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In what some call a ‘national movement,' more than a dozen states introduce menopause bills

In what some call a ‘national movement,' more than a dozen states introduce menopause bills

CNN11-07-2025
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There's a new wave of interest in improving menopause care in the United States – it's in books, on podcasts and dominating social media hashtags – and it's even generating new legislation across more than a dozen states.
From New York to California, lawmakers are weighing whether to support more menopause training for clinicians or mandate comprehensive insurance coverage for menopause treatment. Advocates of such legislation argue that these changes could improve access to care and reduce the risk that menopause symptoms will be dismissed by providers.
At least two dozen bills have been introduced across 15 states this year, according to data from Jennifer Weiss-Wolf, executive director of the Birnbaum Women's Leadership Center at the New York University School of Law, and her colleagues who have been tracking menopause legislation.
Most of the legislation is related to insurance coverage for menopause care, awareness and education, clinician training or menopause in the workplace.
When it comes to menopause care, there continues to be a 'lack of standardized treatment protocols' and 'inadequate insurance coverage for evidence-based therapies like hormone replacement,' Dr. Mary Claire Haver, an ob/gyn at the Mary Claire Wellness Clinic in Galveston, Texas, and author of the book 'The New Menopause,' said in an email.
She hopes that some of the new legislation introduced this year – and future policies – may change that.
Menopause is a natural phase of aging in which a woman has gone at least 12 consecutive months without a menstrual period due to a decline in her reproductive hormones. These hormonal changes can cause uncomfortable symptoms, including hot flashes, insomnia, vaginal and urinary problems, mood changes and weight gain, and can have long-term health implications.
In the United States, an estimated 1.3 million women enter menopause each year, and most have symptoms.
'For decades, menopause has been overlooked in both clinical research and health care policy, largely because it affects women in midlife — a group that has historically been underrepresented and undervalued in medicine,' said Haver, who collaborated with Weiss-Wolf on developing A Citizen's Guide to Menopause Advocacy.
'Women in midlife are speaking out, demanding better care, and using their voices on platforms where they've historically been ignored,' she said. 'We're also seeing more female physicians, researchers, and public figures normalize the conversation around menopause — which is finally translating into policy discussions and workplace changes.'
As the 2025 legislative session has come to an end in most states, some more recently introduced menopause bills may be up for action next year.
Most of the bills may not become laws, but that's not a loss, said Weiss-Wolf, author of the book 'Periods Gone Public: Taking a Stand for Menstrual Equity.'
'This only sets us up for what I hope will be a really impactful, successful state legislative session in 2026,' she said. 'So, for me as an advocate, I'm not only marking success by bills passed, but just that the conversation has gotten to the point where state legislators are willing to step out on this issue.'
Two bills introduced in March relate to raising awareness around menopause, according to Weiss-Wolf and her colleagues. One Illinois bill, passed in May, declares October 12-18 to be Menopause Awareness Week in the state. The other bill, introduced in Nevada, would have designated October as Menopause Awareness Month, but it was vetoed by the governor in June.
Seven bills were introduced this year related to education, aiming to enable health care providers with more education about menopause treatment or requiring health departments to distribute educational resources for the public. One, in Maine, was signed by the governor and enacted last week.
When it comes to enhancing menopause training for clinicians, California and New Jersey both introduced bills related to those themes this year. In California, legislation would require an assessment of physicians' education and training on menopause diagnosis and treatment. In New Jersey, the bill would permit up to three credits of continuing medical education on menopause to be used by providers to renew their licenses.
Meanwhile, five bills have been introduced related to requiring insurance coverage for menopause care. One in New Jersey passed the Assembly, and one in Oregon is awaiting the governor's signature.
'This is absolutely a national movement, and the momentum is undeniable. It's not just happening in California — Washington State, Oregon, Illinois, and Louisiana have all had bills either introduced or successfully passed in this space, with most of them looking to create similar insurance coverage mandates,' California Assemblymember Rebecca Bauer-Kahan said in an email.
This year, Bauer-Kahan introduced Assembly Bill 432, which would mandate coverage for menopause evaluation and treatment options, among other orders. She said the bill was born out of her own experience of having perimenopausal symptoms and being dismissed when she asked her doctors for care.
'I didn't know what was happening to me. So like many people would, I went to my internist. She said I was fine. But I knew I wasn't fine. I knew something was fundamentally wrong with my body. I went to my ob/gyn. Here I am, a woman in my mid-40s, telling my doctor that my brain isn't working properly, and once again, I was dismissed as 'fine,' ' Bauer-Kahan said in the email.
'Women are over half the population, and yet our healthcare system fails to provide us with the care we need as we age,' she wrote. 'This legislation closes the care gap, ensuring that menopause is treated as the central health need it is, not as an afterthought. We deserve comprehensive coverage and informed medical care, just like any other stage of life.'
A Rhode Island bill related to menopause in the workplace was signed into law last week, making it the first state to enact workplace protections for menopausal women – and more could be coming. Legislation introduced this year in New York and New Jersey aims to address menopause in the workplace by preventing discrimination, extending workplace protections and requiring employers to allow remote work or paid leave for employees with symptoms.
Then there are a few other bills, such as in Massachusetts and New York, related to a combination of menopause issues.
'What's particularly encouraging is that menopause crosses party lines,' Bauer-Kahan said. 'On the Assembly floor, my bill passed 70-1. This isn't a political issue; it's about recognizing that half our population deserves proper healthcare.'
Of the menopause bills introduced this year so far, 11 are in committee, seven have passed in some capacity with four to be enacted, five either were vetoed or died in committee and one was amended.
What appears to be a renewed interest in menopause policy comes after more than two decades of 'silence' around menopause, said Dr. Sharon Malone, chief medical adviser at Alloy Women's Health and author of the book 'Grown Woman Talk.'
In 2002, a national Women's Health Initiative study was terminated early after it linked hormone therapy for menopause to an increased risk of breast cancer. The Women's Health Initiative is an ongoing research project conducted by the US National Institutes of Health, focused on preventing disease in older women.
Although the objective of the study was never to test the use of menopausal hormone therapy to treat symptoms of menopause, and it was halted early without definitive findings, it had long-lasting impacts on menopause care in the United States. Many women stopped using hormone therapy because of the study, and some practitioners no longer recommended it for their patients.
But since then, a growing body of research has found that the benefits of hormone therapy outweigh any small risks for most women with menopause symptoms, emphasizing that hormone therapy can be an effective way to treat symptoms because it helps replace the hormones that the body stops making during menopause.
Next week, the US Food and Drug Administration plans to hold a public discussion about menopause and hormone replacement therapy for women. The panel will include FDA Commissioner Dr. Marty Makary and Dr. Sara Brenner, the agency's principal deputy commissioner, who are expected to discuss treatments, education and comprehensive care beyond managing symptoms.
Years of physician training and research around menopause care and hormone therapy was lost after 2002, Malone said.
'We are still digging ourselves out of a hole of the past 23 years, understanding that there are 23 years of physicians who have not been trained in how to treat and how to deal with conditions of women during menopause. So, if you graduated from medical school and trained any time after the year 2000, you probably were never even given a fair discussion of hormone therapy,' Malone said.
'And the biggest problem that we're facing now is that there's 23 years of research that wasn't done because everybody took the Women's Health Initiative as the definitive answer, which it was not,' she said. 'If I could wave a magic wand, what I would do is eliminate the disinformation that's out there about hormone therapy.'
Dr. Monica Christmas, an associate professor of obstetrics and gynecology at the University of Chicago and associate medical director for The Menopause Society, finished medical school and started residency around the time the Women's Health Initiative findings were released in the early 2000s.
'At that time, there was a lot of fear and trepidation around hormone therapy in particular,' said Christmas, who also serves as director of the menopause program at UChicago Medicine.
'I was fortunate that where I did residency, here in Chicago, I was trained by gynecologists who managed menopausal patients. Looking back on it now, they were probably menopausal themselves,' she said. 'And they were still fairly comfortable with prescribing hormone therapy and really understood what later the data came back to show – that, yes, there's this window of opportunity where the benefits seem to outweigh the risks for most people. That window is under the age of 60 or within 10 years of the onset of menopause.'
Increased menopause awareness and additional education for providers are important issues, Christmas said, but she views extended coverage for menopause care and the treatment of symptoms as the most pressing matter.
'Physicians can have a wealth of knowledge, which they do; however, if the person's insurance doesn't cover treatment, then it stops there,' Christmas said, adding that it's not fair to put responsibility on health care practitioners alone to change the landscape of menopause care. 'The policy focus needs to be on ensuring comprehensive and equitable access to medical care, resources for innovative research and new treatment options, and supportive work conditions.'
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