Melinda French Gates Is Fighting to Close the Menopause Funding Gap

23:51Dr. Mary Claire Haver:Women, I didn't know this, no one taught me this, I learned this two years ago, tend to have diffuse microvascular disease, which is why we show up in the ER with atypical chest pain, though we're 51 % of the population and our heart attack is atypical. And then we're misdiagnosed 50 % of the time. We have a much higher chance of dying from a first heart attack than a male. And the medications don't work as well on us as they do on our male counterparts. And the data is not stratified by sex, meaning male versus female. It's just like, oh, this particular drug worked great for this group. But when you look at the data and tease out the women versus the men, the women don't do as well.

24:29Dr. Mary Claire Haver:They definitely don't. And talk to me about where you want to see this investment going for heart disease. So I'm invested with an organization called Welcome Leap through a model, Regina Dugan, who's an amazing scientist. I've known her a long time. And she's taking a model that came out of DARPA to help us. The model helps you get things much faster, much more quickly. three to five years as opposed to 10 or 20. And so we are, that is exactly what they're looking at. They're looking at this plumbing around a woman's heart to say, okay, where are these places coming in microvasculature? And how could we come up with a better diagnostic?

25:09Because even to go to the right place to get the right diagnostic for women is one expensive and available in very few places. So we're looking at, could you come up with a diagnostic that catches this much, much sooner. So the research is specifically focused on a woman's heart and the vasculature around it, not a typical heart, which is assumed to be the male heart.

25:33Dr. Mary Claire Haver:Yeah. I mean, that's really groundbreaking to me. Lisa Moscone, are you familiar with her work? So she's with Welcome Leap as well with the care program where they're using the same model to see what is this connection with Alzheimer's and dementia and menopause because we just see that acceleration. Well, and as you said, again, if a woman gets chronic insomnia and we see the symptom, which is brain fog, but the chronic insomnia can lead to so many things, right? And so there are just so many issues here. And for me, it's actually also exciting to see that we're finally going to be on the brink of this.

26:14We need so much more funding, though. Yeah, we do. I mean, so much more funding. We should expect our National Health Institutes to put far more funding into women's health of all the types you mentioned. Billions and billions and billions. Yes, because that is how research moves forward. It has been our government funding through the NIH that then goes to all the researchers around the world in the U.S. So, you know, again, to think that women live nine years unhealthy in life, we've misthought, oh, well, that's at the end of their life, you know, because they live longer. No, no, no. Half of it is pre-menopausal.

26:55Half of it is those most productive years. And to me, it's just, it's tragic. It just shouldn't be. I think of these stages of women's life, they can either be off-ramps or they can be continued on-ramps into the life that they want, right?

27:13Dr. Mary Claire Haver:So how do you think, you know, and the advocacy arm for Pivotal. Yes. And I'm literally today, I testified this morning for a congressional hearing on menopause. Thank you. So, you know, what is the best way, you know, you've lived this life in business and advocacy to make this happen? I mean, I was doing pap smears and delivering babies, you know, back in the day. But I do think this needs to be mandated. You know, what do you think the best path to that is? Well, I don't have a perfect answer for that. Like, our government is very tricky right now in particular. But I would say this. I think there is absolutely room at the state level to make sure that we demand, and I say to this to all women and men who care about their wives and their sisters and their daughters, We should demand that we get women's health services on the agenda of insurance and Medicaid and Medicare, right?

28:10Because when a woman can take time off for menopause and have, if she needs it, but also be able to hook up to good insurance covering those menopause symptoms, it makes a difference. There are many women in this country who can't afford to go to the doctor to even begin to explore their menopause symptoms. That just shouldn't be. So that's a great place to advocate. I don't know, what else would you say? You're more on this issue than I am.

28:36Dr. Mary Claire Haver:So we have an advocacy arm through my company, and we track state by state all the legislation associated with menopause. Some are educational initiatives, some are mandating training initiatives. And so we take it all the way, see what dies in committee. But it is really bipartisan. I'm not seeing a clear that a red state or a blue state It is really across the board. That's right. The one in Texas sadly died in committee, but at least we got something to the table. And I think women realizing that their vote really matters here. I end almost every stage that, you know, people always ask me, what can we do?

29:15Dr. Mary Claire Haver:And I'm like, vote. Absolutely. Vote for someone who cares about your health. Vote for someone who wants to see you healthy for your entire life. That's right. Because everyone does well. Because women tend to, not all women, give back and tend to reinvest in their community. They want to see the next generation do well. And certainly there are men who do that as well. But we just see that, you know, that when women do well in their 60s, 70s, and 80s, those communities thrive. They do because they're investing in the next generation. They're investing in the community. They often, as they get a bit older, have a little more time on their hands, right?

29:54Or they may have built a little bit of wealth and say, I'm going to give back to my community. So absolutely, people should vote and should pay very close attention to their state representative is, and even at the federal level to say, okay, I want to make sure that we have the right administration or people on the Hill who are going to advocate for the things we need in our lives, whether that is good childcare or good paid leave policies and women's health. These don't have to be either or. These should be ands. Ands. Did you know that your oral health is directly connected to your overall health, especially as you navigate the different stages of womanhood?

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33:28Dr. Mary Claire Haver:The World Economic Forum report really changed my life, I think. The one that talked about where we got the data on, and did you have something to do with that report? That specific one, the Gates Foundation, had something to do with it, yes, when I was there. And that was the first time I saw the data on that 20 to 25 % of a woman's life has been in poor health and their male counterparts. When I saw the data on cardiovascular disease, when I saw the data on osteoporosis and the economic impact. And I sat there and I just went through it page by page by page. And I knew this could be life-changing.

34:09Dr. Mary Claire Haver:If women knew this information, really knew it. So I immediately took it to my social media platform and just talked about it for months and months and months. And, you know, thank you for the foundation, you know, which was helping to fund that because without that data, I think we would be another 10 years behind. And I think women, at least the feedback I'm getting on socials is they are upset and they don't think it's fair. And, but they realize this doesn't have to be this way that, you know, we have, when you look at, when I look at the research around GOP ones, which is amazing, an incredible drug, we use it in our clinic.

34:48Dr. Mary Claire Haver:This was Operation Warp Speed, really. When you have the right motivation, medical research can move very quickly and we can see incredible changes over time. women's health deserves the same amount because I think we could change the world so quickly. That's right. And part of the reason, so when I was at the Gates Foundation as a co-chair, I founded it, but one of the things that I stepped into was making sure we had a gigantic women's health arm of work going on. And the first thing I learned was that we do not have data about women's health. And I learned it because I was working in reproductive health.

35:30And when I would go to the developing world and women would say they couldn't get access to contraceptives, they knew about them, but they didn't have access. I would come home and read the reports and the report said that contraceptives around the world were stocked in. And that didn't make any sense to me because what I was seeing, this is why you always have to be close to what's going on in this work. And I was like, but that doesn't match what I'm hearing in place after place after place around the world. Well, you dig down into that data. Sure, condoms were stocked in because of the AIDS work that was being done, which was great work around the world.

36:06But women would tell you in private settings, they're like, I can't begin to negotiate a condom with my husband in my marriage because either I'm suggesting I was unfaithful or I'm suggesting he was unfaithful. So I realized, my gosh, we have got to go collect the right data on women's lives. And it has to be not just reproductive health and not just maternal health, which we started to get much more data there. It has to be fully about women's lives because if we don't have the data, we don't know where to effectively fund and do the research. And so now we're finally at the stage of, okay, let's supercharge the funding.

36:46Part of me speaking about this and leading on this is to say, look, I'm one small, small funder here. But lead a charge so that others come in and ultimately it has to be government funding because then you get a warp speed type health intervention.

37:03Dr. Mary Claire Haver:So it does take some courage right now in this, especially this political climate. But I don't think when we look at all of women's health, this, we didn't have the data. So I don't think any administration, including this one, has done a tremendous job with women's health, right? But a lot of donors don't want to fund this because it's a little bit of a hot potato. But you don't care. What I care is that women get the health care they deserve. And our health care should not be determined by politics. It should be determined by science. So again, part of this me stepping is to say this is a safe space to fund.

37:43And to show some courage and to say, this is just what's right for society. And my hope is that others will then step in, just like we've seen in breast cancer or Alzheimer's research, right? Of course we should fund women's health. Of course we should. Awesome.

38:02Dr. Mary Claire Haver:You, in the essay, named some disparities out loud. White women are more than twice as likely as women of color to use hormone therapy. though women of color tend to suffer greater, much greater and have more of the long-term consequences as well. But, you know, untreated hot flashes, you have a higher risk of heart attack, higher risk of stroke, higher risk of diabetes, more visceral fat, you know, all the things that lead to all these metabolic consequences. Why do you think that gap exists and what can we do about it? Well, our healthcare system is not only failing women in general in certain ways, it is really failing certain parts of our population.

38:42So I was down in Louisiana late last year. And even just to see what the Dobbs decision has done for women who are going through miscarriages, who are saying, I can't get into the clinics. They don't, because they're confused. I would talk to the healthcare providers. They're confused about what they can do or not do. And the women are saying, I had to keep a dead baby inside of me because I couldn't get the healthcare services I needed. So we've been failing Black women in this country for centuries in terms of maternal health. Again, when you're giving birth to a child, you're two to three times more likely to die if you're a Black woman.

39:26So we're failing Black women and Hispanic women, but we're failing them here and here and all the way through. Across the transition, yeah. And the converse is true. I was down just a few months ago at a clinic in Alabama that was all about wraparound services for women. So the minute she stepped in the door, they start assessing her for her mental health. They do the pregnancy test. They do screenings for other things. And they give her services all the way through both pregnancy and childbirth. And I met a woman named Asia who had had a terrible experience with her first shot of Black woman in the healthcare system.

40:06Then she miscarried. Then she came to this clinic for her second baby, thank goodness. And she said, they are supporting me at every step along the way. And even the days I don't have the transportation money to get here, I get a little something to help. Like women in our country are under tremendous stress, economic stress, to put groceries and a meal on the table, right? And so then to not have their health going well and to feel like, how am I going to provide for my family? That's just additional stress that is horrible for your health and for your family.

40:41Dr. Mary Claire Haver:I practiced obstetrics in Texas where my practice is, and we have a 22-week rule at the time. So that was the age of viability. So terminations were allowed up to that point. And then after that, it could get, you know, there were times when I had a 22-weeker and And waters were rough. You know, we have some obstetrical, just horrific outcome on a wanted pregnancy. And sitting there for a split second, like, can I do this? Can I do this? Is this okay? Who's on? You know, and when they dropped to six weeks, and at that point, I had left obstetrics and was just doing menopause care. I remember crying in my bed and telling my husband, I've walked away from this, but like, I don't know if I could have practiced under that.

41:32Dr. Mary Claire Haver:uncertainty, you know, of the moral injury, the, you know, constantly worried of going to jail, you know, or having my license taken away because I was doing what I was trying to do. That's right. Which is now disagreeing with what some random lawmaker decided, you know, and it differs state by state. It differs state by state. So the confusion, the confusion, I was shocked, actually, the amount of confusion in these Louisiana health care clinics I went into. And the residents who were there training saying, well, so if I don't get trained in this, but I moved to another state where I'm supposed to provide these services, what does that mean?

42:13Or if I do train in this, is somebody going to say I can't get my license, right? Why would we create confusion in a health care system that is not already servicing women and families well. Yeah.

42:27Dr. Mary Claire Haver:So in your book, The Next Day, you talk about the transitions we all move through. You've been through a lot of changes. You've got grandkids now. Congratulations. Thank you. And then, but for you, what have been the upsides? I want to talk about the positive stuff about transitions. Because what we see on social sometimes is, you know, it's all doom and gloom. It's over. All these horrible things are going to happen to you and your hormones go away. And I feel like I'm living my best life right now. Me too. My youngest daughter says my mom is living her best life. And I was like, I think I am.

43:02I mean, look, you know, of course it's sad when your kids go off to college. But I felt like I've done my job. My sister said to me, look at it this way. You've done your job. They're always going to still be close to you. It's what they're supposed to do in life. But what I didn't expect was the vibrancy that would come, right? I don't have all the stress of work and three kids and school forms and doctor's appointments for them. And it's like, oh my gosh, not only is my time opened up, but a vibrancy in life. And what I say in my book about transitions is, I think during transitions, you both have some beautiful ones you want to go through and you have some tough ones.

43:43You don't get to 60 by not having many transitions in life. but what I've learned is there's growth in every transition and even the hard ones if you focus on the growth and know you're going to come out the other side better you don't know exactly how you're going to come out of the other side or where it can be one of the most beautiful times in life I

44:03Dr. Mary Claire Haver:am loving this time in life and I also love being a mom I think feel like every woman deserves that yeah right like coming out of this you know into this last decade you know last two to three decades of feeling like this is the best part of your life rather than, oh, it's all gonna, things are going to start breaking and wearing down. And, and, you know, that, you know, we go through a lot at this age, our parents are aging or empty nesting, you know, helping these people we raise launch into their adulthoods. But I'm, I am loving it. I'm living my best life. And I literally like my mission in life is that every woman looks forward to her last three decades.

44:43Yes, it can be a beautiful time in life. And I was walking with my friends the other day, and we were saying, you know, we just the amount of built up wisdom, too, that you only get by living a certain amount of time, right? Again, we're watching many of our daughters and sons go through the transition now of getting married, right, and starting their own families. And you think, oh, gosh, I kind of wish they knew what I knew now. But they have to learn and live through those stages, right? Where do you, you know, writing checks for funding, you know, looking at,

45:17Dr. Mary Claire Haver:it's more than writing checks, of course, but like, what's your next, where do you want to see some more research and funding going? What excites you? I want to see so much more research and funding going into women's health, not just into this perimenopause, menopause stage, and into heart disease, but I want to see more in the autoimmune space. I want to see much more done for mental health for not just women, but for teenagers and young people as well all the way through. I mean, we do have a mental health crisis in this country. So I think those are all places that I'm looking forward to seeing change come in the future.

45:55Dr. Mary Claire Haver:Yesterday, I reposted a video of a young woman, a researcher, who was sharing a research study that found a gene for PMS and PMDD. Oh my gosh, wow. So it's not just hormones. hormones sets up a vulnerability, but there is a genetic marker they have found for this. I'm like, this is where we need to go. I think they're going to find one for endometriosis and all this, what's going on in autoimmune. Like it's more than, you know, I was brought up, brought up, I say in the medical world, to women tended to be dramatic was the bias. women tended to be emotional and that would skew how she presented to the world right so we always had a heavy sense of it's all in her head you know and Elizabeth Cullen wrote a great book about this and I literally trained with that bias and it took me 20 years of practice to sit back and realize women are not crazy.

47:00Dr. Mary Claire Haver:They're actually hurting. They're actually suffering. They're actually, you know, and it's sad that it took that long. You know, I wish I could be like my daughter, who's a fourth year med student now, you know, who would never tolerate this, who would never, you know, but I just felt like I was lucky to be there. And if someone would tap me on the shoulder and say, we made a mistake, you really don't, you really didn't get into med school, but we're going to let you stay. That imposter syndrome that so many women, Yes, including me faced. Yes. And to watch my children who are 22 and 25 not have that at all, or at least not express it to me.

47:35Dr. Mary Claire Haver:And never, I think we're doing a good job. We are doing a good job. With changing the system. But we, you and I were sent, I'm older than you, but we were sent out into a system that was built for men. And remember, if we go way back in time, we used to say women were crazy and men had the ability to institutionalize them. Right? And that wasn't always the case why they were being institutionalized. So these myths, we just need to break through. Yes, we are emotional. Guess what? Men are emotional too. Guess what? Being emotional is a beautiful thing. It's how, as my mother always taught me, and she's still very vibrant and alive at 85 and exercises every day.

48:15But as she always said to me, emotions are neither right nor wrong. It's what you do with them. Yeah. Right? And so understanding our full range of motions and letting ourselves go through them and then stepping into the world in the way we want to, that needs to be allowed for women and allowed for men. And I'm going to just add one point you made about research, which is I love that they're finding these potentially new genes and sometimes it's a biomarker in different areas. I also like, though, that as women are getting to better places in society, either at higher places in society, more lawmakers, more women at the table making good policy, more women running companies, more women investing in other companies.

49:04what we're seeing is it takes companies to come up with new products. It takes research. It takes the private sector to push things along. It takes our government. It takes all of those places, which is why I want women to step into their full power because when they do, we do change the world. Not because we have a better lens on society than men or a worse lens. We just have a different lens on society. and we can create and we do create change.

49:36Dr. Mary Claire Haver:What do you think is the single most useful thing that a woman who's listening or watching right now can do to push for change? Oh my goodness. It's hard to say one, so let me just say a few. Just give me a list. First of all, advocate for yourself at your doctor's office, always. Number two, talk to your friends and educate your friends or get them to educate you with real health information like you deliver, not some of the fake news that's out there in other places. Number three is advocate. Advocate to your congressperson, your senator. And number four is vote. And vote. And vote. For our listeners, if we have the Citizen's Guide to Menopause Advocacy on our website, that shows you what legislation is currently, you know, in each state and how to reach out to your congressmen, how to reach out to your state representatives, how to advocate on a legal level so that we can age as healthfully as possible.

50:34So beautiful.

50:36Dr. Mary Claire Haver:So women today who are really deep in this perimenopause and menopause transition are really being dismissed at most doctor's offices and told it's just aging. You know, if everything that you're doing and everything that I'm trying to bring a voice along with so many other doctors, advocates, you know, is successful, How do you think this would change that experience? The way I would like to see it change is that anywhere a woman touches the healthcare system, they get good information about perimenopause and menopause, and there become many, many different tools to help them get through in a very healthy way so that they can then go on to live completely vibrant lives.

51:20All right.

51:21Dr. Mary Claire Haver:Melinda French Gates. Thank you so much for coming on Unpaused. All of your advocacy, all of the funding and this incredible pivotal company that you've developed. It's changing the world and I'm just amazed to watch it. Well, Dr. Haver, thank you so much for having me and for what you're doing to make sure that women get credible health information. Thank you. I'd love to hear from you about this topic and anything else that's on your mind. You can find me on Instagram at Dr. Mary Claire and get honest and accurate information on health, fitness, and navigating midlife at thepawselife.com. Full episodes of Unpaused are available on YouTube at Dr.

52:03Dr. Mary Claire Haver:Mary Claire. Unpaused is presented by Odyssey in conjunction with Good Roommate Media and Longwave Digital.