Feeling Nervous About Menopause? These Trailblazers Are Here to Help
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Around the time I turned 12, I became a part-time puberty detective. Determined to intercept my first period before it caused embarrassment worthy of YM magazine’s “Say Anything” column, I hunted for clues that it might be imminent whenever I peed. I will never forget the day I ran triumphantly into my mother’s bedroom after a particularly exciting sleuthing episode, only to discover that she had removed red toenail polish that afternoon and forgotten to flush the Kleenex. I swear I physically deflated as she broke the news.
Growing up, “period talk” found plenty of airtime in my life. My mother gave me What’s Happening to My Body Book for Girls, by Lynda Madras, which I pored over for hours at a time. Friends remember doing the same with Are You There God? It’s Me, Margaret, by Judy Blume. At sleepovers, the main activity among my pals was discussing puberty in all its forms. We liked to sit on our sleeping bags and take polls: “Raise your hand if you’ve had your period.” “Raise your hand if you have any pubic hair.” “Raise your hand when I say your bra size: Double A…A…Double B…”
Yet 25 years later, I somehow stand on the precipice of perimenopause (or what Suzanne Gilberg-Lenz, MD, author of Menopause Bootcamp, calls “the puberty of midlife”) without ever having had a conversation about it.
Style icon and menopause activist Stacy London, who founded the wellness line State of Menopause, says the seed of this aloofness gets planted in sex education curriculums. “Puberty is just round one,” she says. “If we taught people about menopause as younger individuals, even if we were just talking about it contextually as part of the life span of hormonal health, that would go a long way to normalizing this conversation.” Instead, like just about every other woman my age, I learned nothing about menopause as a teenager and, inexplicably, learned nothing again when I went through pregnancy in my late 20s and early 30s. And somewhere along the way—possibly while living through the tumultuous years of my mother’s hot flashes and mood swings—I added perimenopause and menopause to the mental list of phenomena I’d convinced myself would never happen to me, right up there with death.
Why menopause has always been taboo
In a recent global IPSOS survey, men and women rated menopause as the “least comfortable” conversation topic of 11 choices (including aging and finances). To fully understand why requires examining centuries of society’s shaming of “women’s issues,” says Monica Christmas, MD, director of the Menopause Program and the Center for Women’s and Integrated Health at the University of Chicago. It’s also worth scrutinizing the current state of medical training in America: Twenty percent of primary care, family medicine, and OB-GYN medical trainees say they have never attended a menopause lecture in residency, and only 8 percent say they feel adequately prepared to manage women’s experiences of menopause, according to a 2021 survey by the Mayo Clinic.
Gilberg-Lenz sums up the problem: “We don’t talk about menopause, because misogyny and ageism had a baby—and it’s called menopause. So many women feel that they will become invalid, invisible, and irrelevant just by existing on the planet past a youth-oriented expiration date,” she says. But she also shares an important caveat: “As women, we have a choice to accept that narrative or reject it.”
The loud, proud menopause movement
A few weeks ago, I sat in a sleek event space in the West Village crowded with more than a hundred well-heeled women in their 40s and 50s. We were all there for the New Pause Symposium, a day of lectures, conversations, and interactive exercises for women stepping into midlife, the long scope of time when women will first experience perimenopause (which refers to the years during which we transition to menopause) and then officially hit menopause, which officially kicks off after not having had a period for one year. As the hours ticked by, attendees danced, cried, laughed, screamed, and even thrust and ground their pelvises through talks on sexual health, the mental load, friendship, and the power of estrogen. The actress Naomi Watts, who recently released a menopause wellness line called Stripes, served as cohost.
Just a few days later, I witnessed another significant menopause moment: At the first Menopause CEO Summit in Dumbo, Brooklyn, an effervescent Stacy London hosted 16 CEOs from 14 different menopause-centered skincare, haircare, and wellness brands, including Wile, cofounded by another celebrity, the actress Judy Greer. The event was a chance for leaders in this space to share their missions and to mingle with reporters, investors, medical professionals, and menopause activists. London told me that selling products is secondary to her bigger dream: changing the menopause narrative for future generations. Dismantling entrenched stigma requires brands to work collaboratively, not competitively, which is why she invited her competitors to share the stage.
There are said to be at least 34 different menopause symptoms, including dryness, fatigue, hot flashes, insomnia, mood swings, memory lapses, and thinning hair (albeit only two, vaginal dryness and hot flashes, are medically sanctioned). State of Menopause products address a bevy of these. But more than helping women hydrate their brittle hair (which the Rich Hair Mask, $28, does beautifully) or relieve the discomfort of a hot flash (the job of the Cooling Spray, $12, made with peppermint and menthol oils), London wants to raise awareness of menopause’s impact on women’s mental health. When she discovered she wasn’t a candidate for estrogen, she created what she couldn’t find: products, expertise focused on nonhormonal therapy, and a community. State of Menopause, as well as other brands, host digital and in-person communities to help women connect with each other and with doctors and advisers in the industry. London regularly responds to questions sent in via DM on her Instagram channel @shopstateof, while Stripes hosts its community, The Hot Spot, on its website. Womaness, the first-ever menopause brand available at Ulta Beauty, runs a Facebook group called The After Party. On both, the vibes are inspiring and supportive—and no question is too blunt. Meanwhile, StellaVia, a menopause brand known for edibles containing botanicals like CBD, holds Instagram Lives with its three cofounders, Carol Mehas, a former beauty industry exec, Jessica Shepherd, MD, a gynecologist, and Allyson Shrikhande, MD, the chief medical officer of Pelvic Rehabilitation Medicine.
One of the big topics in these communities is the nonhormonal therapy options London was seeking. Turns out, even patients who can safely take hormones may prefer alternative treatment options. In a recently published paper in the journal Menopause, Christmas examined how women in menopause rate their quality of life. The data—pulled from the Study of Women’s Health Across the Nation (or SWAN)—revealed stark differences across racial-ethnic groups. For example, while white women who used hormone therapy had a higher quality of life than white women who abstained from it, Black and Chinese women who used it reported a lower quality of life than those who abstained. Those same communities also had higher reported use of complementary alternative medicine.
“As a provider, I must take that data into the exam room with me,” says Christmas. “I can’t assume that because somebody’s having symptoms that are bothersome to them, it means they want hormone therapy. I need to be able to talk to them and educate them on all the different options.”
The nonprofit North American Menopause Society (NAMS), of which Christmas is a board member, offers a menopause practitioner competency examination that sets the standards for menopause practice and helps the public identify providers qualified to advise on menopause-related healthcare. In 2022, approximately 300 clinicians (physicians, nurse practitioners, nurses, researchers, and others) have sat for the online test thus far. The pace of provider training pales compared with the rapid growth of the menopause wellness industry and the rate of American women entering menopause each year (estimated at more than 1.3 million).
“The vacuum of need for menopause support and information is so large that the sucking sound is almost audible,” says Stephanie Faubion, MD, medical director of the North American Menopause Society and chair of the department of medicine and director of the Mayo Clinic Center for Women’s Health. “These startups are filling that void. Consumers are demanding it.”
A few entrepreneurs who presented at the Menopause CEO Summit said their companies hope to provide education not just to consumers but to physicians, too—a somewhat controversial idea in the medical community, though some doctors are on board. Michael Satow, CEO of supplement producer Bonafide Health, told me that his company employs a national team that calls on mainstream doctors’ offices to speak about the research behind their products. (The brand’s latest, which Satow calls a “game changer,” is Clairvee, $55, an oral probiotic formulated to combat vaginal odor.) “It’s a high bar to get a busy, uncompensated mainstream physician to suggest a supplement. But that’s a big part of our strategy.”
Shopping the menopause marketplace
Beauty and big-box retailers have yet to designate an in-person or digital menopause section where customers can browse all menopause brands. Sifting through offerings in this booming category is too laborious for most consumers; most make their choices based on word of mouth or take mental notes in the bustling menopause communities formed on Instagram, TikTok, and Facebook. As you come across brands that interest you, Faubion suggests approaching them with a critical eye. “Women have to be savvy consumers and look at resources like the Mayo Clinic or the North American Menopause Society,” she says. Gilberg-Lenz, who has consulted on the brand Kindra, has a somewhat less cautious view of the shopping experience. “Whether it’s a beauty product or a telehealth platform, I think we’re grown-ups,” she says. “We can choose where we want to spend our time and money.” Shepherd describes the beauty industry’s influence as a net positive. “Often, the menopausal journey has been embarrassing, so we want to make the product experience delightful,” she says.
While reporting this story, I started to think more about the common symptoms women experience during perimenopause and realized that it can be hard to distinguish them from regular, stressful life. Was that restless night a one-off? Is this winter-is-coming dryness or the first sign of perimenopause? Unclear, although experiencing these along with irregular periods is a telltale sign that perimenopause has begun. The wellness products in the menopausal category can be helpful either way, and so I tried a dozen of them. I expected almost medical experiences (yep, menopause stereotypes die hard) but instead luxuriated in decidedly grown-up bubble baths, woke up to more supple skin, and found relief from cool mists. As I gently dragged the rubbery bristles of Better Not Younger's massaging comb over my scalp after a long day of working and parenting, it hit me that pampering is one element of perimenopause that I don’t mind anticipating. The prospect of developing even deeper friendships, joining a rock-star community, and feeling brave enough in my skin to dance in a room full of strangers is appealing, too.
I walked into the New Pause Symposium and the Menopause CEO Summit as an outsider who viewed perimenopause as “for other people,” but I left as a woman who has made peace with the fact that it’s coming—and knows that her detective work has just begun.
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