Midlife Matters: Rethinking Women’s Health Education

Modern medicine is built on research, yet women’s health has historically been underrepresented in it. For decades, women were excluded from clinical trials, and even now, major gaps remain in how we study and understand conditions that affect them across the lifespan. Menopause, a near-universal stage in women’s lives, is one of the clearest examples, remaining understudied, underfunded, and often overlooked in clinical care. 

This gap is what inspired Women’s Midlife Health: Menopause, Metabolism & Beyond, a new elective at UCSF. This winter, eleven students enrolled in the course, meeting weekly to study menopause and midlife health not as an afterthought, but as a critical stage that demands clinical rigor, research investment, and a more expansive model of care.

From the beginning, the course asks students to reconsider how value is assigned within healthcare. The system tends to treat women as most important during pregnancy. And that changes almost immediately after. But not everyone will give birth, and everyone will age. Women deserve to live a good life at every stage, and we should have the skills to support that.

Despite affecting half the population, menopause education is still limited in medical training. Many clinicians report feeling unprepared to counsel patients on symptoms or treatment options, and many of the evidence gaps in women’s health still persist today. The result is a disconnect that plays out in clinics every day, where patients describe feeling dismissed or left to navigate complex symptoms on their own.

As a first year, it’s striking how much of this feels new. Before taking this course, I did not fully appreciate the extent to which menopause reshapes the body. As one student reflected, “I didn’t realize how systemic it is. Seeing menopause through that lens changes how you think about patient care entirely.”

The structure of the course reflects this breadth. Sessions brought together experts across disciplines to explore midlife from multiple angles, including hormone therapy, sexual health, bone metabolism, neuroimmunology, and menopause care in cancer survivors. 

In one session, Dr. Alison Huang traced the evolving evidence around menopausal hormone therapy, a topic that remains both clinically important and publicly controversial. In another, Dr. Tami Rowen discussed low sexual desire in menopause, emphasizing the interplay between hormonal and neurologic pathways. 

Other sessions addressed culturally responsive menopause care, including the specific needs of Black women, and the long-term effects of hormonal changes on bone and metabolic health.

The course also builds on a broader framework of care that extends beyond physiology. The opening session, led by doula and reproductive justice advocate Latham Thomas, set the tone by emphasizing continuity across the life course. 

That perspective felt especially meaningful to me. My own experience working with doulas shaped how I understand care as something relational and sustained, not limited to isolated clinical encounters. This elective extends that same philosophy into midlife, asking what it would look like to show up for patients with the same depth of attention during this stage of life.

For many students, the course resonates on a personal level. One student shared, “I took this class because my mom is going through perimenopause right now, and I realized I didn’t know how to support her.” 

That sentiment underscores the broader reality that menopause is not distant or abstract. It is already shaping the lives of people we know and care about, even as it remains insufficiently addressed in medical education.

At the same time, the elective is already influencing how students think about their future roles. For some, the course has already extended beyond the classroom, with students beginning to collaborate with guest speakers on research projects. Midlife health, in particular, is still an area where medicine is catching up. For students early in their training, there is a unique opportunity to engage with this gap and help shape how care evolves.

One of the most important themes of the course is learning how to navigate uncertainty. Hormone therapy, in particular, has been shaped by decades of shifting evidence and public debate. Rather than offering simple answers, the course emphasizes the importance of individualized, evidence-based conversations. 

“Hormone therapy is especially controversial right now,” one student reflected. “Learning how to have honest, nuanced conversations about it is what will make us better clinicians.”

Ultimately, the elective challenges a deeper assumption within medicine: that women’s health is most valuable when it is tied to reproduction. In reality, the majority of a patient’s life occurs outside of those years. Women deserve better; I found myself thinking throughout the course. Its not just about surviving these transitions, but about being able to thrive through them.

Women’s Midlife Health: Menopause, Metabolism & Beyond may be a small elective, but it represents a larger shift in how we think about care. It invites students to take seriously a stage of life that has long been overlooked, and in doing so, it begins to fill a gap that should not have existed in the first place.