Commentary: There's federal progress on women's health. No joke

Menopause has been having a moment lately, and Washington is taking notice. On Sept. 16, the Senate held its first hearing on the dismal state of federally funded menopause research and vast gaps in treatment and care. Within 24 hours, the Department of Health and Human Services also convened pharmaceutical manufacturers and physicians to troubleshoot the alarming lack of availability of estradiol patches, an essential menopause hormone treatment, and the Food and Drug Administration held a full day of expert panels on female-dosed testosterone, which is currently only FDA-approved for men.

One week later, Health and Human Services joined the American Urological Association for a discussion about a silent killer of postmenopausal women: urosepsis from recurrent urinary tract infections. There is a simple solution — localized vaginal estrogen — and yet because of outdated guidelines and lack of clinician training, the medication is too often ignored or denied. Nor is the prescription routinely covered by Medicare, despite its well-established health and longevity benefits for women over age 65.

These are among the attempts to now, finally, address decades of policy failures — a refreshing change, quite frankly, given neither political party has ever prioritized menopause. That 2026 marks the year when menopause has entered the policy arena comes as little surprise to me. I’ve been beating this drum for years. Every aspect of daily life that menopause touches — the soaring cost of medical care, inadequate access to health insurance, extreme underinvestment in scientific research focused on women’s health, even the myriad ways midlife women are stretched to the limit caring for kids and aging parents — is smack in the middle of the political zeitgeist. These are the kitchen table issues on the minds of voters this election.

Menopause moment, meet the midterms.

Another issue rightly revealed by menopause is the chasm of public trust in government. As one of the four expert witnesses who testified at the Senate, I was heartened that it was a true bipartisan endeavor. But that’s a rarity these days in Congress, an institution rife with dysfunction. Our federal health agencies have become so shamelessly politicized they are on a collision course with science — from HHS’ overt moves to undermine childhood vaccines, to the decimation of leadership at the Centers for Disease Control and Prevention, which is struggling to respond to the crisis of measles outbreaks across the country.

My goal as a policy advocate is to help turn the tide on this country’s long record of neglect when it comes to menopause. Like many other women’s and reproductive health advocates, after the 2024 election l turned my attention to state legislatures — not just as a consolation prize but as a way to test what range of reforms were feasible and to get as many good laws as possible passed. It was the right move. Over the last two years, more than 60 bills have been introduced in 28 states — to do things like require private insurance and Medicaid to cover menopause care and treatment, improve clinician training and public education, and bolster antidiscrimination protection in the workplace. Ten of those states now have 21 laws on the books.

California is one and can claim real leadership. Among the bills passed by the Legislature, Assembly Bill 2270 from 2023-24 incentivizes continuing medical education on menopause for clinicians, the majority of whom receive little to zero training while in medical school and residency. The California Department of Corrections is now collaborating with medical experts to help bring menopause resources to incarcerated women in state prisons.

Newsom also just vetoed AB 1940, which would have codified menopause as a protected category in the state’s workplace antidiscrimination laws.

The Legislature has been especially deft at easing access to FDA-approved hormonal treatments, including testosterone, often used off-label by menopausal women: AB 82 ends the requirement to report prescriptions to the state’s tracking database; AB 1778 proactively declassifies testosterone as a controlled substance under state law, should there be action in Washington to do the same under federal law.

Although Newsom twice vetoed bills to mandate insurance coverage for menopause treatment — and deserved all the flak he received — the 2026-27 state budget includes a minor course correct: a $3.4-million “ trailer bill” to invest in public education and make menopause treatments more affordable; Medi-Cal patients are not fully covered by the addendum, though, making it a toothless reform for those who need support the most.

Why should California’s menopause agenda, or that of the other 27 states that have introduced reforms, matter to the rest of the country? They offer useful models of what to do — or in the case of Medicaid exclusion, what not to do — in crafting meaningful policies. Perhaps more important, they offer a rationale that can help persuade the public; those who might balk at a congressional bill or federal policy, in part because of skepticism of the federal government or the current administration, can listen to and learn from other stakeholders, including governors and state lawmakers and activists.

Take for example the FDA decision in November 2025 to remove the long-critiqued “black box” warning on estrogen products for menopause. This was the culmination of a decade-long campaign by physicians, researchers and scientists — who had been waging the fight for accurate labeling well before the acronym MAHA ever existed and regardless of which party held power. Yet the very image of Health Secretary Robert F. Kennedy Jr. using his moment at the podium to credit the Trump administration’s deep commitment to women’s health posed a serious credibility challenge. Aligned and contemporaneous state reforms offered much-needed reassurance and clarity to many.

Trust in government is understandably at a low point, but this happens to be when menopause finally has caught the attention of policymakers at all levels of power. Some are taking long-overdue steps for women’s health, however implausibly. Let’s take the wins.

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Jennifer Weiss-Wolf is the author of “ When in Menopause: A User’s Manual & Citizen’s Guide.” She is executive director of NYU Law’s Birnbaum Women’s Leadership Center.

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