We’ve said it once, and we’ll say it a million times until our voices are hoarse from screaming: Society needs to talk about menopause, and no one agrees with that more than Halle Berry. Recently, the Oscar-winning actress spoke to Capitol Hill about menopause legislation, and per Politico, many of the staffers said it was the first time they ever discussed the issue in the monument.

Rep. Yvette Clarke and Rep. Lisa Blunt Rochester have both introduced bills, with Clarke’s bill made to require the National Institutes of Health to focus on menopause, and Rochester’s to focus on funding “a national menopause awareness campaign,” all of which Berry is over the moon about. Berry is currently working with them and other representatives to get these bills going, and for the conversation about menopause to continue.

And in her journey, the Moonfall actress also sat down to talk with Cory Booker about this issue, posting three separate videos. The first video was posted with the caption reading, “Menopause … Let’s talk about it! 9 in 10 women were never educated about menopause. Which is why @corybooker and I dove into the importance of talking about women’s pre-menopausal and menopausal journeys so that we can find more relief in the similarities of women’s inevitable unknown.”

“Every woman, if you live long enough, will go through menopause. And most women spend the longest period of their life in their pre-menopausal or menopausal years, like three decades,” Berry started, in the video. “..I’ve gotten involved to try to de-stigmatize it, to let us understand that when we reach this time in our life, these are our best years. So to think that we should pack it up or we should not pay attention to all of the things that are going on with our body, I think is a, is a real problem. And that’s what most women do.”

The Gothika star talked about how her friends rejoiced when she brought up the topic of menopause, saying how “they were starving to talk with someone about it and not feel shame. And they were starved to share their experiences. And we realized we’re going through a lot of the same things.”

We’re so happy Berry is working with political officials to get the needle moving, and get people talking about menopause. And we truly can’t wait to see what she accomplishes!

(Psst: You can watch the full interview below!)

The study, published yesterday in Nature, found that the cause of morning sickness is GDF15, a hormone that, when produced by the fetus, triggers vomiting and feelings of nausea. The intensity of the sickness, researchers found, depends on how much hormone is produced and whether the mother has been exposed to it before getting pregnant.

The researchers analyzed data from multiple studies, measuring the amount of GDF15 in pregnant people’s blood while looking at their genetic risk factors for hyperemesis gravidarum, an extreme form of pregnancy sickness that causes relentless nausea, vomiting, weight loss, and dehydration.

One important thing to note: tissues in your body produce low levels GDF15 all the time, including outside of pregnancy. If the pregnant person normally has low levels of GDF15 in their blood, they’ll be more sensitive to it during pregnancy, increasing their risk of experiencing severe morning sickness. For example, the researchers found that a rare genetic variant, known to increase risk of hyperemesis gravidarum, was also associated with lower levels of GDF15 outside of pregnancy. On the other hand, women with the genetic blood disorder beta thalassemia have naturally high levels of GDF15. They typically experience little to no morning sickness.

It all comes down to that one hormone — how much of it the pregnant person was exposed to before pregnancy, and how much is released during pregnancy.

“The baby growing in the womb is producing a hormone at levels the mother is not used to,” Professor Sir Stephen O’Rahilly, leader of the collaboritive study and Co-Director of the Wellcome-Medical Research Council Institute of Metabolic Science at the University of Cambridge, said in a press release. “The more sensitive she is to this hormone, the sicker she will become.”

Crucially, he added, “Knowing this gives us a clue as to how we might prevent this from happening.”

One of the studies the researchers analyzed found that mice given high levels of GDF15 showed loss of appetite, considered a sign of nausea. However, the effect disappeared when the mice were treated with a long-acting form of GDF15 beforehand. That, they think, shows a path towards treating morning sickness in humans as well — by building up a tolerance for the hormone or, O’Rahilly says, by “preventing GDF15 from accessing its highly specific receptor in the mother’s brain.”

The researchers especially hope the findings will be helpful for people with hyperemesis gravidarum. “When I was pregnant, I became so ill that I could barely move without being sick,” said co-author Dr. Marlena Fejzo from the Department of Population and Public Health Sciences at USC, in the press release. Fejzo experienced hyperemesis gravidarum during her own pregnancy. Understanding the cause of the condition, she explained, brings doctors “a step closer to developing effective treatments to stop other mothers going through what I and many other women have experienced.”

Before you go, shop these products to get you through pregnancy and bed rest:

The legal challenge to mifepristone comes from the Alliance Defending Freedom, an organization that the Southern Poverty Law Center calls a “designated hate group,” on behalf of four anti-artion organizations in Texas. Originally, their goal was to invalidate the FDA’s original approval of mifepristone, a decision that dates back to 2000.

A Texas district judge ruled in their favor in April, which would have removed mifepristone’s FDA approval, but the Supreme Court put that decision on hold while appeals took place. And sure enough, in August, an appeals court ruled against the anti-abortion groups’ call to overturn the drug’s original approval. The appeals court also upheld the FDA’s 2019 decision to approve a generic form of mifepristone.

So why didn’t the case end there? Well, the appeals court left a few doors open for the anti-abortion groups. Specifically, that court ruled that a few FDA decisions in 2016 and afterward, which increased access to mifepristone, should be put on hold because the actions “were taken without sufficient consideration of the effects those changes would have on patients.”

So, mifepristone isn’t currently at risk of losing its FDA approval, thanks to the appeals court’s decision. What’s up for debate now — and what the Supreme Court will rule on, likely next June — are FDA actions that made the medication more accessible. Currently, the decisions under threat include:

Essentially, if the Supreme Court decides to uphold that original ruling in favor of the anti-abortion groups, mifepristone will become substantially harder to get ahold of.

“No woman should be unable to access the health care that she needs. This should not happen in America, period,” White House press secretary Karine Jean-Pierre said in a statement. The Biden administration and drugmaker Danco, which makes the brand version of mifepristone, will both defend the FDA decisions to the Supreme Court. Overturning these FDA decisions, Jean-Pierre stated, “threatens to undermine the FDA’s scientific, independent judgment and would reimpose outdated restrictions on access to safe and effective medication abortion.”

Mifepristone is one of two pills typically taken for a medication abortion. Mifepristone works to block progesterone, which stops the pregnancy from continue; the second pill, misoprostol, causes cramping and bleeding to empty the uterus, per Planned Parenthood. (Misoprostol alone can also be used to end a pregnancy.) Medication abortions account for more than half of all US abortions, according to Guttmacher.

So what happens now? Currently, access to mifepristone remains the same, and won’t change until a decision is announced. The Supreme Court hasn’t set a date for argument, per the New York Times, but will likely make a decision by late June 2024.

Before you go, read about these celebs who’ve spoken about their abortion experiences:

This content was created in collaboration with Versalie, a one-stop-shop for your menopause needs — offering personalized menopause information, curated products, and access to telehealth. 

Me and my fellow 50-something friends have a lot of running jokes about hoping and praying for menopause. That’s because the whole bloody lead up to it — and I do mean bloody for several of my friends — is such a physical and emotional pain that the idea of getting out of perimenopause and to the menopause finish line is oh-so-very-welcome.

Technically you reach the menopausal stage when you’ve made it 12 months without a period. So as my friends’ once-monthly cycles have gotten wonky, I’ve watched them start a count, sometimes over and over again. “I’ve made it six weeks with nothing!” one will text only to follow up in a few days with, “Damn. It came back.”

My own journey has been less up and down because I was using IUDs for fifteen years. I wasn’t getting periods with those, so I wasn’t sure what would happen when I stopped using an IUD at age 49. Would cramps return? Bloating? Bleeding? Once my gynecologist removed that last one, I was in the waiting-and-watching camp with everyone else. And I was hoping that I was menopausal.

Here are just some of the things you can do when you’ve reached menopause or are postmenopausal: You can pack a swimsuit for vacation and never, ever give a thought to whether you can easily go swimming. Of course you can! You can wear cute lingerie and underwear again, without wondering if they will get messy. They will not! You can have sex with your partner every day of the month without needing to give any kind of warning.

I know this because — tada! — I made it through the 12 months of watching to be sure I was really, truly in the promised land. My friends are jealous. Even though I still have some symptoms, including day and night hot flashes, for the most part I have very few “lady worries.” (Such a stupid euphemism for health concerns that half the population deals with!) My hot flashes are manageable. My husband is used to me sleeping with blankets off while he keeps them on, and I’ll walk around outside in a sweatshirt when everyone else has on a jacket. Luckily for me there’s just not a lot of drama around it.

I’ve enjoyed reaching this new life stage. My thoughts in my 20s, 30s and 40s had to revolve so much around my chances of getting pregnant: First I was on the pill to prevent pregnancy, then I was off of it and trying to get pregnant (I did, in fact, have two great kids), then I was preventing pregnancy again with the IUDs. That’s all in the rearview mirror now and here in my early 50s I have space in my brain for so many other things.

Many of us can really see ourselves now that our lives don’t revolve so much around what our bodies are doing cycle-wise.

There’s a stigma about menopause that would have us believe it makes us old and cranky. I don’t feel that way though. I am still young enough to travel. I like to exercise. I’m happy to have my kids in college. I sleep in on many days, like I’m making up for two decades of sleep deficit. I love having leisurely breakfasts and dinners with my husband. “Me time” is pretty much anytime I want and I treasure that. 

Many women my age do feel depression and so I don’t want to gloss over how hard this stage can be for some. But many of us are also thriving. In my friend circle there is someone who just got engaged and someone who just bought her dream home that’s a weekend place for now but will be her retirement house eventually. Another took what she happily characterizes as her final job — she’ll never have to job-hunt again. We’re hitting major milestones we’ve been fantasizing about for decades.

Most importantly, many of us can really see ourselves now that our lives don’t revolve so much around what our bodies are doing cycle-wise. It’s easier to tell what you genuinely want to do and don’t want to do in life when you’re not also “preventing” or “trying” or “managing.” You can just be, and it’s fantastic.

Everyone’s menopause story is different, as the new guard of menopause advocates will tell you. Plenty of women’s menopause stories are positive, and I don’t feel like those are necessarily shared so much. Or they are shared but framed as “second chapter” stories that have more to do with the kids being out of the house. Let’s be honest, it’s the absence of periods, cramps, migraines and misery that really makes our next life phrase so great. 

If you’re in the countdown to menopause, keep talking to your OB-GYN about your symptoms so you can perhaps gauge how close you are to being done. When you reach the mark of going a year without your period, have a celebration, even if it’s small and just in your head. Enjoy.

Roughly one-third of a woman’s life is spent in menopause, and the transition can often include life-disrupting symptoms such as hot flashes, night sweats, insomnia, and mental health issues. 

For women suffering from menopause symptoms, hormone therapy (HT) is the most effective way to provide relief. And while once a commonly prescribed treatment in the United States, hormone therapy became a controversial subject seemingly overnight in 2002, after one study in the Women’s Health Initiative (WHI) linked the therapy to health risks for women, in particular an increased risk of breast cancer. 

What we know now: Menopause hormone therapy does not increase the risk of breast cancer. And a new report, “Tis But a Scratch: a critical review of the Women’s Health Initiative evidence associating menopausal hormone therapy with the risk of breast cancer,” published in the journal Menopause, aims to set the record straight. “A generation of women has been deprived of HT largely as a result of this widely publicized misinterpretation of the data,” the authors write.

While hormone therapy, like all medications, carries risks, it has been proven to also have a positive impact on cardiovascular health, as well as improving bone density and reducing the risk of osteoporosis. But despite its benefits, the stigma around hormone therapy still lingers decades later.

To break down the benefits of hormone therapy and explain what went wrong in the WHI, we spoke with OBGYN and menopause specialist, Corinne Menn, a medical advisor and prescribing physician at Alloy. (Don’t miss her two-part recap on Instagram of “Tis But a Scratch,” what she refers to as “one of the most important journal articles to be published in the last 20 years on menopausal hormone therapy.”)

What the Women’s Health Initiative (WHI) Got Wrong

Flow: The WHI (2002) reported that hormone therapy is the most effective treatment for vasomotor symptoms, and any small negative findings that they saw in much older, often unhealthy women simply don’t apply to perimenopausal women or younger menopausal women. Even with all that included in the report, there was so much fear and confusion surrounding the findings that we saw a dramatic drop in women taking hormone therapy.  Why do you think that is?

Dr. Corinne Menn: There is one main reason why there is so much fear and confusion around estrogen, hormone therapy and menopause and this is how the WHI reported and misinterpreted their own findings in 2002 when they halted the study. First, the WHI findings were announced in a highly unusual and unprecedented way — with a highly publicized press conference done prior to the actual publication of their findings, prior to a peer review of the data, and before doctors could read the article. 

The WHI reported statistically insignificant results and portrayed them as being meaningful. They misinterpreted their own data and made highly misleading claims that never applied to the vast majority of women in menopause who seek to use hormone therapy. There was also a strange reluctance for the WHI to highlight the many significant positive findings. The media loves ‘bad news’ and ran with highly inaccurate and misleading headlines, rather than facts. And women’s health has suffered ever since.

The Health Benefits of Menopause Hormone Therapy

Flow: In the years following the WHI, dozens of studies have shown that there are many health benefits of hormone therapy. Can you recap what some of those benefits are?

Dr. Corinne Menn: These are the most important facts that we know from the WHI as well as decades of peer reviewed studies:

Why Age Matters

Flow: One of the major critiques of the WHI is that they studied the use of hormone therapy primarily in older women, as opposed to including a more even distribution of women from premenopausal to post-menopausal age. Is age and the time a woman enters menopause important to the benefits of hormone therapy?

Dr. Corinne Menn: Yes, this is one of the most important points I want women to understand, that the average age of women in the WHI were older and less healthy than most women seeking care for bothersome menopause symptoms. The WHI and many other landmark studies have demonstrated that there is a window of opportunity where the tissues, bones, and blood vessels are healthier, where we can prevent many chronic disease states from starting.  

The time frame is in the first 10 years of entering menopause where the benefits are clear and far outweigh any rare risks. The ideal time to start would be when you start having symptoms, as early as the perimenopause or at the time of menopause, which the average is 51. It is also important to note that if you go through menopause a bit later, at say 54, then your “window” is 10-years from then, but the sooner the better. In addition, routine discontinuation after age 60 for arbitrary reasons in women who are otherwise doing well is not supported by ACOG or The Menopause Society, and the 10-year ideal starting window is not the same as duration of therapy.”

Menopause Hormone Therapy Does Not Increase Your Breast Cancer Risk

Flow: The WHI reported that for women taking estrogen plus progesterone saw an increased risk of breast cancer, but that is refuted by their own data. Can you unpack that?

Dr. Corinne Menn: “Yes, hopefully by now the word is out that there were two arms of the study. In one arm, women without a uterus took estrogen alone, and the data has always clearly shown that there was a significant 23 percent decreased risk of breast cancer, and a 40 percent reduction in death from breast cancer. 

The other arm was women who still had their uterus and they were given a combination of estrogen and progestogen. This is where the WHI reporting failed to be transparent and clear. They reported a small increase in breast cancer risk in these women, in addition to one additional case for every 1,000 women per year, but with no increase in breast cancer mortality. But even this conclusion has been highly criticized and disputed. The WHI failed to disclose they were reporting results that were not statistically significant, and they misinterpreted their own data. In fact, on further examination, it is very clear that in women who never used hormone therapy in the past, who started estrogen and progestogen, had no increased risk of breast cancer or dying of breast cancer, even women with a family history of breast cancer.”

For Most Women, the Benefits of Hormone Therapy Outweigh the Risks

Flow: Knowing what we now know about hormone therapy, what are your recommendations as an OBGYN for women who may be scared of the WHI findings?

Dr. Corinne Menn: For the vast majority of women, initiating hormone therapy early in menopause, ideally within the first 10 years, the benefits far outweigh any rare risks. Hormone therapy does not cause breast cancer or raise your risk of getting breast cancer. We have many FDA approved, safe hormone therapy options, in various formulations and doses, including oral and non-oral options like patches, gels, sprays, and rings. The goal of therapy is to treat symptoms while minimizing any side effects, and you should choose the dose and formulation that is best for you.

“I also want to remind women that the genitourinary syndrome of menopause ( GSM) affects most women at some point in menopause with symptoms of vaginal dryness, painful sex, decreased lubrication, urinary urgency, and frequency and increased risk for UTIs.  While systemic hormone therapy can help, local vaginal hormone options are the gold standard to preventing and treating GSM and can vastly improve women’s sexual and urinary health. They are safe to be used on their own or with hormone therapy and are very safe, yet widely underutilized.

I also want women to know that many doctors are misinformed and not educated in the care of menopausal women, including their OB-GYNS. They can look for a provider certified by The Menopause Society. If you are not getting the help you need, keep pushing and asking for it — you are worth it.”

Former Olympic gymnast Shannon Miller’s journey to being diagnosed with ovarian cancer in 2011 started with a doctor’s appointment she nearly missed. “I admit I almost canceled, but I thought better of it,” she says. “During that appointment, my doctor found a baseball-sized cyst on my left ovary.”

Miller, who is now 46 and tied with Simone Biles as the most decorated American Olympic gymnast in history, underwent a series of tests and scans. In January 2011, she was diagnosed with a rare form of ovarian cancer. “My world stopped,” Miller says. “They had caught it early, and the prognosis was good, but I would need to go through this pretty aggressive chemotherapy regimen.” 

At the time, Miller’s son had just turned a year old and she had recently launched a company that was devoted to women’s health and wellness. “I had no idea what my future would hold — if I had a future,” she said. “I didn’t know if my son was going to have a mother. So, it’s very real conversations that you have with yourself.” 

Miller says she tried to stay positive and focus on the treatment steps that were laid out for her, which included surgery, followed by chemotherapy about a month later. “At that point, I kind of reverted back to that competitive mindset I knew so well through sport — those life lessons of goal-setting and teamwork, positive mindset resiliency,” she says. “I could kind of shift that mentality to fight mode. ‘OK, I’m going to give it all I have, I’m going to get through chemotherapy.’”

But Miller says she wasn’t aware at the time how challenging chemotherapy would be. “It’s the hardest thing I’ve ever had to do,” she says. 

However, she learned to focus on things that she could control. That included setting goals for herself with hydration, getting enough protein in her diet, and focusing on her mental health. “I was really focused on giving myself these pep talks and really getting into that headspace that I was going to get through treatment without stopping and without having any breaks,” she says. 

Chemotherapy was a huge challenge for Miller, who says she struggled with gastrointestinal issues, nausea, and fatigue. “At the end of the first week of chemo, I landed back in the hospital because I couldn’t keep down food. I couldn’t keep down water,” she says. “If I didn’t get a handle on it, I wasn’t going to be able to stay on track with my treatments.” 

Miller says she heard from cancer survivors during that time on how to stay healthy, including doing yoga to help with nausea and fatigue, getting outside and in the fresh air as much as possible. Miller ended up having chemotherapy five days in the first week, followed by treatments once a week. She ultimately underwent three rounds of treatment over nine weeks. 

Miller has now been cancer-free for 12 years, a status she says she’s “excited” about. She’s partnered with Enterade to promote the company’s Advanced Oncology Beverage, which is designed to help with the gastrointestinal symptoms she experienced. “Now there are more opportunities to alleviate some of those symptoms by things that weren’t available at the time,” she says. “I’m thrilled to be a part of talking about supportive care and those things that we can do to conquer some of those GI issues, the things that we don’t really want to talk about when we’re battling cancer.”

Miller is no longer tumbling, but the mom of two does commentary and broadcasting for Olympic gymnastics coverage every four years. “It is so much fun to watch these athletes go out there — you know how hard they’ve worked,” she says. 

When it comes to ovarian cancer and managing symptoms and treatment, Miller wants patients to remember that they’re not alone. She also stresses the importance of speaking up about symptoms during treatment. “I didn’t want to complain. I didn’t want to burden anyone else. And I was trying to do this on my own, which clearly we cannot,” she says. “Please reach out to your medical team. If you’re not feeling well let them know, because there are things that can help.” 

Not only can your doctor help you to feel better, getting symptom relief can help you stay on your treatment course, she says. “When we feel better, we can fight cancer harder,” Miller says. “Just know that you’re not alone.”

This content was created in collaboration with Versalie, a one-stop-shop for your menopause needs — offering personalized menopause information, curated products, and access to telehealth.

Turns out, hot flashes and night sweats are not the only uncomfortable symptoms that many midlife women experience.

Vaginal dryness, a name that says it all, may be the least discussed menopausal symptom. While it can occur during perimenopause, the years-long lead up to menopause, it’s most common in postmenopausal women, says urologist, pelvic surgeon, and Flow Advisor Kelly Casperson, MD, host of the podcast ‘You Are Not Broken.’ “It can happen years after menopause,” she adds, explaining, “I think that’s why a lot of people don’t relate it to menopause. Sometimes it’s delayed.”

Menopausal symptoms such as hot flashes or insomnia, are caused, generally, by hormone changes that occur around the time a woman reaches menopause, the official end of fertility. As a woman enter perimenopause, estrogen levels fluctuate, until, eventually, the ovaries stop producing the hormone. 

While there are other potential contributing factors – such as medication, having diabetes, cancer treatment, or using scented soaps or other products around the vagina – most of the moderate to severe symptoms are age-related. As levels of the hormone decrease, vaginal lubrication may diminish. And then, as natural lubrication lessens, the tissue thins, becomes more delicate and vulnerable to infection, such as urinary tract infections (UTIs) and problems like overactive bladder (OAB).

Why is vaginal lubrication important?

Lubrication isn’t essential only for sex; layers of moisture in and around the vagina and vulva protect the genitals, reduce friction, and generally help things run smoothly. What’s more, the natural fluids help facilitate more mundane daily tasks such as walking, sitting, putting on pants, and peeing comfortably.

Estrogen is the hormone that triggers, one way or another, a cascade of complex functions and secretions that ultimately help the vagina maintain moisture, elasticity, and thickness.

Yet once estrogen levels start to dip, things don’t necessarily operate as smoothly and seamlessly as before. There’s more friction, resistance, and inflammation; less moisture, flexibility, and elasticity.  

Whether or not you are having sex, vaginal dryness is a progressive problem that will worsen without treatment, says Stephanie Faubion, MD, MBA, director of Mayo Clinic Women’s Health and medical director of the Menopause Society.

Signs and Symptoms of Vaginal Dryness

When vaginal dryness occurs, some women experience pain sitting, peeing or putting on pants, according to the American College of Gynecologists (ACOG). Some of the signs and symptoms of vaginal dryness include:

How to Treat Vaginal Dryness

There are a range of options when it comes to treating vaginal dryness. Here are some of the most common one:

Vaginal Moisturizers and Lubricants

Applied into the vagina about 3 times a week, vaginal moisturizers typically include a hyaluronic acid that helps the vaginal tissue retain moisture. Dr. Faubion likes to say that vaginal moisturizers are like “face cream for the vagina.” Brands such as Replens and Revaree are applied into the vagina, with an applicator or as a vaginal suppository.

Lubricants, on the other hand, are reserved for use right before sexual activity. If you have mild symptoms, these over-the-counter products, such as K-Y jelly or Astroglide, may help you manage discomfort.

Natural products such as coconut oil work too, but may cause a reaction, warns Jennifer Lang, MD Flow Advisory Council member, an OBGYN and CEO of Buzz Labs, who advises women to do a skin patch test before inserting anything into the vagina. Additionally, she notes, there are preservative-free forms of both products. (When using a condom, remember that oil-based lubes can damage condoms and lead to breakage.)

Estrogen Therapies

The FDA has approved estrogen therapy for the treatment of vaginal dryness. “Unlike non-prescription moisturizers and lubricants that can help you manage symptoms and feel more comfortable, estrogen therapies address the cause of dryness,” says Dr. Casperson. Essentially, estrogen therapy can reverse the loss of lubrication. 

While some women may worry about taking hormones in general, Dr Lang stresses that low-dose vaginal estrogens are extremely safe. “In my opinion as a gynecologist, and also as a fellowship trained gynecologic oncologist, I feel very, very comfortable using low dose vaginal estrogen in people even with personal histories of hormone driven cancers,” she says. 

It’s also worth noting, adds Dr. Casperson, that topical estrogen is local and doesn’t enter the bloodstream.

Non-hormonal Medications

There are also other types of medications that can help vaginal dryness. These include:

Dehydroepiandrosterone (DHEA) or Prasterone turns into estrogen and testosterone in the vagina. It comes in the form of a suppository that is inserted into the vagina once a day.

Ospemifene Another prescription option, Osphena, is a selective estrogen reuptake modulator (SERM). It is not an estrogen, but it acts similarly to estrogen in vaginal tissue. This drug is used to treat women with moderate to severe dyspareunia (painful intercourse) and moderate to severe vaginal dryness. It is not a vaginal medication but a pill that is taken orally. 

Benefits of Treating Vaginal Dryness

With treatment, “there’s a huge benefit in terms of daily comfort level,” says Lang, describing the immediate effect moisturizers and estrogen can have. What’s more, she says, treatment reduces the risk of urinary tract infection, a problem that is much more common, and worrisome, with age. “UTIs can lead to severe health problems in older women,” she notes. Finally, pain or discomfort with sexual activity will be immediately reduced with use.

With so many ways to treat these symptoms, why is vaginal dryness underreported and undertreated? “I think women are afraid that their doctors won’t know what to do, or that there is nothing to help them,” Faubian says. Or, she says, they may not know who exactly to go to.

Most health care providers, including primary care physicians, midwives, and gynecologists, should be able to recognise and treat vaginal dryness, according to Dr. Casperson. 

Partner with a Doctor You Trust

One of the best ways to prepare for long-lasting health is to make sure you have the right doctors in place. At midlife, some women shift from an ob/gyn to a gynecologist, ideally one who is a menopause specialist or experience treating patients in menopause.

“If your doctor tells you nothing can be done for vaginal dryness, you need a new provider,” says Dr. Faubion. While you shouldn’t need to seek out a specialist to get treated for vaginal dryness, if you need to find a new provider about an urgent women’s health issue, the Menopause Society maintains a database of certified menopause practitioners who are accepting new patients. Other options include word of mouth, local listservs or ACOG’s doctor finder. Services such as ZocDoc can be helpful, too, as you can search by location, symptom, and health insurance accepted.

Midlife can come with a range of body changes: Gray hair, stiff joints, and for most women, perimenopause. In the United States, the average woman enters menopause at age 51, and with this can come symptoms such as hot flashes, vaginal dryness, night sweats, mood swings, painful sex, brain fog, low bone density, or insomnia.

For women suffering from severe symptoms, prescription options such as menopause hormone therapy can provide relief. In addition to medicated treatment options, lifestyle choices can also play a major role in keeping symptoms at bay.

“One myth is that lifestyle is not a big factor in menopause,” Flow Advisor Jessica Shepherd, OB-GYN, said during our recent virtual event. “Having studied so many different aspects of lifestyle medicine behind menopause, there really categorically are a lot of metabolic changes that are going on with women during this timeframe.”

Here are the lifestyle changes that can have the biggest impact when it comes to menopause symptoms.

A Healthy Diet Can Reduce Menopause Symptoms

There really is some truth to the phrase, ‘You are what you eat,’ and when you enter perimenopause, your body undergoes a major hormonal shift. During this transition, estrogen levels begin to decline which can negatively impact your metabolism, cholesterol levels, and how your body digests carbs.

Research suggests certain foods can help relieve some symptoms of menopause. With the decline in estrogen, women are at a greater risk of osteoporosis and fractures, and dairy products have been shown to increase bone health. One study found that in nearly 750 postmenopausal women, those who consumed more dairy had significantly higher bone density than those who consumed less. Research has also shown the role diet can play in reducing hot flashes.

Diversity of food and diet is key, says Dr. Shepherd: “I really want people to be inclusive in their diet, because when you’re very restrictive, that usually causes more problems than not.”

Research has also found that a Mediterranean diet rich in vegetables, fruits, herbs, nuts, beans, fish, and whole grains is beneficial to women during menopause for its anti-inflammatory properties. And getting in enough protein is crucial.

“As your muscle starts to whittle away, and our protein usually decreases, there’s nothing there to help build the muscle up,” says Dr. Shepherd. “Which is what a heavy protein diet will do. And so when we look at the adequate dietary protein amount, it is one to prioritize.”

Drinking Can Make Symptoms Worse

The body begins to metabolize alcohol differently as we age, and research shows that it can cause inflammation which can worsen menopause symptoms.

“I will admit I have significantly decreased my alcohol intake as I’ve gone into the perimenopausal phase for two reasons,” says Dr. Shepherd. “This is me personally and then I’ll give some context. One, I don’t metabolize alcohol as well as I used to. We don’t metabolize alcohol as well and then don’t feel as great after. Then you have alcohol that’s sitting in your body longer than it should, which is a lot of glucose and sugar.”

This glucose and sugars increase inflammation in the body, which can intensify menopausal symptoms like hot flashes, night sweats, and even mental health issues.

Menopausal women are particularly vulnerable to depression, especially if they’ve had a history of it, because there is a reduction in serotonin, the pleasure receptor in the brain. And since alcohol is a depressant, it can exacerbate hormonal changes.

“I’ve gotten to a point where it doesn’t mean I don’t drink, but I really think about how I will feel and what is this doing inside my body that’s not helping me at this point,” says Dr. Shepherd. “Then I can make a better decision on whether I am going to drink.”

Strength Training Is Key

Leading a sedentary lifestyle is not a healthy choice for anyone, but during perimenopause and menopause, staying active and moving your body can alleviate symptoms and improve your overall quality of life.

One study found that women who were active for 12 weeks had reduced menopausal symptoms and improved well-being, compared to women who did not exercise.

So, what exercise is best? Dr. Shepherd recommends anything cardiovascular. This can include hiking, jogging, cycling, rowing, running, yoga, and elliptical training.

But weight-bearing exercises are also beneficial, especially as women during menopause are more likely to suffer from brittle bones or poor bone health.

“Women in general usually shy away from weight bearing exercise,” says Dr. Shepherd. “When we look at muscle mass with aging and after estrogen depletion, you really have a change in muscle structure. So, if we can increase our muscle in our weight bearing exercises, you’ll notice that you may be seeing weight gain, but your body is whittling off fat.”

Mayo Clinic defines menopause as the end of a person’s menstrual cycles. It is typically diagnosed after 12 months without a menstrual period, and that transitional phase is called perimenopause. Menopause can occur in your 40s or 50s, but the average age in the United States is 51. It’s associated with a host of uncomfortable symptoms, from hot flashes to vaginal dryness to sleep issues. Some people opt to undergo hormone therapy, or HT, to ease the severity of their symptoms.

It bears repeating: Menopause is something that impacts every person with ovaries. It should not be a taboo topic, but since it affects women and AFAB people, it’s historically under-discussed and under-studied. Fortunately, candid conversations about reproductive health are becoming more commonplace, leading a growing number of people to speak out about their menopause journeys and advocate for better care.

Menopause does indicate the end of a person’s reproductive years, but it says nothing about their spark or vitality. Below, read up on sage advice, sharp insight, and personal anecdotes from celebrities who’ve experienced menopause firsthand.

The study, published this week in the Proceedings of the National Academy of Sciences, looked at California birth records from 2014 to 2023 to determine how the pandemic impacted preterm births. Overall, the researchers found that maternal COVID infection increased the risk of preterm births by 1.2 percentage points since the beginning of the pandemic, an increase that the study authors say is significant.

“To move the needle on preterm birth that much is akin to a disastrous environmental exposure, like weeks of breathing intense wildfire smoke,” explained Jenna Nobles, co-author of the study and sociology professor at University of Wisconsin-Madison, in a press release.

However, the effect was even larger in the first two years of the pandemic. From July to November 2020, the likelihood that an expecting mom in California with COVID-19 would experience a preterm birth (defined giving birth more than three weeks before the due date) was 5.4 percent higher than expected, increasing from a 6.9 percent risk to 12.3 percent. Of itself, that’s a 78 percent increase in risk, the study noted.

As COVID vaccines rolled out in 2021, the excess, COVID-related risk for preterm birth began to decline, eventually dropping steeply in 2022 — a decrease that researchers say has everything to do with the vaccine.

Looking at vaccination rates by ZIP code, the researchers found that in areas with higher vaccination rates, “the excess risk of preterm birth declines much faster,” Nobles said. “By summer 2021, having COVID-19 in pregnancy had no effect on preterm birth risk in these communities.” It took “almost a year longer” for ZIP codes with lowest vaccine rates to catch up.

Preterm births can lead to mild or serious health problems, including small size, trouble breathing, and feeding problems, according to Mayo Clinic. Some complications, including behavior and mental health problems, difficulty hearing, and other ongoing health issues, can last for years. Preterm births can also be expensive, incurring costs of over $80,000 per baby, per studies.

With those factors in mind, anything that can cut down on the excess risk of preterm birth as substantially as the COVID vaccine is significant. “By increasing immunity faster, early vaccination uptake likely prevented thousands of preterm births in the US,” Nobles explained.

The huge swing in preterm birth risk from COVID and the subsequent disappearance of that risk thanks to the vaccine shows a few things. For one, it underscores how harmful COVID can be for pregnant people. On the flip side, the study also shows how protective the vaccine can be when it comes to avoiding a preterm birth, and how essential it is to continue encouraging pregnant people to get vaccinated.

“Vaccine avoidance is higher in pregnancy than in the general public,” the study notes, with surveys showing that “the main barrier to vaccination is concerns about adverse consequences for the fetus.” This study provides even more evidence that the vaccine can actually protect the fetus, when it comes to preterm births, and that COVID itself is what can cause harm.

With that in mind, and as the pandemic continues, it’s more important than ever to stay up to date on your COVID vaccine and boosters, especially if you’re expecting.

Before you go, shop our favorite products to keep you comfortable during pregnancy: