California lawmakers want to boost doctors’ menopause training : Shots

The member of the California Assembly, Rebecca Bauer-Kahan, presented a bill in the current legislative session to impose a menopause education for state physicians.

Rich Pedroncelli / AP

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Rich Pedroncelli / AP

The former teacher of the Lorraine Carter Salazar college is not easily embarrassed. But when she started to have hot flashes at school about a decade ago, she was concerned about the way she came to colleagues, students and parents.

“This does not give skills,” said Carter Salazar, 62. She told how parents could say that she was uncomfortable during meetings. Once, a student even attracted her and noticed that she used to see her grandmother feeling the same thing.

When she took her concerns to her doctor, he did not take them seriously.

“So you sweat,” recalls Carter Salazar. “And he is right. No one dies of perspiration.”

People with symptoms of perimenopause and menopause – which can go from heat puffs and nocturnal sweats to mood changes, a decrease in libido and cognitive problems – often complain of non -reactive doctors and inconsistent care. Symptoms may have an impact on quality of life in the time and health in the long term.

Many doctors are poorly equipped to manage these conversations.

Lorraine Carter Salazar (right) works on a knitting project in a craft group that she frequents each week in a branch of the Sacramento library.

Megan MySCOFSKI / CAPRADIO

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Megan MySCOFSKI / CAPRADIO

An assessment of needs published in the medical journal Menopause In 2023, showed a little less than a third of the obstetrics and gynecology residence programs he interviewed offered menopause training, even if half of the population experienced it.

This led legislators to California and nationally to try to intervene.

In California, legislators presented two bills this legislative session on menopause education for doctors. Bill 360 of the Assembly, which would have forced a state agency to consult the shortcomings of education and how to fill them, was filed last month. But Bill 432 of the Assembly, which would require menopause lessons so that doctors renew their licenses – if at least 25% of their patients are women under 65 – still travel through the Legislative Assembly.

“It reflects my own experience of having to go see three doctors before a doctor can have a conversation with me on menopause,” said Rebecca Bauer-Kahan, member of the Democrat, who introduced the measure.

She says that when she crossed menopause, her brain fog became so intense that she feared that she could have Alzheimer’s disease early early.

And California’s efforts are part of a national trend.

“Thirteen states, including California, have introduced a total of 21 invoices [related to menopause] This legislative session, which is quite surprising in fact for a problem that was not really part of the legislator’s radar, certainly three years ago, “said Jennifer Weiss-Wolf, who heads Birnbaum Women’s Leadership Center of New York University and follows menopause bills.

Several of these bills also address the training of doctors. In New Jersey, for example, a bill would allow providers to use continuing education credits for their license renewal. Arizona and Massachusetts presented the bills this year to provide more information on menopause to providers and patients.

In recent years, Illinois and Louisiana have started to demand insurance coverage for certain treatments of menopause.

Treat symptoms instead of letting patients support them

The training is available for doctors who wish – and treatments are available for people who need it.

“There is no reason for someone to suffer from these symptoms,” said Dr. Monica Christmas from the University of Chicago. She runs the menopause program at the Center for Women’s Integrated Health.

Christmas, which has been practicing gynecology for over 20 years, fell into the specialty because his colleagues continued to send them their menopausal patients.

“I did not know the answers, but I listened,” she said.

After hearing their concerns, she looked for their symptoms before returning with treatment ideas. In turn, they told their friends at work, on a coffee and while waiting for the train about the doctor who took them seriously.

“And if very quickly, I am very busy,” she said.

Christmas said that the training that a school offers on menopause generally depends on how it has stayed. Since few schools have a robust program, many doctors are also looking for information and training elsewhere.

Noël also works for Society menopause – a national organization that offers doctors training on how to treat women at this stage of life.

Christmas said it is imperative that doctors know how to work with many different people – because symptoms vary, as are people’s tolerance levels and confidence in the medical system.

“Black women like me were very reluctant to take anything for the symptoms they felt,” she said. She never understood why and heard a myriad of reasons when she asked. Some patients have explained that menopause is simply a natural process intended to be endured. “However, I could see in front of me, they have hot flashes in the conversation.”

Specialized care for black women

Kim Robinson, with the Black Women for Wellness advocacy organization, said black women should sail discrimination in addition to looking for useful information from health care providers.

She added that doctors should be better paid in the way black women experience this period of life differently from other women.

For example, black women often experience fibroids or benign growth in the uterus, at higher rates than white women, according to a recent study by the American Journal of Obstetrics and Gynecology.

As they reach menopause, Robinson said many doctors suggest that black women obtain hysterectomy, which is the abolition of the uterus, without fully explaining the risks or alternatives. According to the Mayo Clinic, several alternatives exist, such as the regulation of hormones, but almost 60% of women who receive hysterectomy are first to offer another treatment.

“It’s not just this invasive thing, delete your parts and the problem is solved,” she said about the procedure.

Robinson knows from experience. When her doctor suggested that she get a hysterectomy, she knew how to repel and ask questions, to finally find a less invasive alternative.

But, she said, the burden should not be on the patients to defend themselves. Doctors, she said, should get more training and education on symptoms and treatments.

Challenges to have a law on the education of menopause

In California, the measure which would oblige doctors to study menopause develops a bill that the Democratic Governor Gavin Newsom opposed his veto last year. In his veto message, Newsom said the bill was “too much large -scale” because he would have forced health insurance plans to cover expensive and not approved by the FDA.

However, Newsom has encouraged legislators to “continue to work towards a more personalized solution that can improve access to care for perimenopause and menopause, inform patients of their options and encourage suppliers to remain informed of the latest clinical care recommendations,” he wrote.

But Bauer-Kahan, the assembly, kept the arrangements that Newsom cited as a problem. However, it added education requirements, when last year’s bill has strictly focused on insurance.

“We have doubled,” she said. “I think that one of the things I learned last year thanks to the audiences that we held on menopause and this work is how little is understood about menopause.”

The Newsom office refused to comment on the measure.

Opposition in the medical field is also an obstacle.

Dr. Tanya Spirtos, former president of California Medical Association, who represents the doctors, said that the bill was well intentioned but wrong. Doctors generally know that they must remain up to date and informed of the latest treatments, she said.

“We read and education, as I say, to keep a step ahead of our patients,” she said.

Spirtos, a gynecologist, also said that there were a lot of areas – like diabetes or nutrition – where doctors must stay up to date, but require training in everyone would create too much burden. She said doctors should decide themselves what type of training is most relevant for their practice.

“Each area that affects bones or brain or heart or vagina or heat puffs has available literature, which is really easy for our doctors to get and inquire,” she said.

Weiss-Wolf de Nyu says that she hopes to see access to good care of menopause take off. His accent on women’s health also includes the defense of the meeting more accessible to stamps and stamps.

“Admittedly, when I started working on rules, people were not talking about it in a public and systematic way,” she said. “And I would say that 10 years later, it seems to me different.”

She thinks that something similar is happening now for menopause.

This story is part of a series produced for USC Annenberg Center For health journalismEquity fellowship in health equity of California 2025.