October 29, 2021

Menopause Mindfulness: Calls for Research Funding and Addressing Stigma Related to Menopause

Older women laughing with yoga mats

In recognition of World Menopause Awareness Month in October, the Society for Women’s Health Research (SWHR) on October 26 hosted a virtual congressional briefing, “Menopause Mindfulness: Exploring Menopause’s Effect on Health and Well-Being.” Moderator Claire Gill, chief executive officer of the Bone Health and National Osteoporosis Foundation and founder of the National Menopause Foundation, was joined by panelists Pauline M. Maki, PhD, professor of psychiatry, psychology and obstetrics and gynecology and associate dean for faculty affairs at the University of Illinois at Chicago and Arianna Sholes-Douglas, MD, FACOG, founder and medical director of Tula Wellness and Aesthetics. During the event they shared information about menopause, including the current state of menopause research, the health risks for women during this life stage, the stigma often associated with menopause and aging, and social and workplace support needs.  

Menopause—marked as the point in time 12 months after a woman’s last menstrual cycle, generally in her 40s or 50s—is a natural life stage that all women will encounter after a certain age. It is also associated with increased health risk for cardiovascular disease, stroke, osteoporosis, and other health conditions. Yet, there is limited understanding of the impacts of the menopause transition on women’s health and research has documented a lack of discussion surrounding menopause, leaving room for growth among employers, policymakers, and the general public. 

With approximately 95% of women in the United States projected to live past age 51 (the average age of menopause), and 6,000 U.S. women reaching menopause every day (totaling to 2 million women a year), there is an immense need for increased menopause research funding and broader education, Dr. Maki stated at the start of the event.     

Typifying how menopause is often overlooked, particularly when considering the treatment population, panelists noted that menopause is not included among the nearly 300 categories in the National Institutes of Health’s (NIH) Research, Condition, and Disease Categorization (RCDC) System, which is how NIH categorizes and reports the amount it funds across research areas each fiscal year. Beyond its absence in the RCDC system, Dr. Maki noted that menopause is generally underfunded in research. One research gap discussed by all panelists was the need for additional research on and treatment for vasomotor symptoms (VMS), including hot flashes, the “hallmark symptom of menopause.” Notably, research shows there are stark racial and ethnic differences between how long a woman may experience VMS, with white women averaging 6.5 years from the onset of menopause, Latina women averaging 8.9 years, and Black women averaging 10 years. Research is needed to understand why, and how, these variances affect certain populations differently and disproportionately.  

According to Dr. Maki, lingering misconceptions and fears about hormone replacement therapy (HRT) risks from the Women’s Health Initiative (WHI) study from 2002 is one of the factors affecting limited research funding on menopause. She noted that though the trial’s initial results showed HRT had more detrimental than beneficial effects, a reanalysis of the WHI showed the use of HRT in younger women or in early postmenopausal women had a beneficial effect on the cardiovascular system and could address parts of VMS. Despite the updated results, hormone therapy use dropped across the United States and now requires renewed researcher and clinical attention, panelists concluded.  

The lack of public awareness about the menopause transition and the insufficient research and development of menopause-related treatments has a real-world impact. Dr. Sholes-Douglas, in her presentation, noted the stigma surrounding menopause and the lack of medical training on the topic of perimenopause and menopause. An obstetrician-gynecologist herself, Dr. Sholes-Douglas realized “society’s viewpoint was skewed” when she didn’t recognize she was going through perimenopause. From a societal perspective, Dr. Sholes-Douglas noted that the stigma, coupled with symptoms such as sleep disturbances, can affect women’s productivity at home and at work, creating a sizable economic impact. Globally, menopause-related productivity losses can amount to more than $150 billion a year, on top of the cost to the health care system and each individual patient, Dr. Sholes-Douglas stated. Panelists agreed that an effective way to address such stigma, in addition to research funding and employer support, is increasing awareness and improving education on menopause. Educating the general public, with specific attention paid to providers, medical students, women, and girls, about the symptoms and effects of menopause may help combat the adverse outcomes and lack of knowledge many women undergoing the menopause.  

View the menopause briefing event recording in full here.