Voices of U of U Health
Bridging the Gap in Women’s Health: Navigating the “Bermuda Triangle” of Menopause
In this multi-part blog series, researchers at the University of Utah College of Nursing share new insights that are expanding our understanding of women’s health. This second installment discusses evidence-based treatment, integrative approaches, and community support that are helping women move from isolation to thriving during menopause.
By Lisa Taylor-Swanson, PhD, LAc
While menopause is something that nearly every woman will experience, discussion around it has long been quiet.
I’ve worked with communities where it’s rarely discussed at all. Sometimes it’s so taboo that there may not even be a word for it in their language. More often, it’s dismissed with a shrug: It’s just part of aging.
But just because something is normal does not mean you should have to suffer through it.
That silence has consequences. It leaves women confused about what’s happening to their own bodies, and it leaves clinicians underprepared. The result is a gap in care for too many women, right when they need support the most.
When Care Falls Short
I began to see that gap clearly during my years of private practice in Washington State. As an acupuncturist and practitioner of Chinese herbal medicine, I frequently treated women and their partners for fertility concerns. Many of my patients conceived successfully and returned a year or two later—this time, with a different problem.
“I don’t feel like myself,” they would say. “I feel like I’m losing my mind.”
Soon the symptoms would surface: disrupted sleep, brain fog, hot flashes, night sweats, anxiety, heavy bleeding. I dug deeper into the issue and discovered that these women were entering perimenopause—the transitional years before menopause where hormones fluctuate dramatically.
Menopause is defined as 12 consecutive months without a menstrual period. In the United States, the average age at which menopause starts is 51. But perimenopause often begins in the mid-40s and can last four to 10 years. Some emerging data suggest symptoms may begin for some women as early as their 30s.
One common symptom of perimenopause is vasomotor events, often referred to as hot flashes. Experienced by about 80% of women, this symptom may also include heart palpitations, restlessness, or sudden waves of anxiety. When these symptoms happen repeatedly, day and night, they can disrupt sleep, mood, memory, and overall quality of life.
And these symptoms aren’t just uncomfortable. Research shows associations between vasomotor symptoms and longer-term risks such as heart disease, osteoporosis, and Alzheimer’s disease. Those links don’t prove cause and effect, but they’re another signal that this stage of life deserves real attention.
I often say we are in the “Bermuda Triangle” of women’s health care: a place where women can feel lost and clinicians may not have enough training. One study found that more than 80% of women didn’t seek medical care for menopause symptoms, with many of them saying they were unaware that effective treatments exist.
Once I saw the problem, I couldn’t ignore it.
Closing the “Meno Gap”
I set out to build a more supportive, evidence-based model of menopause care that women could actually access and trust. That work grew into MENOGAP, a four-week group medical visit model that combines conventional medicine and integrative approaches like acupuncture, with a follow-up check-in three months later.
Instead of a brief one-on-one appointment, participants meet weekly in a small group setting. I co-lead each session with a prescribing provider. Women receive detailed educational materials, learn practical symptom-management strategies, discuss their experiences openly, and participate in group acupuncture treatments.
The Power of Community
MENOGAP draws inspiration from “centering pregnancy,” a model of prenatal care that emphasizes peer support and shared learning. Many people are social creatures, and we tend to make sense of our experiences through conversation. When one woman shares that she hasn’t slept or doesn’t feel like herself, others see their own experiences reflected back. That kind of validation is powerful. It turns isolation into connection.
Pilot data shows meaningful improvements in menopause symptom scores and increases in self-efficacy or confidence in managing one’s own health. Equally as important, participants reported feeling more informed and supported.
One participant told us, “This is the best health care I’ve ever received in my life.” Hearing that was both affirming and sobering. It underscored how long many women have waited to feel heard.
Some women have described these sessions as life changing. In some cases, conversations surfaced feelings of isolation or despair that had gone unspoken for years. In those moments, the power of community becomes undeniable.
This work has been shaped by community voices. With input from patient advisory boards, we developed two tailored programs:
- Mujeres en Menopausia, an award-winning program created with Latina community health workers, a linguist, and a nurse practitioner
- Waning Moon, developed with American Indian and Alaska Native women with funding from the National Institutes of Health. Women in these cultures tend to experience even more stigma surrounding menopause.
These programs offer a safe space for discussion and connection.
From Surviving to Thriving
I’ve come to see menopause as more than a hormonal shift. It’s also a natural life transition.
Yes, we need to treat symptoms. Yes, we need to promote heart and bone health. But there can also be growth on the other side of this transition.
As hormone levels stabilize after menopause, many women describe a new sense of clarity and self-assurance. Boundaries become firmer. Priorities shift. Leadership and creativity often flourish. I sometimes think of this transition like a caterpillar becoming a butterfly.
But we can’t reach that transformation if we are drowning in untreated symptoms and stigma.
My message to women is simple: Trust yourself. If something feels off, it deserves attention. Seek care. Ask questions. Don’t stop until you find someone who listens.
Menopause shouldn't be shrouded in silence. With evidence-based care, open conversation, and community support, we can move from isolation to connection and from surviving to thriving.
