By Nina Heller, CQ-Roll Call (TNS)
WASHINGTON — Despite deep partisan divisions over issues like abortion and access to contraceptives, lawmakers from both parties appear to have forged a tentative consensus on another women’s issue: menopause.
The similarity became clear earlier this year, when a bipartisan group of female senators first introduced legislation that would increase federal research on menopause and strengthen existing federal government programs related to menopause and the health of midlife women. coordinate.
At a press conference with actress Halle Berry in May, Sens. Tammy Baldwin, D-Wis.; Patty Murray, D-Wash.; Lisa Murkowski, R-Alaska; Susan Collins, R-Maine; Sens. Amy Klobuchar, D-Minn.; and Shelley Moore Capito, R-W.Va., praised the bill outside the Capitol. On Wednesday, Murray joined Denise Pines and Tamsen Fadal, national advocates for improving menopause care and executive producers of the documentary “The M Factor: Shredding the Silence on Menopause,” to highlight the bill during a panel at Capitol Hill — the first time, according to Murray, that such a discussion about menopause took place in the U.S. Capitol
“As one of my Republican colleagues said, if men were going through this, it would already be funded (at the NIH), but it isn’t,” she said.
Kathryn Schubert, the CEO of the Society for Women’s Health Research, said the issue is one that is building consensus at a time of division over other women’s issues.
“We see this as an issue where people can kind of unite on women’s health care,” she said.
Schubert said a major problem hindering research on menopause is the inability to track it. Unlike other chronic or disabling health conditions, menopause lacks research, condition, and disease categorization codes at the National Institutes of Health.
The codes are the system that sorts NIH-funded projects into scientific categories for reporting to the public. The Senate bill would, among other provisions, establish new codes for chronic or disabling conditions in women related to menopause and midlife women’s health.
Another reason advocates say there is a lack of research on menopause is the fallout from the Women’s Health Initiative, a series of NIH clinical trials that began in 1991 and focused on strategies for preventing heart disease, breast and colorectal cancer and osteoporosis in postmenopausal women. women.
Findings from part of the Women’s Health Initiative, which have since been found to be flawed, found that there was an increased risk of developing breast cancer, cardiovascular disease, stroke and pulmonary embolism in those taking hormones.
Since then, further research has shown that hormone replacement therapy does not necessarily lead to an increased risk of breast cancer and that the benefits of hormones outweigh the risks. But the findings linking hormone therapy to breast cancer led to a decline in treatment for some of the more disruptive side effects of menopause, Schubert said.
“We’re quite behind the times when it comes to menopause in particular, and I think we’re now having a much more open and public dialogue about that period in a person’s life and coming to the realization that we really do need to know more. But we need also know more about the other health risks associated with healthy aging,” says Schubert.
Schubert said support for federal research on menopause extends from both sides of the aisle, and that other women’s health issues, such as research into conditions like endometriosis, arise in a similar way.
In April, California Senator Laphonza Butler, a Democrat, and Senator Katie Britt, a Republican from Alabama, introduced a bill that would fund annual maternal mortality surveys for seven years and authorize research that would address inequities related to maternal mortality and the preventable causes of death, in addition to the other provisions of the bill. The House of Representatives has its own version of the bill.
“I think when people hear the words ‘women’s health,’ they might think they’re politically charged,” Schubert said. “I think we need to change the way we think about this and make sure we all understand that we really think about health in different ways across the lifespan. It is really not about one specific disease, condition or organ, it is really all connected.”
The focus on menopause has united members of Congress who normally don’t work together. Unlike abortion, lawmakers have been able to come together on this issue without controversy and the partisan divisions that often plague their work.
“There hasn’t been the same division within the pro-choice community and what others would call the pro-life community,” said Samara Daly, co-founder and board chair of Let’s Talk Menopause, a national nonprofit focused on the menopause. “It is another medical problem that literally crosses all political, social and economic boundaries. It’s a natural part of someone’s life… as a result, we’ve really been able to have people from both sides of the aisle join forces.”
Underrepresented
Women have been underrepresented in medical research for decades – and that was once even the policy.
In 1977, the Food and Drug Administration created a policy to exclude women who could biologically have children from Phase 1 and Phase 2 clinical trials unless they had a life-threatening medical condition.
After pregnant women taking the drug thalidomide had babies with limb deformities, researchers took a cautious approach to women’s participation in clinical trials. Thalidomide was a sedative that was never approved for use in the US but was widely used in Europe and Canada. The resulting FDA policy even recommended excluding women who were using contraception, were single, or whose husbands had had a vasectomy.
It wasn’t until 1986 that the NIH instituted a policy encouraging researchers to include women in research, and it wasn’t until 1993 that Congress passed a law requiring women to be involved in clinical research.
“There are other health issues that may only affect some women. This is one that is universal. Over the past few decades, we have seen more and more stigmas disappear around various types of women’s health issues,” said Cindy Hall, president of the Women’s Congressional Policy Institute.
A 2022 Harvard Medical School study found that in 2019, women made up about 40% of clinical trial participants for the three diseases that most affect women: cancer, cardiovascular disease, and psychiatric disorders, despite women accounting for 51% of the US. population.
According to a survey by The Menopause Society, only roughly 30% of U.S. residency programs offer a formal menopause curriculum.
“We’re just at the beginning of trying to figure out what we need in terms of what happens during the transition to menopause, which hormone therapies work and which don’t,” says Stephanie Faubion, the medical director of The Menopause Society. and the director of the Mayo Clinic Center for Women’s Health.
Another bipartisan bill would require the NIH to evaluate and support the results and status of completed and ongoing research related to menopause, perimenopause, or midlife women’s health.
“It’s really important because it would actually require the NIH to review existing research, but also invest specific funding for additional research, not only around treatments and health outcomes, but also to actually correct the (Women’s Health Initiative) study,” Daly said.
White House Involvement
In addition to bipartisan bills in Congress, the outgoing Biden administration has supported increased research funding for menopause as part of President Joe Biden’s investments in women’s health. However, it is unclear whether the new Trump administration will follow through on this.
In November 2023, Biden announced the White House Initiative on Women’s Health Research, led by first lady Jill Biden and the White House Gender Policy Council.
On October 23, the Biden administration announced $110 million in awards from the Advanced Research Projects Agency for Health (ARPA-H) to accelerate research and development for women’s health across 23 research teams.
Two of those awards focused on menopause: one aimed to develop a new ovarian therapy to prevent diseases during menopause and the other aimed to develop a drug that would eliminate the adverse effects of menopause.
One award, which received $3.5 million, would fund a study to test the development of a drug to extend ovarian function and lifespan. The other, which received $10 million, would fund research into a cell therapy implant that would replace deficient ovarian function, restore normal hormonal processes, manage symptoms associated with menopause and reduce the adverse health consequences associated with menopause would minimize.
Jill Biden launched ARPA-H’s Sprint for Women’s Health in February, making it the first major achievement of the White House Initiative on Women’s Health Research.
The nature of the awards means the projects have the potential to be commercialized and widely used sooner, rather than decades later, the White House said.
Advocates say they hope the shared understanding among female lawmakers about what it’s like to go through menopause will continue the movement on the issue.
“It’s a universal experience. Obviously every woman has a different individual experience with menopause, but the symptoms and the experience of embarrassing hot flashes and different symptoms that make it difficult to go through it kind of form a unity,” Hall said.
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