For the first time in U.S. history, Congress has convened a hearing dedicated solely to menopause, signaling a long-overdue shift in how policymakers address a condition that affects roughly half the population. The hearing, held last month, brought together physicians and experts to testify before the Senate, with Senators Kirsten Gillibrand (D-N.Y.) and Rick Scott (R-Fla.) leading the charge. Their testimony painted a bleak picture: physician shortages, inadequate access to care, insurance hurdles, and a glaring absence of menopause education in medical training.
The senators also requested a Government Accountability Office review of federal funding for menopause research, aiming to identify gaps in training, treatment, and oversight. This move comes after decades of silence on a topic that has long been stigmatized in American culture.
Medical training lags behind
One of the most significant barriers is the lack of emphasis on menopause in medical education. A survey of U.S. OB-GYN residency programs found that only about 30 percent offer a menopause curriculum. The Accreditation Council for Graduate Medical Education mandates that OB-GYN residents perform at least 360 live deliveries, but there is no equivalent requirement for menopause training. This gap extends to primary care physicians, who often are the first point of contact for women experiencing perimenopausal symptoms but frequently lack the knowledge to provide adequate care.
Women undergoing menopause can suffer from hot flashes, night sweats, sleep disruption, mood swings, urinary changes, cognitive difficulties, weight gain, and headaches. Without proper treatment, these symptoms can be debilitating, affecting not only health but also careers and family life.
Economic and workplace impact
The economic toll is substantial. A study estimates that menopause costs the U.S. economy nearly $27 billion annually, largely due to lost productivity and increased healthcare expenses. Yet, unlike the United Kingdom, where companies with over 250 employees are required to publish annual Menopause Action Plans, U.S. workplaces largely ignore the issue. Many women suffer in silence, fearing that discussing their symptoms could jeopardize their standing at work.
For many women, perimenopause occurs during their peak earning years, a time when they have the most experience and potential to contribute. The lack of workplace accommodations and understanding can lead to reduced retention and advancement opportunities.
Cancer survivors face added challenges
Women who have survived breast cancer face additional complications. Hormone replacement therapy can alleviate menopausal symptoms but is often not recommended for survivors due to the risk of recurrence. With 1 in 8 women in the U.S. developing breast cancer, this is a critical concern. More research is needed to develop safe, effective treatments for this population.
Legislative and medical responses
In response to the growing awareness, the American College of Obstetricians and Gynecologists recently updated its recommendations on menopause treatment, the first update in 12 years. Comedian Amy Schumer has also become a public advocate, fronting Midi Health's national campaign to destigmatize menopause through humor.
Legislatively, Senators Patty Murray (D-Wash.) and Lisa Murkowski (R-Alaska) have introduced the Advancing Care and Mid-life Women's Health Act, which would authorize $275 million for training, education, and research. Combined with the GAO review and the congressional hearing, these efforts aim to move menopause from the periphery to the mainstream of U.S. health policy.
As Lyndon Haviland, a distinguished scholar at the CUNY School of Public Health and Health Policy, noted, this shift is urgently needed. Every woman deserves to navigate menopause with accurate information, competent medical support, and the freedom to discuss it openly without shame.
