“I felt so alone, confused, and ashamed.”
“It was like I didn’t have control over my own body.”
“My healthcare decisions were being made for me. At the time, I felt helpless. Now, I feel angry.”
When I heard these reflections from a group of women gathering to discuss the latest innovations in reproductive health at a Jewish networking event, I got chills. I was used to such sentiments at pro-choice rallies or trainings I give to other mental health professionals about supporting women’s reproductive rights. Autonomy over one’s body, access to healthcare services that are safe and well-researched, and accurate information about medical options without stigma are usually discussed as needs in the context of another A-word: abortion.
But these women were talking about menopause.
And I, at nearly 40 years old, was struck by how little I knew about this developmental phase, despite my professional advanced training in women’s health and personal passion for supporting women through vulnerable life transitions. I realized how much there was to learn about perimenopause and menopause, how much there was to fight for so women could get the resources they deserve, and how much overlap there was between abortion and menopause.
Abortion is a healthcare issue and so is menopause. When we care about one, we must care about the other.
So, building off my lifelong commitment to advocating for women’s rights during their reproductive years, I decided to become an expert on what happens when those years end. I wanted to be able to assert not only my own needs when the time came, but also those of others, through my psychotherapy practice and beyond. I wrote the guide for my generation, millennials (now in our 30s and 40s). Many of us are still having babies – or actively trying not to – but my research confirmed that menopause is a topic we need to learn and be proactive about, starting now.
“Why menopause?” I am often asked. “Because I value women’s health and rights at any and all ages,” I answer.
While menopause is universal, each woman experiences it differently. Most women endure a variety of emotional and physical symptoms (like mood swings, sleep disruption, hot flashes, joint pain, and others), many for several years, due to the hormonal fluctuations during perimenopause. Post-menopause, women are at increased risk of issues like heart disease, Alzheimer’s, and osteoporosis.
The good news is that treatment options are available, including lifestyle modifications, nonhormonal medications, and hormone therapy. But the bad news is that in 2002, a misinterpreted study scared an entire generation of women away from hormones, led to decades of healthcare practitioners learning little if anything about the menopause transition, and created a culture in which women were told (if they even dared raise their complaints) to suck up their symptoms as a natural part of aging. The worse news is that women continue to be devalued in our society, including by our government and in popular culture. Too little attention is being paid and too little investment is being made into women’s health, at midlife and in general.
And it can be exhausting and intimidating to demand better, even though we know we deserve it. Sometimes it feels like we have to pick a lane in order to be effective, but I worry that leads us to lose sight of our ultimate destination: women’s reproductive freedom, always.
Since Roe was overturned in 2022, it seems that even the most vocal advocates in women’s healthcare are reluctant to mention abortion. Some of this is strategic: proposed menopause-related legislation like requiring relevant continuing education for licensed doctors is often bipartisan. Even the most anti-abortion among us will go through menopause and may want to access medicine and education on options to alleviate symptoms. We, rightfully, want to collectively demand access. But I believe it’s imperative that we remember the underlying connection to abortion care.
I said as much at a recent event with other healthcare providers, policymakers, and journalists in Washington, DC. We had all gone around the room explaining why menopause care and legislation were important to us, hinting around the word with statements like “I’m sad my daughters are growing up with fewer reproductive rights than I had” and “I worry about women’s access to all kinds of reproductive healthcare.” I raised my hand: “Can we please acknowledge the significance of abortion here? Menopause may mean the end of fertility, but it’s all part of the same package.” My point was met with sighs of relief and even some cheers.
Indeed, both abortion and menopause are intertwined with other reproductive rights topics like contraceptives, perinatal mental health, maternal mortality, all forms of assisted reproductive technology, health equity, and gender equity.
When we advocate for comprehensive sex education, we advocate not only to learn safe sex practices to avoid unwanted pregnancies and sexually transmitted infections, but also for women to be taught that they can get pregnant while perimenopausal and how their cycles work in midlife.
When we advocate for birth control access, we advocate not only for the right to prevent pregnancy but also for the right to receive medical treatment for issues like endometriosis and symptoms like mood fluctuations during the menopause transition.
When we advocate for IVF, we advocate not only for the resources to avoid devastating genetic issues but also for the capability to build much-wanted families that may fall outside of traditional roles, expectations, or timelines.
Women deserve education about how their bodies work, the ability to make independent choices about medical options in ways that work for them, and equitable care from providers who offer collaborate, compassionate services without judgment. Let’s keep advocating for access, for all.
Lauren Tetenbaum, LCSW, JD, PMH-C, MSCP is a Red Tent Fund volunteer and licensed clinical social worker, women’s rights advocate, and writer dedicated to supporting and empowering women through life transitions. With experience as both a lawyer and a psychotherapist, Lauren specializes in counseling women navigating identity shifts related to motherhood, career changes, and reproductive health. Lauren frequently contributes thought leadership to media and professional organizations; she is the author of the acclaimed 2025 book Millennial Menopause: Preparing for Perimenopause, Menopause, and Life’s Next Period. Lauren is also a mom of two who lives with her family outside of her native New York City. Learn more about Lauren at thecounseLaur.com or on Instagram (@thecounselaur).
