Menopause Around the World: The United States—Where Silence Meets the Spotlight

In the United States, menopause sits at the crossroads of modern medicine, capitalist wellness, and cultural reinvention. For generations, it was a hush-hush topic—something women endured quietly, often alone.

But today? That silence is finally breaking.

In this edition of Menopause Around the World, we explore how American women are navigating perimenopause and menopause in a culture that often medicalizes aging—but is also awakening to a more empowered, vocal, and educated narrative.

A System Built for Everything But Menopause

Despite being one of the most medically advanced countries in the world, the U.S. healthcare system is notoriously unprepared to support women in midlife.

Shocking but true:

• Only 20% of U.S. OB/GYN residency programs include training on menopause.

• Many women report being misdiagnosed with anxiety or depression, rather than perimenopause.

• Others are offered antidepressants or told, “It’s just part of getting older. You'll have to live with it.”

  
  

Even with private insurance or concierge care, the average woman might still struggle to find a doctor who:

• Understands hormone replacement therapy (HRT)

• Can distinguish perimenopause from thyroid issues or mental health diagnoses

• Takes the time to listen

  
  

For women without insurance or with lower incomes, the gaps are even wider—and the silence even deeper.

The Rise of the Menopause Wellness Industry

Enter: the $600 billion wellness market. Where traditional medicine fails, the private sector steps in—with:

• Hormone clinics and “menopause bootcamps”

• Bioidentical hormone therapy (BHRT)

• Supplements, adaptogens, nootropics, and “estrogen-safe” skin care

  
  

Brands now market menopause like a niche fitness plan. While this explosion of options shows increased visibility, it also creates confusion and overwhelm.

Women are asking:

• Which solutions are evidence-based?

• Is this brand actually supporting my biology—or just cashing in?

• Why do I need to spend thousands just to feel “normal” again?

From Shame to Strength: The Cultural Shift

Despite the challenges, there’s a powerful cultural shift happening in America.

Women are:

• Talking openly about their symptoms on social media

• Hosting podcasts and writing books on perimenopause

• Building communities where symptoms are not shamed—but shared

  
  

High-profile figures like Oprah Winfrey, Naomi Watts, Drew Barrymore, and Maria Shriver are publicly discussing their menopause journeys. And some platforms are advocating for medical education and public policy reform.

There’s also a growing trend of corporate menopause support:

• Companies like Microsoft and Bank of America now offer menopause resources for employees.

• HR departments are starting to recognize the impact of hormonal health on workplace performance and absenteeism.

What We Can Learn

The U.S. menopause experience is both empowering and problematic. It reveals:

• How consumerism can fill gaps in healthcare—but not always wisely

• The urgent need for standardized, evidence-based menopause education in medical schools

• That community and conversation are often more healing than a prescription

Above all, America teaches us that visibility is power—but it must be matched with access, clarity, and care.

Next, we head to Canada—where universal healthcare brings its own unique set of challenges and opportunities for menopausal women across diverse communities.

👉 Want practical, natural strategies for your own menopause journey? Download my free guide here!