NOTE: a number of the articles cited have paywalls, so I linked them to open archive.is sites. You can click and get there from here…

For decades (well, centuries, really), menopause was not considered a topic for discussion, much less an issue to be addressed medically for half the world’s population that goes through it. Menopause brings with it a lot of physical and emotional changes and health risks that have not been acknowledged, understood or treated. Women have had to suffer with little or no support. No news there.

Fast-forward (very fast–past the development, backlash, misinformation and correction periods for the use of hormone replacement therapy — HRT; read more about it here and here) to now: 2026.

Menopause and perimenopause are now the hot topics for social media influencers, podcasters, writers, and telehealth companies. You can look here for a list of the top 70 (Why 70? no idea) “menopause influencers of 2026”. Tressie McMillan Cottom, social scientist and NY Times critic wrote here last month “Ladies, we’re entering our Crone era. It’s about time.”

In that same publication, Melinda French Gates noted:

Our society’s approach to menopause and perimenopause reflects the deep flaws of a health system that has long treated women as an afterthought. Consider the staggering fact that, according to one survey, less than a third of American OB-GYN residency programs offer a menopause curriculum of any kind.

We need a menopause revolution in this country. Better training is an obvious place to start. By including menopause care in both foundational and continuing education for health care practitioners, we can equip more of them to support their patients. Medical schools and residencies need to embed menopause care in their curriculums, and accreditation bodies and licensing boards need to make it a required part of training — not just for OB-GYNs, but for anyone who treats women in midlife.

And Cottom readily concurs, pointing out the intersectional health disparities experienced by non-white women:

Unfortunately, those greater expectations [of increased research and clinical care] have not necessarily resulted in a consistent, effective women’s health care system. Most women experiencing menopausal symptoms still do not receive any medical treatment for them. As is often true, that bad news is even worse for Hispanic and Black women. Despite entering menopause earlier and having more health-related consequences (like fibroids), Black and Hispanic women are least likely to have medical support for menopausal symptoms.

So, isn’t it a good thing that the podcasters and the social influencers are spreading the word? Isn’t it a win for healthcare equity and access that telehealth companies are offering a variety of new treatments and approaches to managing the symptoms of perimenopause and menopause?

Well, it’s complicated.

In a JAMA Women’s Health article from last month (newsflash: JAMA started a Women’s Health journal. In September 2025. Uh, better late than never?) Kate Schweitzer writes that the “explosion of products and providers following decades of neglect represents a long-overdue investment—a gold rush fueled by growing awareness and demand for better care.” But, she warns that it has”created a rocky menopause landscape akin to the lawlessness of the Wild West, in which bold claims often reach patients before clinical evidence does.”

I couldn’t agree more. We are being pummeled with ads for products that promise no more hot flashes, less fatigue and brain fog, easier and better sex, and (Content Warning here) even no weight gain (as if that’s the worst thing that can happen to a 40- or 50-something year-old woman).

Using another favorite Wild West theme, Stephanie Faubion, MD, MBA, medical director of the Menopause Society and director of the Mayo Clinic Center for Women’s Health, cautions us:

“The pipeline has expanded significantly, and that’s a good thing,” Faubion said. “But you have to consider when it’s not actually creating value for these women.…You’ve got a lot of people out there selling snake oil, too.”

I’m happy to report that snake oil was outlawed after the passage of the Pure Food and Drug Act of 1906 (thanks, Wikipedia, for the info!), but for reasons way above my pay grade, not in my area of expertise and utterly beyond my ken, current US telehealth companies are not regulated such that we can trust that the products they market are 1) tested; 2) effective, or 3) safe.

Hence the Wild Wild West talk.

If you’re interested in a deeper dive into current and emerging interventions for menopause, read the JAMA article; it’s got evidence-based information on what we do and do not know about them.

Here’s my bullet-list takeaway:

• In addition to the much-tested HRT, there are compounded hormones, testosterone therapy, and loads of untested supplements on the market.
• Influencers are out there extolling the virtues of every potion you can imagine, backed by slim to no evidence.
• Telehealth is offering to fill the gaps created by lack of access to primary care, offering similar potions from non-medically-trained folks with little to no evidence basis.
• Dr. Nanette Santoro, an investigator on many studies over decades with the Women’s Health Initiative, summed it up: “What this [boom in menopause treatment products] does is it tells people, ‘You can get ahead of this curve,’” she said. “But because we don’t have enough good evidence, it’s really saying that you are being part of an experiment.”

All I’m saying is, watch your back out there, okay, pardners?