As I talk to friends, family, and patients, I often remind them: If a woman lives long enough, she has a 100% chance of going through menopause. That’s roughly 51% of the population. The other 49% (myself included) will almost certainly love, live with, or care about someone who will experience it.
With that perspective, menopause isn’t a niche issue—it’s a universal one. And yet, historically, medicine hasn’t treated it that way. For decades, research and clinical practice have centered largely on Caucasian males. While that has begun to shift over time, menopause care has lagged behind.
Then, a few years ago, the conversation changed.
A 2023 New York Times Magazine cover story, “Women Have Been Misled About Menopause” by Susan Dominus, helped bring long-overdue attention to the issue. The article explored how research gaps, pharmaceutical marketing, and oversimplified clinical approaches have shaped how menopause has been understood—and often misunderstood. It also highlighted something many women already knew: menopause is not a uniform experience, and the long-term health implications deserve thoughtful attention.
That piece reached millions and sparked conversations across the country. In many ways, it marked a turning point. Menopause, finally, is having its moment.
Clinically, menopause is defined as 365 + 1 days without a menstrual cycle. Simple on paper. Much less simple in real life.
The years leading up to menopause—known as perimenopause—typically last 4–8 years, though for some women, symptoms can persist for a decade or more. During this time, hormonal shifts can lead to a wide range of symptoms that are often missed or dismissed, both by patients and by the clinicians they see.
This isn’t about lack of empathy. It’s about lack of training.
When I completed my MD and MPH between 2009 and 2014, I received perhaps one to two hours of formal education on menopause. Residency added months of obstetrics and gynecology training—but still no structured focus on menopause or midlife hormonal health. Even today, only about one-third of OB/Gyn residencies include a formal menopause curriculum.
That gap matters.
When John and I left corporate medicine to build The Cove Concierge Medicine, we partnered with MsMedicine, an affiliate organization focused on advancing women’s midlife care. One of their core requirements is that all affiliated providers become Menopause Society Certified Practitioners (MSCP).
This certification represents the highest level of formal training currently available in menopause and midlife health. More importantly, it reflects a commitment—not just to learning once, but to continually following evolving evidence and applying it thoughtfully.
That’s where our approach begins.
We practice differently than many hormone-focused clinics because our priority is safety, consistency, and transparency. We favor FDA-regulated therapies because they allow for precise dosing, have the most regulated quality controls, and permit us to make ongoing adjustments easily. We take time to walk through risks, benefits, and alternatives so that patients can make informed decisions—not feel sold to.
My personal motto regarding health: Everything we do has a cost, and everything we don’t do has a cost. The goal isn’t to chase trends or promise quick fixes. It’s to help each person feel like themselves again, using approaches grounded in physiology, evidence, and real-world practicality.
That means individualized care. It means adjusting when needed. And it means recognizing that no two menopause journeys look the same.
The goal isn’t to chase trends or promise quick fixes. It’s to help each person feel like themselves again, using approaches grounded in physiology, evidence, and real-world practicality.
Castle Rock is our home, and the home of The Cove Concierge Medicine. We may not be Colorado natives, but we’re here for the long run—building something sustainable, thoughtful, and deeply connected to this community. It’s a privilege to care for our neighbors. And it’s an honor to help lead with excellence in this pivotal moment of menopause care.