Half the Country, Zero Hearings

You already knew.

You knew it the first time you sat on the paper-covered table, described the 3 a.m. heart-pounding wake-ups, the rage that came out of nowhere, the brain fog that made you forget your own PIN, and heard some version of “that’s just stress.” You knew it when you went home and searched your symptoms at midnight because nobody in a white coat had given you a single useful word for what was happening.

You knew that nobody in charge was paying attention.

On September 16, 2026, the United States Senate said it out loud.

The title says everything

The Senate Special Committee on Aging held a hearing that day. Read its official title slowly, because it is the whole story in sixteen words:

“Half the Country, Zero Hearings: Meeting the Moment to End the Menopause Care Gap in America.”

Zero hearings. Not “too few.” Not “not enough.” Zero.

Every woman who lives long enough goes through menopause. By 2030, 1.2 billion women worldwide will be menopausal or postmenopausal. And until this September, the Congress that writes federal health law had never once held a hearing on it.

That’s not an oversight. That’s a pattern.

What was on the record

The committee heard from four witnesses: a public-health dean and epidemiologist, a gynecologist speaking for the American College of Obstetricians and Gynecologists, a legal scholar who leads a women’s leadership center at a major law school, and a gynecologist who works with the federal Office on Women’s Health.

That lineup is worth noticing. Research. Clinical care. Law. Public policy. The gap was never one problem. It’s a research problem, a training problem, a legal problem, and a cultural problem, all stacked on top of each other, and all landing on you.

Here’s what the stacked problems look like in numbers we’ve verified:

•            $56 million. What the National Institutes of Health spent on menopause research in 2023. The NIH budget that year was $45 billion. That puts menopause at barely one-tenth of one percent of the budget (0.12%).

•            2023. The first year the NIH even tracked menopause as its own research category. Not the first year it funded it well. The first year it counted it.

•            6.8%. Graduating medical residents who felt adequately prepared to manage menopausal patients. The other 93% knew they weren’t ready.

•            About 6,000 a day. American women reaching menopause, roughly 1.3 million a year. The witnesses cited the same number. And they described a country where finding a clinician trained in menopause is its own part-time job.

So, what’s the damage? You’ve been paying for it in appointments, in misdiagnoses, in years.

What the witnesses asked for

The testimony is public, and it’s worth reading. Here is what the four witnesses asked Congress to do, in their words wherever we could quote them.

Fund the research, all of it. The public-health dean has worked on the Women’s Health Initiative, the landmark NIH study of postmenopausal women, since 1993. She told the committee that more than one million American women enter menopause every year, and that most will spend a third or more of their lives after it. Her conclusion after forty years of this work: “We are nowhere near where we need to be.” Two witnesses pointed to the same finding from the National Academies: only 8.8% of NIH grant spending from 2013 through 2023 went to women’s health research.

Fix the training. The legal scholar put the training gap in one sentence: “For those who started residency after 2002 … the majority have not had meaningful or even any menopause training.” She walked the committee through the surveys we’ve been citing for months. Only 6.8% of graduating residents felt adequately prepared. Only 31.3% of OB/GYN residency programs have any menopause curriculum, even though 92.9% of program directors say they should. Her ask: use the federal money that pays for medical residencies to push menopause training into the standards.

Stop the gatekeeping on treatment. The ACOG gynecologist called the FDA’s removal of the boxed warning “a huge step in the right direction” and said the warning “did not reflect the accumulating scientific evidence.” She was just as clear that menopause care “is not one-size-fits-all,” and that the right choice depends on each woman’s own risks. Another witness asked the government to fix the estrogen patch shortage, because more women are now asking for treatment than pharmacies can supply.

Make care affordable. Among the testimony’s recommendations: treat a menopause visit as preventive care, which would mean no cost-sharing under most plans; pay clinicians for the real time menopause care takes; and set minimum Medicare and Medicaid coverage for FDA-approved treatments.

Think prevention, not just symptoms. One of the most striking points came from the gynecologist who works with the federal Office on Women’s Health. Bone loss speeds up around menopause, at an average age of 51. Routine bone density screening doesn’t start until 65. That’s about fourteen years of silent bone loss before anyone routinely looks.

Name the misinformation. “Menopause has become big business,” the ACOG witness said, “and many women are turning to influencers rather than trained clinicians for advice.” (Yes, we noticed the irony of an AI narrator and a pen name agreeing with her. That’s exactly why every number we use comes with a source.)

Pass the bills already on the table. The testimony named several bipartisan bills now in Congress, including:

•            the Advancing Menopause Care and Mid-Life Women’s Health Act, which would expand federal research, clinician training and public education

•            the Menopause Education for Medical Students Act

•            the Servicewomen and Veterans Menopause Research Act

•            the Menopausal Workers’ Fairness Act, on workplace accommodations

None of these is law yet. All of them are now on a record the committee can’t unhear.

What the silence has cost

Silence sounds harmless. It isn’t. It has a price, and women have been paying it.

A Mayo Clinic study of more than 4,400 women put the cost of menopause symptoms in lost work time at $1.8 billion a year in the US. Add medical costs and the figure climbs to $26.6 billion. Thirteen percent of the women had at least one adverse work outcome: missed days, cut hours, even jobs lost or left.

And the diagnosis itself takes far too long. In a large international survey from Newson Research (self-selected, so the women answering were already engaged with menopause information), 1 in 10 women attended more than ten appointments before getting the right treatment. About two-thirds had their symptoms blamed on something else entirely.

Ten appointments. Picture the co-pays, the time off work, the drive home each time wondering whether you’re imagining it.

That’s what “no hearings” looks like from the ground. It isn’t an abstraction in a committee room. It’s your calendar, your paycheck, and your sanity.

Why “first” matters more than it sounds

A first hearing can sound like a small thing. It’s one afternoon in a committee room. Nobody passed a law. Nobody wrote a check.

But here’s what nobody tells you about how change actually happens in medicine and government: nothing gets funded until it gets named, and nothing gets named until it gets on the record.

For decades, the official record said, in effect, that menopause wasn’t a subject. It wasn’t a research category until 2023. It wasn’t a curriculum requirement. It wasn’t a hearing topic. When something isn’t on the record, it isn’t anyone’s job. When it isn’t anyone’s job, it gets no budget line. And when it has no budget line, you get what you got: a fifteen-minute appointment and a prescription for something that wasn’t the problem.

A hearing changes the paperwork of power. Testimony becomes part of the congressional record. Staff writes memos. Memos become questions. Questions become funding requests. It’s slow and unglamorous, and it’s also how every gap that ever closed started to close.

That’s not a victory lap. That’s a door that stayed bolted for generations finally being unlocked.

“We were told” is now “they were told”

For years, the story went like this: we were told it was stress. We were told it was aging. We were told it was anxiety, depression, “just a phase,” “part of being a woman,” or, the classic, all in our heads.

On September 16, the people with the power to change the funding, the training, and the rules were told something back.

They were told that half the country has been living in a care gap. They were told by researchers, clinicians, and legal experts, not by influencers, not by a wellness brand, not by one woman crying in a parking lot after another appointment went nowhere (though, let’s be real, she’s the reason any of this is happening).

This is the part worth sitting with. Every woman who pushed back in an exam room, asked for a second opinion, told her sister, posted her story, or refused to be brushed off created the pressure that put this on a Senate calendar. The hearing didn’t come from nowhere. It came from you.

What a hearing is not

Let’s keep our feet on the ground, because hope that isn’t honest isn’t worth much.

A hearing is not a law. It doesn’t add a single menopause specialist to your town or a single lecture to a residency program. It doesn’t make your next appointment go better.

What it does is change the question. The question used to be “is this even a real issue?” Now it’s “what are we going to do about it?” That second question is a much better one to be fighting over.

And the answer to that second question will be shaped by what happens next: whether the funding follows, whether medical training changes, whether anyone checks back in a year. Hearings that nobody follows up on fade. Hearings that people keep citing become turning points.

So keep citing it.

What you can do this week

You don’t need a Senate seat to use what just happened. You need a sentence.

1. Bring the record into the exam room. If you’re brushed off, you can say: “The Senate just held its first hearing on the menopause care gap because this is a known, documented problem. I’d like us to take my symptoms seriously.” It’s hard to call your concern “just stress” once it’s on the congressional record.

2. Ask the training question. Politely and directly: “How much menopause training have you had? If this isn’t your focus, can you refer me to someone for whom it is?” A referral may take time. Ask anyway. Asking is how demand gets counted.

3. Track before you go. Walk in with dates, symptoms, and patterns written down. A clinician who hasn’t been trained in menopause can still read a clear two-week record. That’s exactly what our free 7-Day Symptom Tracker + Doctor Visit Guide is built for, and it comes with the words to use when you’re told everything looks normal.

4. Tell one woman. Send this to your sister, your best friend, the coworker who keeps fanning herself in meetings like she’s auditioning for a southern soap opera. The gap stays open because women go through this one at a time, in silence. It closes when we stop doing that.

The point

For generations, menopause was treated as a private problem: yours to manage, quietly, at your own expense.

On September 16, it became a public one.

That’s not the end of the gap. It’s the first time the people who can close it had to look straight at it. You were right all along. Now it’s on the record.

Recognition. Research. Respect. One hearing down.

— Delaney

Coming October 18, World Menopause Day: You’re Not Crazy... You’re Menopausal: Science, Strategies, and Swearing Through the Hormonal Apocalypse. In the meantime, get the free 7-Day Symptom Tracker + Doctor Visit Guide at notcrazymovement.com.

Medical note: This article is educational and is not medical advice. Talk to your healthcare provider about your symptoms and your options.

Sources & References

1.          United States Senate Special Committee on Aging. “Half the Country, Zero Hearings: Meeting the Moment to End the Menopause Care Gap in America.” Hearing, September 16, 2026. aging.senate.gov

2.          National Institutes of Health. Estimates of Funding for Various Research, Condition, and Disease Categories (RCDC), menopause category, 2023. report.nih.gov

3.          Allen JT, et al. Menopause education in US obstetrics and gynecology residency programs. Menopause, 2023. PMID 37549396.

4.          The Menopause Society. National survey of graduating residents’ preparedness to manage menopause. menopause.org

5.          Faubion SS, et al. Impact of menopause symptoms on women in the workplace. Mayo Clinic Proceedings, 2023.

6.          Newson Research. International survey of 3,567 women in 71 countries (self-selected online survey), presented at ISSWSH 2026.

7.          Society for Women’s Health Research. Menopause: women reaching menopause daily in the US. swhr.org

8.          Written testimony of the four witnesses (public-health dean, University at Buffalo; gynecologist for the American College of Obstetricians and Gynecologists; executive director, Birnbaum Women’s Leadership Center at NYU Law; gynecologist and Women’s Health Ambassador, HHS Office on Women’s Health), September 16, 2026. aging.senate.gov

9.          National Academies of Sciences, Engineering, and Medicine. Report on women’s health research at NIH (8.8% of NIH grant spending, 2013–2023), as cited in testimony. nationalacademies.org