I always say to my patients, "I feel so lucky to be a Menopause provider right now, when I meet your concerns with YES! Of course we can consider HRT."
However, that is an oversimplification of what is happening in women's health right now. There's a debate, especially in the menopause space, and you've probably seen it play out on social media. Providers sparring publicly, staking out positions, drawing lines. I understand the impulse. As providers, we were trained to defend our knowledge, to hold the line on "evidence-based medicine" as if it were a fortress, and not to succumb to patient whims as though we were a service industry.
But as I watch it unfold, I keep asking myself: What's at the center of this work? Because it doesn't feel like it's the patient.
In an age where FemTech can be worth billions, where social media turns expertise into influence and influence into empire, I wonder how much of what we're watching is really about women's health and how much is about money, spotlight, power, and the very human need for security.
These forces have a way of quietly moving into the apex, displacing the thing that was supposed to be the fulcrum all along.
When I was in training, I learned a few things that I'm now working to unlearn. I learned to hold boundaries firmly by telling women that certain symptoms were "not a GYN issue." I learned to be cautious and conservative, to wait until the evidence is airtight before acting. And I learned implicitly that the doctor's knowledge was what mattered most in the room.
I practice very differently now. And I know exactly when the shift began.
When I was pregnant in 2020, working in person during the height of COVID-19 uncertainty, I tried to figure out how to protect my growing baby while also showing up for my department and my patients. The data was sparse, but the logic felt clear to me: Flu A and B are known to be dangerous in pregnancy; why would we assume a novel respiratory virus was any different? I asked for a simple accommodation: to avoid working directly with known COVID-positive patients.
I was met with resistance from my department chair and from my own OB provider at another institution, both seasoned clinicians, both mothers, both long-term mentors of mine. They told me there was good news: early data out of China showed no risk to pregnant people or their babies from COVID-19 infection.
I remember thinking: how do they believe that? How do any of us?
Looking back, I think I understand. They were managing a system on the verge of collapse. They needed people to stay calm, stay in place, keep showing up. The "evidence" became a tool for containment. I don't say that with bitterness. I say it because it was the first time I felt what so many of my patients must feel: trapped by the evidence and held at arm's length by the very framework that was supposed to protect me.
It changed how I practice. I unlearned my rigid boundaries.
Patients started coming to me having already done their homework by reading studies, listening to podcasts, building communities of shared knowledge. Sometimes they know more about a specific topic than I do. And rather than feeling threatened by that, I found myself becoming comfortable leaning into humility. It didn't feel like a compromise of my role, my status, or everything I'd worked for. If anything, it created something I hadn't expected: genuine connection. And that connection mattered. There is so much "us versus them" energy between patients and physicians right now—so much accumulated mistrust. When a patient feels met rather than managed, something shifts. That's not a small thing.
For too long, women experiencing menopause have been undertreated, dismissed, told their symptoms were normal, and told to get through it. For too long, women have been studied last, believed least, and treated with tools designed around someone else's biology. The opportunity in front of us, if we keep the patient at the center, is not about market share but about the opportunity for understanding.
And I'll be honest about where I'm putting my energy.
Today, I'm working with Qyn Labs, which is developing a hormone-monitoring device. I share that not to sell something, but because I think transparency is exactly what this moment calls for. What excites me about this work isn't the technology for its own sake; it's the possibility of finally collecting real, longitudinal data on women's hormonal health. Data that women can use to understand their own bodies. Data that we as clinicians can actually learn from. Data that can lead to measurable improvements in outcomes.
That's the version of FemTech I want to be part of. Growth driven by curiosity. Research driven by humility. Innovation that earns trust by being worthy of it.
The culture is shifting. Patients are coming in as partners now, as informed advocates for themselves, not as believers asked to place faith in a system that hasn't always deserved it.
