Menopause and Perimenopause

Respectability Politics and the Making of a Menopause Justice Movement

PUBLISHED 9/23/2026 by

After generations of silence, menopause has entered mainstream conversation with remarkable speed, thanks in part to Gen X’s insistence and the emergence of older millennials navigating perimenopause. People are finding language for once-isolating experiences, and researchers and clinicians are paying closer attention.

But this cultural reboot demands that we ask whose stories are treated as authoritative, whose leadership is recognized and resourced, and who can access the care and knowledge being produced. Paid memberships, subscription communities, influencer content, concierge care, exclusive events and information behind paywalls are rapidly turning menopause into a marketplace. Who gains power as the conversation grows?

What may once have operated as a strategy for surviving racial terror has hardened, in many contemporary institutions and marketplaces, into an entrance requirement: Prove you are polished, palatable, professionally credentialed, “properly” gendered, sufficiently resourced and nonthreatening before your suffering can be believed or your leadership affirmed.

We are therefore being asked to interrogate more than whose voices, stories and activism are championed and pushed to the forefront. We must also examine whose knowledge is treated as credible, whose testimony becomes evidence, and whose experiences are permitted to define the full breadth of menopause. If legitimacy still depends on proximity to whiteness, wealth, cisgender identity, able-bodiedness, professional status or institutional approval, then the table has not been transformed. It has simply diversified its guest list.

(This essay is part of the latest Women & Democracy installment, in partnership with Black Girls’ Guide to Surviving Menopause. Menopause is not only a physical transition—it is also cultural, social and political. Recognizing its full scope is essential to advancing true health and civic equity.)

Menopause Is a Public Policy Story. Congress Must Treat It Like One.

PUBLISHED 9/16/2026 by

On Wednesday, Sept. 16, I testified before the U.S. Senate Special Committee on Aging at Congress’ first-ever hearing devoted to menopause. I am an attorney, advocate and author whose primary professional focus is menstruation, menopause and the law—an unusual sphere of expertise, I know. These experiences too often go neglected and are deeply deserving of public policy attention and intervention.

Menopause is a whole-body transition affecting women’s immediate and long-term physical, cognitive, mental and metabolic health. Too often, women navigate these changes without the support they need.

In the United States, about 1.3 million women enter menopause each year—roughly 6,000 per day. Yet there are only around 4,000 certified menopause practitioners across the country, and menopause care deserts are common, especially in rural areas and across the South and Midwest.

Menopause is an individual and collective health story. But it also is a marriage and family story. A career and economic story. An aging and longevity story. And most certainly, a public policy story. There is no singular reform that will respond to every scenario or address every challenge facing every woman in midlife. But a collection of proposals already on the table in Congress, under consideration at federal agencies and advancing in statehouses offer a meaningful start.

(This essay is adapted from the written testimony Jennifer Weiss-Wolf submitted to the U.S. Senate Special Committee on Aging for its Sept. 16 hearing, “Half the Country, Zero Hearings: Meeting the Moment to End the Menopause Care Gap in America”—Congress’ first-ever hearing devoted to menopause.)

Half the Country, a Fraction of the Research

PUBLISHED 9/15/2026 by

For decades, Democratic and Republican administrations alike presided over a medical research system that routinely excluded women. The result? Modern medicine was built on incomplete science—and women are still paying the price. 

It wasn’t until the NIH Revitalization Act of 1993 that federally funded clinical trials were required to include women. Yet changing who participates in research does not rewrite decades of medical knowledge overnight. By then, physicians had already been trained using male-centered evidence, diagnostic standards had been established, and countless drugs had already been dosed using evidence derived solely from men.  

In 2025, the Trump administration has proposed cutting the NIH’s budget by roughly 43 percent (equivalent to $20 billion per year). Its broader HHS budget proposal called for eliminating or consolidating several programs supporting family planning and maternal and child health. Federal agencies also came under pressure to scrutinize or reject grant proposals containing terms such as women, leading to paused or cancelled fellowships and research on conditions such as uterine fibroids and pregnancy. 

There are signs, however, that Congress may finally be beginning to treat women’s health across the lifespan as a serious policy issue.

On Sept. 16, the Senate Special Committee on Aging will hold Congress’ first-ever hearing devoted to menopause. Led by ranking member Sen. Kirsten Gillibrand (D-N.Y.), “Half the Country, Zero Hearings: Meeting the Moment to End the Menopause Care Gap in America” will examine the nation’s lack of menopause research, informed medical care and provider training—and make the case for greater federal investment.

The hearing represents an overdue step forward. But women’s health cannot remain vulnerable to political cycles. Regardless of which party holds power, it must become a permanent priority within American policy and medicine.

‘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: Trump’s Pick to Lead the FDA Gets Her First Senate Confirmation Hearing

PUBLISHED 8/27/2026 by | UPDATED 9/24/2026 at 10:54 A.M. PT

The Senate Health, Education, Labor and Pensions Committee held a two-hour hearing with Dr. Heidi Overton, President Trump’s nominee for commissioner of the Food and Drug Administration. Feminists and reproductive healthcare supporters are sounding the alarm about this pick, who has been public about her opposition to abortion.

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.