There's 'menopause legislation' in the works. What does that mean?

Some women suffered through menopause symptoms such as joint aches and brain fog for years and met with various doctors before reaching out to Elizabeth Lapeyre's New Orleans medical office.

She often prescribed hormone replacement therapy, something not all insurance policies would cover.

“We are leaving so many women behind,” says Lapeyre, a gynecologist who specializes in menopause. "Monthly medication costs can run as high as $500."

It's frustrating when a plan isn't covered. “We want all women to have access to treatment," she adds.

Now state legislators are stepping in to help.

After a conversation with Lapeyre, Louisiana Rep. Aimee Adatto Freeman, a Democrat, in 2024 introduced a bill to require Medicaid and private insurance to cover perimenopause and menopause treatment. It passed later that year, making Louisiana one of the first states to legislate menopause care.

More than half of U.S. states have introduced or passed bills or laws around menopause in the past two years. Last summer, in 2025, Rhode Island became the first state to mandate that companies offer accommodations for menopausal women. And Maryland soon will begin requiring private insurance companies to cover menopause care and will incentivize menopause education for providers.

Legislators are seeing the interest grow around menopause care, now a $20 billion industry that includes everything from herbal supplements to your own personal vaginal speculum promoted by Halle Berry. They also better understand the toll menopause can take on women at work; one study by the Mayo Clinic says menopause leads to $1.8 billion in lost work time a year.

"So many health care providers lack the training about menopause and how to manage it. And most medical schools don't even have a menopause curriculum," says Maryland Rep. Joseline Peña-Melnyk, who was inspired to write her state's bill earlier this year after a friend visited five doctors, had 13 blood tests and was prescribed anti-anxiety medicine before a doctor finally diagnosed her menopause.

"No woman should have to suffer like that. Frankly, menopause is a natural and inevitable part of aging," the Democrat says. "But because it's a woman’s issue, it’s remained under-researched, under-discussed and stigmatized."

'You shouldn’t have to fight your insurance company'

With 1 in 10 women leaving the workforce because of menopause, and an additional 1 in 5 considering retiring early, it can lead to fewer women leaders at a time when they make up fewer than one-third of top jobs.

There is no federal policy that protects women in menopause or perimenopause, the time leading up to menopause. Perimenopause can last up to 10 years and include a fluctuation in hormones, presenting symptoms ranging from frozen shoulder to hot flashes.

Companies need to keep women in the workforce to remain competitive, says Sarah Chavarria, CEO and president of Delta Dental Insurance Company.

"We spend a significant portion of our working lives navigating menopause," she says. "Menopause affects both oral and whole-body health and in no way should managing these symptoms impact your success at work or your employment status," she says.

For Ohio Rep. Ashley Bryant Bailey, introducing a bill in March to improve menopause coverage felt like common sense as legislators discussed how to attract a strong workforce.

“How do we retain the workers we have? Women are the backbone of our country and if they are retiring early or taking a less stressful job to shoulder these symptoms because they aren’t being covered [by insurance] at the scale of other conditions, we need to fix it,” the Democrat says.

One in 5 women delayed or passed up menopause treatment due to financial concerns and only 26% have insurance coverage for hormone replacement therapy, according to a 2025 study from GoodRx.  

“Menopause is inevitable,” Bryant Bailey says. “But you shouldn’t have to fight your insurance company.”

The need for 'action'

Philanthropist Melinda French Gates sees too many women leaving work at the prime of their career.

“Just when the woman's about to step into the CFO role, or step into the CEO or president role, like she has all this training and knowledge and experience,” French Gates told USA TODAY in May. “I think we want that put into the workforce, not taken out. You have to be healthy to be able to do well at your job or at home.”

She called on state lawmakers to address menopause.

“We also need action from policymakers, particularly at the state level. Advocates should press lawmakers to create new education requirements, expand insurance and Medicaid coverage for menopause treatments and ensure that women in menopause have workplace protections the way they do in pregnancy – like the ability to take time off to seek care – so they can keep doing their jobs without sacrificing their health,” she wrote in a New York Times editorial.

Legislation is passing even in states that rank near the bottom on most women’s health measures.

“I live in a state where a raped 11-year-old has to have the baby,” Louisiana's Freeman says. “But we came together to pass this menopause bill. People are beginning to understand how important this coverage is.”

“It’s something that we are seeing right-leaning and progressive-leaning women alike agreeing on. They know it is inevitable, they’re going to go through menopause,” says Jennifer Weiss-Wolf, the executive director of the Birnbaum Women's Leadership Center at New York University's School of Law, and author of the upcoming "When in Menopause: A User's Manual & Citizen's Guide."

Legislation has fallen into a few categories: insurance coverage, education and workplace accommodations.

Weiss-Wolf is inspired by the pace at which states have passed menopause legislation, and the potential for spurring federal laws.

As if on cue, Democratic U.S. Rep. Valerie Foushee of North Carolina introduced the Menopause Education for Medical Students Act, this month. It would add menopause education in medical schools to better prepare all physicians to care for women.

Laura Trujillo is a national columnist focusing on health and wellness. She is the author of "Stepping Back from the Ledge: A Daughter's Search for Truth and Renewal," and can be reached at [email protected].