For a long time, menopause was barely discussed.
Women were told their symptoms were normal, that they just had to get through it, or that there was not much to do.
That needed to change.
But we have now swung pretty far in the other direction.
Menopause is everywhere. Hormones, testosterone, supplements, peptides, longevity, weight loss, bone health, brain health, sexual health, sleep, cortisol, inflammation. There are podcasts, influencers, telehealth companies, specialty clinics, supplement brands and very confident opinions about what every woman should be doing.
Some of this is excellent. Women are asking better questions, physicians are paying more attention, and treatments that were underused for years are being discussed openly.
But it has also become incredibly noisy.
I see women who are convinced they need hormones because they are 48. Others who are terrified of them. Some arrive with a long list of supplements and laboratory tests they have been told they need. Others have attributed nearly every change in their body to menopause.
The problem is that midlife is also when a lot of other things start happening.
Bleeding changes may be perimenopause, but they may still need evaluation. Fatigue may be hormonal, or it may not be. Weight changes, sleep problems, sexual symptoms, mood changes and joint pain can all be related to menopause, but that does not mean menopause is the only thing worth thinking about.
Hormone therapy can be extremely useful. So can nonhormonal treatment. Sometimes the most useful thing I do is prescribe something. Sometimes it is explain why I would not.
The goal should not be to make every woman a menopause patient.
It should be to help each woman figure out what is actually happening to her, what deserves treatment, what deserves investigation, and what she can safely ignore.
That requires a little less noise and a lot more judgment.
