Menopause is the area of medicine where the gap between what we know and what women actually get told is widest. Most of my patients arrive having been offered an antidepressant for hot flashes, or told that what they are feeling is stress, or simply that it is normal and will pass.
Some of it is normal. Very little of it has to be endured.
The biggest recent change is that the FDA removed the boxed warning from menopausal hormone therapy. That warning was written for one population and then applied to everyone, and it ended the conversation for a generation of women. What happened was a labeling correction rather than new outcome data, but the practical effect is real. Hormone therapy is back on the table for a great many people it was never actually contraindicated in.
How I approach it
My menopause training is through The Menopause Society. I practice entirely by telemedicine and am licensed in all fifty states, the District of Columbia and Guam.
Most menopause care is history, shared decision making and follow up, which suits video well. Symptom evaluation, whether hormone therapy makes sense for you, dose adjustment, and the long conversation that never fits into a fifteen minute in person slot.
What video does not cover is the pelvic exam, the mammogram and the bone density scan. Those happen near you. I will tell you plainly when they are needed rather than pretending a camera covers everything.
The part that gets missed
Menopause is a cardiometabolic event, not only a symptom problem.
Body composition shifts toward visceral fat, lipids move in the wrong direction, insulin sensitivity changes and bone loss accelerates. Those changes get filed under ordinary aging and go unaddressed for a decade, which is roughly the decade when doing something about them matters most.
That intersection, between menopause and metabolic health, is where most of my work sits. It is also why the weight questions and the menopause questions keep turning out to be the same conversation.
Where to start
Perimenopause and Menopause Symptoms and How to Manage Them
Begin here. What the transition actually looks like and what can be done about each part of it.
FDA Removes Black Box Warning From Menopause Hormone Therapy
What genuinely changed this summer, and what did not.
Does Menopause Cause Weight Gain, or Is It Just Aging?
The two are separable, and the answer matters for what you do next.
Vaginal Dryness After Menopause: Why It Does Not Go Away
The symptom least likely to be raised in a visit and among the most treatable.
Why Menopause Care Is Missing From Women’s Checkups
How an entire life stage fell out of routine preventive care.
Menopause Treatment by Telemedicine: How It Works
What a virtual menopause visit actually involves.
Everything else
The wider women’s health archive covers mammograms, screening schedules, contraception and gynecologic infections. The full archive is here.
Because menopause and metabolic health overlap so heavily, the weight and metabolic health section is worth reading alongside this one.
Scott Rennie, D.O.
Board Certified in Obesity Medicine and Family Medicine
This site is for educational purposes only and does not constitute individual medical advice. Always consult your own physician about your specific situation.