Menopause is having its overdue moment

Congress recently convened a first-ever hearing on menopause. That it took this long for lawmakers to address this important issue mirrors how we as a nation have failed to publicly confront, thoughtfully study and allocate meaningful federal funding to address this predictable stage of women’s health.

Last month, Sens. Kirsten Gillibrand (D-N.Y.) and Rick Scott (R-Fla.) invited physicians and experts to testify before Congress on the current state of menopause training, research and care. Their collective assessment was discouraging — physician shortages, inadequate access to care, insurance challenges and a lack of medical education were cited among many reasons why there’s been little progress.

The senators also asked the Government Accountability Office to examine how the federal government has funded menopause research to identify gaps in training, treatment and oversight.

Menopause is the normal part of a woman’s aging process that marks the end of her reproductive years. A major hormonal shift takes place, often triggering hot flashes, night sweats, sleep interruption, emotional swings, urinary changes, concentration loss, weight gain and headaches. These symptoms, if left untreated, can be enormously challenging for women and their families.

Menopause is a biological reality that roughly half of the U.S. population will experience. These women will spend as much as one-third of their lives in perimenopause and menopause. Yet, for generations, it has occupied a taboo place in our culture.

Because it’s a topic no one wants to talk about.

The problem begins, in part, with medical training and education. Menopause isn’t prioritized as a field of study among obstetricians and gynecologists. One survey of U.S. OB-GYN residency programs found that just over 30 percent had a menopause curriculum.

The Accreditation Council for Graduate Medical Education requires that an OB-GYN in training must log a minimum of 360 direct deliveries . Today, there is no such standard required for doctors treating menopause.

Women often consult primary care physicians as perimenopausal symptoms develop, and there are significant gaps in menopause knowledge among clinicians who practice internal medicine. A lack of training is among the most frequently cited barriers to providing quality menopause care globally.

A woman in menopause experiencing insomnia, brain fog or hot flashes, or any one of a myriad of normal menopausal symptoms, can find herself in an extremely difficult situation. She is going through a normal transition, yet because of unfair gender stereotypes, she can jeopardize her standing in the workplace if she talks about it openly.

Most companies have policies addressing pregnancy, disability and other health conditions. But in the U.S., menopause remains largely absent from workplace planning, even though symptoms such as sleep disruption and concentration loss can affect productivity, retention and advancement.

That stands in stark contrast to the United Kingdom, where companies that employ over 250 people are legally required to publish annual Menopause Action Plans for the purpose of “ building equitable, productive workplaces .”

For many women, perimenopause occurs during high earning years at a time when women have more experience and time to give to their careers. One study put menopause’s total annual cost to the U.S. economy at nearly $27 billion.

And there are added complications for women who have survived cancer. Hormone replacement therapy can be a helpful treatment for some women experiencing menopausal symptoms but is often not recommended for breast cancer survivors as it may heighten the risk of recurrence. This is especially alarming as 1 in 8 women in America will develop breast cancer.

That’s why congressional calls for more research and training matter. Women deserve treatment options based on evidence — not guesswork from physicians.

The medical community is responding to the heightened interest in menopause. Days ago, the American College of Obstetricians and Gynecologists refreshed its recommendations on menopause treatment options. Its last update was reportedly 12 years ago.

Awareness is also critical. In April, comedian Amy Schumer became the face of Midi Health’s national “ Midlife Back in Session ” campaign, using humor to talk openly about menopause symptoms ranging from hot flashes to mood changes.

And legislation to improve federal funding for menopause is underway. This spring, Sens. Patty Murray (D-Wash.) and Lisa Murkowski (R-Alaska) introduced the Advancing Care and Mid-life Women’s Health Act, which would authorize $275 million for training, education and research. Combined, these efforts can move menopause from the sidelines of U.S. women’s health policy to the mainstream of medical education, research funding and workplace practice.

This shift is urgently needed. Because every woman deserves to enter menopause equipped with accurate information, delivered by trained medical professionals and have the ability to talk about it openly, without fear of being judged or burdened by misguided feelings of shame or embarrassment.

Lyndon Haviland, DrPH, MPH, is a distinguished scholar at the CUNY School of Public Health and Health Policy.