For decades, menopause has been treated like a medical nuisance to be managed silently. Women, knowing it’s taboo to talk about, have quietly dealt with symptoms like hot flashes, vaginal dryness, restless nights, brain fog, mood swings, and plummeting libido.
“We’ve had a two-sided problem that is being unraveled: patients who have been left to suffer and providers who have been left without education,” Jessica Nazzaro, a board-certified OBGYN, certified menopause practitioner, and a medical advisor for at-home hormone tracking company Mira, told Business Insider. Patients now “know they are not alone, not crazy, and can find help.”
Today, many can test their hormone levels at home, talk to menopause specialists online, and get personalized prescriptions shipped directly to their doors.
This shift marks a reimagining of how women navigate their midlife years. Once dismissed as an inevitable decline, menopause is now treated as another phase of health — one that can be supported, studied, and optimized.
Hormone therapy gets a makeover
Hormone replacement therapy (HRT) — which restores a patient’s levels of estrogen, progesterone, or both to relieve menopause symptoms — was once the only solution women could turn to for things like night sweats, hot flashes, and vaginal dryness.
Then came the Women’s Health Initiative (WHI) study in 2002, a long-term national study on preventing breast and colorectal cancer, heart disease, and osteoporosis in postmenopausal women, which found that HRT could increase cancer risk.
Prescriptions plummeted, and stigma spiked.
In the years after, a group of doctors and researchers revisited the study and found it to be flawed because of its narrow scope. The WHI, which looked at disease risk in postmenopausal women, did not include vaginal estrogen, for example.
Experts now tend to advocate for personalized treatment plans and say that cancer risk depends on the type of hormones used and the duration of treatment.
“We’ve learned that HRT is indeed protective of heart health, brain health, and bone health. It does not cause breast cancer, as was publicized by the WHI, but rather can proliferate an estrogen-sensitive tumor in the breast or other tissue,” Nazzaro said.
According to Dr. Kathleen Green, an OB-GYN at Maven Clinic, “More recent studies show that for most women, the benefits of HRT far outweigh the risks.”
Starting hormone therapy closer to the onset of menopause — typically before age 60 or within 10 years of entering menopause — can help alleviate symptoms and improve bone health.
The biggest change? Personalization. Doctors now consider a woman’s age, symptoms, medical history, and time since menopause to determine the best form and dose of HRT — whether it’s a pill, patch, gel, vaginal cream, or ring.
Tech makes menopause more manageable
As more women demand better care, tech companies are offering to meet them where they are. At-home hormone testing tools like Mira and Proov can track users’ hormone levels and turn them into personalized scores and cycle insights.
According to Nazzaro, Mira’s device tracks hormonal shifts with lab-level accuracy and “helps women see patterns in their own cycles, understand which stage of menopause they’re in, and make informed decisions about symptom management, lifestyle adjustments, or treatments.”
Dr. Sophia Yen, the CEO and cofounder of Pandia Health, is a fan of Mira and told Business Insider that it’s seamless to use — you simply collect your urine in a cup — and it provides “lab-grade results,” all from the comfort of your home.
Telehealth companies such as Midi, Gennev, Pandia Health, and Winona provide virtual appointments with menopause-trained clinicians — such as board-certified OB/GYNs and doctors who are also NASM-certified menopause practitioners. Pandia Health also offers asynchronous telemedicine, where women can message doctors without face or voice contact — establishing a safe space to share their concerns.
Beyond hormones: New options for symptom relief
Even with the rise of personalized HRT, some women can’t or prefer not to take hormones — especially breast cancer survivors. That’s driving innovation in non-hormonal therapies.
In 2025, the FDA approved Lynkuet, a gel capsule from Bayer that blocks brain receptors responsible for hot flashes. In clinical trials of more than 700 women, it cut the frequency of hot flashes within a week.
“Many cannot or will not take hormones, so Lynkuet could be a wonderful option,” Alyssa Dweck, the chief medical officer at Bonafide Health, told Business Insider.
Other new options include estetrol, a natural estrogen steroid pill, which is designed to address hot flashes, vaginal atrophy, and loss of bone mass. Vaginal estrogen creams and suppositories that treat dryness, itching, and irritation can also help.
After years of debate, the FDA recently removed the “black box” warning — the FDA’s highest issued safety label — from estrogen-related products. The move could make women feel more comfortable using these medications, Nazzaro said.
“I’ve had patients who pick up their prescription for vaginal estrogen after a thorough discussion and decide not to use it specifically because of the black box warning,” Nazzaro told Business Insider.
Doctors say the shift isn’t just happening among menopausal women — it’s starting earlier.
“I have women in their 30s presenting to my office wanting to understand what they might anticipate when they enter perimenopause,” Dweck said. They want to understand “what proactive measures can be taken to avoid distressing symptoms.”
That proactive mindset, paired with more tools and data, could redefine menopause care for the next generation.
“I feel incredibly optimistic,” Dweck said.
The bottom line in menopause care
Staying open-minded to emerging research and aware of the risks and benefits of new therapies is crucial to navigating this phase of life, said Dweck. She suggested being proactive and educating yourself about menopause with credible sources like The Menopause Society.
Certain lifestyle adjustments like exercise, nutrition, and sleep can also make a major difference and support treatments like hormone therapy, non-hormonal drugs, or clinically studied supplements, Dweck said.
And remember — although the menopause care market offers many products that are touted as “solutions,” they may not have solid scientific evidence to support their claims.
“Product labels can be overwhelming, frightening, and confusing, and for this reason, a comprehensive discussion with an experienced healthcare provider about indications for use, risks, benefits, and specific use instructions is warranted,” Dweck said.
She recommended considering personal needs based on symptoms, medical and family history, medications, and lifestyle habits. There’s no one-size-fits-all approach or experience when it comes to menopause.
