A new generation of women are demanding that the next chapter of their lives no longer be ignored, overlooked or squandered.
This story originally appeared in the Summer 2024 issue of Ms. magazine. Join the Ms. community today and you’ll get the Summer issue delivered straight to your mailbox.
Menopause is having its moment—or so declares a recent piece in The New York Times as well as similar stories in news magazines and business journals. At a time when reproductive rights are under attack, progress and momentum for women’s health on any front is welcome news.
But are we experiencing déjà vu all over again?
Flash back to the early 1990s when the late journalist Gail Sheehy published what became the best-selling classic The Silent Passage, part of her Passages series, taking on menopause with a whiff of empowerment. Menopausal hormone therapy was in its heyday, brimming with celebrity endorsements and touted by icons.
A 1992 opinion column in The Times, “Mighty Menopause,” posited that the rise of baby boomer women in politics was a direct result of hormonal shifts—and that “the biological changes wrought by menopause” ultimately “bolster [women’s] interest in power and increase their ability to use it.”
That same year, health reporter Jane Brody wrote for The Times: “Menopause, long mired in myth and controversy and shrouded by a cloak of embarrassed silence, is fast becoming the leading women’s health issue of the decade.” Whereas Brody’s article warned of a dearth of governmental research in the long-term safety of hormone therapy, other writers and advocates stressed that denying women access to treatment was also an affront.
In 1993, a Ms. magazine story, “What, Menopause Again? A Guide to Cultural Combat,” offered a searing critique of society’s failure to address and eradicate stigma—of aging, of sex, of gender roles—or to look beyond products designed to keep women perpetually appealing to men.
It took four feminist lawmakers on Capitol Hill—Reps. Patricia Schroeder and Olympia Snowe, both co-chairs of the Congressional Caucus for Women’s Issues, along with Reps. Barbara Mikulski and Constance Morella—to press the federal government and the National Institutes of Health (NIH) to invest in rigorous research in women’s health. With that, the Women’s Health Initiative (WHI) was born, the largest undertaking ever to investigate health outcomes for menopausal women, as well as the largest randomized clinical trial in history to involve only women. (Side note: Medical research did not routinely include women in clinical trials until a federal law required it in 1993. Shocking.)
Designed in large part to assess whether hormone therapy decreased the risk of cardiovascular disease, recruitment for the WHI began in 1993. Less than a decade later, in July 2002, one arm of the initiative—studying women assigned to the estrogen-plus-progestin formulation—was shut down suddenly by way of a high-profile press conference and a startling headline about slightly elevated risks of breast cancer, heart disease and stroke.
Not surprisingly, this led to a public frenzy, one that abruptly ended the first great menopause moment.
Eventually, doctors and experts revealed that the government data was dramatically misinterpreted and poorly communicated. In particular, the health risks initially reported did not apply equally to women under 60 or to those who were closer to the menopause transition (whose last period was within the past 10 years). The WHI had taken the results from the older (and less healthy) population of women on the estrogen-plus-progestin formulation of hormone therapy and applied it to all women of all ages and to all hormone therapies.
I’m not even a betting woman, but I’ll bet today that this is the first time a president of the United States has ever signed an executive order that mentions the words ‘menopause’ and ‘women’s midlife health’ in it.
Maria Shriver, journalist
Today the official position of leading experts like the North American Menopause Society, the American College of Obstetricians and Gynecologists, and the American Association of Clinical Endocrinologists is that the benefits of hormone therapy typically outweigh the overall risks for most healthy, symptomatic women (dependent on their personal and family health history).
But there was no putting the genie back in the bottle. The collateral damage wrought—the subsequent dearth of attention afforded to menopause and public commitment to understanding its trajectory, its treatments, its disparate impacts on women of color, and its role in long-term health and longevity—caused incalculable harm and suffering for a generation of women.
Until now.
A new, modern menopause movement is underway, mobilized by a diverse coalition of doctors, journalists, and social and racial justice activists, and through the openness of influential leaders including Michelle Obama, Tracee Ellis Ross and Oprah Winfrey, among others. Some attribute it to generational politics, the estimated 6,000 Gen Xers like me now entering menopause every day in the United States. We are bookended by our postmenopausal moms and mentors and by millennials, who are already or soon to be in the throes of peri-menopause, which can last for a decade.
Together, our accumulated wisdom and experience contribute profoundly to the economy, to culture and to public life. Menopause is not an afterthought for us. Nor can we continue to tolerate being society’s afterthought.
We are here to insist that the sheer potency of this next vital chapter of our lives no longer be overlooked, ignored or squandered. And, urgently, to demand investment in the science that could help solve or at least ameliorate the deep challenges that accompany the transition to menopause: the physical and emotional symptoms endured by millions.
In a forthcoming book, Period. Full Stop. The Politics of Menopause, I propose a policy agenda that will enable this progress.
- First and foremost, we need government-funded research. Recent advocacy efforts culminated in the creation of a White House Women’s Health Research Initiative, an executive order signed by President Joe Biden in March calling for a $12 billion commitment to a wide range of women’s health issues. The executive order is bolstered by the introduction of four bipartisan congressional bills: in the House, the Menopause Research and Equity Act, the We’re Addressing the Realities of Menopause (or the “WARM” Act), and the Servicewomen and Veterans Menopause Research Act; and in the Senate, the Advancing Menopause and Mid-Life Women’s Health Act. The NIH is now obliged to embark anew upon an evaluation of the status of menopause research and recommend and fund new studies. It is imperative that it also quickly and publicly update and reset the record about hormone therapy.
- One-fifth of the female U.S. workforce is now in or on the brink of menopause. For those afflicted by the most debilitating symptoms like hot flashes, brain fog and insomnia, there is a measurable drain on productivity. A 2023 study estimated that missed work due to menopause results in $1.8 billion in lost wages annually. Employers must balance competing interests—retaining top performers, equitably administering employee benefits, respecting privacy—all while minding bottom lines. We must map out a best-practice menopause agenda for workplaces as well as a way to ensure antidiscrimination protections and determine how best to engage and win the support of private-sector and political leaders.
- In the current information and education vacuum, a vast menopausal “wellness” industry has mushroomed, hitting $15.4 billion globally in 2021 and estimated to reach more than $24 billion by 2030. The inventory is expansive, ranging from sweat-wicking bras and bedsheets to cooling sprays and lubricants, as well as health, nutrition, herbal and dietary supplements—many with clever names, un-proven claims and hefty price tags. On the one hand, it’s a boon for burgeoning second-career female entrepreneurs and investors; on the other, a potential predatory cash grab, preying upon public fear about hormones. Too many products parrot misinformation and profit off sexist, ageist tropes. We must adopt reforms that help ensure quality control and consumer protection.
It’s 2024. Time to make menopause the catalyst for better, more representative public policy, especially when it comes to investments in scientific research and education—as well as the fuel for meaningful innovation and the foil for commercial exploitation.
Not surprisingly, none other than Sigmund Freud declared, “It is a well-known fact … that after women have lost their genital function” they become “quarrelsome, vexatious and overbearing.” Only to be countered decades later by anthropologist Margaret Mead: “There is no greater power in the world than the zest of a postmenopausal woman.”
Talk about a duet of fighting words. Let these be our banner, our call to commence a post-menstrual, pro-menopausal mobilization. Period. Full stop.
Essential Resources
- Alloy is a digital platform providing access to accurate information; board-certified menopause-trained doctors; community and conversation; and science-backed solutions.
- Black Girl’s Guide to Surviving Menopause is a multidisciplinary platform centering the stories and needs of Black women, femmes, nonbinary, genderqueer and gender-expansive people.
- Let’s Talk Menopause aims to change the conversation around menopause by helping create a world in which menopause is broadly understood and comprehensive menopause care is standard.
- The National Menopause Foundation houses the Women’s Midlife Health Policy Institute to help advance research, education and public policies related to menopause.
- The Swell is a learning platform and community of “curious, kind, soulful, humble, kickass, fearless and generous humans who are leaning into the second half of their lives.”
Up next:
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