Meet the women embracing menopause—and those hoping to end it

The palm trees along Ocean Avenue are veiled in mist as I walk toward the Proper Hotel in Santa Monica, California, on a Saturday morning in March.



Inside the glass-and-cement building, where more than 300 women’s voices beckon, I’m confronted with an electric rainbow of statement blazers—Barbie pink, blush pink, velvety mauve, lime green, highlighter green, ’70s plaid, leopard print. The “festive casual” dress code didn’t mention power dressing, but it didn’t have to. We’re here for a symposium on menopause, dubbed “The New Pause,” and the women of a certain age who are in attendance have earned the confidence that their clothes convey.



How old these women are is hard to say. In the U.S., the average age at which women officially enter menopause, or a year without experiencing a menstrual cycle, is 51. (Throughout this article, we use the word women to refer to people with ovaries and a vagina.) But here—among women who have dropped $195 on a day spent exploring the latest research around menopause, while learning how to optimize their bodies through diet, exercise, supplements, prescription drugs, and intentional gratitude—the specific age associated with menopause feels less material than the life stage it represents. These women are parenting teenagers, or have recently become empty nesters. They have careers. They have sex lives. And they have disposable income.



That makes them among the most enticing demographics today. And over the past few years, spurred by a generational shift that has made older women more vocal and more visible, a fast-growing world of products and prescriptions has emerged to ameliorate the trials of menopause and the period preceding it, known as perimenopause. While the most notorious symptom is the hot flash, the full list includes nearly three dozen possibilities, from fatigue to thinning hair to joint pain. A 2020 analysis, published by Female Founders Fund, an early-stage venture firm, tallied women’s spending on menopause-related doctor’s visits and treatments at $2,000 a year, on average. If true, that would suggest that menopause—as both a medical condition and a life stage—could be as much as a $600-billion opportunity. The menopause market, once invisible to investors, is on its way to hitting $16 billion by 2025, according to CB Insights.



At the New Pause, I’m among the youngest in the room. At 39, I’m still closer to my two pregnancies and three miscarriages than I am to menopause. But I’m familiar with the complex negotiation that women make between their bodies and their sense of self, and the reductive power of society’s gaze. Pregnancy makes a woman highly conspicuous, but it can also eclipse her. Watching the parade of new menopausal solutions march across my social feeds—supplements, serums, hormone-replacement telehealth services, and more—I’m intrigued, but also wary. It’s hard to feel encouraged about your expanding options when they render you a one-dimensional marketing target the second you search “hot flash.”



Even as menopausal products trip over themselves to infiltrate TikTok feeds, in research labs, there are teams on the verge of breakthroughs that could diminish menopause’s power, even end it. By tinkering with the hormones that regulate ovarian function, the entrepreneurs behind these efforts aspire to empower women, and I hope that they will. But part of me resents them. For decades, if not centuries, companies have been selling women on ways to “fix” their faces and figures. Soon, we’ll be able to fine-tune our biology.



Susan Sontag once observed that aging makes women “obscene” in society’s eyes. In a sense, the women around me at the New Pause are here to spar with society—and themselves—on this point. Women in midlife are better represented in corporate boardrooms and on Hollywood’s silver screens than ever before, yet society seems as fixated as ever on aging in women as a problem to be solved.



On stage in the linen-paneled ballroom that will be our home for the afternoon, serial entrepreneur Alisa Volkman, cofounder and CEO of Yhe Swell, a membership community for women who are over 40, takes to the podium alongside her cohost, actor Naomi Watts. Last year, Watts launched Stripes, a menopause-focused beauty and wellness brand; her product line includes face moisturizers and an oil-based lube.



“Our bodies are biologically designed to pause,” Volkman says. “After so many years of giving our time, our energy, our blood, our womb, for some of us, to others, it is all returning to ourselves. So the question is, What are we going to do with that?”



“Aging is not a failing,” says Watts, echoing the message of empowerment. “Aging is actually a fantastic sign that we’re living.” Women in the crowd, all of whom have been gifted a Stripes cooling and calming face mist, murmur their agreement.



Earlier, in the terra-cotta bathroom, a woman confronted her reflection in the mirror as we washed our hands. “At least the lighting in here is good,” she told her friend. “It’s making me feel better about my life.”







The idea of life after menopause is relatively new. One hundred years ago, life expectancy for U.S. women was 58.5 years. With that number now approaching 80, women can anticipate living for multiple decades after menopause. They are also working longer, earning more, and having children later in life. But their biology remains unchanged.



As with puberty and pregnancy, menopause experiences vary widely. Some women might not even notice that their bodies have undergone a shift, if it weren’t for the absence of their period. Others battle a debilitating list of symptoms, including night sweats, brain fog, low libido, vaginal dryness, and depression. Hot flashes can sound trivial until you’re experiencing one while wearing a constricting uniform at the start of your shift. Brain fog is the stuff of comedy until you’re a surgeon who no longer trusts herself in the operating room. In the U.S., Black and Hispanic women are among those who suffer the most severe symptoms, which can last for a decade. Statistically, they are also the least likely to be able to afford the wellness-as-luxury menopause solutions emerging today. (Symptoms vary widely around the world, suggesting that environmental and systemic factors play a role.)



Menopause also accelerates aging. Emerging research suggests that many of the conditions that we associate with aging in women, including osteoporosis, Alzheimer’s disease, and heart disease, are linked to the hormonal shifts that take place at the onset of menopause. The concept of a “geriatric” pregnancy at age 35 may sound hyperbolic, but it reflects a biological truth. Ovaries age at twice the rate of other organs, leading to a decline in fertility and a host of secondary effects. Hormonal changes at menopause accelerate cellular aging by 6%, according to a study by researchers at the University of California, Los Angeles. Earlier menopause is associated with a shorter life.



In the face of these challenges, a universe of menopause-related beauty products and supplements has sprung up. There are berry breeze–flavored gummy vitamins ($45), with ingredients such as Black Cohosh, a flowering plant thought to help regulate body temperature, from women’s health brand O Positiv. There are vaginal moisturizers, like Bonafide’s Revaree inserts ($62), which contain hyaluronic acid and can be paired with the company’s Ristela tablets ($57) as part of a “sexual satisfaction bundle.” There is a collagen-boosting moisturizer ($72) from Pause Well-Aging, sold alongside a silver “fascia stimulating tool” ($115), which promises to tighten “sagging facial contours.” And for women who like to live on the wild side, there is whatever Gwyneth Paltrow is doing.



[Illustration: Sophi Miyoko Gullbrants ]



In parallel, there are at least a half-dozen telehealth startups looking to correct what they see as a gap in medical care for menopausal women. Menopause training is an afterthought at most medical schools, even among doctors pursuing specialties like gynecology. Furthermore, many doctors still believe that hormone therapy involving estrogen, while effective in managing symptoms like hot flashes, can increase the risk of breast cancer—a conventional wisdom that took hold as the result of an influential 2002 study. In the years that have followed, a growing chorus of medical professionals has challenged that study, pointing to flaws in its design and noting that its own data do not support strident warnings around cancer risk.



Twenty years ago, menopausal women were flushing their hormones down the toilet after reading alarming headlines about breast cancer and estrogen. Today, they’re seeking out startups like Alloy, Evernow, Peppy, and Vira Health in order to explore hormone therapy as an option. Over the past few years, these companies alone have raised more than $100 million from healthtech investors and celebrities alike. Evernow counts Paltrow, Cameron Diaz, and SpaceX president Gwynne Shotwell among its backers.



Whether their focus is wellness or healthcare, these emerging brands are speaking to women who are demanding more than the narrow roles that have historically been assigned to older women in our society—doting grandmother, perhaps, or power-walking retiree. Women want their health. But they also want relevancy. “This is for people who are not in the long process of giving up,” declares Caddis, maker of fashionable women’s reading glasses, on its packaging; the glasses blanket a display table at the symposium.



Caddis is selling resilience, starting at $99 a frame. Beyond these walls, menopause brands are selling wisdom and vitality to women across the media ecosystem. In 2021, a “Let’s Talk Menopause” ad campaign appeared at nearly 200 subway stations in New York, sponsored by a nonprofit advocacy group. That same year, venture dollars flowing toward “femtech” startups in the U.S. surpassed $1 billion for the first time, with women investors playing a leading role. This year, menopause had its Super Bowl debut, thanks to a spot by Astellas Pharma highlighting VMS, or vasomotor symptoms, better known as hot flashes and night sweats. Social media platforms that previously categorized menopause as a medical condition have loosened restrictions on menopause marketing and sales; influencers now peddle everything from vitamins to “vaginal microneedling” devices. Five years ago, most of these products didn’t exist. But when there’s an opportunity to monetize women’s hopes, fears, and bodies, market forces close in with ruthless efficiency.



Between panels at the New Pause, psychologist Aliza Pressman takes the stage to lead us through a mindfulness moment. We close our eyes, hands on our hearts, to meditate on the people we love. We learn about the connection between happiness and letting go. But it’s hard to ignore the competing signals.







Across the room, during a break in the symposium, I spot a woman in a periwinkle blue top, her hair the effortless sun-kissed blonde that dyes try to mimic. It’s Daisy Robinton, cofounder and CEO of Oviva Therapeutics, and a former model. Like me, she’s technically underage for the event. But she’s here to gauge the audience. Robinton’s biotech startup hopes to end menopause as we know it.



Robinton, who has a PhD in human biology and translational medicine from Harvard, initially focused her research on stem cells. But she shifted to ovarian aging when, as a 31-year-old, she visited a reproductive endocrinologist to discuss her fertility and was faced with her own perfectly normal, but rapidly declining ovarian reserve. What she expected to be a consultation about egg freezing became a new career path.



At the time, in 2017, aging was an increasingly popular scientific field. Robinton had been to countless dinners, salons, and panels focused on the topic. Yet she had never heard anyone mention the ovaries. “Once they’re kaput, which happens at what is now midlife, the rest of our aging is accelerated,” she says. “The ovaries are the canary in the coal mine.”



Robinton heard about research being conducted at Harvard by a team focused on reproductive biology. Throughout a woman’s life, her body is steadily maturing and then discarding the million-plus eggs that her ovaries contain at birth. By harnessing a protein known as anti-Mullerian hormone to slow the process, it’s theoretically possible to prolong fertility and extend health span. Robinton recruited the Harvard researchers, incubated their approach at Cambrian Bio, and formed Oviva, which has raised $11.5 million in seed funding.



“Our hypothesis is that if we can preserve the ovarian reserve, then our ovaries will continue to function,” she says. Such an intervention would “potentially delay or completely forestall menopause entirely, thereby allowing us to have a more consistent quality of life and age like normal people—or I guess age like men, which I hate saying.” (Women experience a zigzag hormonal decline during perimenopause, followed by a sudden drop at menopause; men’s hormonal decline follows a gradual slope.) Oviva is not, Robinton emphasizes, working toward a mythical fountain of youth, nor is its goal to enable women to become mothers later in life, though it would open that door. “We’re not preventing you from aging,” she says. “It’s just that we’re stopping that cliff moment.”



Oviva is one of a handful of biotech startups working toward therapeutics that would end menopause as we know it, or at the very least give women better options for managing their fertility. New York–based Celmatix, which has raised just over $100 million, is also trying to pick the scientific lock on ovarian function. When founder and CEO Piraye Yurttas Beim, who has a PhD in molecular biology and mammalian embryology, created her company in 2009, her initial product centered around gathering data on women’s reproductive health in an effort to present women with better information about their chances of success with IVF. She was able to build a data set that includes genetic information, microbiome sequencing, reproductive outcomes, and more.



Now, she’s developing multiple drugs, including a therapeutic that targets the same protein as Robinton, and with a similar objective—to transform menopause’s cliff into a more gradual slope. Every woman’s hormone levels are different; in theory, the proprietary data sets that Beim has compiled will support the creation of precision medicine interventions that can better engineer an optimal slope for each woman. Beim expects Celmatix’s first human trials to focus on women who have been diagnosed with cancer and are facing early menopause as a result of chemotherapy treatments.



[Illustration: Sophi Miyoko Gullbrants ]



“Going through breast cancer treatment, you lose about a decade of your ovarian function,” she says. “That’s certainly bad news if you want to have any more children, but it’s also bad news because all of the things we hear about the menopause transition—the hot flashes, the sleep disruption, the sexual disruptions—are greatly amplified.” But her mission is bigger than addressing premature menopause in cancer patients. “One of the biggest lies in healthcare today is that menopause is a natural phenomenon, or a phenomenon that we should feel empowered by somehow, as a rite of passage,” Beim says. In her eyes, it’s a “public health crisis.”



Not everyone agrees. Martha Hickey, a professor of obstetrics and gynecology at the University of Melbourne who published an article last year in the medical journal The BMJ titled “Normalizing Menopause,” tells me she’s exasperated by the “attribution of all things bad about women to their hormones.” To her, it smacks of the same “Victorian beliefs” that led people to conclude that women’s hormones were making them hysterical. Many aspects of aging are unrelated to hormones. On the other hand, women over 50 are four times as likely as men to be diagnosed with osteoporosis, which is exacerbated by menopause and can lead to back pain, broken hips, and severely diminished quality of life. It’s sobering to think that much of this could be avoided with the right interventions in midlife.



Beim sees the conversation around menopause as a chance to better educate women about their own health. “A big misconception that a lot of women have is that their ovaries are just for making babies,” she says. “But the reality is that the ovary is the central command of our endocrine system, our metabolic system.”



In the same way that women are screened today for certain cancers, women in the future might be screened in early adulthood for ovarian health. The total addressable market for such a diagnostic: roughly half the world’s population.







Like most women, I didn’t think much about my ovaries until they were a problem. I started to feel discomfort while trapped in the back of a rental car along with my fiancé while my future brother-in-law drove us from New York to Washington, D.C., for the holidays. As the discomfort grew, I wanted to curl up on the side of the road, from pain as much as embarrassment. Back home, the gentle midwife at my OB-GYN’s practice told me that I had developed ovarian cysts—a fine-print risk factor associated with my IUD that no one had previously bothered to explain. One of my cysts had ruptured.



As a woman, it can be surprisingly easy to forget that your body belongs to you, especially when everyone else seems to have an opinion about it. This alienation is fueled by the fact that women have so little information about their own inner workings, following decades of underinvestment in research and patronizing medical practices.



This lack of research has meant that businesses addressing menopause, to date, have isolated women’s symptoms, offering separate products to address them. Each symptom generates new concerns, new fears, new marketing opportunities. But we’re now discovering that there’s a highly coherent biological system behind them all.



The three-year-old Global Consortium for Reproductive Longevity & Equality has become the hub for this line of inquiry. The center’s stated mission is to “alter the societal balance toward equality for women by defining what leads to menopause and developing interventions to slow or reverse it.” It’s made grants worth $7.4 million in support of nearly two dozen researchers across the globe and plans to nearly double that amount this spring. Neuroscientist Jennifer Garrison, who has a PhD in chemical biology, established the consortium alongside Nicole Shanahan, ex-wife of Google cofounder Sergey Brin.



Despite fighting jet lag following a red-eye flight to Europe, Garrison is more than happy, when I get her on Zoom, to give me a quick biology lesson on the connection between the ovaries and the brain—specifically, the ovary and the neural circuits in the hypothalamus. The hypothalamus, she explains, is engaged in a chemical conversation with the body’s organs, mediated by hormones, such as estrogen and progesterone.



“When you start to focus on any aspect of female reproduction through the lens of the brain, the symptoms that are experienced during puberty, periods, pregnancy, lactation, and menopause—suddenly, they all make sense,” she says. “Neurons that control body-temperature regulation could be overlapping with the neurons that control reproductive function. These neurons also control the affective components of behavior, so things like mood and emotion.” In other words, those disparate, seemingly random symptoms that are the precursors of menopause share a common neurological infrastructure.



“The moonshot goal,” Garrison continues, “would be simply to sync up aging in the ovaries with aging in the rest of the woman’s body, and that would mean extending reproductive span—pushing out the edge of menopause or even getting rid of menopause altogether.” In the next five years, she expects that researchers will achieve a first major milestone on that pathway: better diagnostics for women. Later, we might see therapeutics capable of maintaining a level of hormonal function that benefits overall health.



The implications are potentially profound: older mothers, longer careers, perhaps an entirely new architecture for our life stages—that is, for women who can afford it. Current disparities in healthcare would almost surely shape this brave new world.



As Garrison speaks, I think of what passes for empowerment for women at the moment. Wrinkle prevention. Working a side hustle. On TikTok, young influencers getting boob jobs and proudly declaring, “I did this for me.” But actually understanding women’s biology, and your own body? It’s hard to conceive of how revolutionary that would be.



Back in Santa Monica, six hours of panels and presentations and motivational talks have come to an end. We spill out into the vestibule, greeted by glasses of chardonnay and mocktails infused with Reishi mushroom. Today, selling menopause is becoming a big business. By the time I retire, selling the end of menopause could be an even bigger one. As we age, each of us will have to navigate this shifting landscape on our own. Needing to jot down some notes, I return to the ballroom, hoping to sit down for a moment. But the chairs are already gone.