Menopause and Perimenopause

A Letter to My Future Self in a Time of Undoing

PUBLISHED 2/10/2026 by

This essay is one of three “Letters to My Future Self” included in Flipping the Menopause Script Is Essential to Democracy. Through personal reflection, political memory and spiritual inquiry, these letters consider menopause and midlife as thresholds—moments of undoing, reckoning and renewal. They invite readers to see aging not as decline, but as a site of transformation, agency and hard-won power.

“Since we were born in 1967 … we were told, implicitly and explicitly, that we were the first generation of Black children born into the fullness of freedom promised by law. The first generation of Black women was meant to be fully protected by the government. Free to vote without obstruction. Free to be educated without limits. Free to open a bank account, hold a credit card and own property. Free to marry who we loved. Free to live without our rights being constantly renegotiated.

“That was the promise we inherited. …

“Menopause sharpened my understanding that rights, like bodies, require attending to and care. That neglect is a political choice. That erosion is not accidental. That what happens to aging bodies mirrors what happens to democracies that refuse to honor those most impacted by time, labor and sacrifice. So I am writing to you, Future Me, because I want us to meet each other awake.

“Who are we when I finally arrive?

“Are we softer without being smaller? Stronger without armor? Have we learned how to rest without apology? Have we let go of the belief that our worth must be proven through exhaustion? …

“If you are an ancestor now, please remind me of what mattered most. Not the accolades. Not the fear. Not the scarcity. Remind me that I belonged to myself. That I belonged to my people. That I trusted the wisdom of my changing body.”

(This essay is part of the latest Women & Democracy installment, published in the middle of Black History Month, 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.)

Midwifery Is for Menopause, Too

PUBLISHED 2/10/2026 by

When I was younger, I remembered the kitchen turning into a collective of family midwives. Without understanding, they boisterously discussed the “change of life,” “personal summers” and somebody being “carefree, hot in the pants.” They waved their hands in praise, testifying, “Tell it!” “Who you tellin’!” “Just you wait!” 

Their language seemed mysterious to me since I was less than six months into menarche. The only reason I was allowed in that sacred space was because I started my period. I was seen and not heard. But I was an audience in this menopause reverie.

Midwives, for centuries, chose who they passed on the secrets of the womb. These secrets included how to support those beyond their childbearing years and whose bleeding cycle unexpectedly came to an end. My family’s knowledge was passed down during the communing of the midwives and womb bearers. 

Midwifery is individualized care. It’s my #1 favorite aspect of the profession. Midwifery includes the menopausal experience. In my one-hour appointments, each person is able to talk freely. I listen, gather precious information, hear their concerns, hopes and expectations, so that I can offer care that’s specifically designed for their journey. To improve their reproductive and menopausal health, we discuss their experience and the differences between perimenopause, menopause and post menopause stages. I want them to feel affirmed and know where they are on their journey. Fourteen years later, and over 50 perimenopausal, menopausal and post-menopause clients later, the individualized care model remains.

(This essay is part of the latest Women & Democracy installment, published in the middle of Black History Month, 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 in Prison Is a Public Health Crisis We’re Ignoring

PUBLISHED 2/10/2026 by

Speaking from a Texas prison, journalist Kwaneta Harris reveals how menopause is neglected and punished for those living under state control.

“You know what menopause looks like for most folks? Maybe some hot flashes at work, some joint pain and mood swings. Perhaps you adjust your thermostat frequently or get hormone therapy from your doctor.

“Now let me tell you what menopause looks like under state control. Imagine having a hot flash in a non air-conditioned cell with a recorded temperature of 119 degrees. The guards won’t let you have ice water. You’re bleeding through your state-issued white uniform because you had to beg an 18-year-old man-child for a pad this morning, and he said, ‘Maybe later.’ You get exactly five tampons a month, along with a handful of pads, if you’re lucky. Your hormones are all over the place, but there’s no hormone replacement therapy. Just Tylenol—if the guards remember.

“And here’s the kicker: They write you up for having an ‘attitude problem’ when you’re actually having hormone-induced mood swings from perimenopause. Those write-ups? They keep you from getting parole. So now you’re not just dealing with your biology changing, you’re trapped here longer because your biology is being criminalized.”

(This essay is part of the latest Women & Democracy installment, published in the middle of Black History Month, 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.)

Queering Menopause: A Conversation on Story, Power and Policy

PUBLISHED 2/10/2026 by and

What would it mean to treat menopause not as a private medical event, but as a collective, political and even spiritual transition—one that spans far more bodies and experiences than mainstream narratives allow?

In this wide-ranging conversation, writers and cultural workers Syd Yang and Austen Smith reflect on their own experiences of perimenopause and menopause—experiences shaped by queerness, trans identity, spirituality and community—as well as the broader systems that render many menopausal people invisible.

Iranti Ẹ̀jẹ̀ and Menopausal Mapping: How Womanist Cartographies Make People Into Place

PUBLISHED 2/10/2026 by

A Black feminist menopause convening in Durham reimagines “place” as something created by bodies and community—mapping care, memory and power across physical, digital and spiritual terrains often erased from mainstream menopause discourse.

(This essay is part of the latest Women & Democracy installment, published in the middle of Black History Month, 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.)

What’s Next for Menopause Legislation in Your State?

PUBLISHED 1/7/2026 by

An unprecedented 19 states have introduced three dozen bills to improve menopause care and treatment; eight of those bills are now law.

At the federal level, the U.S. Food and Drug Administration finally removed the “black box warning” on estrogen products, ushering in a new era for menopause care whereby women and their doctors can make decisions without the unnecessary fear the prior label engendered.

And so, we kick off the new year with a mighty impressive track record. Can we expect more of the same in 2026? My prediction is a resounding yes. This is only the beginning of a long overdue and much deeper series of demands. Here’s my forecast for what to expect in the weeks and months ahead.

A Very Bad Year for Women’s Health

PUBLISHED 12/24/2025 by

When I started writing for The Contrarian, a funny-not-funny inside joke was whether there would be enough fodder for a weekly democracy column that overtly centers gender. I think you already know the punchline. Suffice it to say, I did not miss a single Wednesday in all of 2025.

For my final entry of the year, we thought it worthwhile to offer a snapshot—a year’s worth of reporting on the depth of damage this administration has wreaked on women’s health, with real-time Contrarian reporting noted.

This FDA Decision Could Transform Menopause Care

PUBLISHED 11/12/2025 by and

On Monday, Nov. 10, the U.S. Department of Health and Human Services announced that the Food and Drug Administration would eliminate the “boxed labeling” requirement for estrogen products.

The “black box warning,” as it’s commonly called, is part of the fallout from a press conference that occurred more than 20 years ago, announcing the findings of the Women’s Health Initiative (WHI). It’s also been the subject of a half-century-long push and pull with the federal government.

Make no mistake, this has been a longstanding demand—it’s neither new nor MAHA-driven. Doctors and scientists have made the case for its removal since the start to no avail, arguing the data from the WHI—the largest, most expensive, and only randomized placebo-controlled study of post-menopausal women—never supported putting it there in the first place.

The FDA’s reversal of the labeling requirement is a major win for evidence-based medicine. Now it’s up to us to responsibly inform women of their choices.

FDA Rewrites the Story on Estrogen: A Win for Women

PUBLISHED 11/10/2025 by

Estrogen, the hormone long cast as a public health threat, has been unfairly maligned.

The FDA has finally announced it will remove the incorrect “boxed warning” from vaginal estrogen products and issue corrected labeling for other estrogen therapies—a much needed course correction for one of modern medicine’s most damaging missteps.