The Fight for Midlife and Menopausal Health is Essential to Reproductive Rights—and Democracy

By Jennifer Weiss-Wolf

One week into the Trump presidency, attacks on reproductive health and rights have begun.

The administration reinstated the “Global Gag Rule,” banning aid to groups abroad that discuss or provide abortion. Twenty-three individuals convicted of violating the Freedom of Access to Clinic Entrances (FACE) Act were pardoned. Among the blitz of Inauguration Day executive orders, “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government” conspicuously incorporates the vernacular of fetal personhood, a central legal strategy for enforcing a federal abortion ban. Simultaneously, federal health agencies are dealing with an alarming order to halt external communications, stymieing the flow of crucial information to the public and stalling timely review of research grants.

Against this backdrop, it may sound surprising to hold out hope for the immediate future of any women’s health issue. But I think menopause may be an outlier.

Perhaps you’ve seen the headlines: menopause is having a moment, from this month’s new tell-all books by Brooke Shields and Naomi Watts to viral clips of Halle Berry shouting from the steps of the U.S. Capitol: “I’m in menopause, OK?!” Commitment goes well beyond celebrity moments and includes notable support from public policy leaders across the spectrum—Democrats and Republicans in Congress, and in blue and red states. These prominent voices are part of a new wave of recognition that menopausal women deserve to make informed choices about our bodies. Just as the fight for reproductive rights is an essential tenet of any free and fair democracy, so too is autonomy and health at this life stage.

Enter A Citizen’s Guide to Menopause Advocacy, a new digital resource featuring a dozen leading health experts. (I am a co-author of the Citizen’s Guide, together with Dr. Mary Claire Haver; Maria Shriver wrote the foreword.) Our goal? To mobilize everyday people failed by the nation’s longstanding lack of investment in and commitment to mid-life and menopausal healthcare. In the words of leading neuroscientist and Citizen’s Guide contributor Dr. Lisa Mosconi: “Menopause remains one of the most under-diagnosed, under-researched, under-treated, and under-funded fields in medicine. We owe women centuries of research.”

Women’s representation in scientific research has been historically woeful. (Up until 1993 there were no laws requiring that women be included in clinical trials.) According to the most recent National Institutes for Health (NIH) annual budget review, less than ten percent is dedicated to women’s health, according to an analysis by National Academies of Sciences, Engineering, and Medicine. The first year the NIH ever tracked its menopause-related spending was 2023. The total amount? Just over one percent.

The Citizen’s Guide details federal opportunities that remain ripe for action—especially now. Among these:

• Even if the White House Women’s Health Research Initiative, launched in 2023, becomes a casualty of future executive orders (it remains intact as of this writing, though the public link to it is inaccessible), it has catalyzed nearly a billion dollars in investments already underway, including grants awarded by the Advanced Research Projects Agency for Health Sprint for Women’s Health, and a Department of Defense commitment of $500 million to menopause and women’s midlife research among Service members, veterans, and beneficiaries.

• Congress continues to have an important role to play. Halle Berry’s above-mentioned star turn on the Hill was to join a bipartisan cadre of U.S. Senators introducing the Advancing Menopause and Mid-Life Women’s Health Act of 2024, which would advance critical educational initiatives, in addition to funding for research. Support for the bill may be stronger this session with the addition of Sen. Lisa Blunt Rochester who championed one of three companion bills in the House last year.

• Among federal agencies, the U.S. Food and Drug administration (FDA) could enable a simple but meaningful and long-sought menopause reform: removal of an outdated, inaccurate warning label requirement that impedes usage of a safe, cost-saving treatment, and even life-saving treatment, vaginal estrogen. (Check out the Unboxing Menopause campaign for more information.)

The Citizen’s Guide also points to state and municipal leadership opportunities. As of 2024, the Louisiana legislature became the first in the nation to mandate Medicaid and private health insurance plans to cover perimenopause and menopause treatments. A year prior, Illinois lawmakers required the same for women who have undergone hysterectomy; a 2024 amendment to the law will expand coverage under all circumstances, going into effect January 2026.

All of this is hardly a niche interest or weak consolation prize. Menopausal women are a contingent 75 million strong in the U.S. and entitled to accessible, competent care and treatment. We have every right to demand lawmakers and political leaders invest in our well-being, our dignity, our humanity. And we know that when we fight for ourselves, we also fight for our daughters.

The above reforms have bipartisan support and go a long way in serving women and families. The Citizen’s Guide itself is written and designed to engage everyday people. I dare say it: This is what democracy looks like. We owe it to ourselves and to generations to come not to back down from these priorities and demands.

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Jennifer Weiss-Wolf is executive director of the Birnbaum Women’s Leadership Center at NYU School of Law.