The Sorry State of Menopause Care for American Women

menopause care
Healthcare for midlife women leaves a lot to be desired on both sides of the Atlantic, as our US-based correspondent reports.

I officially became a ‘menopausal woman’ in my mid 40s and wow, did it hit different from the other biological phases of womanhood. While menopause is a health reality for 100 percent of midlife women and a majority will experience disruptive symptoms, it is a surprisingly quiet marketplace in America. Women who look for menopause care are often left unsatisfied.

After my 40th birthday, my fate soon involved jolts of suffering from anxiety, insomnia, memory loss, hair loss, hot flashes, joint pain, erratic periods and more. I began to feel unsteady, insecure and stupid in moments I did not want to be.

I was slowly losing my A-game at work and home. I was also no longer in the mood to slip into or out of a little black dress. I didn’t realise that what I really needed was menopause care.

Menopause support that lets women down

Both my Ob-gyn and I should have known I was coping with the insidious symptoms of the estrogen-depleting menopause, but instead the focus was on my thyroid. While the average age of menopause is 51 years old, the trickiest multi-year phase leading up to it is called ‘perimenopause’. I had no idea what the hell that was or what it meant for me in my forties.

I was surprised to learn I am not alone in my ignorance. Survey after survey has shown many midlife women are dimly aware of menopause symptoms in this 21st century. The how’s and why’s this fact is possible is wrapped up in old-fashioned sexism and ageism.

An invisible phase of life

Through all the physical and mental pain of puberty and pregnancy that I experienced in my younger years, I took pleasure in knowing society, pop culture and corporate America understood me, or at least tried. I was ‘seen’. They spoke to my heart, my needs, and especially to my young, tiny wallet.

As for mainstream support of American women in menopause, it is fair to say the support dries up. I did not know what to expect beyond the end of periods and fertility sometime in midlife. I worried less about the stereotypes of menopausal women as irritable, lamebrained and super horny or not. I expected to become more self-conscious much later. The Golden Girls TV sitcom in the 80s were my only role models.

But the times are changing, and the US is aging. The first women of the millennial generation turned 40 this year, and I do not expect they will accept the menopause silence as the status quo.

The missed menopause opportunity

It is foolish to treat menopause as barren ground. Instead, it is a rich land of opportunity. The Female Founders Fund reports that healthcare treatment for menopause’s vascular motor symptoms alone is a $600 billion market on the worldwide horizon.

British women leaders get it. They’ve been exposing the menopause truths with an effective Make Menopause Matter campaign that launched in 2018 in the U.K. Their government, healthcare industry, school system and major companies are responding with outspoken support.

If American women today go searching for menopause support, they’ll find a drizzle of passionate health experts and businesses devoted to solutions. But it takes effort and patience to find the right help and menopause support from the medical community.

From the start, I spent thousands of dollars for my menopause-related care pertaining to brain function, mental health, sleep, energy, sexual health, skin and beauty, spirituality, education and more. (The ‘more’ involves two sweet cats.) No menopause expert or brand successfully reached me with their limited marketing resources. I found solutions only through loads of research and many conversations.

Finding the right menopause health counsel 

I had wasted money and time on doctors who paid little mind to menopause before I discovered a menopause center with a team certified by the North American Menopause Society (NAMS).

I am one of the fortunate women for whom menopause support is accessible. Outside of big cities, these experts are hard to visit for most American women. Telehealth companies such as Gennev are making menopause pros more accessible, though it would also be ideal if menopause clinics could be found near every Target or Walmart (or wine retailer or cat café).

Mixed messages on HRT

I was most overwhelmed by the conflicting science and opinions reported on the safety of hormone replacement therapy (HRT). The NAMS 2017 position on HRT gets little attention. Meanwhile, the U.K. has experienced a shortage of HRT due in large part to greater awareness and a higher demand. I am fortunate to be a good candidate for HRT, which diffused my symptoms and got me back into that little black dress kind of vibe.

Make menopause matter in the US

Perhaps healthcare professionals would be more willing to become menopause-certified if menopause became in vogue. Modernizing menopause is a noble calling for pop culture, corporate America and government.

What if entertainment media and Hollywood were to cast menopause as an unforgettable plot or sub-plot in bestselling novels, award-winning screenplays and documentaries? What if major companies and brands that market to midlife women did their part to raise awareness? What if beauty brands better educated about skin and hair needs during estrogen depletion? What if venture capitalists funded menopause-centric services and brands?

Midlife women speaking out

What if more midlife A-list celebrities would publicly acknowledge menopause and campaign to end the silence? Michelle Obama made media waves in 2020 when she spoke her truth about menopause. She should keep talking.

What if major employers begin to offer free menopause education and coaching, and health benefits to cover perimenopause exams? Could this action help increase the number of women leaders in the C-suite or increase women’s longevity in the workforce?  And could this mission gain government’s investment in more research and education for midlife women?

More support for women

Women need communities they can trust. Hundreds of thousands of women join private menopause Facebook groups for support and advice out of fear they are losing their ever-loving minds. Healthcare voices are absent in most discussions. What if this could change?

It will take an outpouring of support and education to normalize and monetize menopause. So who’s in? 

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