When Melinda French Gates — a woman with access to the finest medical care available — needed three doctors before receiving a perimenopause diagnosis, she encountered not a failure of individual physicians but a failure of the system that trained them. Only one in three OB-GYN residents in the United States receives any formal menopause education, a structural gap that quietly shapes the health trajectories of millions of women regardless of their privilege or resources. Her willingness to name this experience publicly invites a broader reckoning with how medicine has long treated the biology
Gates: Even with best healthcare, took 3 doctors to diagnose my perimenopause
Menopause-related symptoms cause significant workforce disruption, with approximately 10% of affected women leaving or considering leaving employment.
Even with the best healthcare, it took three doctors to diagnose what was happening
Mark
Why does it matter that it took her three doctors? Isn't that just one person's experience?
Mimi
Because she's not one person—she's a signal. If someone with unlimited resources and medical access needs three doctors, what happens to everyone else? It reveals the system is broken at the foundation.
Mark
But the doctors weren't doing anything wrong, you said.
Mimi
Exactly. That's the point. They weren't negligent. They just weren't trained. You can't diagnose what you've never been taught to recognize. Only a third of the specialists who should know about this get any training in it.
Mark
So it's a medical education problem.
Mimi
It's a medical education problem that becomes a women's problem. Two in five women say menopause symptoms wreck their work. One in ten leave their jobs. That's not a personal failing—that's a system that hasn't made room for half of humanity.
Mark
What would fixing it look like?
Mimi
Start with training. Make menopause standard curriculum, not optional. But also acknowledge that this gap exists because menopause has been treated as a minor issue, a personal problem, not a public health crisis. Changing that takes more than curriculum updates.
O Pulso
- A woman with extraordinary healthcare access still needed three doctors to diagnose perimenopause — exposing how deep the system's blind spots run.
- Only 31% of OB-GYN residents receive any menopause training, meaning the specialists most trusted with women's health are routinely sent into practice underprepared.
- The consequences spill beyond clinic walls: two in five women say menopause symptoms interfere with their ability to work, and one in ten has left or is considering leaving a job because of them.
- French Gates shared her experience on Norah O'Donnell's new podcast 'Healthful,' using her platform to reframe the problem as structural rather than personal.
- Advocates and researchers are pressing for menopause to become a required part of medical residency curricula — a shift that would need to happen at the institutional level to close the diagnostic gap at scale.
When Melinda French Gates — a woman with access to the finest medical care available — needed three doctors before receiving a perimenopause diagnosis, she encountered not a failure of individual physicians but a failure of the system that trained them. Only one in three OB-GYN residents in the United States receives any formal menopause education, a structural gap that quietly shapes the health trajectories of millions of women regardless of their privilege or resources. Her willingness to name this experience publicly invites a broader reckoning with how medicine has long treated the biology of half its patients as a specialty rather than a standard.
Melinda French Gates was in her early 40s when perimenopause arrived. Despite having access to some of the finest medical care available, it took three separate doctors before anyone could accurately identify what was happening to her body and offer the right treatment. She described the experience as "kind of unbelievable" — a word that carries weight precisely because her situation was so exceptional.
She shared this on the debut episode of Norah O'Donnell's new podcast, "Healthful." French Gates had heard about menopause from older friends during their weekly walks together, so she wasn't entirely unprepared. But lived experience, she found, is something different from secondhand knowledge.
The root of the problem, she came to understand, wasn't individual failure — it was structural. Only about one-third of OB-GYN residents in the United States receive any formal menopause training during their residencies. A 2022 survey put the number at just 31.3 percent. When the doctors most responsible for women's health haven't been taught to recognize and treat menopause, the condition gets missed or mismanaged — even for patients with every advantage.
The consequences reach well beyond the exam room. Research from women's health app Mira found that two in five women say menopause symptoms interfere with their ability to work, and one in ten has already left a job or is seriously considering it. These are not rare outcomes — they represent millions of women navigating an impossible tension between their health and their livelihoods.
French Gates has made women's health central to her philanthropic work, and this personal experience clarifies why. The argument she is making is not about access alone — it is about what medicine has chosen to teach. Until menopause becomes a standard part of every OB-GYN's training, the diagnostic delays will continue, regardless of how much a patient can afford.
Melinda French Gates was in her early 40s when perimenopause arrived. She had the resources most people can only dream of—access to some of the finest medical care available. And yet, when the symptoms began, it took three separate doctors before anyone could tell her what was actually happening to her body.
She talked about this experience on the debut episode of Norah O'Donnell's new podcast, "Healthful," which launched this week. French Gates said she had been prepared, in a way. Her older friends mentioned menopause during their weekly walks together, so she knew the general territory. But knowing about something and experiencing it are different things. "It was kind of unbelievable to me," she said, "that even in this unbelievably privileged situation I'm in, where I feel like I can get some of the best healthcare, it took me three doctors to really diagnose what I was going through and to get the right treatments."
The problem, she came to understand, wasn't negligence or incompetence. It was structural. Only about one-third of OB-GYNs in the United States receive formal training in menopause during their residency. A 2022 survey found that just 31.3 percent of OB-GYN residents reported having any menopause curriculum at all in their training programs. That gap ripples outward. When the doctors who are supposed to specialize in women's health haven't been taught to recognize and treat menopause, the condition gets missed, misdiagnosed, or inadequately managed—even for patients with every advantage.
The consequences extend far beyond the doctor's office. Research commissioned by Mira, a women's health app, painted a stark picture of how menopause disrupts lives. Two out of every five women surveyed said their symptoms interfere with their ability to work. One in ten said the symptoms were severe enough that they had already left their jobs or were seriously considering it. These aren't edge cases or rare outcomes. They represent millions of women making impossible choices between their health and their livelihoods.
French Gates has made women's health a focus of her philanthropic work, and this personal experience sits at the center of why. The issue isn't that good doctors don't exist. The issue is that the medical system hasn't prioritized training them. A woman can have access to exceptional care and still fall through the cracks because the infrastructure of medical education hasn't caught up to a biological reality that affects roughly half the population. Until that changes—until menopause becomes a standard part of what every OB-GYN learns—the diagnostic delays and treatment gaps will continue. The full conversation airs on the "Healthful" podcast this week.
Citações Notáveis
It took me three doctors to really diagnose what I was going through and to get the right treatments, even though I have access to some of the best healthcare— Melinda French Gates
Only one-third of OB-GYNs in this country are trained in menopause— Melinda French Gates
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