Menopause
California plans US$3.4m menopause care overhaul
California plans US$3.4m for menopause care, screening and treatment access in a budget proposal advocates say could begin to close care gaps.
If approved by the legislature through the budget process, the proposal would require menopause screening for all women from age 40, direct health plans to expand coverage of FDA-approved menopause treatments, meaning treatments cleared by the US regulator, “as medically necessary”, fund menopause services, education and awareness programmes, and allow clinicians to receive continuing education credit for completing menopause training.
The proposal follows governor Gavin Newsom twice vetoing similar legislation in recent years, citing cost and insurance coverage concerns.
In October, when he vetoed a bipartisan bill seeking similar changes, he said he supported better care but directed state agencies to explore alternatives through the budget process.
Newsom said in a statement last month that the proposal “will expand access to essential, evidence-based care in a way that’s affordable and fiscally responsible”.
Assemblymember Rebecca Bauer-Kahan, who authored two of the vetoed bills, supports the budget proposal but has raised concerns that it does not apply to Medi-Cal, the state’s health insurance programme for low-income residents.
The 7.6 million women and girls served by Medi-Cal are disproportionately Latina and Black.
“That is a gaping hole in this, just so we are clear,” Bauer-Kahan said.
“That will be one of the next fights.”
For Bauer-Kahan, 47, the policy grew out of personal experience.
She said: “It started by being a perimenopausal woman who couldn’t get care. I was going through this and started talking to friends and others about it, and I realised it was more pervasive than I previously understood.”
Experiencing severe brain fog, which can mean problems with memory and concentration, she sought care from multiple doctors who reassured her nothing was wrong, leaving her worried about early onset Alzheimer’s because of intense forgetfulness.
Relief came only after visiting a menopause specialist.
“He sent me a questionnaire that was pages long about my symptoms, and I was tearing up,” she said.
“When I finally got the care I needed, it was game-changing. I feel like myself again.”
Menopause happens after a woman has gone 12 consecutive months without a menstrual cycle, though the transition usually begins years earlier in perimenopause, when fluctuating hormone levels can cause symptoms including hot flushes, brain fog, joint pain, fatigue, irregular periods, mood swings and insomnia.
Studies have found the sudden drop in oestrogen is associated with cardiovascular disease, cognitive impairments and dementia.
Dr Rajita Patil, assistant clinical professor in the obstetrics and gynaecology department at UCLA health and director of its Comprehensive Menopause Program, said: “This is an opportunity to best optimise long-term health and make sure they have optimal longevity.”
However, training for physicians has been limited.
Many providers receive only a brief menopause lecture in medical school, if they get one at all, according to Patil.
A study from the AARP Public Policy Institute released last year found that only about one-fifth of women receive menopause treatment, and women of colour are much less likely to receive it.
“There is exponential demand for care that should have been there in the first place,” Patil said.
“Doctors are not really trained for this kind of care.”
Patil said the lack of training and a widely reported 2002 study from the Women’s Health Initiative, which suggested hormone therapy increased certain health risks but was later criticised and refuted by researchers, set menopause care back by decades.
Nationally, California is lagging behind other states. Last year, nearly two dozen states saw more than 50 menopause-related bills introduced, and eight became law in states including Oregon, Washington and Rhode Island, according to the nonprofit Let’s Talk Menopause.
Janet Lee-Ortiz, a Los Angeles middle school teacher who began experiencing symptoms about a year ago, said: “It should be treated like a big deal because it’s a big freakin’ deal. I’m in the middle of trying to figure it out, and I really feel alone, navigating it by myself.”
The proposal also raises equity concerns.
Research shows Latina and particularly Black women often enter menopause earlier and experience more severe symptoms for longer than white and some Asian women, yet the proposal’s expanded coverage, training and education provisions apply only to commercial health plans.
Bauer-Kahan said: “There are real racial equity issues built in. How do you get everybody in the doors to be treated? How do you make it more equitable for everybody?”
She said initiatives like this one often start with private insurance and then expand to public programmes once costs become clearer, adding: “It’s going to lead to healthier, happier and longer lives for women.”
Immunotherapy may temporarily restore fertility in women with autoimmune premature ovarian insufficiency, a pilot study suggests.
Three of the 10 women who received treatment later gave birth to healthy babies.
Premature ovarian insufficiency, or POI, affects just over three per cent of women worldwide and occurs when the ovaries stop functioning before the age of 40.
The condition significantly reduces fertility and can have several causes, including autoimmune processes and genetics.
Researchers at Karolinska Institutet examined whether immunotherapy could make the ovaries temporarily responsive to hormonal stimulation in women with POI caused by autoimmunity.
The study included 12 women aged between 18 and 35 with autoimmune POI.
Two withdrew before treatment began. The remaining 10 underwent ovarian hormone stimulation before receiving rituximab and again four to six months after treatment.
Rituximab is an approved and well-established medicine used to treat several autoimmune conditions and cancers.
None of the women responded to ovarian stimulation before receiving the drug.
After treatment, six developed follicles that made it possible to retrieve eggs in response to ovarian stimulation.
Follicles are small sacs within the ovaries where eggs develop.
Professor Angelica Lindén Hirschberg, the study’s first author and a professor at Karolinska Institutet’s Department of Women’s and Children’s Health, said: “The results show that in some women there remains an egg reserve that can be activated when the autoimmune process is suppressed.”
In five women, mature eggs could be frozen or fertilised.
Three later had embryos transferred and all three gave birth to healthy babies.
For safety reasons, the embryo transfers took place no earlier than one year after treatment.
One serious side effect was reported and was linked to the hormone stimulation rather than the immunotherapy.
Women with autoimmune POI commonly have other autoimmune diseases.
All six women who responded to the treatment also had autoimmune Addison’s disease, a condition in which the immune system destroys the adrenal glands.
The study was a proof-of-concept investigation without a control group and involved a small number of participants, meaning the findings must be interpreted cautiously.
A proof-of-concept study is an early investigation designed to assess whether an approach could work before it is tested more widely.
Professor Lindén Hirschberg said: “This is a first step. To determine whether the method is effective and safe, larger, randomised studies are required.”
The research team has launched a larger randomised study.
The work was carried out by researchers at Karolinska Institutet, Karolinska University Hospital and the University of Bergen.
It was funded by organisations including the Swedish Research Council, the Knut and Alice Wallenberg Foundation, the Novo Nordisk Foundation and Region Stockholm.
The researchers reported no conflicts of interest.
POI is also linked to long-term health risks caused by oestrogen deficiency, including osteoporosis, an increased risk of cardiovascular disease, cognitive decline and poorer mental and sexual wellbeing.
Hormone replacement therapy can relieve menopausal symptoms and reduce many of these risks, but no treatment has been reliably shown to restore fertility in women with POI.
Egg donation was previously the only option for women with the condition who wanted to become pregnant.
An EU committee has backed a report warning of systemic inequalities in women’s health research, diagnosis and treatment across Europe.
The European Parliament’s Committee on Women’s Rights and Gender Equality approved the report, which was initiated by Renew Europe.
Women remain under-represented in medical research and clinical trials.
Around 72 per cent of drug trials do not provide data separated by sex and gender, while only five per cent of global research and development funding is dedicated to women’s health.
The report was led by Renew Europe rapporteur Billy Kelleher MEP of Fianna Fáil in Ireland.
It calls for greater investment in women’s health research, stronger inclusion of women in clinical trials and gender-sensitive diagnostics and treatments, particularly for endometriosis, menopause and cardiovascular disease.
Kelleher, first vice-president of Renew Europe, said: “Women’s health remains one of medicine’s biggest blind spots.
“When research, clinical trials and medical data fail to reflect women’s experiences, the result is poorer diagnosis, treatment and care.”
The report also calls for improved access to sexual and reproductive healthcare, including follow-up to the successful European Citizens’ Initiative “My Voice, My Choice”.
Its recommendations include better support for women’s physical and mental health and access to high-quality care throughout pregnancy, childbirth and the postnatal period, free from discrimination.
It also highlights additional healthcare barriers faced by LGBTQI+ people and women in marginalised communities or vulnerable situations.
Kelleher said: “This report is about closing those gaps and ensuring that women’s health is recognised as a core measure of the quality and fairness of our healthcare systems.”
By placing women’s health higher on the political agenda, the report aims to support the implementation of the EU Gender Equality Strategy and shape future European health policies.
A final vote by the European Parliament is expected in September 2026.
Statins have been linked to more severe menopause symptoms and a higher risk of muscle loss in postmenopausal women, a study suggests.
The medicines are among the most widely prescribed in the world, with strong evidence supporting their use to lower cholesterol and reduce cardiovascular risk.
However, some recognised side effects may resemble symptoms associated with menopause, raising questions about how the two could interact.
The US Food and Drug Administration has flagged potential adverse effects linked to statin treatment, some of which overlap with menopausal complaints.
Researchers examined data from 1,184 postmenopausal women across nine Latin American countries, assessing menopausal symptoms, sarcopenia risk and cognitive function.
They compared women taking statins with non-users after accounting for factors including age and body weight.
As the study was cross-sectional, meaning it examined information collected at one point in time, it could identify associations but could not prove that statins caused the outcomes.
Women taking statins were 56 per cent more likely to have severe menopausal symptoms than those who were not using the medicines.
The difference remained after researchers accounted for other variables.
Statin users were also 65 per cent more likely to be at risk of sarcopenia.
Sarcopenia is the gradual loss of muscle mass and physical function, which tends to accelerate after menopause.
Declining oestrogen levels already make muscle loss a concern at this stage of life. It is linked to a higher risk of falls, fractures and reduced quality of life.
Musculoskeletal symptoms were reported by 53.1 per cent of statin users, compared with 33.9 per cent of non-users.
Researchers said this was separate from the finding on sarcopenia risk and may point to a wider pattern of physical discomfort among women taking the medicines.
Women taking statins also recorded slightly lower scores in tests of delayed memory recall and visuospatial function.
Visuospatial function is the ability to understand the position of objects and their relationship to one another.
The study found no overall association between statin use and mild cognitive impairment, so the differences in individual tests are early signals rather than firm conclusions.
Researchers said effects associated with statins may overlap with menopausal symptoms and add to the overall symptom burden during midlife.
This means symptoms attributed to menopause and possible statin side effects may look similar and, in some cases, could compound one another.
Further research is needed to separate the possible effects of the medicines from symptoms linked to menopause.
The findings are not a reason for women to stop taking statins.
Their cardiovascular benefits are well established, and stopping treatment without medical guidance can carry serious risks.
The study provides more information about what statin treatment may mean specifically for postmenopausal women, who have historically been under-represented in cardiovascular research.
Women who notice more severe menopausal symptoms or changes in muscle strength or physical function while taking statins should discuss them with a doctor.
A healthcare professional may consider whether the symptoms could be related to the medication and whether screening for muscle loss is appropriate.
They may also review whether the current statin remains the most suitable option, as different statins can have different side-effect profiles.
Resistance training and consuming enough protein are well-supported ways to help preserve muscle mass during midlife.
Statins can be life-saving, but the findings suggest their possible side effects should receive greater attention in postmenopausal women.
The study adds to evidence supporting more individualised care for women during midlife.
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