now have generic versions, so patients can get the same strength and active ingredients for less than a hundred dollars. However, it’s still a cost women incur that men don’t.
It doesn’t help that women’s healthcare is often fragmented into a patchwork of providers. Though menopause is something women have been going through since the beginning of time, just one in five OB-GYNs receive menopause training in medical school. That means that many menopausal women have to make costly trips to see specialty menopause providers and take myriad tests, some of which may be unnecessary. According to women’s health company Elektra Health, a misdiagnosed woman could spend up to $65,000 more than necessary throughout her menopausal transition.
Why is menopause challenging (and costly) to treat?
Menopause can’t be treated in one fell swoop. Though it usually lasts around seven years, symptoms can persist for up to 14 and are accompanied by a wide range of mental and physical symptoms that vary based on the person, according to the National Institute of Aging.
The condition generally comes in three phases — the first one is perimenopause, which typically starts in women ages 40 to 44, and can last as long as 10 years. Next up is menopause, which isn’t diagnosed until after someone goes a full 12 months without a period. The final phase is post-menopause, and while symptoms are generally less intense, the risk for heart disease and osteoporosis goes way up.
In each of these stages, women may have different medical needs. There are an estimated 34 different symptoms related to menopause, ranging from changes in mood and sex drive to vaginal dryness and night sweats.
What’s worse is that many of these symptoms go unrecognized by healthcare providers. On top of the sheer lack of menopause training, Dr. Shen says primary care doctors typically get only 15 minutes (or less) with patients during each appointment. While this may not leave enough time for a diagnosis, she points out that it could be enough of a window to at least screen for the condition. “Doctors should have a questionnaire that they hand out to the patients at the beginning of the visit,” she tells us, “so they can check boxes if they’re having certain menopause symptoms.”
Some doctors say we need a more proactive approach to identifying (and treating) menopause, because medical errors could not just cost your wallet, but your life: Menopause significantly speeds up bone loss, increases the risk of osteoporosis, and has been linked to heart disease. “It’s not just about having hot flashes — it’s about women and their future health,” says Dr. Shen.
What’s being done to address these disparities?
Some companies are stepping up amid this gap in care. Microsoft, the NBA, Abercrombie & Fitch, Palantir, and Standard Chartered Bank are among those currently offering employees educational or financial assistance for managing menopause, according to a report by Bloomberg.
Unfortunately, they represent a minority of companies: Only 4 percent of employers cover the costs of aid for menopausal women, such as hormone therapy and counseling, according to a survey of HR policies by benefits consultant NFP.
There has been a noticeable increase in telehealth companies, like Gennev, geared toward guiding women through menopause. Founded in 2015, the company is made up of OB-GYNs and dietitians who work holistically to provide personalized treatment for women seeking relief from symptoms like hot flashes, insomnia, anxiety, and loss of libido. This includes prescribing various hormone-related treatments (only those that are backed by the Food & Drug Administration of course.)
They aren’t meant to replace doctors, but rather serve as an additive form of care to make sure women are getting the treatment and diagnosis they need. “Primary care has been receptive to the fact that they just don’t have the capacity and their model isn’t set up for this type of patient,” she tells us. “And so that’s where we’ve been an effective collaborative fit.”
Plus, unlike other types of specialty care, it’s covered by insurance. “There’s a real opportunity to provide women with quality menopause treatment and care, particularly in this case with hormone replacement therapy,” Angelo tells us.
But both of our experts agree that not all companies in this space are legitimate. “When there’s a big boom in any industry, like there is now in menopause, you’re going to have some bad actors,” says Angelo. The best thing women can do, according to Dr. Shen, is to advocate for themselves and not settle for a healthcare provider who isn’t receptive to addressing their concerns. “My big message to women is don’t be afraid to ask — be your own best advocate.”
