Tonight: Alabama wants monthly proof you're not pregnant before you can fill specific prescriptions, the forgotten waiting room of the menopause boom, and more.
— Meghan McCarthy
P.S. Think you know menopause? Scroll to answer this edition’s Women's Health Trivia question 🤔
ALABAMA WANTS MONTHLY PROOF YOU'RE NOT PREGNANT
Alabama now requires women ages 11 to 50 to pass a pregnancy test in a doctor's office every 30 days to keep using medical cannabis, unless they can prove they've had surgery that makes pregnancy impossible. No other state has built this kind of routine pregnancy surveillance into medical cannabis access. Physicians are barred from certifying anyone pregnant, breastfeeding, or "attempting to conceive," and patients pay for each in-office test themselves. Alabama leads the country in jailing pregnant women over drug use and is one of three states that apply child-endangerment laws to pregnancy.
THE MENOPAUSE BOOM HAS A FORGOTTEN WAITING ROOM
The New York Times reports that as hormone therapy gets marketed online as a midlife miracle, the women who medically can't take it, because of breast cancer, clotting disorders, or heart risks, say they feel cut off from the whole conversation. The frustration is compounded due to a lack of provider knowledge: nonhormonal options exist, including the newer drugs fezolinetant and elinzanetant, cognitive behavioral therapy, and vaginal estrogen, but many doctors don't raise them and patients don't know to ask. The Menopause Society's medical director says the toolkit is far bigger than the marketing suggests. Hormone therapy is only approved to treat hot flashes, night sweats, and bone loss, not the longer list influencers attach to it.
WE KNOW HOW TO STOP THE LEADING CAUSE OF MATERNAL DEATH. WE OFTEN DON'T.
Postpartum hemorrhage kills around 43,000 women a year and remains the leading cause of maternal death, yet a three-part Lancet series argues most of those deaths are preventable with tools that already exist. NPR dives into how it could work, starting with measuring blood loss in a calibrated drape instead of eyeballing it, which misses roughly half of hemorrhages. The next step is moving fast on a bundle of uterine massage, medication, and IV fluids. Across a trial of more than 200,000 women in four African countries, that approach sharply cut severe bleeding. One WHO author's estimate: used consistently, what we have now could prevent more than 95% of these deaths.
TURNS OUT IT WAS NEVER ABOUT CYSTS
Washington Post’s Leana Wen looks at why polycystic ovary syndrome is being renamed polyendocrine metabolic ovarian syndrome, or PMOS—a change 56 medical societies signed onto. The old name was a double misnomer: the "cysts" are actually normal ovarian follicles, and the disorder originates in the endocrine system, not the ovaries. That reframing matters because the condition, which affects roughly one in seven women of reproductive age, drives insulin resistance and raises the risk of diabetes, heart disease, and endometrial cancer. Advocates hope the new name finally pushes doctors to screen for those risks starting in adolescence.
THE DRUG THAT "FAILED" MAY HAVE JUST BEEN AVERAGED AWAY
An investigational brain drug delivered as a nasal spray reached the brain in different amounts depending on sex and, in women, on where they were in their menstrual cycle, Tel Aviv University researchers found in mice and a small group of healthy adults. Female mice absorbed more when estrogen peaked. The authors argue that averaging results across men and women can bury a real effect, one reason a promising therapy can look like a flop in trials. Their point: hormones and cycle timing belong at the center of how brain drugs are designed and dosed, not treated as noise.