The Great Menopause Grift

Many influencers and physician-educators have financial ties through sponsored content or brand partnerships, sometimes pushing lines of supplements or their appearances on the speaking circuit.

BY ALAN CASSELS

View original article at Brownstone.org.

Well, well, look here. In its June 2026 update the venerated OED or Oxford English Dictionary, finally added the ‘new’ word, fearmonging. It explains fearmongering as “the action or an act of spreading fear or alarm among the public, esp. by exaggerating the dangers associated with a political, social, or economic issue; alarmism.”

Thank goodness, the dictionary has caught up to our society’s most pernicious habit; that is, using fear to sell anything. Especially when it comes to our health.

Here we find the most destructive aspect of fearmongering, ie: trying to convince normal, healthy people we are “abnormal” or “sick,” and fundamentally changing the way we think about ourselves. The marketing of fear often drives people to their doctors, and to the inevitable prescription pad, with predictable results: people getting unnecessary, sometimes harmful drugs for natural, normal phases of life.

The grift goes wide and deep. Many influencers and physician-educators have financial ties through sponsored content or brand partnerships, sometimes pushing lines of supplements, telehealth services, books, or their appearances on the speaking circuit. Sadly, information about who funds them to say what they say is not always straightforward and the top social media posts about certain drugs or therapies often obscure their potential conflicts of interest (e.g., selling related products/services).

We know that many of these campaigns are backed by medical specialists or social media influencers, wedded to their theories and pushing whatever to cash in on all the fear. Those campaigns are about ‘moving product’ by subtly convincing millions of healthy people that their bodies are broken, dysfunctional, deficient, and decaying. I’ve written these words before but they are worth repeating: fearmongering is an assault on our collective soul and the theft of wellness for which we all pay a high price.

Full-On Menopause Mongering

We can see fearmongering everywhere, but the most brazen current example is the full-frontal assault on menopause. If you’ve read a newspaper or scrolled through social media lately you might be asking yourself: Why the heck is everyone getting worked up about menopause? Are hot flashes taking over the planet? Are women really as angry as the media portrays them to be? And the drugs: who do you believe about whether the drugs will help or harm you?

These are good questions, focusing on a condition that every woman—our mothers, grandmothers, great-grandmothers and so on – went through, back to the dawn of time. The fearmongering today bypasses the fact that most women who arrive at the end of their periods get through this phase without serious discomfort or suffering. For some, it’s a big “meh.” Others might be helped by what’s on offer but they have to swim through a sea of corporate-sponsored fearmongering messages to get there.

The key theme in most of the media stories is that women’s needs are unmet, many of them are deeply suffering and they all need to be considering MHT (Menopausal Hormone Therapy) in order to live their best lives. By the way, MHT is the new way hormones are branded, which used to be called HRT (hormone replacement therapy). Same stuff, different wrapping, carrying less baggage of the HRT horrors of the past.

In the mainstream media you’ll find oodles of journalists in love with a story like this, featuring female suffering, emancipation, and empowerment in one tight little bundle with enough frilly gift wrapping to hide pharma’s fingerprints. The dangers of hormones haven’t changed, only the marketing of those dangers has.

This might have been kicked off by a story, “Women Have Been Misled About Menopause” in the New York Times Magazine, (Feb 1, 2023) a long-form essay which barely camouflages a shameless bit of salesmanship, setting the tone for so many other media outlets to follow. It aims to correct those who are still being ‘misled’ by outdated ideas about the dangers of hormone therapy, mainly breast cancer, also asserting that there are more “updated” interpretations of the alleged dangers of these drugs.

A newer New York Times article from last month (June 15, 2026) claims “Millions of Women are Left Out of Menopause’s Moment” and further cements the hormone marketing by telling the sorry tale of those women who are totally FOMO because they are at a higher risk of breast cancer and therefore shouldn’t dip their toes into the hormone pool.

Menopause mongering got a huge bump a while back when the US FDA reversed a 20-year-old black box warning of the dangers of hormone therapy and many media outlets (NPR, Slate, Nature,) jumped on the bandwagon and leapt into covering the issues related to the removal of black-box warnings on HRT. Note to file: Black boxes are the most serious warnings applied to approved pharmaceuticals. The manufacturers fight like hell not to get a black box on their products, and when there is one there, they fight like hell to have it removed, regardless of whether their arguments are warranted. In this case, they won.

The official FDA/HHS announcement was titled: “HHS Advances Women’s Health, Removes Misleading FDA Warnings on Hormone Replacement Therapy.”

Pure unadulterated marketing. The science behind why those black box warnings of blood clots, cancers, and strokes didn’t change, so why remove the black box? Yet here you have a senior FDA official saying: “The removal of the black box warning, based on the best science and data, is an incredible step forward to empower millions of women to live longer, healthier lives.”

You can read about how disempowering it is to bamboozle women about the dangers of hormones in my last Brownstone article on this issue, where I report that the sudden stopping of hormone replacement therapy 20 years ago resulted in the biggest drop in breast cancer rates in the US ever.

But. But. But….Didn’t you hear that there is a huge “unmet need” that has to be fulfilled? That essentially is the thrust of the media’s take over the last two years on this very topic.

A sample of this includes Nature’s January 2025 article: “The new science of menopause: these emerging therapies could change women’s health” and Slate’sNovember 2025 Article “How Did Perimenopause Get So Popular?” This article made lots of hay out of the little sister of menopause, “perimenopause” which cranks up the fearmongering while aiming it at younger and younger women. In the words of the marketers (and Kramer from Seinfeld), you don’t sell the steak, you sell the sizzle. And there’s nothing better to seed a market than to tell younger and younger cohorts of women what kind of special hell will await them when their periods are over. That’ll get them positively tripping over each other to get to their doctors for their hormone prescriptions.

One of the brighter stars among the media stories of menopause was a piece this January in STAT News “How the perimenopause movement is hurting women,” which is, as far as I can tell, one of the only stories bothering to delve into the real harms of hormone therapy. Today women are being more and more exposed to promotional messages and downplaying the harm of a product we know increases risks of breast cancer, regardless of patients’ age or the formulation.

Added to this collection are pieces in Time, Forbes, Vogue, The Atlantic, focusing on the “Menopause Industry Boom” and the way celebrities are onboard with selling the idea of menopause as a “wellness opportunity” rather than just a medical event.

Here you see fear being sold in almost every conceivable space in the world of menopause. There is the fear of missing out, the fear of the drugs, the fear of the suffering, and the fear of the alternatives. There is the fear that doctors won’t take a woman’s hot flashes and night sweats seriously, there is the fear of consequences in the workplace and women fearing career discrimination because of what menopause is doing to them, and there is the fear of their bodies not being attractive or sexual in a way they are used to. Fear everywhere.

Women might feel that they are being betrayed by their ovaries, while also being shoveled hefty amounts of psychology, and “wellness” products including the pills, creams, and pricey interventions like it’s the end of femininity.

There is a price tag to all of this, not just in the vertigo women might feel in the menopause marketplace, but in what it might cost them. Estimates are that the global menopause market is worth around $16–18 billion per year, but that is projected to grow to $24+ billion by 2030–2033. Suffice to say there is a lot of grift to be found in the medicalizing and medicating of menopause.

Pharma’s influence is pernicious and ubiquitous, even if it doesn’t seem that obvious to the casual observer. Drug companies have their hands in medical societies, research organizations, and educational/ marketing campaigns that shape narratives. Many of us would assert that the current pro-HRT renaissance (emphasizing a hormone’s benefits while downplaying the known and serious harms) is partly driven by industry-friendly messaging, even if direct-to-consumer ads for hormones are rare.

Except for patented alternatives. Here’s the fearmongering again, this time to subtly promote “non-hormonal” menopausal drugs. On February 11, 2024, Astella’s newly approved menopausal drug, Veozah was advertised on the biggest billboard in the world, at Super Bowl LVIII. Astellas aired a 60-second commercial for Veozah just before kickoff, featuring a tagline “Fewer Hot Flashes, More Not Flashes.”

Pushing Veozah (fezolinetant) as a non-hormonal treatment might seem clever, but it acts to further medicalize hot flashes, which for many women are trivial and are often dealt with quite effectively without drugs. The worrisome side effect profile of Veozah would make one think twice about this medication costing between $500 to $700 a month. In a year-long trial, the most common adverse reactions were pain, diarrhea, insomnia, back pain, and hot flashes. Go figure. Drug-induced liver injury is the real worry, and the elevation in liver enzymes means that women need to have baseline liver tests repeated at 3, 6, and 9 months. All this for some mild symptom relief. Hope the risk of liver failure was worth it.

Everyone’s Talking Empowerment (But Nobody’s Doing It)

Thankfully we no longer refer to menopause as an “estrogen deficiency disease,” a corporate-sponsored tagline if there ever was one. But we still have a long way to go.

Much of the commentary and media reports today focus on how to deal with the symptoms of menopause, which assert that doctors are basically missing in action when it comes to menopause, and that patients need, more than anything, “empowerment.”

What an old-fashioned thought that is: you mean women should ignore all the junk science, pharma marketing, and menopausal grifters out there and just follow their own intuition? Sounds like what Grandma would have done.

There are no glib and easy answers to all the menopausal marketing surrounding us, but perhaps the least offensive summary I’ve seen was a March 2024 article published in the medical journal, the Lancet, called “An empowerment model for managing menopause.”

While obnoxiously heavy on the “hormonal remake” theme, there are some key points worth noting. Particularly, menopause isn’t a disease; it’s a life phase for women who live long enough. The symptoms often come in miserable bundles — hot flashes, ruined sleep, low mood. Patients face it and doctors have to deal with it and they should do so beyond the default reflex which is a script for hormones and a pamphlet.

While no one can argue against respecting the clichés of “evidence-based” options and “shared decision-making,” we can’t forget that “evidence-based” often means whatever specialists push and what’s easiest to prescribe. In this case, hormones, or MHT as they’ve rebranded it. For those who say menopause is a normal life stage rather than a pharmaceutical marketing opportunity, the menopause salespeople and other grifters are singing loudly, “Don’t be Cruel.”

The Lancet, similar to most vocal menopause specialists, insists that MHT is the only thing that fixes both hot flashes and genitourinary symptoms (while providing some small level of reduced fractures). No doubt the pills are convenient, especially for the industries and guidelines which favor a one-stop pill solution.

At the end of the day if “true empowerment” is possible, the experience of menopause for many women could be better. They don’t need more pills or lotions, though some may be helped by these. They need good information, respect, and above all, agency.

Qualitative work done in the UK shows menopause is “simultaneously normal, devastating, identity-shifting, and liberating,” which is to say, all over the map. Something this complex cannot be solved with clinical one-liners and fancy treatment algorithms. At the same time misinforming women as to the actual benefits and long-term harms of hormones is not cool, especially when that advice is delivered with a big dose of white-coated confidence, amnesia, and hubris.

The Lancet article manages to get to the heart of the issue: helping women manage symptoms is important, but medicalizing every aspect of menopause can be downright harmful.

Thankfully the Lancet does give a shout-out to a practical way for women to regain the kind of agency many of them want: CBT or cognitive behavioural therapy has shown some level of benefit. It reports that “for symptom clusters such as hot flashes, disturbed sleep, and depressed mood, RCTs show that CBT is effective.”

How? Well, this makes me recall the work of the philosopher Viktor Frankl, who wrote Man’s Search for Meaning. His main message is that although you can’t always change your circumstances, you can choose your attitude toward them. That’s a helpful perspective to adopt when facing many of life’s challenges. If CBT helps women learn about their symptoms, accept them, and help them develop ways to cope with them, that might go a lot further than the flotsam washing in on a tidal wave of fearmongering.

Back to Frankl for a second. He wrote that finding meaning in life is the primary human motivational force. The ability to find meaning through work, love, and suffering could always be seen as a way forward. Many women seeking some kind of help for this particular transition in their lives have both time and options on their hands. They can, if they choose, go forward and demand to be taken seriously, without succumbing to the sharp end of the menopausal marketing machine.

Let’s sing an ode to menopause, wrapped up in a little rhyme.

Or hum a wistful song for wombs that’ve clearly done their time.

Let’s make a plea for all life’s stages, as all things must finally pass,

And let’s expose the grifters’ motives, with a bit of snarky sass.

Let’s not forget the lying, their fearmongering shrill notes,

Let’s ask the specialists why we should trust their clean white coats.

Let’s put the lie to cringy brags of pharma’s innovative growth,

Let’s look at how we trampled the sacred Hippocratic oath.

Let’s not forget the central thing, the one essential theme,

That flies far further than the mongers’ wicked meme.

That within a single woman her fate is hers and hers alone.

And she needs freedom’s will to act on what is felt and known.

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