Menopause and Perimenopause

‘That’s Just Aging’ Is Not a Diagnosis

PUBLISHED 8/28/2026 by

As a physician, I was trained with the same mantra: that hormone therapy was only for women who were absolutely miserable, and that if we were to prescribe it, it was for the least amount of time at the smallest dose.

That was completely wrong.

In 2002, part of the Women’s Health Initiative study was halted prematurely for a press release that essentially stated that hormone therapy caused breast cancer—when in actuality, the women who took estrogen alone (those without a uterus) actually had a reduced risk for breast cancer.

The mangling of that messaging is in large part responsible for scaring a generation of physicians off prescribing hormone therapy and terrifying generations of women away from taking the very things—estrogen and progesterone—that improve the immediate symptoms of menopause (such as hot flashes, night sweats, vaginal dryness and recurrent UTIs) and prevent the long-term consequences of estrogen depletion like osteoporosis, heart disease and premature cognitive decline.

Every time you refuse to accept a doctor telling you, “That’s just aging,” you aren’t just advocating for yourself. You’re doing structural work. You’re demanding to be seen as a full person, not as a set of body parts.

The questions women ask in exam rooms are how the gap between medical evidence and clinical practice closes. It’s how we close the disparity between men’s health and women’s health.

Health, after all, isn’t about having all the answers. It’s about asking better questions—of yourself, and of the people responsible for your care.

Heidi Overton and the Overton Window

PUBLISHED 8/27/2026 by

Last week, President Trump posted to Truth Social his plan to nominate Dr. Heidi Overton as commissioner of the Food and Drug Administration (FDA). (The Contrarian covered the departure of her predecessor, Dr. Marty Makary, when he was pushed out in May.)

This nomination indicates the administration’s further normalization of gutting healthcare and drug safety—yes, its attempt to shift the Overton Window. (Given her last name, how can I resist?) The Overton Window theory reflects the efforts of deft politicians to deliberately mold public perception of a policy or idea—and its eventual support or rejection. Hence, the widening or closing of the Overton Window.

Overton’s record leaves no doubt this administration aims to smash the window altogether. She currently serves as deputy director of the White House Domestic Policy Council and was part of the first Trump administration as well. Though she trained in surgery at Johns Hopkins University School of Medicine, there’s been nothing subtle about her resume or affiliations since her residency—including and especially her prominent role at America First Policy Institute (AFPI), a think tank that “exists to advance policies that … prioritize[e] free enterprise, national greatness, American military superiority, foreign-policy engagement in the American interest, and the primacy of American workers, families, and communities.”

A highlight reel of her AFPI tenure: She publicly celebrated when the Supreme Court overturned Roe v. Wade with its Dobbs v. Jackson Women’s Health Organization decision in 2022, stating that the ruling “will allow Americans to reevaluate the value of the potential of every baby in the womb and choose life through a democratic process.” She has questioned the long-established safety record of mifepristone, indicating her opposition to the FDA’s approval for its availability via telehealth. She has authored research and papers opposing gender-affirming care for minors; in a 2024 Newsweek op-ed, Overton complained that Democrats “won’t even define what a woman is.”

My Hysterectomy Was a Gift. Dr. Kemi Doll Shows Why Women Need to Share Our ‘Womb Stories’

PUBLISHED 8/8/2026 by

Determined to prevent uterine cancer deaths, Dr. Doll published A Terrible Strength: The Hidden Crisis of the Black Womb and Your Survival Guide to Healing in May. Both comprehensive and compassionate, the book focuses on individuals of African descent, showing how everyone will benefit.

Upon finishing A Terrible Strength, I took its message to heart: One need not have a womb to prioritize womb health. We can all join Kemi Doll’s Womb Sisterhood through the “deliberate telling and sharing” of “womb stories” with “our true friends.” 

Fortunately, women have already started talking. Personal testimonies changed health outcomes in the 1970s and ’80s—and they’re doing the same now. Earlier generations suffered through perimenopause in silence, but today, women in their 20s, 30s and 40s hear about not only hot flashes but also itchy ears and frozen shoulders. And, as a woman in my early 50s, I’m not completely in the dark about hormone replacement therapy (HRT).

Nevertheless, deadly silence remains.

I am childfree by choice, so pregnancy never fueled my concerns, but I became preoccupied with gynecology in 2017. Fibroids were wreaking havoc in my life, and I pursued a hysterectomy to end my suffering. As Doll puts it, this “definitive treatment” is “welcomed by some and mourned by others.” Though I very much welcomed a hysterectomy, I couldn’t secure one until May 2021, despite my best efforts. 

From now on, I will participate in the “deliberate telling and sharing” of “womb stories.” Doing so is difficult but necessary. As Doll explains, sharing our experience requires us to “shift away from a strength that withstands suffering, silence and pain.” It requires, in her words, “a strength that embraces our vulnerability and can demand better care from the larger world.”

Hegseth’s Testosterone Bit Isn’t About Health

PUBLISHED 7/24/2026 by

The Trump administration has gotten rather … hormonal. As someone who cares deeply about the science and politics of all kinds of bodily matters, including and especially hormonal health and treatments, it is a truly bizarre exercise to unpack the latest news.

Last week, the defense secretary took to the airwaves to announce new mandatory screening of testosterone levels for all military members over 30, arguing the need to “optimize performance,” “combat Operator Syndrome” (a physical and behavioral condition uniquely attributed to soldiers who undergo intense training) and “maximize mission readiness.” Anyone deemed testosterone-deficient will be offered hormone therapy, presumably including the 230,000 women in active-duty service — who presumably may seek access to estrogen, progesterone and/or testosterone (hard to say given that women were not mentioned).

But of course, debate over optimal hormonal health is hardly the point. Only the most jacked-up soldiers fulfill Hegseth’s military fever dream — which he has made clear is devoid of women, whom he wants removed from combat roles altogether (he also has continued to block promotions of active-duty female Naval officers). The Trump administration has already banned transgender soldiers, at least based in part on the theory that their hormone treatments (though, in this case, they’d call it gender-affirming care, with a sneer) would be challenging to sustain.

It is not easy for me to put aside Hegseth’s distorted recasting of testosterone. That said, it happens to be true that federal regulatory guidelines for its usage are in need of an update and upgrade. As a menopause advocate, I fight hard for a world in which accessible, affordable hormonal care and treatment is a priority for all.

Four Years After Dobbs, Women’s Healthcare Is a Scarce Resource

PUBLISHED 6/24/2026 by and

This week marks four years since the Supreme Court revoked the federal right to abortion, catapulting the nation into an era of state-sanctioned deprivation of bodily autonomy for American women.

On this anniversary, we write to take stock of one of the underreported outcomes of Dobbs: the growing number of individuals and families for whom access to healthcare is diminishing because of a rise in medical deserts.

It’s common sense—there is no reason for highly mobile professionals to remain in places where they find themselves increasingly facing the prospect of personal risk for practicing medicine.

Not surprisingly, medical deserts are prevalent in conservative and rural states; the downstream pressure suggests it soon will become an issue for blue states, too.

The impact on America’s unconscionable maternal and infant mortality rates cannot be overstated. The United States has the highest maternal mortality rate of any wealthy country; as rates continue to drop worldwide, they climb higher here, with Black women more than three times more likely than white women to die in childbirth. Infant mortality has risen specifically in states that enacted abortion restrictions since 2022, again with impacts worse among Black infants.

The Untapped Power of Post-Menopausal Women

PUBLISHED 6/14/2026 by

Melinda French Gates announced last week a historic $215 million commitment to women’s health, including a $10 million gift to the Menopause Society. It is a beautiful and necessary act of generosity.

It arrives on the same day a new Mayo Clinic study showing hormone therapy use among menopausal women has dropped to a historic low of 1.7 percent—even as evidence of its safety has grown.

We are moving backward and forward at the same time.

French Gates put a spotlight on the fact that women’s health has been inexcusably underfunded. The questions to add to that conversation: What would medicine look like if it saw menopause not as nature’s mistake, but as evolution’s investment? What would our economy look like? What would our communities look like? What problems might we finally solve?

The science exists. The economic case is clear. And the legislative momentum is building. What is missing is the cultural shift that allows medicine, policy and society to see post-menopausal women not as a problem to manage, but as a resource we cannot afford to waste.

America’s Medical Research System Has Been Failing Women for Generations

PUBLISHED 6/11/2026 by and

For decades, women have been systematically excluded, overlooked and underfunded by America’s scientific and medical institutions—and the consequences are measurable. Women were not required to be included in federally funded clinical research until 1993, and even today, no more than 8.8 percent of NIH grant spending goes toward women’s health research. The result is a dangerous knowledge gap that affects everything from cardiovascular disease and autoimmune disorders to drug safety, maternal health and reproductive care.

The problem transcends partisan politics. While the Trump administration’s cuts to women’s health research have intensified concerns, Democratic and Republican administrations alike have failed to prioritize women’s health.

Private philanthropy and venture capital have also fallen short, with women’s health receiving just a fraction of available funding.

As women face rising healthcare deserts, worsening maternal mortality rates and persistent gaps in diagnosis and treatment, meaningful progress will require action on every front—from federal investment and philanthropy to innovative new funding models focused specifically on women’s health research.

A Government for Big Tobacco and Bigger Families

PUBLISHED 5/14/2026 by | UPDATED 5/17/2026 at 7:40 A.M. PT

The Department of Health and Human Services (HHS) made multiple headlines last week—starting with the apparent implosion of Dr. Marty Makary’s tenure as Food and Drug Administration commissioner. But beneath the chaos lies something more troubling: a federal health apparatus increasingly shaped by antiabortion pressure campaigns, pronatalist messaging and culture-war governance masquerading as public policy.

From the Supreme Court fight over mifepristone access to the Trump administration’s bizarre new moms.gov initiative—complete with links to antiabortion crisis pregnancy centers and rhetoric about Americans being “under-babied”—the week offered a revealing snapshot of where U.S. health policy is headed. Meanwhile, flavored vape approvals for Big Tobacco sailed through the FDA, even as reproductive healthcare access remains under constant attack.

Chaos may be Trump’s currency, but the throughline here is ideology: rewarding conservative allies, policing reproductive autonomy and repackaging motherhood as a nationalist project while offering little meaningful material support to actual families.

Forget the ‘Manosphere’—The ‘Meno-Sphere’ Is the Voting Bloc With Real Power

PUBLISHED 4/7/2026 by and

A recent report from centrist think tank Third Way predicts many of the “swingy, moderate, low-propensity young men” who supported Trump will sit out the midterms this year.

So who should progressive political strategists and hopefuls turn their attention to? The oft-forgotten, invisible aging woman, or, what we like to call the meno-sphere.

There are many good reasons to prioritize the electoral and mobilization potential of women over 50. Back in 1992, The New York Times published a piece called “Mighty Menopause,” which posited that the then-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.”

If ever there were a moment to prove that to be true, it’s now—as our daughters’ and granddaughters’ rights are rolled back, as communities are terrorized, as the power elite’s willful alignment with the rot becomes clearer by the day.

Symptoms, Hormones and the Fight for Better Care: What Every Woman Should Know About Menopause and Perimenopause

PUBLISHED 4/7/2026 by | UPDATED 4/14/2026 at 10:54 A.M. PT

When it comes to the menopause and perimenopause landscape, many women are left navigating symptoms without clear, trustworthy information.

This conversation aims to change that—offering evidence-based insights, practical guidance and a broader look at the systemic reforms needed to improve menopause care.