Menopause is a universal experience for women who live long enough, yet despite its inevitability, far too many struggle to receive the medical care and support they need. For decades, menopause has been under-researched, underfunded, and poorly understood by both the medical community and society at large. Women often find themselves dismissed, misdiagnosed, or shuffled between specialists who treat their symptoms in isolation rather than addressing the root cause: the hormonal shifts of “the change.”
This failure in care stems from multiple systemic issues, including inadequate medical education, lingering stigma around women’s aging, and a healthcare system that does not prioritize women’s health after reproduction ends.
My Own Journey: From Undereducated to Advocate
I know this firsthand because I was not a great menopause doctor for years. Like most physicians, my medical training largely ignored menopause beyond the basics of hormone decline and vasomotor symptoms. The critical aspects of sexual function, metabolic changes, cardiovascular risks, and long-term healthspan were barely covered. I treated symptoms in isolation, without fully grasping the broader impact menopause has on a woman’s body.
It wasn’t until I experienced my own menopause that I truly understood how undereducated I was. The symptoms I faced sent me on a deep dive into the literature and connected me with an incredible network of experts — what I call the “Menoposse.” Under the guidance of pioneers like Jim Simon, Lauren Streicher, Vonda Wright, Howard Hodis, Wendy Mack, Barbara Levy, Karen Adams, Kelly Casperson, Avrum Bluming, Carol Tavris, Sharon Malone, and many others, I realized how much I had yet to learn. Their research, clinical insights, and dedication to menopause care completely reshaped my approach to treating women in midlife and beyond.
The normalization of menopause-related suffering has led to generations of women being dismissed when they seek care. Many are told that their symptoms are just a part of aging or, worse, that they’re exaggerated or imagined. This dismissive attitude reinforces the outdated belief that menopause is merely a temporary inconvenience rather than a major physiological transition that can have long-term health consequences.
Menopausal symptoms are frequently misdiagnosed as mental-health disorders or lifestyle issues. Women struggling with anxiety, depression, or cognitive changes are often prescribed antidepressants rather than being evaluated for hormonal changes that could be effectively managed with hormone therapy or other targeted interventions. Similarly, weight gain, metabolic dysfunction, and increased cardiovascular risk — direct consequences of declining estrogen — are often attributed to poor diet or lack of exercise rather than the underlying hormonal shift.
Lack of Standardized Treatment Guidelines
Even when women do find a healthcare provider who acknowledges their symptoms, they often encounter conflicting and confusing medical advice. This is largely due to the lack of standardized, up-to-date guidelines for menopause management.
The field of menopause research has been hindered by outdated studies, including the widely publicized Women’s Health Initiative (WHI) study from 2002, which initially suggested hormone therapy (HT) carried significant risks. Though subsequent analyses have clarified that HT is safe and beneficial for most women when initiated at the right time, the damage was done — many physicians remain hesitant to prescribe it, and many women fear it.
Beyond hormone therapy, there’s no clear framework guiding physicians on how to approach menopause-related conditions, like osteoporosis, metabolic syndrome, or cognitive decline. For example, the current guidelines for the treatment of vasomotor symptoms in menopause vary greatly between the American College of Obstetricians and Gynecologists (ACOG) and The Menopause Society (TMS). This inconsistency leaves women to navigate a fragmented system where they must advocate for themselves, often without access to accurate, evidence-based information.
Societal Stigma
Another major factor in the lack of menopause care is our society’s discomfort with aging women. In a culture that prioritizes youth and fertility, menopause is often viewed as the end of a woman’s most “valuable” years. This stigma affects not only how women perceive their own health, but also how the medical community prioritizes their care. Unlike pregnancy, which receives widespread medical and societal support, menopause is frequently ignored or even ridiculed.
This stigma contributes to the lack of funding for menopause research. Of the National Institutes of Health’s $43 billion budget in 2023, only $15 million was allocated to menopause research. This lack of investment means that women today are often left with decades-old treatment options and minimal innovation in menopause care.
Insurance and Accessibility Barriers
Even for those who find informed providers, financial and logistical barriers often prevent them from getting the care they need. Insurance coverage for menopause-related treatments, including hormone therapy, bone density scans, and metabolic screenings, is often inconsistent. Many women must pay out of pocket, making proper menopause management a privilege rather than a standard of care.
Additionally, the lack of menopause specialists means that women in rural or underserved areas may not have any options when it comes to knowledgeable providers. Telemedicine has expanded access to some degree, but it still remains out of reach for many.
The Path Forward
The medical community and society at large must take significant steps to improve menopause care. First, comprehensive menopause education must be incorporated into medical training for all healthcare providers, not just OB-GYNs. Physicians in primary care, endocrinology, cardiology, and psychiatry must be taught to recognize and address the systemic effects of menopause.
Second, we need more funding for menopause research, ensuring that future generations have access to better treatment options based on high-quality, evidence-based studies.
Third, we must work to destigmatize menopause by shifting the cultural narrative. Menopause is not an end, but a new phase of life that deserves the same medical attention and respect as any other health transition.
Finally, women must be empowered with accurate, science-backed information to advocate for their own care. This includes greater public health initiatives, accurate medication labeling, employer support for menopausal women in the workplace, and broader insurance coverage for menopause-related treatments. To advocate for these changes, please check out The Citizen’s Guide to Menopause Advocacy. This nonpartisan guide, authored by Jennifer Weiss-Wolf and me, with a foreword by Maria Shriver and contributions from multiple menopause experts, will help you contact your lawmakers to begin to initiate real change.
Women struggle to get the care they need in menopause due to a deeply ingrained combination of inadequate medical education, stigma, lack of standardized guidelines, and healthcare system barriers. I know this because I lived it — both as a doctor and as a patient. By prioritizing research, education, and advocacy, we can ensure that women receive the support, treatment, and respect they deserve during this critical life stage.
