The Wellness Collective

The Invisible Side of Menopause No One Talks About

Reviewed by Adam Gardner, Licensed Pharmacist & COO of TelyRx

A group of women enjoy a yoga class together.
A group of women enjoy a yoga class together.

Table of Contents

Imagine if the standard of care for a heart attack depended entirely on which ER doctor happened to be on duty that night. Some would provide life-saving intervention, while others might tell you to “wait it out” or “just take an aspirin.” This sounds absurd for cardiac care, but it’s exactly what’s happening with menopause treatment across America.

The invisible side of menopause isn’t its symptoms—although the emotional changes during menopause like anxiety and mood shifts are often minimized or dismissed. The real problem is the battle women shouldn’t have to fight: convincing doctor after doctor that their symptoms deserve treatment while relying on sheer luck to determine whether they’ll receive appropriate care for a major life transition affecting millions.

menopause by the numbers

Every day in the United States alone, six thousand women officially hit menopause, a milestone measured by having gone 12 consecutive months without a period. That’s over 2 million women a year entering a transition that can span 15+ years of their lives—from early perimenopause symptoms starting in their late 30s through post-menopause effects continuing into their 60s.

As Millennials approach their 40s and Generation X moves through their 50s, this translates to approximately 70 million American women who are now either entering or actively navigating the menopause transition. These are individuals accustomed to having agency over their reproductive choices, who have built careers, and who have advocated for themselves throughout their personal and professional lives.

They’ve successfully turned to modern medicine for support with everything from puberty through childbirth—contraception, prenatal care, and routine preventive screenings—yet are largely left to navigate menopause without a reliable compass. Worse, when seeking menopause treatment, many encounter doctors still operating from an outdated playbook, where the quality of care depends on the beliefs of whatever physician they happen to see rather than on standardized, evidence-based protocols.

what’s missing from the menopause conversation

A doctor consults a patient on menopause symptoms.
A doctor consults a patient on menopause symptoms.

This is the part of the menopause story that rarely gets told. Women across demographics and geography report strikingly similar experiences when seeking medical help to navigate this transition:

Systematic dismissal follows a predictable script. “Your bloodwork is normal” is an authoritative but flawed conclusion that completely ignores the fact that hormone levels fluctuate wildly during perimenopause, making singular blood tests virtually meaningless for diagnosis. This can lead women to rule out perimenopause entirely as a possibility, often sending them on an expensive wild goose chase through cardiologists, endocrinologists and psychiatrists, while their actual hormonal symptoms go untreated.

Symptom minimization starts early. Women in their early 40s describing irregular periods, mood changes, or cognitive shifts are often told they’re “too young” for perimenopause, despite medical evidence that the transition typically begins 8-10 years before final menstruation.

Cross-examination becomes the norm. Women find themselves defending their own experiences: “Are you sure it’s not just stress?” “Maybe it’s depression.” When discussing mental symptoms of menopause like perimenopause brain fog, anxiety, social withdrawal, or feelings of invisibility, many women are routinely offered antidepressants. This contradicts clear medical guidelines stating antidepressants should not be used as a first-line intervention for menopause-related mood changes. The reality is that when hormone levels are properly balanced through evidence-based treatment, many women find their moods naturally stabilize without the need for psychiatric intervention.   

Flat-out refusal of treatment is shockingly common. Women describe being told that hormone therapy is “too dangerous,” that they should just “wait it out,” or that menopause is a “natural part of aging” that doesn’t necessitate medical intervention. The message is consistent: suffer in silence. The challenge is that many doctors haven’t kept up with evolving medical guidance around the range of FDA-approved options now available.

It’s estimated that about four in five midlife women experience problematic symptoms of menopause like hot flashes, night sweats, sexual problems, sleep disturbance and brain fog, all of which have been shown to affect a woman’s quality of life, relationships, career, and overall health. And yet only 49% of women in perimenopause and 58% of women in menopause have spoken to a healthcare professional about their symptoms.

While some women hesitate to bring up symptoms they suspect will be dismissed, others who do seek help often leave appointments feeling unheard, and consequently their symptoms go untreated. This is not because effective treatments don’t exist—it’s because many doctors simply don’t know how to help them.

the education gap

An up-close image of a stethoscope, a notebook, and glasses, with a doctor filling out paperwork in the background.
An up-close image of a stethoscope, a notebook, and glasses, with a doctor filling out paperwork in the background.

Here’s the simple truth behind why menopause care so often feels like a game of chance: 80% of OB/GYNs are untrained in treating it. And if the specialists we turn to as menopause experts lack the proper training, what hope do women have of getting appropriate, evidence-based care from their general practitioners?

According to research published in Mayo Clinic Proceedings, 80% of graduating internal medicine residents do not feel competent to discuss or treat menopause. A separate study published in Menopause found that only 31.3% of OB/GYN residency programs include any formal menopause curriculum, while 83% of OB/GYN program directors surveyed acknowledged their programs needed more menopause educational resources.

In this aspect of medicine in particular, many doctors are still operating from information learned decades ago, often based on a single, controversial study from way back in 2002 that sent shockwaves through the medical community and dramatically changed how physicians viewed hormone replacement therapy. 

Fortunately, the tide is beginning to turn.

the fda takes a fresh look

In July 2025, the FDA took an unprecedented step when it convened an official expert panel to reassess the “black box” warnings placed on hormone replacement therapy over two decades ago. Following that panel meeting, FDA Commissioner Dr. Marty Makary voiced his strong support for removing these warnings entirely.

According to The New York Times, Dr. Makary has stated that “there’s probably no medication that improves the health outcomes of a population more than hormone replacement therapy for women who start it within 10 years of the onset of menopause,” and that “women live longer, feel better. The benefits are overwhelming.”

This newfound recognition of hormone therapy’s benefits is a powerful validation of what women have intuitively known for years: their symptoms are real and demand effective solutions, not formulaic dismissals.

The shift also underscores the profound impact of hormones like estradiol on overall well-being and health. As Dr. Rachel Cady, MD, a Board-certified OB/GYN and NAMS-certified menopause practitioner explains, “Estradiol is one of the body’s most amazing anti-inflammatory hormones. When estradiol declines, women suffer in a variety of tangible ways for years longer than previously thought.”

how online menopause care can fill the gap

A patient sits on her couch browsing the TelyRx website.
A patient sits on her couch browsing the TelyRx website.

While we wait for traditional healthcare to catch up with current research, there’s no reason to continue leaving your menopause care to chance. You know the feeling—wondering whether your next appointment will finally connect you with someone who understands your symptoms, or if you’ll face another round of dismissals and outdated advice. 

Platforms like TelyRx can fill that gap now by connecting you with board-certified doctors who can prescribe online menopause medication through a comprehensive range of treatment options, all from the comfort and privacy of your home. No more enduring in-person dismissals or frustrating delays. TelyRx provides direct access to the care you deserve from licensed providers in your state who understand that your symptoms are both real and treatable.  
Starting at $89.99

Estradiol Patches

Estradiol patches are a form of HRT used to treat hot flashes, night sweats, and vaginal dryness through a patch on the skin.

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Starting at $34.99

Progesterone Capsules

Progesterone is a female hormone used to help prevent endometrial hyperplasia associated with estrogen therapy.

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Starting at $34.99

Estradiol Vaginal Cream

Estradiol (estrogen) is a hormone used to alleviate symptoms of menopause, including vaginal dryness, burning, and painful intercourse.

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Starting at $29.99

Estradiol Tablets

Estradiol (estrogen) is an oral hormone used to help alleviate symptoms of menopause, including vaginal dryness, burning, and painful intercourse. 

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Starting at $59.99

Estradiol Transdermal Patches

Estradiol is a hormone used to alleviate symptoms of menopause, including dryness, burning, and painful intercourse through transdermal patches.

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what you can do starting today

You have more control over your menopause experience than you might realize. Here are some practical ways to reclaim that control:

  • Keep a symptom tracker to build your case: Documenting the frequency and severity of your symptoms creates compelling data that supports your experience. When you walk into appointments with concrete patterns and specific details, you transform from someone struggling to find words for vague feelings into someone presenting objective medical evidence.
  • Start early with prevention in mind: Remember that perimenopause can begin in a woman’s late 30s, years before anyone expects it. You’d never wait for your fuel gauge to hit ‘empty’ before looking for a gas station; nor is it a good idea to wait until your ovaries stop producing estrogen to begin supporting your hormones. Early intervention can ease your transition into menopause significantly while preventing symptoms from becoming overwhelming.
  • Seek comprehensive care that includes mental wellness: Mental health symptoms like anxiety, brain fog, or mood changes are not “all in your head,” they’re legitimate menopause symptoms that deserve attention. Look for care that addresses both the physical and emotional aspects of this transition, because you deserve support for your whole self.
  • Consider telehealth for a more targeted, immediate, and satisfying approach: Why navigate the uncertainty of traditional appointments when you can connect directly with physicians experienced in menopause care?  Digital telehealth/pharmacy platforms like TelyRx offer discreet and convenient access to doctors who understand current treatment approaches; no more wondering if “this appointment will be different.”

your path forward

A new era is dawning in menopause care. The medical landscape is evolving to recognize what you’ve known all along—that your wellbeing matters, and you deserve to feel supported every step of the way. The FDA is reassessing outdated guidelines, telehealth platforms are expanding access to knowledgeable physicians, and you have more options than ever to find the support you need.

You don’t have to wait for the change to reach your current healthcare setting. You can take control right now by connecting with physicians who embrace current science and are committed to helping you thrive through this transition.

Menopause is a significant transition, and it deserves the same attention and care as any other major milestone in a woman’s life. With evolving treatment options, accessible telehealth platforms, and your own informed advocacy, you have the power to shape your experience.

Momentum is building in your favor. The question is: what steps will you take to claim the level of care you deserve?

Disclaimer

This blog post is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. The content provided here is not a substitute for professional medical advice, consultation, or care from a qualified healthcare provider. Always seek the guidance of your physician or another licensed health professional with any questions you may have regarding a medical condition or treatment. Do not disregard or delay seeking professional medical advice based on information read on this site. Learn more about our editorial standards here.

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