When opening social media, women between the ages of 35 and 60 are often greeted with numerous videos that promise to ease the symptoms of menopause.
And on the TikTok Shop, an e-commerce platform that allows people to sell products directly through the app, there are hundreds of products listed that promise menopause relief — vitamins, supplements, neck fans and more.
“There's a lot of predatory things on there that play into fear, I hate that, or they play into practitioner mistrust — ‘Your doctor won't tell you this, so you need to click right here and get this information, and, Oh, by the way, here's the code to get a discount on the product I'm selling,’” said Dr. Becky Lynn. She’s a longtime menopause practitioner who’s certified by The Menopause Society. “So, if someone is trying to sell you a product, you cannot take their word at face value because it's biased.”
Menopause is defined as the point when a person has not had a menstrual period in 12 consecutive months. It’s also marked by a decrease in production of hormones, such as estrogen. According to the Office of Women's Health, the average age of onset in the US is 52.
Perimenopause, on the other hand, occurs in the years prior to that. It can begin in people’s late 30s to 40s and is marked by hormonal fluctuations.
"You can take those nuggets that you learn on social media and go to your practitioner and discuss it... but if someone is trying to sell you something or trying to instill fear — that's just a red flag."Dr. Becky Lynn
Lynn said that during both of these periods, hormonal changes lead to uncomfortable and disruptive side effects, such as hot flashes, sleep disruption, persistent brain fog, mood changes, irregular periods, vaginal dryness, and much more.
In the last few years, Lynn said people have begun to talk much more openly about their experiences with menopause and perimenopause — due in part to social media.
And while this is a good thing and there is some quality information online, Lynn said there's also been a rise in misinformation and unregulated products that could keep women from accessing scientifically-backed treatment, such as hormone replacement therapies (HRT), or even, potentially, be dangerous.
Plus she adds that the symptoms of perimenopause and menopause can impact a person’s overall quality of life, their relationships — and their performance at work.
"If you're giving a presentation, you're in a room full of men, and you're dripping sweat from your armpits — you look nervous, you don't look confident," Lynn said. "And if you can't sleep, you're a little bit more irritable, right? You don't have as much patience, you can't think straight, you can't focus."
The economic impacts of menopause
Last fall, the non-profit think tank Rand published a report on the economic impacts of menopause in the US. According to the report, approximately 30% of women in the US labor force are aged 45-60, the age range most associated with menopause.
“Conceptually, when we think about the role of menopause, as it contributes to women's participation, we're again talking about a time where women's sort of career participation and expertise is rising,” said Dr. Wendy Troxel, a licensed clinical psychologist and a senior behavioral scientist at Rand. “And if you have these symptoms getting in the way without a society that has supports for it, then we're really stalling women right at a time where they could really hit their stride in terms of their performance and productivity.”
Troxel and the rest of the research team found that the economic cost of menopause symptoms was $5.4 billion in lost productivity, due to missed workdays, reduced hours and layoffs — each year.
"The report emphasizes the need for targeted workplace policies and interventions to support women experiencing menopause and mitigate these economic losses.""The Economic Impacts of Menopause in the United States," Rand
In Missouri, they found that nearly 450,000 women fit into the 45-60 age range, and the projected loss to the state economy each year is more than $86 million.
“The purpose of our report,” Troxel said. “It is not that women are damaged or broken as they undergo this transition. It's really a universal experience among women, and they constitute a huge and important, vital part of our working force. So, we need to offer access to treatments that are effective to mitigate the symptoms.”
Troxel added that the economic impacts are likely to worsen in coming decades as the number of working-age women going through perimenopause and menopause is expected to increase.
“Addressing menopause-related productivity losses becomes increasingly urgent for sustaining economic growth and competitiveness,” the report read.
Troxel said it’s about creating workplace policies that accommodate symptoms and provide flexibility, as well as ensuring that employees have access to quality care.
“This can last up to a decade, the symptoms sort of wax and wane, and women are major contributors to the workforce, so supporting that is really important,” Troxel said. “Women live longer than men, so we have the opportunity to contribute more to the workforce — we just need to be supported, so we can be a strong and resilient workforce.”
So what is hormone replacement therapy, or HRT?
“What I've seen is an increased interest in talking about [menopause] because there is this impact in the workplace, and the other thing that is driving this increased interest in menopause… is the understanding that hot flashes are not harmless. Menopause is not harmless. It's not just about dressing in layers and carrying a fan,” Dr. Lauren Streicher said.
Streicher is a nationally recognized menopause expert, as well as the founder of the Northwestern Medicine Center for Sexual Medicine and Menopause.
She said there are many health consequences from untreated perimenopause and menopause, such as mental health issues, the development of osteoporosis and an increased risk of cardiovascular disease and stroke.
"Women live longer than men, so we have the opportunity to contribute more to the workforce — we just need to be supported, so we can be a strong and resilient workforce."Dr. Wendy Troxel, Rand
“So there's really been more of an awareness of that,” Streicher said. “People are saying, ‘Wait a minute, I don't want to just ignore this stuff because I know this has an impact.’”
She said for many years it was standard practice to prescribe menopausal women hormone replacement therapy (HRT) , but that changed in the 90s with the Women’s Health Initiative.
According to the National Heart, Lung, and Blood Institute (NHLBI), which funds the work, the initiative was designed to focus on strategies for preventing heart disease, breast and colorectal cancer, and osteoporosis in postmenopausal women.
But in 2003, the FDA imposed a “black box warning” on HRT because some early data appeared to show an increase in breast cancer, heart attacks, stroke and blood clots. In other words, the “overall health risks exceeded benefits.”
According to research from the University of Vermont in 2012, HRT usage rates quickly fell more than 46% in just a few years. And more recent data from the Mayo Clinic, found the HRT usage among women 40 years of age and older fell to just 1.7% in 2023.
Streicher said she believes the black box warning should never have existed in the first place, as the original study skewed older (over 60) and more research was needed to determine the actual effects of HRT – especially in women in their 40s and 50s.
“That data was then… reevaluated for the younger cohort of women – so women aged 60 years or less, or within 10 years of the onset of menopause – and found those risks to be dramatically reduced or non-existent.” University of Missouri Health Care OBGYN Dr. Lisa Brennaman said. “A large meta-analysis was published in 2015, and then subsequent follow-up observational studies have really strengthened the data we have regarding the safety of hormone replacement therapy for the vast majority of women.”
Due to this, the FDA announced its plan to withdraw the black box warning in November 2025, and they approved the first prescribing information without the warning in February 2026.
Brennaman said there’s still a lot of work to do to repair the fear that warning has left behind.
She said they now know that HRT treatment can actually be beneficial to a woman's health if started before the age of 60.
According to the FDA's 2025 press release, the use of HRT was found to reduce the risk of all-cause mortality and fractures, and was has been associated with 50% reduction in heart attack risk, 64% reduction in cognitive decline, and 35% lower risk of Alzheimer’s.
Plus, it quickly alleviates perimenopause and menopause symptoms.
“We typically begin to see improvement in symptoms pretty early, like within seven days of initiation,” Brennaman said.
HRT also comes in many options, such as an oral pill, estrogen patches, vaginal rings, and more. It's also relatively inexpensive and widely covered by insurance.
“I think any time we have symptoms that are occurring daily or near daily, or impacting functioning, that they deserve to be educated about their options for treatment,” Brennaman said. “I don't think we need to arbitrarily, universally medicate every single patient through menopause, but I think patients that are having symptoms do not need to wait until the time of severe disability or negative consequences like job loss, relationship loss, sleep exhaustion, osteoporotic fracture, before they seek help.”
Brennaman added it’s important to remember that HRT is not the right treatment for everyone, and doctors should explore other possible reasons for symptoms.
Additionally, she said that some forms of the medication might not be the best option for those with a history of blood clots, strokes or estrogen sensitive cancers. She recommends speaking with one’s physician about making a treatment plan.
