When Oprah Winfrey puts her spotlight on a subject, people listen. In her recent primetime special, she turned that spotlight to menopause—a topic long shrouded in cultural silence, misinformation, and clinical neglect. The show featured candid conversations with women from various backgrounds, discussing not just the physical symptoms, but the mental, emotional, and social dimensions of this life stage.
For decades, menopause has been treated as a private matter, relegated to whispered conversations or dismissed altogether. Despite affecting half the population, it has remained an under-discussed and under-researched chapter in women’s health. Oprah’s special didn’t just inform—it validated. It reflected a growing movement of women demanding better care, deeper understanding, and space to tell their stories without shame.
BlackDoctor.org spoke with family physician Dr. Natasha Bhuyan, MD, to discuss why it has taken so long for menopause to gain serious attention in the mainstream and medical communities—and why now may be the moment to finally change that for good.
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Why Has Menopause Taken So Long to Enter the Mainstream?
The silence around menopause isn’t an accident—it’s the byproduct of a culture that often avoids frank discussions about women’s aging, reproductive health, and sexuality. Unlike puberty or pregnancy, menopause has historically lacked public rituals, positive narratives, or media representation. Instead, it has been associated with invisibility, decline, and discomfort—topics rarely embraced by mainstream platforms until recently.
On the medical side, menopause has suffered from a similar lack of attention.
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“Perimenopause and menopause are both conditions that have long been under-recognized and under-researched in the medical community. The lack of research has led to misconceptions, even among physicians,” Dr. Bhuyan explains.
Culturally, women have often been conditioned to endure the symptoms silently. In many communities, particularly among women of color or those in traditionally underserved populations, talking about menopause remains taboo. This has compounded disparities in access to quality care and accurate information.
Fortunately, things are beginning to shift.
“Many women are changing this by sharing their own stories and owning the narrative. Shining a light has helped bring menopause into mainstream conversations. This is inspiring other women to talk about what they have been through,” Dr. Bhuyan adds.
Media visibility, social media advocacy, and women sharing their stories are helping to normalize these conversations. But this moment didn’t happen by chance—it’s the result of persistent voices pushing against a legacy of silence.
Medical Gaps and Missed Opportunities
Despite affecting every woman who reaches midlife, menopause is still not adequately covered in most medical education. In fact, many family physicians receive little to no formal training on managing menopause.
“Oftentimes, menopause care is managed by gynecologists. And even then, it’s often managed by gynecologists who have an additional specialty designation. The truth is, family physicians like me are able to manage menopause. But oftentimes, we don’t get the level of training that we need in medical school or even residency,” Dr. Bhuyan shares.
This gap in training means that patients seeking help for symptoms like fatigue, mood swings, or irregular cycles are frequently dismissed or misdiagnosed. Their symptoms may be labeled as anxiety, depression, or simply “part of aging,” instead of being understood within the broader hormonal shifts of perimenopause and menopause.
As a family physician specializing in reproductive health, Dr. Bhuyan recognized this shortfall early on.
“I sought additional training on my own to feel well-versed and comfortable in managing menopause. However, it’s been a great service to my patients because they are able to receive all of their primary care as well as menopause care with me. I know their whole history, so I’m able to address their menopause needs within the context of their entire health,” she notes.
The truth is, menopause shouldn’t be a niche area of medicine. It’s a core part of primary care, and more physicians, especially family medicine providers, should be equipped to manage it. Empowering general practitioners with the right tools and knowledge could close many care gaps and reduce the burden on patients who are often left navigating conflicting advice on their own.
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Beyond Hot Flashes – The Real Impact of Menopause
Too often, menopause is reduced to a punchline about hot flashes. But this narrow framing fails to capture the profound, multifaceted impact menopause has on nearly every system in the body.
For some women, hot flashes are a dominant symptom—but for others, the transition manifests through mood changes, insomnia, headaches, joint pain, or cognitive fog. Libido can fluctuate, energy levels may plummet, and emotional resilience can wane. The hormonal shifts that drive menopause affect brain chemistry, muscle tone, skin elasticity, and even cardiovascular health.
The mental and emotional toll can be just as significant as the physical symptoms. Many women experience a loss of identity or a reevaluation of their role in family, work, and society. Some face changes in their relationships or self-image, especially in cultures that tie a woman’s value to youth or fertility. These internal shifts are rarely discussed in clinical settings, leaving women to navigate complex emotional terrain on their own.
“This is why it’s helpful to address this with a family physician, as we are uniquely able to link menopause’s impact on our patients’ mental health, physical health, and identity,” Dr. Bhuyan shares.
Stigma is one of the most enduring barriers to menopause care, and it often hits hardest in marginalized communities. In many cultures, menopause is not openly discussed, especially among women of color. This silence can stem from traditional norms, mistrust in the healthcare system, or simply a lack of accessible, culturally competent care. The result? Many women suffer in silence, unsure if what they’re experiencing is “normal” or worthy of medical attention.
“Cultural stigma still prevents people, especially women of color, from openly discussing menopause and from seeking care. This is why I try to proactively discuss peri-menopause with women in their 40s to open the dialogue. What I find is people are often so happy that I’ve started the conversation. They have so many questions and many are often experiencing symptoms in their 40s,” Dr. Bhuyan says.
This silence is not just cultural—it’s systemic. Women from underserved backgrounds are less likely to be asked about menopausal symptoms during routine care, and more likely to have their concerns dismissed when they do speak up. Language barriers, lack of insurance, and historical medical neglect all contribute to the disparities in menopause care.
“Something I hear from my patients over and over is that they have felt dismissed by the traditional healthcare system. When they’ve shared symptoms in the past, those symptoms have been attributed to mental health issues or minimized. This is likely due to providers having a lack of menopause education,” Dr. Bhuyan shares.
To make menopause care truly inclusive, we must amplify diverse voices, train providers to recognize cultural nuance, and invest in building trust with communities that have long been underserved. Representation matters—not just in media, but in medicine.
Improving Conversations and Clinical Practice
The conversation around menopause needs to evolve—from oversimplified, one-size-fits-all guidance to personalized, empowering care. Too often, treatment is narrowly equated with hormone replacement therapy (HRT). While HRT can be life-changing for some, it’s not the only option, and even within hormone therapy, many types and formulations need to be carefully matched to an individual’s needs.
Unfortunately, many patients report feeling overwhelmed or confused by their options. Worse, some are never even offered alternatives. This confusion stems in part from a lack of provider education and in part from poor communication in the clinical setting.
“Discussions about menopause care need to be far more nuanced. I know that some people just link menopause treatment to hormone replacement therapy. There are certainly many options for patients… Patients should seek providers who are willing to explain options and empower them to make the right decision for their own health,” Dr. Bhuyan notes.
In her practice at One Medical, Dr. Bhuyan takes a different approach.
“At One Medical, we recognize the need for high-quality menopause care. We provide dedicated menopause visits with our trained clinicians. Prior to the visit, we ensure that patients complete a comprehensive survey about what they are experiencing. During the visit, I always make sure to give patients adequate time to share, and I validate their feelings,” Dr. Bhuyan explains. “We also give patients the choice to be seen in our office or virtually. Some people are more comfortable in a virtual environment, while others prefer conversing in person. Finally, I make sure that I am regularly following up and connecting with patients – they can even message me in between visits if they have questions. I want to make sure people understand that I am their health partner in this journey.”
For meaningful change, more clinicians need to embrace this kind of patient-centered, ongoing care. And our healthcare institutions must support them in doing so, with time, training, and systemic reform.
Menopause in Context – Life Changes and Support Systems
Menopause rarely happens in isolation. It often intersects with other major life events—career transitions, raising teenagers, caring for aging parents, or reevaluating long-term relationships. These overlapping responsibilities can compound stress and make it harder for women to prioritize their health.
Unfortunately, the healthcare system isn’t always designed to support this complexity. Traditional models tend to focus on one issue at a time, in short appointments, without fully understanding the broader context of a woman’s life. But menopause care cannot be siloed. It must be integrated into a patient’s whole health picture and life stage.
“In general, the healthcare system should be proactive about anticipating the needs of patients entering menopause and offering up personalized solutions. We also need to offer much more flexibility in the healthcare system to make sure that patients are able to play an active role in their healthcare while also living their busy lives,” Dr. Bhuyan says.
Healthcare providers should ask not only about physical symptoms, but about what’s happening in a woman’s life. Are they navigating burnout? Experiencing relationship strain? Feeling invisible at work? These questions are just as important as asking about sleep and periods.
“This could help gain trust, especially in communities that have been historically marginalized by the healthcare system. At an individual level, we should understand that menopause is not just one visit or one snapshot in time – it’s an ongoing journey that’s a part of someone’s overall health,” Dr. Bhuyan adds.
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A Turning Point, but Not the End Point
There’s no denying that this moment, ushered in by Oprah’s special and amplified by the voices of countless women, is significant. For the first time in a long time, menopause is being talked about openly, seriously, and with respect. That cultural shift alone can make a huge difference in how women feel about their bodies and their options.
But this is only the beginning. We still need more robust medical research, especially that includes diverse populations. We need better training for providers, more time in the exam room, and a healthcare system that understands menopause as the full-body, full-life event it truly is.
“I’m hopeful because I am seeing more women taking charge of the menopause dialogue and expecting more from the healthcare system. I’m also seeing a larger recognition among employers about the impact of menopause. We certainly do need far more medical research in this area, especially in more diverse populations. The need for systemic change will persist, but I am feeling optimistic about the future thanks to the many women who have pioneered the importance of understanding menopause,” Dr. Bhuyan concludes.
