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.”
Brain fog in menopause is common but still poorly understood, with researchers calling for more work to explain the link and how best to support women.
For a new perspective article published in The Lancet Obstetrics, Gynaecology, & Women’s Health, researchers based in the UK and Australia reviewed the evidence on menopause-related cognitive symptoms. They found that symptoms such as forgetfulness, reduced concentration and brain fog are common during the menopause transition, but are still poorly recognised and under-researched.
More than two-thirds of women report difficulties with memory or concentration over the menopause transition. Multiple factors may contribute to these cognitive symptoms, including hormonal changes, sleep disturbances and psychological and psychosocial stress. Yet, because cognitive symptoms are not widely discussed, they can cause considerable worry, with some fearing they are signs of dementia or undiagnosed neurodevelopmental conditions.
The review paper emphasises that overall cognitive performance for women experiencing menopause-related brain fog typically remains within expected ranges and, importantly, that cognitive symptoms are not linked to an increased risk of dementia.
Professor Aimee Spector of UCL Division of Psychology and Language Sciences, co-author on the paper, said: “Cognitive symptoms such as forgetfulness and ‘brain fog’ are incredibly common during menopause, yet they are often overlooked. Our findings highlight just how complex menopause-related cognitive symptoms are, and how much we still don’t know about what drives them. More targeted research is essential if we are to identify which biological, psychological or lifestyle factors contribute most, and what types of support or treatment are likely to be effective.”
The authors argue that clinicians can play a key role in understanding and validating women’s experiences by asking about the duration of cognitive symptoms, impacts on day-to-day functioning and any other medical or psychosocial factors that could be contributing to cognitive symptoms.
The review also discusses a range of approaches that may ease cognitive symptoms, such as improving sleep quality, engaging in regular aerobic exercise and eating a balanced diet. There is also little but promising research into the impact of psychological therapies targeting cognitive symptoms, with a recent meta-analysis of three cognitive behavioural therapy-based studies showing significant improvements in memory and concentration. The evidence is more mixed for the benefits of hormone therapy on cognitive symptoms during menopause.
The authors identify cognitive symptoms as a major area of unmet need in menopause research. They call for a unified definition of menopause-related cognitive changes and for prospective, longitudinal studies that can track women from pre- to post-menopause. Better understanding of the biological, psychological and social factors that contribute to cognitive symptoms will be crucial for developing effective treatments.
Lead researcher Dr Caroline Gurvich of Monash University said: “There’s a lot of pressure to use objective measures of cognitive decline, like a memory test, for example, in a clinical trial, but the key symptom of brain fog is a subjective experience. So having a definition that acknowledges the key cognitive symptom is critical.”
This is not without precedent – we already use subjective or self-report measures for depression, anxiety and other mental health conditions with great success.
Dr Gurvich said the proposed definition would also validate women’s individual experiences while empowering them through the reassurance that any objective decline in their cognitive ability is subtle.
She added: “This is a decrease in cognitive or learning efficiency, not functionality or capacity. For many women, the perception they are losing capacity is what drives them to stop work or lose the confidence to live fulfilling lives during and after menopause. I hear all the time from women who have gone through menopause that validation would have made a significant difference to their resilience and the approach they took to living with menopause.”
Co-author Professor Martha Hickey of the University of Melbourne and Royal Women’s Hospital said: “Our analysis of the best available research shows that many women experience some degree of cognitive symptoms, such as brain fog, during the menopause transition.”
“But there’s a lack of long-term data, which means that there’s a gap in our knowledge about how the brain fog symptom develops and changes from peri-menopause to after menopause ends. It’s a real gap in our understanding.”
Professor Spector added: “We increasingly see women, typically at the peak of their careers, losing confidence in the workplace, often translating to leaving work or reducing work hours. Having simple strategies to support and retain them at work is also a broader economic issue.”
Mariella Frostrup has been appointed the government’s women’s employment ambassador, a new role to support working women across the UK.
The new role comes as the government steps up efforts to support women with menopause symptoms, with businesses being encouraged to publish action plans aimed at tackling the £1.7bn lost each year through sick days, lost productivity and women leaving the workforce because of menopause.
The women’s employment ambassador role expands the remit of the menopause employment ambassador post, which Mariella Frostrup held over the past year.
In that role, she oversaw the launch of the Menopause Advisory Group and discussions with hundreds of employers to improve workplace support for women experiencing menopause.
In the expanded role, Frostrup will work closely with employers across the country to raise awareness of key health issues affecting women at work and champion the economic contribution women make.
Experts from across sectors will be brought together to gather evidence, identify barriers and opportunities, and provide informed recommendations on supporting women’s health at work.
Frostrup said: “Menopause support in the workplace has come a long way, and that progress is something to be proud of, but it cannot be where our ambition stops.
“Women’s health affects their working lives long before menopause, and for too long many have been navigating these challenges without the right support around them.
“Every woman deserves to know, at every stage of her career, that her health will not be a barrier to her success.
“I am delighted to take on this role and look forward to working with employers across the country support their imperative female workforce and retain them.”
Many health conditions affect women long before they reach menopause, including endometriosis and fibroids, making it vital that support is available throughout their working lives to stop women dropping out of the workforce for good.
This comes as part of the government’s drive to reverse the rise in the number of women who are economically inactive because of long-term sickness, which has hit a near-record high of 1.48 million.
Large businesses with 250 or more employees are also being encouraged to produce and publish voluntary action plans setting out how they will support employees experiencing menopause symptoms in the workplace.
Companies will be asked to commit to at least one action to support employees experiencing menopause, such as setting up support groups, tailored workplace adjustments including alternative uniforms, and more.
Dame Diana Johnson, minister for employment, said: “Too many women still face barriers that prevent them from reaching their full potential in the workplace.
“This new ambassador role sends a clear signal that we are serious about changing that, and Mariella Frostrup is the ideal person to take this on.
“By championing the brilliant contributions women make – as entrepreneurs, workers, and leaders – we can unlock economic growth that benefits everyone.”
The action plans are one part of the Employment Rights Act, which will boost employment and improve job security for more than 18 million workers and will benefit women balancing health, care responsibilities and careers.
Tracy Black, CBI chief commercial officer, said: “Businesses are committed to taking action to help women both stay and succeed in the workplace.”
“Awareness of the impact of menopausal symptoms at work is rising, leading to businesses taking a more pro-active approach to providing support. This is part of a wider trend of firms sharpening their focus on health and wellbeing.”
The women’s health ambassador, alongside the government’s renewal of the women’s health strategy, are working to make faster, more decisive progress on the health outcomes that matter most to women and girls across the country.
These measures, along with the new ambassador role, are intended to ensure employers are better equipped to support women and that women know how to access help throughout their career. Supporting women into work and throughout their career is a key part of the government’s commitment to Get Britain Working.
From spring 2026, employers with 250 or more employees will have the option to produce and publish a voluntary action plan alongside their gender pay gap.
A cooling bracelet for menopause relief is entering Ireland’s growing non-medical women’s health tech market.
The MyCelsius bracelet, worn like a wrist watch, entered the Irish market on 7 April 2026 and has been co-developed by Aonghus O’Donovan.
It works by cooling users’ wrists by 10C in under 10 seconds and is designed to reduce the discomfort of hot flushes.
Co-founders O’Donovan, 33, and Maxime Kryvian, 37, chief executive of the start-up cooling tech company, say it has an 80 per cent efficacy rate for women experiencing one of the most uncomfortable perimenopause and menopause symptoms.
O’Donovan spent three years researching the cooling bracelet, which lowers local skin temperature, helping the entire body feel cooler in moments of sudden heat.
The MyCelsius bracelet is a non-medical device and represents the culmination of three years of research and development.
The cooling system is claimed by O’Donovan to be five times more powerful than competitors’ devices.
O’Donovan said: “The wrist is one of the most thermally sensitive parts of your body and applying cold to it sends a signal to the hypothalamus (the body’s thermostat), to stop the sweating and flushing associated with a hot flush.”
“It uses advanced thermo-electric cooling to create a soothing, cold sensation directly onto the wrist.”
“By lowering local skin temperature, it helps the full body feel cooler in moments of sudden heat.”
It also works to counteract uncomfortable heat caused by hormonal changes or stress and anxiety.
Research in recent years has shown that almost four in 10 women in Ireland have considered quitting their jobs due to menopause symptoms.
Based in Bristol, England, O’Donovan studied mechanical engineering at the University of Limerick, which included a year in New York designing heating, ventilation and air conditioning systems for skyscrapers.
He went on to work at Dyson before moving into Formula 1 and aerospace engineering and has since applied design and thermodynamics principles to women’s health, working closely with hundreds of women to develop MyCelsius.
The bracelet has five different modes, including a night-time setting to prevent heat-induced sleep disruption.
MyCelsius worked with a community of women who were integral to shaping the product’s look, feel and functionality.
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