Menopause Is Having a Policy Moment. Black Women Must Be at the Center.
BWHI’s new report examines 171 state and federal menopause-focused bills and asks a critical question: as the country finally pays attention to menopause, are policies being designed to meet the needs of Black women?
For generations, menopause was treated as something women were expected to manage quietly. Hot flashes? Deal with them. Trouble sleeping? Push through. Brain fog, fatigue, depression, changes in sexual health, weight gain, symptoms spilling into work and relationships? Too often, women were left to figure it all out on their own.
That’s finally beginning to change. Menopause has moved into a much larger national conversation about women’s health, the workplace, research and public policy. Legislators across the country are introducing bills to improve menopause education, expand insurance coverage, train providers, fund research and create workplace protections. That momentum matters, but at the Black Women’s Health Imperative, we believe another question matters just as much: as menopause policy moves forward, are Black women actually being centered?
Our new report, Menopause and the Change Ahead: State and Federal Legislative Trends and Policy Insights (2021–2026), examines how policymakers are responding to menopause and where significant gaps remain. What we found is both encouraging and urgent.
Menopause Is Not the Same Experience for Every Woman
Menopause is a natural stage of life, but that doesn’t mean every woman moves through it the same way. Research examined in the report shows that Black women tend to reach menopause earlier and live with symptoms longer. Black women reach menopause at an average age of about 49, compared with the national average of 52, and our symptoms last an average of 10 years, compared with about 6.5 years for white women. Black women are also more likely to experience frequent and severe symptoms, particularly hot flashes and night sweats, and more likely to report real limitations in physical functioning during midlife.
Biology alone can’t explain those disparities. Chronic stress, structural racism, socioeconomic inequality, higher rates of chronic health conditions and unequal access to quality healthcare across the life course all shape how Black women enter and experience menopause.
And then there’s the healthcare system itself. More than 30% of Black women report feeling that their health concerns or symptoms weren’t taken seriously by providers, and about 40% report having to speak up just to get proper care. During menopause, when symptoms can be complex and overlap with other conditions, having a provider who is prepared to listen isn’t a luxury. It’s the whole ballgame.
Black Women Told Us What They Need
Before examining a single bill, BWHI wanted to hear from Black women themselves. In 2025, we conducted a study of 1,574 Black women exploring their knowledge, experiences and needs during the menopause transition. What we heard was striking.
41% said their healthcare provider had not discussed menopause symptoms with them.
54% said they did not have enough information to effectively manage their symptoms.
52% were uncertain about which menopause recommendations to follow.
The symptoms themselves were significant. Many women reported experiencing them for nine years or longer, and night sweats, brain fog and fatigue were often described as more disruptive than hot flashes. More than half, 55%, reported struggling with weight gain, and 42% reported experiencing depression.
One of the most telling findings: healthcare providers were the source women cited most often for menopause information, yet they were rarely considered the most useful source. Sit with that for a moment. The people we’re told to turn to first are the ones leaving us with the fewest answers, which means too many Black women have to become their own menopause experts before they ever walk into an exam room.
As BWHI President & CEO Joy D. Calloway, M.B.A., M.H.S.A. writes in the report:
“No woman should have to navigate years of discomfort, disruption, or uncertainty during a stage of life in which we should be able to move through with care and dignity.”
Policymakers Are Finally Paying Attention
The good news is that menopause is increasingly being treated as a public health and policy issue. BWHI analyzed menopause-focused legislation introduced between January 2021 and March 2026, and the growth has been dramatic. In 2021, only two menopause-focused bills were introduced nationwide. By 2025, that number had jumped to 63. And in just the first three months of 2026, another 60 bills landed.
Altogether, BWHI identified 171 menopause-focused state and federal bills during the analysis period. Of those, 26 passed, 70 failed and 75 remained active during the study period. In other words, the conversation is moving quickly. But introduction is not implementation, and momentum alone doesn’t guarantee that women will actually receive better care.
The States Are Leading the Way
Most of the action is happening at the state level. Between January 2021 and March 2026, 28 states introduced menopause-focused legislation, and 16 of them passed at least one measure. In all, BWHI identified 159 state bills, and they approached menopause from several angles: 81 addressed public and patient education, 39 included health insurance coverage provisions, 33 addressed provider education and training, 28 included research initiatives or task forces, and 23 addressed workplace or legal protections and accommodations.
But only 21 bills addressed racial or geographic disparities in menopause care, outcomes or access. That number deserves our attention. If Black women are more likely to experience longer and more severe symptoms, and if we already face documented disparities in care, equity can’t be sprinkled on after the fact. It has to be baked into how policy is designed from the beginning.
Some States Are Trying New Approaches
The report highlights several state efforts that show what more comprehensive menopause policy can look like. California proposed funding to expand specialized menopause programs across the University of California health system, modeled after UCLA’s Comprehensive Menopause Program. Rhode Island became the first state to explicitly require workplace accommodations for employees experiencing menopause and related conditions. North Carolina introduced a broad framework combining insurance coverage, workforce training, grant funding, public awareness, data collection and health-system infrastructure focused on midlife women’s health. And Massachusetts paired expanded treatment coverage with a commission examining gaps in menopause care, provider education, workplace impacts and disparities.
These approaches recognize something important: menopause doesn’t happen only inside a doctor’s office. It follows a woman into how she sleeps, how she works, how she cares for family, how she manages other health conditions and how she moves through her everyday life. Good policy meets her in all of those places.
At the Federal Level, There Is Still a Long Way to Go
Federal action has been far more limited. BWHI identified just 12 federal menopause-focused bills introduced between January 2021 and March 2026, and none passed during the period examined. Most focused on research: nine of the 12 included research collaborations, task forces or other study efforts. Only three included provider training, three included public or patient education, and three addressed racial or geographic disparities. Notably, not one included requirements for menopause-related insurance coverage or workplace and legal accommodations.
Research is essential. We still have far too many unanswered questions about menopause, particularly when it comes to Black women. But research can’t be the finish line. Women experiencing symptoms today also need trained providers, affordable treatment options, supportive workplaces and information they can trust.
Awareness Is Important. Access Is Better.
One of the most important messages in Menopause and the Change Ahead is that awareness alone won’t solve this. Talking about menopause more openly is progress. Celebrities sharing their stories is progress. Public education is progress. But awareness doesn’t automatically turn into better health outcomes, and even insurance coverage isn’t enough by itself. A treatment can technically be covered and still sit out of reach because of cost-sharing, prior authorization, provider shortages, transportation, geography or the sheer difficulty of finding a clinician with real menopause expertise.
This is where policy has to move from intention to implementation. Telling women more about menopause while they can’t find a trained provider doesn’t solve the problem. Neither does covering a treatment while making it financially or administratively exhausting to obtain, or acknowledging disparities without ever measuring whether Black women’s care actually improved.
Menopause Is Also a Workplace Issue
Menopause doesn’t politely wait until after the workday ends. Sleep disruption, fatigue, brain fog, hot flashes and depression can all affect productivity, attendance and a woman’s ability to function comfortably on the job. The report cites research estimating that menopause-related absenteeism costs the United States approximately $1.8 billion every year.
For Black women, the workplace stakes run even higher. We are often the primary earners and caregivers in our households, which means struggling through menopause without support can shake not just our health but our family’s economic stability. Yet workplace protections and accommodations were among the least represented areas in the legislation BWHI examined. And the accommodations in question aren’t exotic: flexible scheduling, access to temperature control, remote work where it makes sense, leave when symptoms flare and protection from retaliation for asking. No woman deserves to be forced into choosing between managing her health and protecting her livelihood.
Better Policy Starts With Better Care
BWHI’s recommendations call for a far more comprehensive approach. That means improving access to clinicians who are actually trained in menopause care, strengthening continuing education for healthcare professionals with real attention to racial bias in how Black women’s symptoms are recognized and treated, exploring telehealth and technology-enabled care for communities where specialists are scarce, and making sure women receive proactive information from trusted professionals before they find themselves battling symptoms they don’t understand. Black women deserve better than having to repeatedly convince providers that something is wrong before being taken seriously.
We Also Need Better Data
One of the clearest recommendations in the report is that health equity can’t remain a vague promise. We need data, including more research focused specifically on Black women and a real understanding of how menopause symptoms, care, treatment and outcomes differ across communities. And when policies pass, we need to measure who actually benefits: whether more Black women gained access to menopause-trained clinicians, whether treatment became more affordable, whether workplace protections helped women stay employed and economically stable, and whether disparities truly narrowed. Without measurement and accountability, inequities can stay hidden inside even the most well-intentioned policies.
Menopause Does Not Happen in Isolation
Another lesson from the report is that menopause can’t be separated from the rest of a woman’s health. Black women disproportionately experience conditions including cardiovascular disease, diabetes, osteoporosis and uterine fibroids, all of which may intersect with health during midlife and the menopause transition. Menopause isn’t a siloed women’s health issue. Reproductive health, chronic disease, mental health, sexual health, healthy aging and menopause are all connected, and our healthcare systems and policies need to be connected, too.
Community Matters, Too
Not every solution will come from a statehouse or a doctor’s office. Menopause can be deeply isolating, especially for women who grew up in families or communities where it was rarely discussed. BWHI supports peer-led and community-based models where women can talk openly, share experiences, learn from trusted experts and navigate menopause together.
That philosophy shaped BWHI’s Power in the Pause initiative, which created spaces for Black women to have honest, intergenerational conversations about perimenopause, menopause and thriving in midlife. Because sometimes the first step toward better health is simply hearing another woman say, “Yes. I experienced that too.”
This Is About More Than Getting Through Menopause
There’s a phrase women hear far too often when something happens to our bodies as we age: “That’s just part of getting older.” Sometimes that sentence closes a conversation that needed to begin. Menopause is a natural stage of life, but suffering in silence was never part of the deal. Being dismissed isn’t inevitable, being uninformed isn’t inevitable, and losing quality of life doesn’t have to be the price of reaching midlife.
Black women deserve information we can trust, care that recognizes our experiences, workplaces that understand women’s health doesn’t stop mattering at midlife, and policies designed not just to name disparities but to change them. As Joy D. Calloway puts it plainly:
“Black women cannot be an afterthought in the national conversation about menopause.”
There’s real momentum around menopause policy right now, and a real opportunity to make sure that momentum becomes meaningful change. As Calloway writes in the report, “We will not stop until Black women can move through menopause informed, prepared, and supported at every stage.”
Neither will we.
