What we know, what's missing, and what we'd like to support.

SWAN (Study of Women's Health Across the Nation)

The gold-standard longitudinal cohort, running since 1996. Oversampled Black, Hispanic, Chinese, and Japanese women. Black women enter perimenopause roughly 8.5 months earlier, have longer transitions (median 10+ years vs. 6.5 for white women), more severe vasomotor symptoms, and are less likely to be offered MHT. Hispanic women report more vaginal dryness and forgetfulness.

MIDUS (Midlife in the United States)

Longitudinal data on midlife mental and physical health, with some race and socioeconomic breakdowns. Less menopause-specific than SWAN, but useful background.

PRIDE Study

U.S. cohort of LGBTQ+ adults; has begun collecting menopause and midlife hormone data. Still small, but the only large queer-specific dataset of its kind.

JAMA Medical News (July 2026) — "Wild West or Gold Rush": the menopause marketplace, examined

A JAMA news feature on what happened after decades of neglect: a boom in products, telehealth and influencer advice that now outpaces the evidence behind it. The numbers in it are the part worth keeping. A Mayo Clinic analysis led by Stephanie Faubion found menopausal hormone therapy use in the US had fallen to 1.7% by 2023, against nearly 1 in 4 women before the 2002 WHI fallout — so the treatment with the strongest evidence is still the least used, while less-studied options fill the space. Nanette Santoro's line on testosterone being at "an all-time fever pitch", Faubion calling stacks of hormone-level printouts "close to worthless" because levels swing day to day, and Raffael Heiss's work on parasocial trust in influencers all land in the same place: interest has run ahead of research. Also flags a companion JAMA Network Open study finding people describe emotional and cognitive symptoms far more often in online forums than they appear in their own medical records.

Canino et al. (2026) — Twenty-five years of supplement research, counted

A bibliometric analysis in Menopause mapped every US dietary-supplement intervention study on menopause from 2000–2024. The whole literature comes to 253 publications, growing at 3.89% a year, spread thin across more than 80 different ingredients — and 234 of those studies look at postmenopause. Perimenopause, the stage where most people start reaching for supplements, is almost absent. That combination (many ingredients, few studies each, almost no replication) is exactly why so much of our supplement shelf grades low: it isn't that the products failed, it's that the research was never done.

GreenShield + Women's Health Collective Canada — first national Canadian menopause study (August 2026)

A major Canadian insurer and a women's-health philanthropy are jointly funding Can-RISE, the first national investigator-led study of perimenopause, menopause and post-menopause in Canada. It explicitly centres equity-deserving populations and the health, social and economic effects of the transition — including at work. The fact that this data didn't exist at a national level until now is itself the gap.

Manulife Canada (2025) — HRT claims up 228% in five years

Manulife's aggregate claims data shows hormone therapy claims among Canadian women aged 45–54 rose 228% from 2021 to 2025 — one of the first insurer-level confirmations that Canadian demand is finally climbing after two decades of the WHI chill, in the same age band as Canada's average menopause age of 52. It's a claims-based figure (employed women with benefits), so it undercounts the uninsured and anyone paying out of pocket, but it tracks with what pharmacists and clinics report on the ground. Demand moving is not the same as the evidence gap closing — but it's the demand-side signal the research pipeline has been waiting for. Source: Manulife Canada aggregate claims data, 2021–2025, cited in a Manulife/Cleveland Clinic Canada article.

NHS Business Services Authority / The Pharmaceutical Journal (2026) — who England's HRT rise reached

England's HRT prescribing more than doubled since 2020/21, from 781,170 women aged 40 and over to 2,038,025. The deprivation gap held anyway: about 8.8 in every 100 women over 40 in the most deprived fifth of England receive HRT, against 14.2 in 100 everywhere else, with Newham at 4.5 per 100 and Brighton and Hove at 23.4. A Menopause All-Party Parliamentary Group report found Black women five times less likely to be prescribed HRT than White women (5.2% vs 23.3%) and Asian women four times less likely (6.2%). Pharmacists interviewed name appointment access, clinician confidence, translator availability, faith and cultural attitudes, and a breast cancer message from 2002 that is still doing quiet work. One caution worth keeping: a low prescribing rate is not proof of unmet need on its own, which is exactly why symptom data has to be collected separately from prescribing data. Canada has no equivalent national figures, which is its own gap.

APPG on Menopause / Wellbeing of Women (October 2025) — Rebuilding trust: tackling inequity in menopause care

A UK parliamentary inquiry that asked who menopause care is failing, and heard from six groups in turn. Disabled and neurodivergent women, whose symptoms get filed under their existing condition. Ethnic minority communities, where Black women are five times and Asian women four times less likely to be prescribed HRT than White women, and earlier onset ages go unrecognised. LGBTQIA+ people, excluded by the language of the services themselves, with the 2024 NICE guideline silent on anyone taking gender-affirming hormone therapy. People in poverty, blocked by ID and fixed-address rules and digital-only booking. Domestic abuse survivors, who receive trauma-uninformed care, whose perimenopause is associated with starting around 35% earlier, and two thirds of whom report abuse increasing during menopause. And women in prison, a group that grew 179.5% among those 50 and over between 2003 and 2023, facing convoluted medication access and almost no privacy. The recurring shape matters more than any single figure: no tailored information, then stigma and silence, then late help-seeking, into a setting that was not built for them. The inquiry's own conclusion is a research gap, and its fifth recommendation is dedicated funding to close it.

Ozmen et al. (2026) — Surgical menopause and GSM severity

First sizeable comparison of genitourinary syndrome of menopause (GSM) burden in surgical vs natural menopause, published in Menopause (journal of The Menopause Society). Surgical menopause came with significantly more severe GSM exam findings and symptoms (dryness, painful sex, reduced desire, dysuria, urinary frequency), adjusted OR 1.08 per point of severity (95% CI 1.04–1.12). Matters because surgical-menopause patients have historically been folded into 'postmenopausal women' in trials; the field is finally treating them as their own population, which is what the lived experience has been saying for years.

Apple Women's Health Study (Harvard Chan / Apple / NIEHS)

The first long-term, at-scale study pairing iPhone and Apple Watch cycle data with periodic surveys to map menstrual patterns against gynecologic and broader health outcomes — including perimenopause and menopause. Real-world evidence at a scale the classic cohorts (SWAN, MIDUS) could never reach. iOS 26 also added menopause and perimenopause life-stage tracking in the Health app, which feeds back into this work. Credit: Harvard T.H. Chan School of Public Health, Apple Inc., and NIEHS.

WEF Women's Health Innovation Radar (2025)

World Economic Forum mapping of where women's-health innovation is concentrated and where the science-to-patient pipeline breaks down. Names menopause as one of the high-impact conditions where translation, not just discovery, is the bottleneck. Useful framing for why a consumer platform like Nila exists alongside the labs.

Wellcome Leap + Pivotal Life Sciences — US$250M women's-health commitment

Wellcome Leap's partnership with Pivotal Life Sciences puts a quarter of a billion dollars behind women's-health research programs. Not menopause-exclusive, but the scale signals the funding gap is finally being named by people who can move money.

Melinda French Gates — US$215M for women's health worldwide

Pivotal Ventures' 2024 commitment to improving women's health globally, with a stated focus on under-studied conditions and historically excluded populations. Same direction of travel as the Wellcome Leap announcement: the philanthropy capital is starting to land where the evidence base is thinnest.

Kearney [w]Health Employer Index 2026

Annual benchmark of how employers cover women's health — including menopause — in benefits design. The 2026 report frames the shift from awareness to accountability, which matters because workplace coverage is one of the few levers that closes the access gap quickly while the trials catch up.

Menopause Mandate Mega Menopause Survey 2025 / MM25

A UK patient survey completed by more than 15,000 women, with UCL research support. It surfaces the honest reality of menopause support today: what has improved, what is still missing, and where urgent change is needed — from access to informed medical care to which employers are stepping up. Patient-org data at a scale most clinical cohorts don't reach, and a useful counterweight to employer self-reported benchmarks.

SOGC / Medscape Canada — Lack of menopause care reflects systemic issues (July 2026)

The Society of Obstetricians and Gynaecologists of Canada names publicly what patients have been saying for years: primary-care menopause training isn't mandatory, fee-for-service under-pays counselling, and there's no billing code for group or novel care models. The 2002 WHI overcorrection scared a whole generation of prescribers away from MHT, and the gap is now being filled by private clinics charging $500+ a visit with uneven oversight. Bill S-243, a national framework for women's health in Canada, is currently moving through the Senate. Worth flagging alongside the funding signals above: the gap is being named by the professional body, not just patients.