Congress, the Food and Drug Administration, and the Department of Health and Human Services have recently taken a health policy interest in menopause. However, doctors and medical professionals have pushed for these bodies to pay more attention to menopause for well over a decade, regardless of the administration.
Diving into this issue, attorney and author Jennifer Weiss-Wolf joins Jen to talk about her new book: When in Menopause: A User’s Manual and Citizen’s Guide. They discuss the growing appetite for reforming menopause policy, the multifaceted issue of women’s health, and how it is inseparable from women’s empowerment.
Jennifer Weiss-Wolf is executive director of the Birnbaum Women’s Leadership Center at NYU School of Law. She also leads strategy and partnerships at Ms. Magazine.
The following transcript has been edited for formatting purposes.
Jen Rubin
Hi, this is Jen Rubin, Editor-in-Chief of the Contrarian. I am delighted to have with us Jennifer Weiss-Wolf. She is the Executive Director of the Birnbaum Women’s Leadership Center at NYU. She is also the leader of Partnerships and Strategy at Ms. Magazine. She is a lawyer, she is a multiple book author, and she is out with a new book entitled, as her shirt reads, When in Menopause, A User’s Manual and Citizen’s Guide. Welcome, Jennifer, it’s so nice to see you again.
Jennifer Weiss-Wolf
I love being with you. Thank you.
Jen Rubin
It is our pleasure. Well, the book hits you right up front with the forward. Everything I thought I knew about menopause and about estrogen replacement is apparently wrong. And it’s wrong in a very important way, and it has had ramifications for women for decades. Explain what the misnomer is, the misinformation is, about estrogen replacement, and why that’s been so important for women’s health.
Jennifer Weiss-Wolf
Yeah, so, Dr. Sharon Malone, who is an extraordinary force and an OBGYN and menopause expert, wrote the foreword. And basically, she unpacks in it what is now a 25-year-old story, but really, it actually defines, I think, the entire modern experience of menopause, especially for the generations here and now. The quickest way to tell it is, The arrival of estrogen treatment as part of menopause care in the later part of the 20th century was actually taken quite seriously at that time. And in the early 1990s, with a political wave of women coming to Congress in 1992, the year of the woman, the largest and most biggest investment in menopause research was was ever made and still to this day. It’s the women’s health initiative. It was supposed to be a really groundbreaking study. It was looking at the cardiovascular, the potential cardiovascular benefits or risk. of menopause and estrogen treatment for menopause. And instead, what happened was with, a national press conference, National Press Club press conference, an announcement that, menopause treatments, estrogen in particular, were the cause of… increased the risk of breast cancer. Everybody, in one fell swoop, stopped using it, stopped prescribing it, stopped talking about it, stopped researching it, and just basically menopause care fell by the wayside, and that was in 2002. Experts and doctors very quickly debunked that finding to show that it was misapplied, it did not… it was not statistically relevant, it did not matter for all people taking treatments, it was for a very specific cohort who are older and in less robust health. But the ramification… you couldn’t get the genie back in the bottle after that happened, which is why I’ve been really insistent that we have to talk about menopause as a political story and a policy story as much as a health story, because those were choices that were made at the time, and they’ve implicated choices that have been made ever since. And we’re living now, in 2026, still in the shadow of that, with a massive underinvestment in research, with the vast majority of doctors not trained in how to care for menopausal patients, with menopause treatments not covered by insurance, not affordable, not even accessible these days. I don’t know about anyone who’s listening who’s tried to get their hands on… an estrogen patch, and a vast commercial market that has filled that gap. So I’ve just stepped in to be the voice of public policy and what can we do to course correct from a systemic and political perspective.
Jen Rubin
Let’s unpack that a little bit. What was lost by depriving women of this one treatment option? What were the kinds of diseases, conditions that women, frankly, suffered through that they might not have? Had estrogen treatment proceeded either in some modified form or for a specific cohort of women.
Jennifer Weiss-Wolf
It’s actually really impossible to add up what the detriments have been. For the generation of women who did not take estrogen treatment, so basically anyone who was in menopause or about to be in menopause starting in 2002, really up until now. And again, everyone should remember I’m a lawyer, not a doctor, so nobody should be taking medical advice or analysis from me, but I can translate it out, and certainly in terms of how I come to understand it, working with doctors, and how I translate that further into what public policies are needed. But the things we do and don’t know about hormone treatments are just, like, a complete mess as they’re communicated to the public. People think that there are risks that don’t actually exist or apply to them. People don’t know if there are benefits, because we actually haven’t had the clinical trials, the gold standard research, to show for certain what a lot of doctors suspect through observational studies and other sort of less rigorous invested studies that There could be potential benefits to hormone treatments, whether that’s for cardiovascular health, whether that is for our future neurological health. The FDA has approved hormone treatment for the prevention of osteoporosis and for bone health, and that one is very clear. But we deserve that clarity on all of the rest. And one of the, just the research factoids that I pulled out in the book is that we have a massive amount of studies of the positive effects of Viagra on Alzheimer’s. in men. And we have zero, zero clinical trials on whether there are positive effects of estrogen for women in menopause for Alzheimer’s, and women are far more likely to wind up with Alzheimer’s.
Jen Rubin
So I have this medical disaster happened. Did they simply panic when they saw certain results? Why did they have a press conference in which they said, not a nuanced message about a subgroup. Or a mild increase of risk, but essentially stopped the study cold and sent out a very alarmist message.
Jennifer Weiss-Wolf
I know. I mean, I don’t know. I’ve talked to people and met people who were part of the original WHI cohort. I testified at the Senate, U.S. Senate, a couple weeks ago on this, and one of the other panelists was a member of the original WHI study. And there is a real resistance to walk it back still, even though the broadest medical community is doing so, and there’s a real, you know, drumbeat in the media, an elevated conversation, and, you know, social media, everything. Like, this conversation is happening in a way that was probably impossible in 2002 just because of the tools that we have. But this much I’ll say, and, you know, I might be dabbling in conspiracy theory here a little bit, but why not? It’s a good Tuesday morning for a conspiracy theory. I mentioned the wave of women who were voted into Congress in 1992, and it was called the Year of the Woman. And I went in researching this book, I did a lot of, examination of the media at the time. I was super curious how the media was reporting on menopause over the course of the 20th century. And in the early 1990s, the drumbeat was about as loud as it is right now. There were celebrities, there was political interest. And in October 1992, an op-ed was published in the New York Times called Mighty Menopause. And I swear, if you read it right now, you would think it was written this past week. And there was a real appetite for reform, and it was those women who brought the WHI to bear, that investment from the NIH. It was the first-ever woman leader of the NIH as well. That should have been An incredible moment for what the future of menopause was going to be. I don’t think it’s a coincidence that the idea of women rising to power was scary to some folks. And there was, you know, the… I want to, like… it’s hard to say it out loud, because I really don’t want that to be true, but there was something to be gained in some hall of political power from keeping women in this stage of our lives as healthy and as, you know, powerful as we could be. I just can’t see that that’s a coincidence. But then again, that’s my conspiracy theory.
Jen Rubin
One of the things that makes your book so fascinating is that it’s not just about menopause. It’s about… Faith in the medical system, which is right now under siege because of our current regime that has basically made people wary about anything coming out of government offices, particularly about health. Talk to us a little bit about the credibility crisis and how women have had now to cope with government officials speaking about health when there is so much evidence that there are bad actors, there’s a political agenda. Who do you believe? How do you know what to believe?
Jennifer Weiss-Wolf
So, there’s a couple ways to unpack that, and I’m gonna actually start with the here and the now, because we’re at this really strange moment where the FDA, or HHS, And Congress. are very interested in what’s happening for menopause and wanting to step into this space. The FDA did actually a good thing last November when they finally removed the outdated, inaccurate warning labels that had persisted since the WHI on menopause estrogen products. It was actually less hard to get the FDA to do that here and now than it was to convince the public that it was a legitimate move. And that’s a really you know, bizarre position to be in as a progressive advocate and a women’s health advocate. I’ve written about it about… so Contrarian readers have definitely seen me chime in on the menopause story. But at the time. I felt that it was really important that doctors and everybody who’d been advocating for this for over a decade really had to be full throated, not stand side by side with RFK Jr. And he did make a grotesque announcement. He stood at the podium and said, this is Maha, you know, this is Maha here to serve you. And this is President Trump’s, you know, love for women. And, you know, we had to sit in the room while he said that. And we went out right away to the media and said, that’s not what’s going on here at all, obviously. What is going on is this is a demand that doctors have been making since 2014. In fact, the FDA denied this same petition, this same request in 2018 that they approved this time. But these are the voices you should be listening to. These are the people who fought for this, no matter which political party was in power, and that was hard to do, but important to do. And what’s happening right now… so that was… that was a year ago, that was November 2025. Right now, in October 2026, they’re stepping out again. The day that I testified in the Senate, the FDA held a public meeting on female dose testosterone, which we currently do not have an FDA-approved version for, despite it being a frontline treatment for many people, for many women in menopause. And HHS held a meeting on lack of availability Estradiol patches, which is also a real crisis that’s happening right now in this country, around the world in fact, so. that all of that happened at the same time, you know, in any other administration would have been cause for celebration. Now it’s cause for suspicion. The way I’ve been dealing with that is part of what the whole advocacy trajectory has been. In 2024, after Trump was elected, I turned my attention immediately to state legislatures. I thought, we might as well start using those laboratories for seeing what kinds of reforms can stick, for getting some good stuff done for people, and for, you know, having something to turn to in the future. It’s too urgent to wait till the next time around. So that was the plan for a lot of advocates, and it was really successful. Since two legislative sessions, so now we’re, you know, we’re about to embark on 2027. So in 2025 and 2026, more than 60 bills have been introduced in 28 states. 21 of those have been signed into law, and that’s in 10 states, some of multiple laws. So what I’ve really been urging people to do is if you find the federal government to not be, you know, an honest player or have an agenda that frightens you, which is, you know, real. Maybe your state legislator is more… a more trustworthy stakeholder to you. Maybe your governor is. Maybe they’re not. Maybe it’s other advocates and other doctors who you might listen to, but thankfully now, there is a wide variety of voices saying the same thing, possibly for different reasons, but if they’re getting the right outcome, stopwatch can be right twice a day. Listen to the people you believe, and have a little faith, because we can’t… always feel like we have no choice but to lose right now. And I know the Contrarian doesn’t lose, and I know our entire community does not… that’s not what we’re doing, but we gotta take these wins for women’s health, too, because they’re too few and far between.
Jen Rubin
Absolutely. And the broken clock is right twice a day is exactly the right metaphor. The book is, as you say, a user’s guide and really covers the entire topic of menopause. Which is really about empowering women, educating women, making them advocates in the doctor’s office, in the legislature. Give us the big picture about why you think The menopause issue is really a multifaceted issue about women’s health, women’s empowerment.
Jennifer Weiss-Wolf
Well, I think your question helps to answer it, because women’s health and women’s empowerment is multifaceted. And anyone who thinks that women’s health is not a political issue, is not an economic issue, I’ve written this week that this is a midterm… this is a midterms issue. This is the heart and soul of what we’re talking about at our, you know, our so-called kitchen tables. The cost of healthcare, lack of access to insurance. Lack of investment in women’s research and women’s lives. These are all the things that affect our ability to earn a paycheck, to take care of our families, especially people. I’m like… Classic Gen X. I’m 58 years old. I’m like right in there of the generation that’s thinking about everyone around me. And all of these are the things I’m bringing into the ballot box. But that said, I do think there’s something very unique and special about the fight for women’s midlife health now, and I’ve written a bunch about this. at the Contrarian, too, which is midlife women are a much mightier force for democracy than, I think. Either that they voted for themselves, you know, polls have shown, you know, where older white women especially have landed, but here and now in this regime we have seen older women doing living democracy. We saw that in Minneapolis. Who was the ones organizing the meal trains and getting kids to school safely? Who knows how to run a car? You know, who is rallying against the Save Act? We see the writing on the wall. We’re kind of old enough to be angry, not super… not so jaded that, you know, that anger still doesn’t drive us, but we know what we’re doing. And I have been… I wrote together with our… I’m sure our shared dear friend, Joyce White Vance. We did a piece called the Menosphere versus the Manosphere, Meno being menopause, not men, and really imploring both political parties to take midlife and older women seriously, especially the Democratic Party, because these are the forces for democracy that need to be tapped, but that’s totally tied to what it means to be in menopause. To… to have that level of awareness and fury that the systems have failed us completely, and the only way out is through it, and the only way out is to fight it.
Jen Rubin
We will have an entire other interview. I know that period about…about the horrendous events in Put that in one perspective. There is a huge amount of anger out there that institutions that we thought were farther along are not. And the gains we thought, have been taken away. One of the messages of this book is really about how to be an advocate, and what political advocacy is about. A choose-your-own-narrative kind of advocacy. Talk to us about… The larger issue of political advocacy. And taking that anger, that frustration that so many women feel, whether it’s about Cornell, whether it’s about abortion rights, whether it’s about democracy, and finding a way to express that in a productive way.
Jennifer Weiss-Wolf
Yeah, so that’s exactly what I call the book. I say advocacy is a choose your own adventure story. And it is, because we all have different skills and different gifts and different interests and different time commitments, you know, that we can make. But I want everybody to know that this is the experiment of democracy, and that their voice and their participation does make a difference. And menopause is perhaps the greatest case study for this right now, because in a very short amount of time, without sort of, you know, in a very organic way, it’s not like this is a funded movement with a group in charge and a mandate to follow. This has really risen from the grassroots. This has risen from people who are frustrated that they haven’t gotten the medical care that they deserve, they haven’t been taken seriously. They’ve been gaslit and their health has suffered and their families have suffered. And they’re just, they’re, they’re, they want change. And that was really what I saw as I started stepping into this space that people were hungry for it. And what is so amazing about this, this case study or this microcosm is it is we’re seeing what it looks like to win. We’re seeing that if you start perhaps a little smaller and get some wins in state legislatures. teachers you’re creating a different drumbeat for large-scale reform. We’ve seen that if we just have conversations with each other, we discover things we didn’t even know were just the stat, you know, the status quo about menopause. So, I just did a talk in my gym this weekend, because part of what I write about in the book is what it means to take these conversations to real people, not just to sit, you know, in the lofty halls with a lot of people applauding. your book and thank you very much, but to actually sit on the floor with real people and ask what their experience was in the doctor’s office and have six other women say, wait, wait, wait a second. When that happened to me, I did this, and this is how this changed. So I could see, like, the light bulbs coming on in real time, and then I was there to say, what I want you all to remember is this is not just your bad luck. You didn’t just stumble into a bad doctor, and she just happened to have a few good tips. This is purposeful, this is systemic. Whether it’s from benign neglect or nefarious neglect is neither here nor there at this point. Because we have an entire government, an entire structure and system that has not been built with us in mind, and the only way that is going to change is if we change it. But we’re making those changes in real time. I know they’re probably, you know, some… I’ve done this work in the menstruation space, too, and often I get, like, a response like, are you really changing the world by, you know, eliminating the sales tax on tampons, or, you know, getting, you know, changing some billing codes for menopause care? And the answer is yes, because it wholly triggers conversations that have never been had. I worked with a Republican legislator in Illinois in 2017 when their state eliminated the tampon tax. And he told me that afterwards that among his entire party, and they were the majority in the Illinois legislature at the time, and there was a Republican governor as well, Bruce Rauner. And he told me that it opened up conversations with their constituents that they’d never thought about before, about just sort of some of the economic realities and probably some of the like biological realities, too. But he said they went on to expand the state’s Equal Pay Act. And also they became Illinois became the 37th state to ratify the federal Equal Rights Amendment that brought it one step closer to the story we’re now. having about its full ratification. And that was… he credited that to having talked about menstruation at all. And I actually asked him to go on record with that, and we co-wrote an op-ed together in, like, I don’t know, 2018, talking about what that felt like to work across the aisle to change that that dynamic. That 2018 was then, and this is now. Although I guess that was still the first Trump administration. But I’m not so Pollyanna-ish to think that, you know, we’re leaving every little breadcrumb to a new future, but I actually am a little bit, because I see it working, and I see it igniting people, and that’s what the book is intended to do. I also realize everyone doesn’t walk around calling themselves an advocate like I do, but I want people to know that advocate can mean a lot of things, and it’s not so scary to be called one, and it’s not so scary to engage. In fact, it’s probably one of the most enjoyable things you can do, and you’ll meet the coolest people, and you will be part of what You know, what lies ahead for us.
Jen Rubin
Folks, I cannot recommend the book more highly.
Jennifer Weiss-Wolf
I can go hold it up. There it is.
Jen Rubin
When in Menopause, it is about consumer fraud, it’s about advocacy, it’s about women’s rights, it’s about communication, it is a world unto itself, because women And their stories are all contained in there. It is a fabulous book. Congratulations on its launch, Jennifer Weiss-Wolf.
Jennifer Weiss-Wolf
Thank you, Jen Rubin.
Jen Rubin
And we loved having you. We love your work at the Contrarian. Folks, again, the book is When in Menopause. Go get it. It’s a wonderful book. Buy it for a friend. Buy it for a man. Buy it for someone who’s nowhere near menopause. They’ll enjoy it. Thanks so much, Jen. It was great seeing you.
Jennifer Weiss-Wolf
Thank you.
