In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Melinda French Gates, philanthropist and founder of Pivotal Ventures, an investment and philanthropic organization focused on advancing women's health and equity, to talk about the funding and advocacy push she recently announced for women's health and menopause care. Melinda opens with the statistics driving her urgency: nearly one in three women over forty has menopause symptoms severe enough to disrupt her life, only about one in four gets treated, and fewer than a third of OB GYN training programs teach about menopause at all. She recently announced two hundred fifteen million dollars in new funding for women's health and menopause research.
The conversation traces why this happened in the first place. Dr. Haver and Melinda discuss how the Women's Health Initiative study decades ago halted meaningful research and training almost overnight, leaving an entire generation of doctors, including Dr. Haver herself, undertrained on hormone therapy and menopause care. Melinda shares her own experience seeing three doctors before getting the right care for her symptoms, despite what she calls unbelievable privilege and access to some of the best health care in the world, and describes the chronic insomnia and brain fog that made her doubt herself walking into meetings with world leaders and CEOs.
They dig into the data gap behind the underfunding, including the McKinsey finding that less than five cents of every dollar spent on medical research goes to women's health. The two also talk candidly about racial disparities in care, the confusion created for clinicians and patients by shifting reproductive health laws across states, and new research directions Melinda is funding, including work on women specific heart disease and microvascular diagnostics through an organization called Wellcome Leap.
The episode closes on a hopeful note, with both women describing midlife and menopause not as decline but as one of the most vibrant chapters of life, and Melinda offering concrete advice for listeners who want to push for change: advocate for yourself with your doctor, educate the people around you with credible information, contact your elected officials, and vote for candidates who prioritize women's health.
Guest links:
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Melinda French Gates (YouTube)
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Melinda French Gates (Instagram)
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Melinda French Gates (Facebook)
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Melinda French Gates (LinkedIn)
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Melinda French Gates (X)
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Pivotal
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Moment of Lift Books
- Gates Foundation
Books:
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“The Next Day,” by Melinda French Gates
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“The New Perimenopause,” by Dr. Mary Claire Haver
- “The New Menopause" by Dr. Mary Claire Haver
Articles:
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Addressing Menopause Symptoms - Barriers and Opportunities for Improvement (Mayo Clinic Proceedings)
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The 2022 hormone therapy position statement of The North American Menopause Society (Menopause)
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Menopausal Hormone Therapy Use Among Postmenopausal Women (JAMA Health Forum)
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Needs assessment of menopause education in United States obstetrics and gynecology residency training programs (Menopause)
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Impact of Menopause Symptoms on Women in the Workplace (Mayo Clinic Proceedings)
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National Use of Postmenopausal Hormone Therapy - Annual Trends and Response to Recent Evidence (JAMA)
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A Sustained Decline in Postmenopausal Hormone Use: Results From the National Health and Nutrition Examination Survey, 1999–2010 (Obstetrics & Gynecology)
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Insurance Type and Menopausal Hormone Therapy Use Among US Women (JAMA)
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Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women - Principal Results From the Women's Health Initiative Randomized Controlled Trial (JAMA)
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Editor’s Choice - Impact of initial hospital diagnosis on mortality for acute myocardial infarction: A national cohort study (European Heart Journal: Acute Cardiovascular Care)
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Adequate enrollment of women in cardiovascular drug trials and the need for sex-specific assessment and reporting (American Heart Journal Plus)
- Participation of Women in Cardiovascular Trials From 2017 to 2023: A Systematic Review (JAMA)
Other Resources:
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Women's Empowerment, Population Dynamics, and Socioeconomic Development (National Academies of Sciences, Engineering, and Medicine)
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Women political leaders prioritize public goods that are of concern to women and female citizens are more engaged in civic discussion when women hold public office (Gender Action Portal/Harvard Kennedy School)
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RCDC Categories at a Glance (NIH Grants and Funding)
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ACOG - Menopause
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Menopause (World Health Organization)
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Melinda French Gates: Women, We Deserve Better Than This (New York Times Opinion)
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Menopause and the Workplace (Fawcett Society)
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Susan G. Komen Foundation
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Women’s Health Initiative
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U.S. Census Bureau
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Regina E. Dugan (Wellcome Leap)
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Wellcome Leap
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2025 Summary of State Menopause Bills (The ‘Pause Life)
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Closing the Women’s Health Gap: A $1 Trillion Opportunity to Improve Lives and Economies
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Family Planning: Messages (Gates Foundation)
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Why Birth Control Is Still a Big Idea (Foreign Policy)
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Federal Ministry of Health Nigeria - Nigeria: Contraceptive Logistics Management System Assessment Report
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Working Together to Reduce Black Maternal Mortality (CDC)
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Accelerating Research to Prevent Maternal Morbidity and Mortality (NIH)
- Is Your DNA Different if You Have PMS/PMDD? (Dr. Mary Claire Haver/Instagram)