Crypto News: Bw Reads: The menopause boom is failing women

Welcome to Bw Reads, our weekend newsletter featuring one great magazine story from Bloomberg Businessweek. Today Kristen V. Brown writes about how the healthcare mainstream hasn’t kept pace with women’s midlife needs. You can find the whole story online (free) here. You can also listen to it here.

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When Yasmin Harris was in her early 30s, she began to suffer an array of perplexing symptoms. She had chronic urinary tract infections and always felt irritated. She was no longer interested in sex. One cold Colorado winter’s day, she found herself feeling so overheated that she went and stood outside on the porch, buck naked. But when she went to the doctor, all her labs came back normal. She received a prescription for antidepressants that she says didn’t seem to help. “I started thinking I was just crazy,” she recalls.

Harris, who works in IT, tried to white-knuckle these symptoms until one night in October 2022 when, while she was making pasta for dinner, her heart started pounding. Her father had died young of a heart attack; she feared she was having one too. At 39 she was diagnosed with congestive heart failure, her first indication of any heart condition, prescribed a cocktail of drugs and eventually implanted with a pacemaker. She was baffled. In a few years she’d gone from a healthy, happy woman to someone in a perpetual state of distress. Then her periods went haywire, lasting for weeks at a time. She began to suspect all those disparate symptoms weren’t random. When she typed them into Google, the results suggested she was in perimenopause. “It all came together,” she says.

Harris at home in Aurora, Colorado. Photographer: Jimena Peck for <em>Bloomberg Businessweek</em> — Harris at home in Aurora, Colorado.

Harris’ doctors disagreed. She was too young, they said. A doctor prescribed birth control to regulate her cycle and sent her on her way. So Harris did what many frustrated patients do and turned back to the internet for ideas. She sought solace from Reddit and advice from ChatGPT. She drank more water, ate less sugar and went for walks. She got a prescription for a compounded hormone therapy cream. In the course of about a decade, she forked over thousands of dollars, including for all kinds of supplements that popped up in ads on Instagram and TikTok: black cohosh, ashwagandha, something called Steel-Libido. “If I saw it, I tried it,” she says. If only any of it had worked.

Although women around the world live longer than men, they spend more of their years in poor health. This is partly because of differences in biology and partly because doctors and scientists just don’t know enough about how a woman’s body works, especially as it ages. That includes many medical specialists: A 2023 survey found that roughly 70% of responding OB-GYN residency programs in the US didn’t include any menopause curriculum.

Whether or not you’re through med school, here’s a primer. Menopause is a single day in a woman’s life, marking 12 consecutive months without a period. In addition to signaling the end of her childbearing years, it marks a whole-body change with sweeping consequences, including elevated risks of stroke, heart disease and osteoporosis. But the process of getting there can be a yearslong, confusing slog, as a woman’s reproductive system starts to behave more erratically. This phase is perimenopause (“menopause’s hot, cool little sister,” as comedian Amy Miller has joked), the infamous transitional era of hot flashes, night sweats, brain fog and mood swings.

Women have long been counseled about menopause through whisper networks, instructed to tough it out, or told nothing at all. In recent years, though, a swath of telehealth companies and influencers have begun promoting the power of modern remedies. Now everywhere you look, someone is blaming unruly hormones for another middle-aged ailment. Migraines? You must be approaching menopause. Anxiety? That’s menopause too. Weight gain, dry skin, digestive issues? Ding ding ding: menopause! Earlier this year, after Jennifer Lawrence scratched at her ears during an appearance on Amy Poehler’s podcast, Poehler told her that itchy ears are a sign of perimenopause. “Congrats, babe,” Poehler said, as the 35-year-old Lawrence’s jaw dropped in apparent horror. To be a middle-aged woman is to live in diagnostic suspense, perpetually one symptom away from wrestling with “the transition.”

Generally speaking, the gold standard for treating symptoms such as hot flashes and vaginal dryness is hormone therapy — a boost of estrogen (and, in some cases, progesterone) delivered commonly via pill, patch or cream. Evidence also broadly supports hormone therapy to reduce the risk of osteoporosis and to treat estrogen decline caused by early loss of ovarian function, and as an added bonus, it may reduce the risk of cardiovascular disease and diabetes. Many women also report that it relieves other symptoms, including anxiety. But a lot of things can look like perimenopause, including autoimmune and thyroid disorders. Experts continue to debate just how much midlife misery can be pinned on menopause and when medical intervention is appropriate. “Menopause is happening in parallel with one of the peak accelerated-aging moments,” says Jill Liss, an OB-GYN who specializes in menopause and an adjunct associate professor at the University of Colorado. “Hormones are so powerful and important, but they do not determine every health outcome.”

Liss, who has also recently signed on as senior medical director for the pharmaceutical giant Bayer, advises women who suspect they’re undergoing a menopausal transition to seek out an appointment with a doctor who’s conversant in evidence-based treatment options. Here, though, we return to the problem of supply. The Menopause Society, an Ohio nonprofit that offers education to US doctors, has through its exams certified roughly 5,300 medical professionals across the country as experts in midlife women’s health. That’s not nearly enough to serve the 1.3 million American women who reach menopause every year. Only 1.7% of US women age 40 and up used systemic hormone therapy in 2023, according to a Mayo Clinic study from June. Liss says her patients wait an average of six months to see her. Absent an army of new OB-GYNs, a massive industry of a different sort has sprung up to monetize all that midlife dread.

Now, instead of having no choices, women are confronted with a cacophony of products, providers and promises. The global market for menopause treatment was $18.7 billion in 2025, and it’s expected to reach $28.8 billion by 2033. Women spend more than $10 billion a year on nonmedical treatments such as supplements, according to an AARP survey, basically the opposite of evidence-backed therapies. The occasional utilitarian product, such as a symptom-tracking app that uses artificial intelligence to generate reports for a woman’s doctor to review, is far outnumbered by a morass of creatine powders, red-light-therapy vibrators and pricey empowerment retreats. “You’ve got everybody trying to get in on it,” says Monica Christmas, director of the Center for Women’s Integrated Health at the University of Chicago. “Women are left in the middle.”

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