Mary Claire Haver, MD is a board-certified OB/GYN, a Certified Culinary Medicine Specialist, a Certified Menopause Provider and author of the recently published The New Menopause: Navigating Your Path Through Hormonal Change with Purpose, Power and Facts
“The research on menopause is really exciting right now.” Dr. Mary Claire Haver on The Mel Robbins Podcast March 2024
The New Menopause Marks A Watershed Moment in Menopause Care
Perhaps the most compelling reason that every woman over 40 should read The New Menopause is that most of us are not getting the best advice about menopause from our medical practitioners. In fact, most of us are getting the worst advice—that is, dated advice that is in direct opposition with the latest research and analysis, as published by The Menopause Society. That’s the leading resource on menopause for medical clinicians in the U.S. It was formed as recently as 1989, which suggests that many, if not most of us, are seeing doctors with virtually no formal training on this significant hormonal change in our bodies.
“Doctors are not helpful. They haven’t had training, and they’re not up to date.” Philip M. Sarrel, professor emeritus of obstetrics, gynecology and reproductive services at the Yale School of Medicine
I first met Dr. Haver at The New Pause Symposium in NYC this past October, which gathered leading menopause experts for a day of insight and to share and advance what we know about menopause. Both an informational session and a charge to action, it was co-hosted by The Swell and Naomi Watts’ new menopause wellness company Stripes. I wrote about the biggest take-aways from the Symposium for The Crush Letter in PrimeCrush Hotflash: The 5 Things You Need to Know About Menopause.
The stats that were discussed at the Symposium were staggering: only 20% of ObGyn residencies in the U.S. offer menopause training, according to AARP, and half of ObGyn residencies felt they needed more education on menopause; 80% of graduating internal medicine residents felt incompetent to discuss or treat menopause. There are an estimated 64 million women in the US who are 50 or older, 100% of whom have or will go through menopause, yet The Menopause Society had certified only 1300 practitioners as of November 2022.
The New Menopause comes at a watershed moment for menopause: our understanding of it, the advancement of research on it and our treatment of it. There’s been a “seismic shift” in research and analysis on menopause since 2002, Haver writes. That’s the year the Women’s Health Initiative Study came out, which dominated news cycles and abruptly ended the use of hormone therapy to treat menopause systems. There have been significant advancements in our understanding of menopause since 2002, but medicine can be a slow-moving ship, says Haver. A course correction based on newer research and analysis has taken too long.
“Duke University did this elegant study looking at frozen shoulder … so common in women, especially in menopause … the studies show that women on hormone therapy have a lower chance of frozen shoulder. They pulled all the data and there are tons of estrogen receptors here! And and when we lose that estrogen, it’s an anti inflammatory hormone in the bones and joints.” Dr. Mary Claire Haver on The Mel Robbins Podcast March 2024
(Read about Duke’s “frozen shoulder-estrogen” study here.)
The New Menopause arms its readers with the necessary facts to get the best advice out there on how to manage menopause symptoms. Part One: The Story of Menopausal Medicine outlines the brief and tumultuous history of menopause medicine, critical to understanding why women can’t trust what our doctors have been telling us when we share what we’re going through. It’s a validating section for those of us who have been told that certain symptoms we’ve endured are “all in our heads” (and worse). Among other eye-opening revelations, Haver points out the woefully small amount of research funding allocated to women’s health generally, and to menopause specifically—only 0.003 percent of all federal funds went to menopause research in 2021–even though there are an estimated 64 million of us over 50 years of age. A lot is happening to change that imbalance and to increase access to good menopause care, according to Haver, much of which readers can help advance with the information she outlines in Part One of her book.
Part Two: Getting to Know Menopause tells you what is happening to your body during each of the three stages of hormonal change: perimenopause, menopause and postmenopause. It’s eye-opening to read through the symptoms, and to view them through a “flowchart” that outlines a medical clinician’s informed “decision tree” for determining treatments. In this chapter, Haver discusses in detail the many options for hormone therapy as well as its risks, and provides enough information for you to begin to educate yourself on your own specific risks.
All of this leads to what was ultimately the most practical section of the book for this reader: “Preparing for Your Appointment.” In it Haver outlines the relevant information to bring to your first appointment with your menopause medical practitioner to get the most out of it, such as relevant family history and symptoms (more on that below), and suggests that you go in with a sense of your preferences so that you and your practitioner can make the best and most informed decisions for you.
Here’s something Haver suggests that I wish I knew before my first appointment with a new ObGyn after attending the New Pause Symposium in October: call the OBGyn’s office first; make sure that they understand that you specifically want to discuss menopause; and that they are willing to review all of your therapeutic options (include hormone replacement theory). I moved to a new state recently and had to replace my ObGyn. My former ObGyn was up-to-date on menopause medicine and had prescribed hormone replacement treatment to me a few years ago, pointing to some of the updated research Haver covers in her book. I was shocked to find myself sitting in front of my new ObGyn and listening to her cite decades old research as a basis for refusing to discuss (or prescribe) hormone replacement treatment.
Needless to say, she did not become my ObGyn, but I feel sorry for all of her patients who are getting outdated advice and suffering needlessly. Hopefully Haver’s book will be instrumental in changing that.
Part Three: Symptoms and Solutions provides a “toolkit” for addressing menopause symptoms. It might be the most informative part of the book for readers who are just beginning their journey of understanding how menopause affects them. Dr. Haver lists dozens of symptoms—many, like brain fog, heart palpitations, joint pain and vertigo—are unexpected and have not historically been associated with menopause, as well as symptoms we have all become aware of, like hot flashes and acne. For each symptom, Haver offers potential solutions that cover a range of approaches, from lifestyle changes to low-invasive strategies to pharmacological options. She is an advocate for adhering to a foundational program of good nutrition, thoughtful exercise and commitment to good sleeping habits.
How to Find an Informed Menopause Healthcare Provider
“We could do so much better. We’ve got to do a better job training every single healthcare professional and all specialities … on what the lack of estrogen is doing to each and every organ system. Each female has a unique expression of our menopause.” Dr. Mary Claire Haver on The Mel Robbins Podcast March 2024
Finding an informed provider is the most important first step in getting good menopause care from a medical practitioner. Haver provides the basic yet invaluable “blocking and tackling” information you need to do this. While it is covered in her book in more detail, Haver has also written a short post on How to Find the Best Menopause Care Provider near you. It includes a link to Haver’s Community-Recommended Physician List. Note that these are not Haver’s personal recommendations—her community submits the names and information on practitioners who have provided them with informed, excellent care and then her team does some verification before the names hit her list. I performed my own search on this database and was relieved to come up with a suggested ObGyn in my new hometown. The Menopause Society also provides a Menopause Practitioner database to look for providers with their MSCP Certification. Finally, Evernow, Alloy and Midi are all digital healthcare companies that offer virtual options for informed menopause care, which may be the best option for many women either for its convenience, or because of limited in-person options near them. Haver outlines their respective offerings in her post linked to above.
More Information.
Dr. Mary Claire Haver has an active instagram account drmaryclaire, and provides additional information on her website thepauselife.com. In addition, I highly recommend that you listen to the March 21, 2024 episode of The Mel Robbins Show Hosts Dr. Mary Claire Haver about the state of menopause medicine, steps you can take with diet and exercise (and more) to address menopause symptoms and The New Menopause.
The Menopause Society
Here’s a list of the instagram accounts of the menopause experts who spoke at The New Pause Symposium:
Dr. Mary Clare Haver - @drmaryclaire
Dr. Vonda Wright - @drvondawright
Lisa Mosconi - @dr_mosconi
Dr. Robin Noble - @robinbnoble
Dr. Heidi Snyder Flagg - @m_pause
Peter Attia - @peterattiamd
Dr. Emily Morse - @sexwithemily
If you’d like to support one of the nonprofits educating and advocating for further research and funding on, and on behalf of women with menopause, check out these two:
Let’s Talk Menopause aims to empower women with the information they need to navigate menopause, and also advocates for the medical community to invest in additional education and better care for women through menopause.
In addition to the above, the National Menopause Foundation has announced a Women’s Midlife Health Policy Institute, which will engage policymakers on research and care initiatives.
Both the National Menopause Foundation and Let’s Talk Menopause support the enactment of The Menopause Research and Equity Act of 2023to bolster the study of menopause at the National Institutes of Health.
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