The Menopause Movement Is Making Waves

by Angela Nelson

Not long ago, menopause was a discussion topic that, like breastfeeding and menstruation, was largely reserved for private conversations among women. Mention it in mixed company and, well, let’s just say things could get awkward.

These days, more women are speaking openly about menopause and seeking treatment for the symptoms that can accompany this natural stage of midlife.

As demand for menopause care grows nationwide, the field of menopause medicine is gaining traction to address a longstanding gap in women's health. At Tufts, that work is taking shape through a university-wide initiative that combines clinical care, research, nutrition science, and medical education.

Menopause is not a disease or a medical condition. Many women spend a quarter to a third of their lives in perimenopause and the menopausal transition. Yet historically, it’s an area of women’s health that has received only a tiny fraction of federal research funding, even though it affects half the population.

“It’s estimated that 6,000 women enter menopause every day in the United States. But in 2024, the National Institutes of Health spent just 0.1% of their research budget on menopause-specific research,” said Larissa Calancie, the Linda and Jeffrey Moslow Assistant Professor of Women’s Health and Menopause at the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University, and a researcher who focuses on nutrition and population health. “This is something that deserves resources and attention.”

That lack of research and financial support translates to gaps in healthcare that women can experience when they seek information and treatment for their symptoms. It’s what happened to Linda Moslow, A16P, A18P, when she entered perimenopause in her early 40s. Months of anxiety, sleeplessness, and confusion left her unable to recognize herself until she found a team of doctors who helped her understand what was happening.

“I was prepared educationally for what could happen, and I thought that because I took great care of myself that I would be immune to perimenopause,” said Moslow. “It hit me like a tornado! I was so grateful to have had incredible medical doctors who were well versed in women's health and recognized what I personally needed in support. This is what drives me to change the experience for other women.”

Realizing that millions of women lacked the support she managed to find, Moslow and her husband Jeff Moslow, A86, A16P, A18P, chair of the Tufts University Board of Trustees, made a $4 million gift to establish the Tufts Women’s Health and Menopause Initiative, a university-wide effort that brings together research, education, and clinical care to improve women’s health, and endow two inaugural professorships.

“Patients are almost overwhelmed with emotion just having a conversation about their symptoms, because they have felt for too long that people haven't listened to them,” said Megan Evans, the Linda and Jeffrey Moslow Professor in Women’s Health and Menopause at Tufts University School of Medicine and an obstetrician and gynecologist at Tufts Medical Center. “It's not uncommon that I see patients who want a second opinion after another physician dismissed their symptoms or didn't recognize perimenopause or menopause changes. The transition into menopause encompasses every aspect of someone’s well-being—mental health, sexual health, cardiovascular health, their life.”

Menopause medicine is a growing specialized area of practice devoted to helping women navigate the years before, during, and after menopause. Clinicians draw on expertise from gynecology, nutrition, endocrinology, primary care, and preventive medicine to address everything from hot flashes and sleep problems to bone health and cardiovascular risk. Evans sees all of this in her clinical practice, and she understands her patients’ frustrations: They feel terrible and want to feel better, but some are told that their symptoms don’t require medication, while others face waits of six months to a year to see a menopause specialist.

In addition, women in their 40s and 50s report being bombarded with information on social media related to aging and health. Evans says her patients often cite information they heard from wellness influencers. As a result, some turn to online retailers for hormones or visit medical spas, which may be able to offer appointments sooner, Evans said, but they may also promote supplements or injectables that may have harmful side effects or are not safe for all patients.

“Some of that information is accurate, and some of it is only partially accurate,” Evans said. “One of the challenging parts of menopause medicine is that there's a huge lack of research in this space, so there’s a lot we don’t know. Unfortunately, I think patients can get taken advantage of because of that. They want answers now, but research takes time to show that things are safe and effective.”

“It’s estimated that 6,000 women enter menopause every day in the U.S. But in 2024, the National Institutes of Health spent just 0.1% of their research budget on menopause-specific research. This is something that deserves resources and attention.”

- Larissa Calancie, the Linda and Jeffrey Moslow Assistant Professor of Women’s Health and Menopause at the Friedman School of Nutrition Science and Policy

Uniting Care, Research, and Education

Calancie and Evans are the co-directors of the Women’s Health and Menopause Initiative, which has three main goals: building a multidisciplinary clinical center of excellence for menopause care, developing research infrastructure that to explore the unknowns, and educating medical students as well as practicing physicians so they feel more comfortable caring for patients in or around menopause. 

Menopause-dedicated clinics have opened in Boston, Braintree, and Norwood, with plans to expand in 2027, Evans said. One early project highlights the initiative's approach: the creation of a comprehensive intake process that gathers clinical, lifestyle, and nutrition information before patients arrive, allowing providers to tailor care while creating a valuable research resource.

“The patient intake form will also include a validated dietary screener that looks at dietary patterns and quality, which we're really excited about,” said Calancie. “There are not many menopause health clinics around the country, and it’s especially unique to have one that looks at nutrition from the start and throughout care.”

Calancie said having healthy eating patterns that resemble a Mediterranean-style diet, or a diet rich in high-quality fats and carbohydrates, is associated with fewer vasomotor symptoms like hot flashes, as well as weight loss, healthy body composition, and lower rates of depression.

The research arm of the initiative will try to answer questions about menopause, such as why some women experience severe symptoms and others don't, which interventions work best for which patients, and how lifestyle factors such as diet influence symptom severity.

On the academic side, Evans notes that medical students and residents historically have not received adequate training around menopause, which means that even some practicing physicians may not have complete understanding or comfort around menopause management.

Part of her role, she says, is to address those missing pieces across medicine in a comprehensive way. She would like to see menopause discussed across multiple areas of study, including cardiovascular health, metabolism, and pregnancy, rather than confined to one lecture. She also envisions building menopause education into the curriculum not only for medical students but also for physician’s assistant students, physical therapy students, and more. 

“The infrastructure we're building is very exciting, but the driving force for me is to be a space where patients can feel that someone is listening and paying attention to their symptoms,” said Evans. “This is so much beyond treating patient symptoms. It's treating their whole self.”

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