Get caught up with Contemporary OB/GYN's latest coverage from The Menopause Society Annual Meeting in San Diego, California.
News|Videos|October 26, 2026
Missed & Dismissed: From perimenopause to menopause, the transition medicine keeps missing
Fact checked by: Ben Saylor
Key Takeaways
- Perimenopause symptoms in women in their late 30s and 40s are often attributed to stress without a plan for next steps.
- Black women report more intense and longer-lasting vasomotor symptoms weathering and medical mistrust may compound those differences.
Jessica Shepherd, MD, MBA, FACOG, joins Missed & Dismissed to discuss why perimenopause is overlooked and how disparities shape who gets care.
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In the second episode of Missed & Dismissed: Closing the Diagnostic Gap in Women's Health, host Calbeth C. Alaribe, DMSc, MPH, PA-C, CPCHE, welcomes Jessica Shepherd, MD, MBA, FACOG, a board-certified OB/GYN, chief medical officer of Hers, and author of Generation M: Living Well in Perimenopause and Menopause. Shepherd is also the founder of Modern Meno and
Alaribe and Shepherd discuss how women in their late 30s and 40s are often told their sleep problems, mood changes, brain fog, and loss of libido are stress, with no plan for what to do next. Shepherd reflects on previous hormone therapy headlines and how patients and clinicians moved in opposite directions, noting that only a small share of eligible women use menopausal hormone therapy today.
They also examine how Black women report more intense and longer-lasting vasomotor symptoms, as documented in the SWAN study, and how weathering, chronic stress, and medical mistrust can compound those differences. The conversation turns to who is missing from the data, including Latina, Asian American, and Indigenous women, and to the role of telehealth and AI-generated protocols in either narrowing or recreating existing gaps.
The episode closes with Shepherd's reflection on being trained to wait for a menopause diagnosis before treating, and the one question she believes all clinicians should ask their patients: "What do you want out of this?"
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Misread Women’s Health Initiative data sidelined hormone therapy and menopause education, according to Mary Jane Minkin, MD, FACOG.
Susan Reed, MD, on the MsFLASH network's pooled findings, including nonhormonal therapies comparable to low-dose estradiol and CBT for sleep.
Late recurrence, high-risk features, and treatment failure can signal midlife night sweats aren’t menopause, according to Cheryl Cox Kinney, MD.
Hormone therapy was associated with more frequent, longer migraines in postmenopausal women, but not with greater severity or analgesic use.
JoAnn V. Pinkerton, MD, offers primary care counseling on elinzanetant's side effects and the early onset and continued relief of hot flashes.
Menopausal brain fog is common, and hormone therapy has neutral cognitive effects, according to Pauline M. Maki, PhD.
Stephanie S. Faubion, MD, on choosing between fezolinetant and elinzanetant, liver monitoring, follow-up, and open questions in menopause care.
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