Melinda French Gates calls for a menopause revolution in women’s health

Melinda French Gates used a June 4 New York Times op-ed to call for a menopause revolution in the United States, pairing the essay with a new $215 million commitment to women’s health through Pivotal. She said women are too often left with no diagnosis, no treatment and no plan, even though the menopause transition is common and predictable.

The essay, titled Women, We Deserve Better Than This, leaned on a problem many women already know well: even with access to excellent health care and decades of advocacy experience, French Gates said she still had to bring up menopause herself with her doctor and push for options. Her total women’s-health giving over the previous two years topped $600 million, underscoring how much of the current push is coming from private philanthropy rather than the health system itself.

Federal health agencies put the clinical timeline in blunt terms. The Centers for Disease Control and Prevention says most women experience menopause between ages 45 and 55, and the National Institute on Aging says the average age of menopause in the United States is 52. The NIH Office of Research on Women’s Health says perimenopause usually begins between ages 45 and 55 and can last several years. Symptoms can be mild for some women and debilitating for others, including hot flashes, sleep disruption, mood changes and memory problems.

The care gap is visible in the data. NIH materials say researchers are still looking for better ways to treat perimenopausal symptoms and that few women receive treatment that effectively relieves them. A 2025 survey of 4,432 U.S. women examined help-seeking for perimenopause symptoms, while KFF’s 2024 Women’s Health Survey included 5,055 women ages 18 to 64 and put preventive and access-to-care questions at the center of the policy conversation. Komodo Health has reported that perimenopause still lacks a dedicated medical code, only 7% of women ages 45 to 51 had a documented perimenopause or menopause diagnosis, and women with commercial insurance were more likely to be diagnosed than women on Medicaid.

That combination of symptoms, weak coding and uneven diagnosis helps explain why French Gates’ essay landed so sharply online. It also sharpened the scrutiny on whether elite advocacy can move the system, not just describe its failures. The Menopause Society says one of its goals is to improve care by giving clinicians better tools and training, a reminder that the fix starts long before a woman leaves the exam room.