To the Editor:
Re “Menopause Should Not Be Such a Mystery,” by Melinda French Gates (Opinion guest essay, June 7):
Ms. Gates is right: Women deserve far better menopause care. But the crisis is not only medical. It is cultural as well.
For too long, menopause has been framed as decline, when human evolutionary history suggests something very different. Postreproductive women were not marginal. They were central to survival, knowledge transmission, food security, social stability and leadership. That is still true today.
Rhode Island has already shown us what the sort of cultural change we need can look like. Lori Urso, a state senator, helped pass the nation’s first state law requiring workplace accommodations for women experiencing menopause. That kind of policy matters because it recognizes what millions of women already know: Menopause is a work force issue, a health issue and a dignity issue.
Ms. Gates’s call for funding, education and workplace protections is exactly the kind of leadership this moment requires. Now we must go one step further and change the story itself.
Christopher Henze
Cliffside Park, N.J.
To the Editor:
Melinda French Gates’s $215 million commitment to women’s health is monumental, and her call for more foundational research is deeply welcome. However, her narrative misdirects public frustration by framing the crisis as a failure of medical training and physician initiative.
As an academic faculty member and a practicing physician, I must emphasize that the bottleneck in menopause care is not a lack of clinical will and caring. We cannot teach what is not yet scientifically proved, nor can we ethically prescribe medications that lack robust safety and efficacy data.
By framing this data gap as an institutional shortcoming of doctors, the narrative inadvertently erodes public trust. This suspicion drives vulnerable perimenopausal patients away from evidence-based clinics and straight into the hands of unregulated private equity operations and social media influencers.
Philanthropy should view physicians as ready allies, not as barriers. To truly revolutionize menopause care, the narrative must shift from blaming the clinicians on the front lines to acknowledging that we are all waiting for the foundational science.
Joy Zia
Seattle
To the Editor:
Melinda French Gates is right that menopause care in America is in crisis, but that crisis does not begin at midlife. It comprises the full arc of a woman’s hormonal life — from the first period to the last.
For millions of women, that arc includes an array of common conditions — including premenstrual syndrome, endometriosis, adenomyosis and premenstrual dysphoric disorder — that the medical system has never taken seriously enough to study rigorously or treat consistently.
And the change that is needed will not be complete until it extends to social media platforms as well. Language describing the female body is often flagged and blocked by algorithms and adult content filters. Platforms that govern what public information travels online often suppress medically accurate content about menstruation, fertility and hormonal health.
More than 600 women’s health leaders recently signed an open letter documenting the systematic removal and restriction of educational women’s health content on major social media platforms — a problem significant enough that the British Parliament debated it in May.
Women are already being failed by the medical system. They should not also be failed by their feeds.
Terry Chang
New York
The writer is the founder and chief executive of Two Moons Health.
To the Editor:
Melinda French Gates calls for workplace protections modeled on pregnancy leave, public education campaigns and women speaking openly about their experiences. The medical case she makes is real, but the workplace strategy is not.
A woman I know, one of the sharpest people in her organization, opened a meeting by telling the room she was going through menopause and experiencing morning brain fog, which was why she could not answer a C-suite leader’s question. I watched the information land and the temperature change. Whatever she hoped to accomplish, she had successfully handed people a vocabulary they did not need and would inevitably use against her.
In environments already looking for reasons to move expensive senior women out, publicly naming specific symptoms does not build accommodation. It helps create a taxonomy to justify an anticipated decline.
G.G. Moitra
Boston
