Beyond Politics: A Citizen’s Guide to Fighting for Better Menopause Care with Jennifer Weiss-Wolf
Show Snapshot:
Frustrated with menopause healthcare? You should be. Menopause is undertreated, underfunded, and under-researched. Channel your outrage into action with a game-changing conversation on making your voice heard!
Women’s health advocate Jennifer Weiss-Wolf, who has partnered with Dr. Mary Claire Haver, Maria Shriver and many of the country's leading menopause experts, walks us through "The Citizens Guide to Menopause Advocacy"—a free digital playbook for change. Discover six simple ways you can help fix a broken system (did you know menopause research gets less than 1% of health funding?!) and learn how everyday women are already driving major change in states across the country.
Whether you're struggling to find a knowledgeable doctor, shocked by treatment costs, or frustrated with mixed messaging about optimal care, you'll learn simple ways to fight for the healthcare women deserve.
No policy experience? No problem. Busy schedule? They've got you covered. Make your voice heard, whether you've got 5 minutes or 5 hours to spare. No politics, no complex jargon—just clear steps to better healthcare for all. Time to turn your menopause frustration into real change!
Download the Free Guide
Transcript:
Katie Fogarty [0:03]
Welcome to A Certain Age, a show for women who are unafraid to age out loud. I'm your host, Katie Fogarty. Beauties, we are living through a time when women's rights are under attack and investment into healthcare research continues to shrink, but we are bringing you something different today—a conversation about an issue that transcends political divides.
Today, we're joined by lawyer and women's health advocate Jennifer Weiss-Wolf. We are cracking open her digital Citizens Guide to Menopause Advocacy, which is a practical, actionable road map designed to share simple steps for busy people like you and me who want to create real change in the menopause healthcare landscape.
This project brings together a truly extraordinary coalition of top voices, including award-winning journalist and Alzheimer's advocate Maria Shriver and Dr. Mary Claire Haver, author of the number one New York Times bestseller The New Menopause. Jennifer has assembled a team of leading women's health experts and advocates like Dr. Sharon Malone, Dr. Lisa Mosconi, and Dr. Judith Joseph. Together, they have identified six key policy goals that can add up to better, more equitable healthcare. And best of all, they are sharing simple, clear, concrete steps that you and I can take to call on our local, state, and federal leaders to improve women's healthcare, no matter your political beliefs, no matter your busy calendar and time constraints, no matter if you are new to policy work or advocacy. You are going to learn exactly how you can be part of this transformative movement. Ready to take action to shift the needle? This conversation is for you. Welcome, Jen.
Jennifer Weiss-Wolf [1:53]
Hi. Thank you so much.
Katie Fogarty [1:56]
I am so excited. You're returning to the show. You came on and walked us through five ways that the Women's Healthcare Initiative back in 2022 continues to impact our menopause experience. You have been a leading voice in women's reproductive health issues and policy advocacy for a long time, and I'm so excited that you've created this really user-friendly guide to help us all get involved. So I appreciate you coming back on the show.
Jennifer Weiss-Wolf [2:21] I am so glad to be here. And there is a lot to talk about.
Katie Fogarty [2:25] There certainly is. I want to start by talking about something that I saw in the foreword. Maria Shriver, who I called out as being a leading sort of healthcare advocate, a longtime journalist, she says in her foreword that women make up over 50% of the population. We live with more chronic diseases than men, but Women's Health Research has historically been allocated under 11% of the national health research budget. Maria Shriver says, quote, "This is scandalous and outrageous," and we agree, but we are ready to move from outrage into action. Give us a quick overview of how the Citizens Guide to Menopause Advocacy came to life.
Jennifer Weiss-Wolf [3:15]
Sure, and I'll actually reinforce that stat with not only has it hovered around that 10% mark, just in 2023 was the first time that menopause itself was assessed on its own in terms of its research allocation or research dollars allocation, and then it was less than 1%. So, yes, this is long overdue...
Katie Fogarty [3:36]
That's even more outrageous, Jen.
Jennifer Weiss-Wolf [3:38]
Yeah, I know, just to keep the mood appropriate. But the Citizens Guide is born out of that story. It's not just a "here, now, 2025 what is possible? What can we do? How do we all cope?" sort of in this very challenging moment. But it's a much longer-term agenda than that, and it's a much longer story than just, you know, the past year, the past two years, even the past 20 years.
But the Citizens Guide itself, it's kind of remarkable. It's a good parable in what smart, capable women can do when they set their mind to it, because I came up with the idea for the Citizens Guide in November of 2024.
Even further, sort of thanks to the politics at the moment, but I knew it was really crucial that people understood what they could do in the here and now. I did not want them to be thinking that just because we're entering a political era that is fraught, to say the least, that all the achievements and excitement that has emerged around menopause in the public discourse and as a public policy matter over the past year or two, was going to have to be waylaid or was going to be stymied in any way.
And truth be told, I think there are a lot of opportunities for menopause and some of these policy ideas in the here and now, if we mobilized for them effectively. But I really wanted to be able to communicate that quickly, and I really wanted to be able to communicate it to the people for whom I knew the message would matter, and that's all of the patients, that's all of the women, that's all of the people who've struggled to receive menopause care.
And I thought, who better to team up with than the doctors who see them, who know them, because those are the people who really, I think, once they have finally figured out their own menopause plan, how they're going to take care of their own health, and they discover that this is something systemic and that it is potentially solvable. They're the ones who want to take action. And those people can cross all political lines. It's really born of their own experience that they want to get involved.
So I reached out to Dr. Haver to tell her of this idea in November, and she was just all in. She got it. She understood that she not only agreed with the idea that we should be fueling policy advocacy and activism and bringing everyday folks into it, but she knew she had access to those people, because, again, they're the people she talks to on social media, and they're the people who she sees in her practice.
So together, really, over the holidays, we pulled together all of this text that I'd been drafting, and they'd been part of this book manuscript, and teased out what we thought were the six most feasible policy goals for the here and now, 2025, and 2026, and not only explain them in language that everyday people could absorb and digest, but tied them to direct action steps.
Katie Fogarty [7:27]
This is such a user-friendly guide. I want all listeners to know it's a free, digital, downloadable booklet. Jennifer will, in a minute, share where you can get access to it, but it features many of the top voices, many of the top doctors in the menopause and advocacy space, and 37 pages, and each one walks through a policy goal, gives you concrete steps and links to make taking action even easier.
It has a wonderful foreword by Maria Shriver. It has a wonderful note written by Dr. Sharon Malone. And the very last page is kind of like a take-action cheat sheet. It's a quick guide where all of the goals are quickly outlined with the 1-2-3 steps that you might take. Jen, where can our listeners download? We're in a minute, we're going to dive into each of these six policy goals, but I want to make sure our listeners know where they can download and get access to this Advocacy Guide.
Jennifer Weiss-Wolf [8:25] So the advocacy guide lives as a PDF document that can be accessed from Dr. Mary Claire Haver's website. I assume you'll put that in...
Katie Fogarty [8:34] Yeah, I will link out to that in the show notes on social when it's shared. And as you said, it's free to download, you don't have to subscribe, you don't have to put in an email. My goal for it, and our shared goal, was that it'd be a very democratic document. We want everybody to have access to it.
Jennifer Weiss-Wolf [9:11]
And I want to hop in for our listeners to say it's a very democratic lower case 'd' document.
Katie Fogarty [8:34] It's democratic in that it is accessible to democracy.
Jennifer Weiss-Wolf [9:17] Yes, that's actually a really important point. It's non-partisan. So I appreciate that.
Katie Fogarty [9:21] Yes, it is non-partisan in every way, and it's intended to be used in service of our grand democracy. Exactly. It's for everyone and for anyone. And I hope everyone's going to go check it out.
So we are going to walk through in just a minute, when we come back from our break, what these six needed policy changes are and a couple of the concrete action steps that people can take to get moving. We'll be back in just a minute.
Katie Fogarty [9:52]
Jen, we're back from the break. When we went into it, we said that the Citizens Guide to Menopause Advocacy is a free downloadable PDF. I'm going to link out to it in the show notes so people can get it. It's 37 pages. It's written in clear, layperson's language, so you can understand each of these needed policy changes, and they have very simple, concrete steps that you can take to get involved.
Let's start off with the number one policy goal, which is reset the record around menopausal hormonal treatment. This is foundational, right, which is why you begin with it. Can you share with our listeners why this is your starting point for advocacy?
Jennifer Weiss-Wolf [10:27]
As folks who are listening to this probably know, in 2002 the Women's Health Initiative, which was already a decade into its research exploration of some of the efficacy around menopausal hormone treatment, in particular for cardiovascular health, issued what was a jaw-dropping, mic-drop statement at the time through a big national press conference linking MHT to breast cancer rates among other health adversities.
And we know—and this conversation has happened in this podcast, in the media—that much of what was put forth was debunked. There's general agreement about everything that went wrong with that statement, but what there hasn't been since then is an attempt to right the wrong and reset the record. And it's really important, because it's like, what you think you know is what lingers in the back of your head, and without the might of the federal government making that kind of statement, it's really, really hard to go forward when everybody sort of has question marks hanging over every statement that they make.
Now I do, and I stand by that this is where we need to start, and I also recognize that we are now in some uncharted times when it comes to the roles of our federal agencies and the potential leadership of our federal agencies and people's belief in science and facts and political leadership when it comes to health.
So I don't have any false sense that this is an easy lift, but I think it belongs at the heart and start of everything that we're talking about, because it is foundational. We'll see as we go through the next policy steps that some of them are going to move, likely in quicker order than where we started. So I just want to be clear that just because number one is going to be potentially hard, if not less than possible, to achieve in the next year, that it still needs to remain our North Star and foundational goal.
Katie Fogarty [12:45]
100%. I was just in a room last week of 115 women. My high school asked me to moderate a panel on menopause, and within that room, the audience asked questions of the panel at the end. And it is 100% clear that confusion still exists about the link between HRT, also known as MHT, and breast cancer. So that the lingering fallout from that faulty interpretation of the science continues to impact women's willingness to engage with this potential modality for treating their menopause symptoms.
So if we are in agreement, if we would like to see a reset, a public acknowledgement that the science was misinterpreted and that there was this sort of fallout over this last two decades, what is an action step that a listener can take to move that goal forward?
Jennifer Weiss-Wolf [13:38]
Well, the action step that we name is literally to flood the lines and to make that known to the Office of Research on Women's Health that is part of the National Institutes of Health. You know, again, I'll caution that the NIH is having many challenges of its own at the moment, given presidential executive orders that are keeping certain information from being shared, that are enabling data to be scrubbed.
It's a rough time, and it's hard to imagine this really surfacing as a priority at that agency. But again, that doesn't mean we drop the idea and we drop the issue. We just go into it with eyes wide open of what's going to be possible. So we include the website, the phone number, the email address, and I think it is important for people to keep this as a top-of-line ideal. I would encourage people not to be discouraged if they don't see movement on this in the near future, because I'll be frank, that's not likely.
Katie Fogarty [14:41]
Well, make our voices heard. Hold it out as the North Star, keep going, and, I guess, continue to just advocate for what is needed. All right.
Policy goal number two: catalyze a modern, equitable menopause research agenda. Here we're talking about dollars. You outline the massive amount of money that gets allocated to research and to healthcare advocacy. There's also a massive inequity. Can you help us walk through the numbers?
Jennifer Weiss-Wolf [15:08]
So we started the discussion with just even this 10% stat that is allocated in terms of federal research dollars to women's health and the 1% to menopausal health. So that's probably where the clearest visualization of the inequity is.
But what is actually quite heartening is that over the past year, there has been significant attention to creating a more level playing field there and ensuring that research dollars are more equitably distributed. In particular, that emerged in Congress, where a bill was introduced in the US Senate that would call upon Congress to allocate... In that particular bill, it included $275 million allocation, and it's coupled with what was an executive order that was issued and signed by President Biden that called upon Congress to allocate another $11.5 billion to that for a total of $12 billion.
Where that all stands right now is that the executive order, first and foremost, is still standing. It hasn't been touched by the new administration, and it already allocated a billion dollars by the end of 2024 through various health agencies or federal health agencies or other agencies that still can direct research dollars, like the Department of Defense, for example, to the lives of women veterans.
So people should feel good that that work that started or that started to bear fruit in 2024 still has vast potential with dollars that have already been sent out and distributed, that the executive order itself is still in play, and that Congress, and in particular the US Senate and the bipartisan slate of US senators who introduced the bill—what's called the Advancing Menopause and Midlife Women's Health Act—are planning to reintroduce it this spring, and there will be a lot of opportunity to show your support for that legislation.
I think the fact that the executive order remains untouched is a good sign. I think the fact that even as the administration and the Office of Personnel Management ordered federal agencies to remove certain data and information pertaining to women's health, that the menopause pages at NIH still weren't touched during that time. I think that's good reason to believe that there is support for this agenda and that we can be the catalyst for advancing it.
Katie Fogarty [18:00]
Especially given the bipartisan support that you just outlined, this is an issue that crosses party lines. We all need to move this ball forward. In the guide, you quote neuroscientist Dr. Lisa Mosconi as saying that 130 million women use some form of HRT, but the effects of HRT on women's brains have never been studied, never right?
So we want to make sure that we can change that, and make sure that dollars are going to look into things that adversely impact women, like Alzheimer's, like cardiac impacts post-menopause, like women's osteoporosis rates and more. So if we want to make sure that research dollars—you know, what can we do to support? Is it weighing in for these bills? Is it calling a representative? What is an action item you recommend?
Jennifer Weiss-Wolf [18:45]
I think the key action item here is to urge your members of Congress, that is your US Senators and Representatives, to support the Advancing Menopause and Midlife Women's Health Act when it is reintroduced, and that's in the Senate, and then urging the companion House members to create comparable legislation in the House pronto.
If we really want to see any advancements on women's health this year, that's where we're going to see it. I think it's pretty clear that there are a lot of other areas in women's reproductive health in particular that are going to be off the table for progress. This is one where everybody should be encouraged, if anyone in any party wants to see this kind of advance. This is the bill to support.
I will add to that there are opportunities in state legislatures to move research dollars as well. We think of federal agencies and we think of the National Institutes for Health in particular when we think about research opportunities. But quite often state legislatures have oversight of state budgets that are directed towards their state university systems, and there can be everything from incentives to contests for innovative research that can be issued through state budgets by state legislatures to state university systems, which is in fact, where a lot of this research ends up taking place.
Same is true for clinical programs, and we'll get to that when we talk about the next goal, which is education. But we should not be discounting what state leadership can accomplish, always, and especially at a time where it could be harder to move anything federally, the states are clearly where we need to be looking.
So I would urge people to—and it's a lot easier to talk to, often, a state legislator. You know, you can call your member of Congress, and you might get a voicemail, you might get an answering machine, or you can send an email, and maybe you'll get a staffer on the phone with your state legislator. Chances are they're somebody. So you can really, actually have extraordinary influence in what could amount to millions of dollars. So I would urge people to think really creatively about talking to their state leaders.
Katie Fogarty [21:17]
That's wonderful advice. In my hometown on Long Island, our state legislators are very active. We see them regularly at events in the community. They show up at community organizing events. They show up at nonprofit organizations. So I think it's much easier to reach those people that you've put in office, that as a reminder work for you, and to make your voice heard on this topic. So that's a great recommendation.
Jennifer Weiss-Wolf [21:45]
I see my—one of my state representatives, Linda Rosenthal, Upper West Side New York City. I see her in Trader Joe's all the time. And we talk about this every time we run into each other over the frozen food aisle. We talk about menopause policies.
Katie Fogarty [22:01]
Well, first of all, I love that you're talking about the hot topic of menopause in the frozen food aisle, which feels very appropriate.
Jennifer Weiss-Wolf [22:07]
Or over the spicy chips.
Katie Fogarty [22:12]
I love it! All right, number three policy goal, I think this one is so, so critical. This is a policy goal that impacts every single one of my listeners, whether they know it or not, and that goal is update and mandate menopause education for providers. Walk us through this policy goal and why you see it as so needed.
Jennifer Weiss-Wolf [22:32]
People hear a lot of statistics that basically translate to like, one in five doctors has ever had any menopause training of any sort. It's generally not required through any avenue in which our providers receive their education and training. Through medical school, you know when they're studying textbooks, through their residency, when they're learning clinical practice, even through their continued professional education. Like many professionals, they have to get continuing education credits, and menopause is almost nowhere to be found.
And it's not just for OB-GYNs, which would be maybe the obvious place where people would think that menopause training is part of understanding the reproductive life cycle, but we know as well that in our real lives, it's not just gynecologists that we're going to for menopause symptoms at this point, when it is heart palpitations, when it's fractured bones, when it's brain fuzziness, that perhaps brings us to somebody who can provide that kind of care.
So for all of the disciplines that can touch menopause, part of what we are urging is that there needs to be training about the symptoms of menopause and about the efficacies of the kind of care and treatment that follow. It's a tricky policy agenda in that there are a lot of different oversight bodies, some of which are public, some of which are private, some of which are nonprofit, that oversee the kind of maze that is medical education.
But we boil that down to what the accrediting bodies are, and especially for people who are in the medical profession, whether you are a doctor, nurse, mental health provider or otherwise, how you can be an advocate for the kind of reforms that happen within the medical profession.
But in terms of where public leadership comes in, there are ways that, again, both Congress and state governments can be a nudge or have influence over where dollars are spent and how curriculums are invested in. So one example at the state level is that in California, just this past year, it is now permissible under continuing medical education accreditation programs that menopause training and menopause materials be included.
And folks probably know or seen or heard of the film The M Factor, and one of the producers of The M Factor, Denise Pines, was the genius behind getting that legislation passed in California. But that's something again, when you see your lawmaker, your state lawmaker, at an event or in the grocery store, that you can push them to do. There's now a model bill, because California did it. So take that and ask them to replicate that in your own state.
And in Congress, I will say that the same bill we talked about before, the Senate bill, the Advancing Menopause and Midlife Women's Health Act, has educational provisions in it as well to ensure that both public education in the form of PSAs and otherwise, as well as spurring more robust training for providers. That's baked into that bill too. So again, support for that bipartisan bill has the double punch of supporting both research dollars and educational standards.
And if I may, I just want to say one quick word about PSAs and then another quick word about state university systems. PSAs. I've had this grand idea for a long time. So if there are any PR folks or really creative folks listening, I'm calling on you for a partnership here. I have this weird vision that our generation, the generation smack in the throes of menopause right now, Gen X, we are the generation that was raised on PSAs, whether we called them that or not.
The question I'll always ask people my age—I'm going to ask it to you now, Katie, too—if you see an egg frying in a pan making really loud sizzling noises, what do you think of?
Katie Fogarty [27:03]
I think of "just say no to drugs," because this is your brain on drugs.
Jennifer Weiss-Wolf [27:07]
Yes, nobody who is our age who I've ever asked this question to has ever gotten it wrong. "Yes, this is your brain on drugs." We are a generation brought up to know that. We watched Schoolhouse Rock. We heard "Do you know where your children are?" We grew up on PSAs. Can you imagine the power of sort of old school, vintage, 70s, 80s style PSAs focused on menopause?
Katie Fogarty [27:35]
Jen, I have an idea for you that I'm going to tell you later. I have somebody that I can introduce you to. I'm not going to say her name on camera, but I have a great idea, and I'm going to share it with you when we stop recording.
Jennifer Weiss-Wolf [27:47]
In my advocacy career, I did this for menstruation-related policy and wound up pairing up with a leading PR agency and a big-time celebrity to do this tampon tax PSA that went viral. You know, the right agency who gets it could win lots of awards doing this, but I think about the reach it would have. It would get through to our generation. We are not the TikTok generation. We are the PSA generation, and that PSAs are baked into the Senate bill makes me very happy.
A budget for them, but we don't even need the budget. We can all put our creative brains together and make them go viral. But then the other thing that I want to add is that in addition to the California law, the new law that enables menopause to be part of continuing medical education, the other place where state governments and state budgets can be very influential is in state university systems.
There are some amazing university clinics at public and private leading hospitals around the country, the Cleveland Clinic, where Maria Shriver is a leading force, but everywhere from NYU to—and of course, now I'm blanking on universities, but I'm here at NYU. That's why that comes to my head. But the investment in the State University clinical centers...
Katie Fogarty [29:09]
We have them in every state. We have state university medical centers.
Jennifer Weiss-Wolf [29:14]
Yes, that's a really easy place for state governments to show their support.
Katie Fogarty [29:18]
And this is why it's so important. Again, I said earlier in the show that I was in a room of 115 women just last week. And another one of the questions that multiple women raised was, "How can I find a doctor who gets it? How can I work with a trained menopause specialist?" And the answer is, it's hard, even in a room full of 115 women in New York City, one of the biggest cities in the country with some of the best access to medical care. It's still hard to find a doctor because there's a shortage.
So when I said earlier that this policy goal is so critical, every single person listening wants to work with the best healthcare providers, and so it's really incumbent upon us to call on our federal government and our state government to make sure that we are training and educating future generations of doctors who can help with this need. So I love this.
Jennifer Weiss-Wolf [30:11]
Well, and that's where the university clinics come in. Not only are they great places to get care, they're often one-stop shops that have a lot of the threads of menopause covered. So it's not like you—even if you have a menopause expert as your doctor and but then you need to go see a cardiologist or a bone doctor—whose word is escaping my brain—an...
Katie Fogarty [30:36]
Orthopedist, maybe an osteoporosis doc, but yeah, they need a bone doctor.
Jennifer Weiss-Wolf [30:40]
At the clinics, oftentimes it's a one-stop shop, so a lot of that care will be available under one roof. And it's not just that you're getting the benefit of that care, but you're part of the training of the next generation. It's just like good on every level, and that is really a place where state university systems and the state governments that fund their budgets can have a real impact.
Katie Fogarty [31:07]
Phenomenal. We need a menopause eco-care system. Okay? So policy goal number four, and this one's a biggie as well: make menopause treatments affordable, right? Can I get an amen? We all want affordable, great healthcare. In the guide, you walk us through some good news on this front, which is terrific. There's some reasons for optimism, but you also identify the gaps and some of the failures. Can you give us an overview?
Jennifer Weiss-Wolf [31:34]
So the biggest gap right now, and it's not surprising when we think of the whole context of menopause and women's health, is starting from the WHI. The lack of interest in investment in MHT or HRT is part of this whole story, right? It's part of why education is flailing. It's part of why research has been neglected. It's also why the ecosystem that is both our regulation of these drugs and coverage of these drugs is so lacking.
I talk about it a lot in the book, sort of the different paths that erectile dysfunction medications and HRT have taken, leading to highly affordable, accessible, well-advertised—everything about it studied—ED drugs and the polar opposite for MHT. And one of the ways that plays out is in terms of affordability. They're not sort of produced in the forms that make them highly affordable, generic or otherwise. And they also are not uniformly covered by insurance programs, whether that is private insurance or whether you use your state Medicaid program and Medicare. There's not a universal path to coverage.
So one of the quick solutions to that has been state-specific, whereby we've now seen three states raise it: California, Louisiana, and Illinois, each in sort of a different way, and I'll tell each of their stories. But right now we have one state, Louisiana, which is again, kind of interesting when we think of red state, blue state politics, but Louisiana is the first and only state that requires that all menopause treatments be covered, both by private health insurance and public Medicaid coverage in the state.
Katie Fogarty [33:37]
Well, shout out for Louisiana. That is good news, and that is a reason to be optimistic. It's also setting a great example.
Jennifer Weiss-Wolf [33:43]
Yeah, I mean, where other things aren't going right there, that is one place where they've interestingly taken the lead. California passed similar legislation this year, but Governor Newsom vetoed it, not believing there was room in the state budget for it. So that's an advocacy lesson—to never assume that once you've passed the legislature that you're an easy sale through the executive signature. Very disappointing that he didn't sign it.
And then in Illinois, even more interesting story. In 2023, they passed a law mandating that menopause treatments be covered only for women who'd gone through earlier premature menopause on account of hysterectomy.
Little sidebar note of the way state politics work, going back to sort of like that local energy and the influence you can have. It is not uncommon in state politics for a lawmaker to have strong beliefs about something—and I'm using air quotes so you can't see it—only to change their mind when it happens to them, or they become aware of it when it happens to them.
So the Illinois story, if I had to guess, and I'm not saying this with knowledge, I'm giving an educated guess. Here is that there is somebody in the legislature for whom that was their family's experience. And then they became aware of the devastating impacts, often, of what it looks like to go through menopause overnight, and mandated treatment for that purpose, thankfully.
And that's, you know, it's not a bad start, and that was passed in 2023. Thankfully, a group of bipartisan women legislators in the state have now added a rider to that bill, amending it—or that now it's a law, amending it—so that as of January 2026, roughly a year from now, menopause treatments will be covered for all people who take them and need them. Again, similar to Louisiana, private insurance as well as state Medicaid coverage.
So those are sort of three different tales of how such advocacy could go down, I guess, maybe serving as both cautionary and inspirational to listeners. If you've not engaged in advocacy, there's no reason to think it's hard and terrifying, but to know that it involves sort of a thoughtful process along the way, that nothing is a given, that everything requires our attention, but it's a lot of promise that getting all 50 states to do this should absolutely be on our agenda.
There was a bill in Congress over a decade ago to do this nationwide, including for Medicare, Medicaid programs as well as private health insurance, and that bill hasn't seen the light of day since 2011. So I would also say it's high time we encourage our lawmakers on Capitol Hill to introduce it.
Katie Fogarty [36:34]
Jen, what is the role of telehealth in terms of making menopause care affordable and accessible? And what can we do as citizen advocates to help make sure that telehealth continues to be a thriving option?
Jennifer Weiss-Wolf [36:47]
Yeah, telehealth is such a—like a success story born out of the desperate circumstances of the pandemic, when we all suddenly couldn't leave our homes. There was a very quick pivot to telehealth. Not that telehealth didn't exist before, and I know a lot of the menopause companies that have created telehealth platforms were doing so before the pandemic, but I think it really was the pandemic that turned all of our—whatever hesitations we might have had about it. We all, to some extent, became believers.
But it wasn't just that people wanted to use it. It's that restrictions that the government had placed prior to how telehealth operated, and especially in terms of reimbursement and prescriptions and things like that, became loosened during the pandemic, so that it was feasible for everybody to use it, both patients to utilize it and providers to provide it.
So where we stand now is that there are federal restrictions that were loosened during that time and continued to be extended, and what I think we can all do as citizens, in addition to educating ourselves about how to best use telehealth for our own needs and purposes, is to also push our legislators, and this is in particular in Congress, to make sure that the ways that they eased the use of telehealth continue.
Most recently, it was part of the federal budget negotiation at the end of the calendar year in 2024, and one particular provision for usage of Medicare for telehealth was extended to the end of March of this year, so another six weeks. So keeping that high on policy makers and lawmakers' radar is very important.
I should add that it's had extraordinary bipartisan support, and without getting too political here, though, although some of this stuff is political, it is the associate of the president who has a lot of influence, it seems, in Washington, DC, Elon Musk, who was opposed to extending the telehealth loosened guidelines. So I don't know how that's going to play out, but lawmakers pushed back hard in December.
Katie Fogarty [39:13]
We are going to have to keep our careful eye on that, because telehealth services go a long way in democratizing—lowercase d—access to qualified providers in areas of the country where there just is a shortage, a dearth of people that you can see in person.
Jennifer Weiss-Wolf [39:32]
I would say that then keep their eyes... There's legislation referred to in the Citizens Guide that, again, you can show your support for, but I would say that when the budget process heats back up, which it's about to, making your voice heard on this particular issue is important, because it is likely going to be on the chopping block.
Katie Fogarty [39:53]
Okay, great piece of advice. All right, let's go to policy goal number five: make menopause treatments free of outdated warning labels. Now this is a topic that's close to my heart. Jen and I are connected. For anyone who's listening who doesn't know this, we both sit on the board of the nonprofit group, Let's Talk Menopause. Let's Talk Menopause has taken a lead in trying to unbox menopause, which is a national campaign to remove a warning label from local vaginal estrogen.
I have done a podcast episode on this where I had the great pleasure of being schooled by two leading voices on this topic, Dr. Rachel Rubin and Dr. Kelly Casperson, both of whom appear in this guide. I will definitely link out to that show, because it's truly a deep dive into the topic of vaginal estrogen, why it's important for our vaginal and bladder health, and why this current label exists. But I would love for Jen to quickly share a top line overview of this policy goal for anybody who might have missed that earlier show.
Jennifer Weiss-Wolf [40:55]
Yeah, I highly recommend Kelly and Rachel—doctors Casperson and Rubin—have influenced me enormously in my support for this. But the top line sort of backstory is prior to the WHI, more in like the 1980s and early 90s, when there was a lot of excitement for estrogen, both in terms of menopause treatments and in terms of the emergence of birth control pills and oral contraception in the 60s and 70s, a big push to ensure that there was careful information and warnings to women about estrogen usage, given what was and wasn't known at the time, and that is when warning labels on estrogen products first emerged.
After the WHI, there was an even sort of like tightening of what the federal government's idea was about what it meant to warn us of the dangers of estrogen, rooted again in the sort of misguided, miscommunicated study and findings. So at that point, around 2005, they made the warning label on estrogen products, including vaginal estrogen, which is...
Well, here I'm just going to say the warning label is very, very hyperbolic. It's scary, Jen, it's stated right to the worst possible outcomes of the miscommunicated study about a particular form of estrogen treatment. And it is applied to every form of it. And it's, you know, you've probably seen it, you can go take a look at yourself: probable dementia, all these things. Basically, it's like a skull and crossbones on it.
But the campaign we're talking about here that you just mentioned is specific to vaginal estrogen, which, if folks know, is applied and used topically. It doesn't enter the bloodstream. Not only does the estrogen warning label—I'm trying to think of the easiest way to say this—it's rooted in a completely different form of treatment, yet applied to vaginal estrogen, which is not systemic, which is not the version that was part of the WHI and does not share any overlapping considerations.
So the problem is that that warning label serves as a real deterrent, not just for people who are afraid to take it once they come home and see the warning label in the box, but even for doctors to prescribe it because they think it's true or they don't want to counter that language.
Katie Fogarty [43:46]
I've had numerous doctors on the show that say they hear from patients time and time again, "Why are you giving me this vaginal estrogen? I'm reading this warning label, and it's completely scary." And so it shows you the doctors who prescribe—and those are the doctors who prescribe it, who have the same reaction as the patients.
Jennifer Weiss-Wolf [43:59]
Yeah. So this campaign is basically—the FDA, the Food and Drug Administration, is the federal agency that has oversight of these warning labels, and they were responsible for putting it on and they can take it off. They're the only ones who can take it off.
So we are both part of a group that is organizing through the nonprofit, Let's Talk Menopause, a campaign that is called Unboxing Menopause. And it's a Citizens Campaign and signature collection that will be presented to the FDA to make the case.
To be clear, the FDA has been lobbied before for this and has shown that it's not willing to even understand the science behind it. They use a lot of like sort of continued misguided language and nomenclature. So we're just revving this campaign back up again that did not succeed in the mid-2015, 16 period of time, because there is so much better organizing and attention being paid to menopause. We think the time is right to reignite this campaign. So that is a really simple citizen step, which is to click on the link to the petition and sign it.
Katie Fogarty [45:25]
Absolutely. You can find that petition at letstalkmenopause.org. Okay. Policy goal number six: ensure meaningful workplace interventions. And again, this is a very critical step. We spend a large chunk of our days and our lives at work, in organizations, at corporations. What are you calling for here as a needed change, and what can we do to make sure that our workplaces support us during this life transition?
Jennifer Weiss-Wolf [45:56]
So this one is like sort of a different flavor of citizen engagement, in part, because there's a little bit less that we can do vis-a-vis lawmaking bodies. I will say that the biggest challenge that I see that needs reform when it comes to menopause in the workplace, is not just getting more workplaces on board to have effective accommodations and benefits and things that they offer—and the Citizens Guide points to places and articles and experts who really lay those out. So I will say that one thing that citizens can do is to take those to your own places of work, or if you run a company, to think about implementing those in your place at work.
But the thing that I worry about as a policy wonk is that we don't have very effective anti-discrimination law in this country, such that people will be protected if somehow they utilize these benefits and are still discriminated against or otherwise have obstacles or barriers to their success in the workplace.
So the response to that anti-discrimination law really belongs to some of the lawyers in the room and people who study and are experts in how anti-discrimination law could be applied, whether it's discrimination on the basis of pregnancy, on the basis of age, on the basis of disability. And there are legal scholars who are unpacking those questions.
And I just want people to be aware of that, because I don't think it's just as simple as "we need menopause policy in the workplace." Because not only is it, you know, we see that it's challenging to get companies on board, even though there's a lot of media attention and it seems to be a very trendy thing to do, it's still not the norm. But I do want people to be aware that that, in and of itself, isn't the answer or the panacea. That we actually need kind of a three-dimensional approach to ensuring that we're protected, also in the workplace, from discrimination.
Katie Fogarty [48:09]
Yeah, and the guide lays out a lot of great resources that you can spend time with to really bring yourself up to speed at what's being done well in other organizations. All right, so six great, needed policy changes, a wealth of ideas about how we can get in action and get engaged. What is next for the Citizens Guide to Menopause Advocacy, beyond downloading it, beyond coming to the show notes and getting it through the hyperlink? Where can our listeners engage with it? Where can they light their friends up about learning more about it? Sort of put us in action and how we could continue to engage with this content.
Jennifer Weiss-Wolf [48:45]
So there's a couple of ways that the content is having bigger life on the internet than in person. So I'll share some of those, and then flag some engagement opportunities coming up too.
So together with the providers who contributed, and you've listed many of them, Dr. Haver and I are planning to do some online workshops that anyone who downloads and has access to the guide will have access to a Zoom link to, and those will be scheduled, I think, for later in the spring and around the introduction of the Senate Bill, happening, I believe, next month.
There are also a few media outlets that have been terrific partners in continuing to distribute this and give it more audience. So Oprah Daily is doing so. Both Dr. Haver and I have written pieces about this for Katie Couric Media, and those articles are really good summaries and supplements to what's in the Citizens Guide and how we're each thinking about it now that it's been out in the world for a month.
So I think those are some really good resources. As you'd mentioned earlier, Maria Shriver contributed the foreword, and she, too, has an excellent media site, The Sunday Paper. So all of these places are places where you can get even more information and background and backstory about the ideas that are in the Citizens Guide, and what it looks like to be part of the movement advocating for them.
Katie Fogarty [50:25]
Phenomenal. It's so great to see those media properties really lifting this topic up, lifting these resources up. I follow all of them myself, and I can highly recommend it. And Jen does a lot of writing for different news outlets herself. She is contributing, as she said, she's written many for Oprah Daily and for Katie Couric Media. Maria Shriver—I also know that she works and writes for Ms. Magazine, and you shared with me before the top of the show that you're now contributing to another outlet, and I would love to make sure we put this on our listeners' radar.
Jennifer Weiss-Wolf [50:58]
Yeah, this one is super exciting to me. There's a kind of a slew of leading journalists, again, of all political stripes, who have left their outlets and mediums in sort of the in recent weeks out of concern of how their coverage of the state of our democracy is unfolding. And a lot of them have come together at a new Substack called The Contrarian, which I love the name because it gives you the opportunity to weigh in from many different angles. But it's really intended to be a site focused on democratic—little D—democracy values.
Jennifer Rubin, formerly of The Washington Post, and Norm Eisen of Brookings Institution created it, and interestingly, they were excited to have a women's health perspective reflected in their coverage. So I have been serving in a women's health contributor role. I actually did a piece on menopause policy there. I thought it was really important for that community, which is perhaps a little bit more wonky in the technocratic aspects of democracy, to be thinking about what women's health looks and feels like at this moment and really where opportunities remain. So much of what we talked about today, I wrote it for that platform too.
So there's a good menopause piece there, if you make your way over to that Substack, but it also has—you can join it for free, or there's paid subscriptions too, but there's a free subscription as well. So I'm giving my little plug for The Contrarian, which is a big favorite of mine these days.
Katie Fogarty [52:42]
Yeah, I'm going to link out to that in the show notes. I'm anxious to subscribe to it myself. As you know, you mentioned Jennifer Rubin, and she's a perfect example of somebody who was at The Washington Post, is a Republican sort of journalist. And so you can pull from all sides of the political aisle here to educate yourself about what's happening in our country today. It's so important.
And I think, honestly, to be a good menopause patient, you really need to educate yourself about all the resources and tools, which is why I was so excited when you shared this guide over email. I emailed you right back and said, "Come back on the podcast and talk about this." And I'm so, so thrilled that you said yes and have been walking us through this.
Before I let you go, though, I want to close with something that Maria Shriver says in the foreword to this digest. And she says, if we want, quote, "sea change"—and this is sea change like S-E-A, not S-E-E—"if you want sea change in the world, you must muster up the courage to get in the water and swim," which I love. But before I say goodbye, what are some final words of encouragement that you would share with our listeners about getting involved, diving in, and starting to swim?
Jennifer Weiss-Wolf [53:53]
I actually—I loved her sea change analogy in your question, because maybe you know or maybe you don't, and I'll share it here. My New Year's Day practice every year is to go swimming in the Atlantic Ocean at Coney Island as a way to start the year with a real jolt to my system.
Katie Fogarty [54:13]
Form of courage!
Jennifer Weiss-Wolf [54:16]
I can send you a picture. I've been doing it for a long time, and it's a personal practice and belief that I ascribe to that keeps me going. And it sounds silly to some people, you know, some people kind of make fun of it a little bit, or, like, what, you know, who would do that? And some people don't understand why I take it so seriously, like, I am convinced, like, the world will stop spinning if I don't do it.
But to make it more of a parable, I would say that for all of us, there's something like that that really motivates us, kicks us in the butt, keeps our perspective intact, keeps us humble, and keeps us fired up at the same time. So when she wrote that, it happened to be New Year's, right? Because we did this over the Christmas week. So I was so excited when she wrote that, because I was like, "Yes, I am diving into the water, literally."
So for everybody else, figuratively, it is, what is the thing that drives and motivates you? You can plug that into this menopause space. It is a very big tent, and there are a lot of opportunities for big changes and small changes. And I just really hope that everybody sees that. I feel that from listening to this conversation, I believe it, and I'm involved in a lot of different advocacy in my work life, my professional life, my personal life that runs issues beyond menopause. And menopause is the one where I really do sort of feel that—I feel it. I know that there is direction for us this year. There's too much that has happened in the past few years alone to think that it can and should just stall at the moment. So I'm not willing to let that happen. But it is in part because I go swimming on January 1 that I have that energy still now in February.
Katie Fogarty [56:09]
What a marvelous story. Oh my gosh. I love that story, Jen, but I'm so glad I asked it. What a marvelous note to end on. Big change, small change is possible. We can all drive it forward. You have a free 37-page downloadable booklet that spells out in crystal clear terms how you can get involved. So I'm encouraging everyone to download this wonderful resource to sort of be the change you want to see in the world. Jen, thank you so much for your time today.
Jennifer Weiss-Wolf [56:38]
Thank you. I'm so glad to be here.
Katie Fogarty [56:41]
This wraps A Certain Age, and this wraps a phenomenal conversation. Every single Monday, I am so inspired by the women who join me as guests. They share so much great information, tools, resources, inspiration to help us thrive during midlife. This show was no exception. Jen Weiss-Wolf is up to so much good in the world. Her Citizens Guide to Menopause Advocacy should be in the hands of more women. So please forward this show onto your friends. Please take just a few minutes to write an Apple Podcast or Spotify review, because your reviews help other listeners decide if a show is worth spending time with, and this show is worth spending time with.
Thanks for sticking around to the end. Thanks for being a fan of the show. Thanks for joining me every week. I see and appreciate you. Special thanks to Michael Mancini, who composed and produced our theme music. See you next time. Until then, advocate boldly, Beauties.