Ep 461: The True Cost of Menopause: Your Health, Your Career & Your Wallet
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- Hey everybody, thanks so much for joining me today on Her Money. I'm Jeanne Chatzky and today we are gonna talk about health

You know that you love it when we talk about health. Our episode on what happens to your brain during menopause with Dr. Lisa Moscone was one of our most popular episodes of 2024. We will link to that in the show notes if you haven't had a chance to listen to it yet because it is truly fascinating. So we are going to talk more about health and specifically more about menopause.

Menopause. As all of you know, I have been there and I have done that. And I know that there are so many questions that come along with it, including what kind of a financial toll is this going to take on your life? Research from Simply Health found that nearly a quarter of women have considered quitting. Yes, quitting.

quitting their jobs due to the impact of either menopause or menstrual symptoms at work, which tells me and anybody else who critically looks at the data that women are not getting the help and the attention that they deserve in this area of their life. A 2023 survey from Bank of America found that nearly 60% of women do not discuss menopausal symptoms at work, partly because menopause

They worry that they'll be judged by their coworkers, and partly because they worry that they'll be seen as old. It is time to bring these conversations to the table for us and for every woman. My guest today, Jill Herzig, is no stranger to all of you. She has been here before, but in her role as a magazine editor and editor

in some of her other roles after that. Today she's here to talk about a totally different subject. We are going to dive into menopause and Jill has described her perimenopause journey as chaotic.

She knows firsthand the importance of talking about it because she turned it into a business opportunity. Jill is the chief brand officer and co-founder of Midi Health. It's a virtual platform designed for women's health by women that offers a holistic approach and virtual visits that are covered by most insurance. Jill, it's so great to see you. It's so nice to see you, Jean. Thank you for having me on. Absolutely.

Absolutely. You know, we've done menopause shows before. They've been among our most popular episodes. I'm through menopause myself, at least I hope. I'm still on the hormones, but I plan to stay on them. We can discuss my life, but I plan to stay on them forever. They're going to have to drag them out of my hands. Me too.

They will bury me with my badge on. Exactly. Exactly. But I want to start with your menopause journey, which is really a big part of your work journey. You had just taken on a big new job, editor-in-chief of a national magazine at age 42. You found out you were in perimenopause. How'd you find out and what happened?

Yeah, so I was attributing some skipped periods to maybe stress because it was a big new job with big change. And I had lost a few pounds and I was like, huh, it's never interrupted my periods before. Maybe that's what's happening. So I went to a new OBGYN like everybody. I, you know, had kind of lost track of my OBGYN after I'd had my second daughter.

And so I went to a new one and I asked him what was going on and he did a few tests and he said, oh, you're well into periglornopause on your way to being a nipopo. And I was very surprised. And I will tell you that while I appreciated the information, he just dropped me like a hot potato at that point. He didn't ask me whether I was having any other symptoms other than the irregular periods.

He didn't talk to me about what was coming, what I could expect. And he didn't offer me any solutions to any of it. He just sent me on my way. And that was just, it was so unhelpful. Wow. And that is so the opposite of the experience that I had. I mean, I... I'm glad to hear it. Tell me more.

I stuck with the doctor, a doctor named Becky Brightman, who's been a guest on this show. I stuck with her after I had my kids and she with me and we grew up together. She's a couple of years older than me. And so she was going through everything a few years before I was going through it. And thank the Lord, because I'm

She just basically telegraphed what was coming for me and for all the women my age. And so when I started having 20 hot flashes a day. Yeah.

Let's put it aside for me as well. Yeah, she, you know, she knew exactly what to do. And I kind of had the feeling that 20 hot flashes a day was unusual, but maybe not. What do you hear from women as far as the symptoms that they experience with perimenopause and menopause? Yeah, well, I want to caveat this for your listeners first by saying

There are solutions to everything I'm about to talk about, because if you don't say that, people just get sort of horrified when they hear about what could be coming down the pike for them. And, you know, I think it's just helpful to make this blanket statement that there is treatment for all of this. You do, none of this have to go untreated, but there are estroglycerides in every part of your body, like head to toe, from your skin and your hair to your bones, your heart.

So it affects every organ, every system in your entire body. And for...

roughly 85% of people that cause those symptoms. And for a lot of those people, they're moderate to severe. And it ranges from, you know, the hot flashes and night sweats to anxiety, depression, almost like 87% of the people who come to me talk about weight and body changes. And those can come out of the blue and be quite traumatic, even though you're doing the same exercise and eating that you've always done.

We get people coming to us with terrible muscle and joint aches. They're thinking they have arthritis, rain, fog. You know, they are worried that they have early Alzheimer's. The period irregularities, of course, of like the canary in the coal mine. But it can be headaches, sexual symptoms, vaginal dryness, painful sex, those hair and skin changes. And then those are really just, there are more than 50 people

symptoms that are sort of officially linked to the drop-off that's happening with your estrogen as you go through perimenopause and menopause. And those are just the things that you can feel. Underneath the surface, there are a lot of changes as well. Your risk of heart disease,

bone loss, cognitive decline, all of those things increase with the loss of estrogen if those symptoms are not treated, if you don't sort of weatherproof your body. Why do you think it is? And let me just tell my listeners, I know that we're a financial show. We are going to get to the money in just a sec and to the impact on your career. But why do you think this has been in a closet for such a long time?

You know, there are a lot of reasons. I think some of them are cultural. This is, you know, for eons, women's worth has been tied to their fertility and their youth. And we still live in a patriarchal society. Many things have reminded of us of that lately.

So I think some of it is cultural. Women just not wanting to talk about getting older, feeling their stigma associated with it. That's changing, and I'm so excited to see it changing with a lot of celebrities talking about their menopause and perimenopause experiences.

But there's also a medical reason, which, you know, I won't dig into the history too much at length, but there was a study that was done about 20 years ago called the Women's Health Initiative. It was an enormous, enormous study, one of the most expensive undertaken ever in the United States. And it essentially...

discredited the use of hormone replacement therapy, which was the fifth most common drug prescribed in the United States at the time when that study was done. So women were commonly taking HRT and getting great relief from it. And because that study was really the results of it were miscommunicated to the public,

women and doctors became completely paranoid that HRT would harm them, could cause breast cancer. And that has really set us back. I mean, it's set us back decades. And now even those study authors are acknowledging that

those results were misinterpreted and that the safety profile of HRT is actually pretty great for the vast majority of women. Yeah. I mean, I remember when I went on HRT myself, and it's been a number of years now, I mean, my mother was still very concerned about the results of that study and did not like that idea at all. And I pulled out the research that my doctor showed

And that she had leaned on when she went on HRT herself and sent it along to my mom. I mean, they did have me get tested for the BRCA gene to make sure that it was okay to take. But boy, changed my mind.

And changed it at a time when I really needed it. I mean, I went through perimenopause well before the pandemic when I was on the road speaking a ton, on television a ton. And these hot flashes were coming when I was on stage, when I was on the air. There was a real cost, I felt, to my career. And I think that's true. About 20% of the entire time

workforce is women in midlife. We are talking about a lot of people here. So when you think about

the financial costs of menopause and perimenopause. I think it breaks down into sort of two buckets. We have the cost to our careers, and then we have the cost of treatment and the different solutions. Can we talk about both of them? But let's talk about what happens to a woman's career when she is going through perimenopause if it's not addressed. Yeah. So

I think it's a great topic to really dig into. And a doctor named Phil Sorrell out of Yale did great research into this and, you know, came up with the hard numbers. It's extraordinary. Women who have untreated, we're just talking about hot flashes. He just looked at vasomotor symptoms, hot flashes. Women with untreated vasomotor symptoms,

incur $2,000 more in medical expenses per year than women who receive treatment. So that's the financial cost. Hopefully you have great insurance, but let's face it, very few of us have great insurance. So we're carrying the burden of those costs. But it's not just that cost, it's the time and the erosion. Think of the time you spend going to see specialists seeking out that treatment because

Honestly, Jean, you were so lucky and I'm so happy you had that great experience with your clinician, but most women don't. They do not have a great experience and they do not get treatment. You know, we see that in medical school, less than 20% of OBGYNs, the people who we expect to be experts in this, less than 20% of them get any schooling at all.

And the 20% who get something, they get a couple of lectures maybe. I mean, this is just not part of the medical curriculum, even though it's something every woman alive will go through. It's really quite extraordinary. Is that changing? I'm so sorry to say no. We see no evidence of it changing. I mean, we see women...

pushing for change. And I think that's where we're going to see the evolution. Doctors are wonderful service providers. They do this career because they want to do good and they want to help us. If we go to them and say, look, I need this treated. I need you to help me with these symptoms. I don't want to just tough it out. I think they will respond. But the other stat I wanted to bring up is that women who do look for treatment are

Even amongst those who seek out treatment, and a lot of us don't, 75% of them come away with nothing. And then they wind up kind of polyshopping specialists. So they go to more than six different specialists seeking care. That's where the $2,000 comes from, you know, the lost productivity. And then I really think you brought up a good point. There's a lot of lost confidence. Like the symptoms that I had, they felt lost.

like they were a nuisance on one level, but on another level,

it was like what they say, that saying about Fred and Ginger, Ginger does everything Fred does but backwards in high heels. I felt like I was doing it backwards in high heels with a blindfold on and having to pee all the time. I mean, it was just, it was ridiculous. And I just, I think of what I was trying to achieve in my career at that time and that I was raising kids and trying to keep a marriage going and all the rest of it. And I think, my God, it would have been so much easier if

If I hadn't been having dozens of hot flashes, if I hadn't had the brain fog that I was experiencing and needing to make lists upon lists to get things done, if I hadn't had the urinary symptoms or I was running to the bathroom and ending meetings early, you know, it was just...

It was stuff that really was far beyond a nuisance. It was devastating to me. I think that that is such an important point because although my experience was easy comparatively, I waited, right? I just sort of figured I can tough these hot flashes out. Every woman goes through this. This is not, you know, like...

And it wasn't until I was dripping on stage that I realized, like, no, I can't. And I went to the doctor. And it took a good couple of years for me to say, you know, give me the pill or whatever. I'll take it. We are such toughies, women, who we live in this female body, and it puts us through a lot. And unfortunately, I think by the time you get to...

perimenopause, your body has put you through so much that you think, oh, I can get through anything. But why? Why? There's no medal that you get at the end for suffering through menopause symptoms. Nobody gives you a trophy. Why do it? You don't need to. And we're seeing real costs to women's careers. There's good research coming out of the UK where you're seeing 50% of women say they don't seek a promotion because their symptoms are

have just made them feel like they aren't up to it. And that 10% of women actually leave their jobs. 25% think about leaving their jobs and 10% do it. Think about the financial cost to us as individuals and the devastating cost to our economies and our businesses. These are women who have so much wisdom and they're

at the peak of their careers, they're in their leadership moment and they're leaving. Right. They're leaving at the peak of their earning power when they're able to make the biggest 401k contributions of their lives. And this is what's getting in the way. We're going to take a very quick break. But when we come back, I want to talk about solutions, the rise of companies like MidiHealth to step in and provide us with a place to call to get some answers.

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We are back with Jill Herzig, former magazine editor, now chief brand officer and co-founder of Midi Health.

So, Jill, you made a huge career pivot. This was a biggie, right? This was not like I'm going to go from one magazine to another. This was I'm going to leave magazines altogether and I'm going to start a company to help women with menopause. What happened? Well, there were a few steps along the way. Leaving magazines, I'm going to tell you, was very humbling. I had some skills deficits that I had to really work on and manage.

I also just needed to find my new direction. The one thing I knew is I really wanted to help people with health. I had edited a magazine about health for Hearst. I was passionately dedicated to it. I'd focused on it my whole life. I'd talked to women specifically about their health my whole career. And

I sort of hit this moment where I realized that continuing to just put out information about the kind of care you should be getting, when I knew and was experiencing myself how broken the healthcare system was, in some ways I felt like I was doing no one a service. It's almost worse to know this is the kind of care I should be getting and not get it and not be able to find it. So...

Fast forward, I was talking to my good friend and co-founder, our CEO, Joanna Strober, about ideas she had for a startup. And I was working at a different startup at the time. And when she talked about perimenopause and menopause, fireworks went off in my head. And I just said, ding, ding, ding, that is the idea. And started helping her to work on decks and met people.

and became wonderful friends with our other co-founder, Sharon Mears, who's the chief operating officer. And the idea for Midi was born, and we did a pilot. It would be exactly three years ago. We finished our pilot. We took on a few dozen women. We had a great doctor. Honestly, we sort of set up a fake company, but we had real care and excellent care.

to find out from them, what is it you want? What do you need? What's most important to you? And those women were incredibly generous and they trusted us. And that is the company that we built. And we now have hundreds of clinicians working for us. It's a telemedicine company. We hire and train a small army of nurse practitioners who are overseen by doctors

experts, MDs who are really involved with the care in a very hands-on way, but they are incredible. They come to us with great experience, but we then put them through a pretty rigorous boot camp of training that really specializes in all things female health and midlife.

And they then deliver the care. We have a 95% patient satisfaction rate, which makes us really happy. 91% of our patients say that within two months of their first visit, their symptoms are significantly improved.

So we recently had Val Monroe on the show, who I know you know. Val writes an amazing newsletter called How Not to Fuck Up Your Face. It's incredible. I love it. I love it, too. She actually featured you in a recent edition, which I was excited. I was like, oh, my God.

worlds collide. This is a lot of fun. But what I loved so much about the conversation with Val was that she told us what not to buy. She told us what was not going to help. And the New York Times recently wrote that we're in the middle of what it called the menopause gold rush with beauty products and supplements and viral concoctions that are supposed to minimize our symptoms and

And, you know, look, I am really glad that we're talking about it, but I also would like to know what is snake oil. So what do women need to know before we spend good money on these solutions? Yeah, women are wasting a tremendous amount of money. And when I say that I sort of I welcome the...

new entrance in this space, I mean that I welcome companies like MidiHealth that treat this as a medical problem in a medical way. That doesn't mean that we always treat our patients with prescription medication. We often do. But we also talk to them about evidence-based, you know, herbs and botanicals and integrative therapies and a lot of other solutions that can help them.

But I would say if you're trying to evaluate this, you want to make sure that you're not looking at what is essentially a beauty company applying products

Beauty products will not help you with menopause symptoms. This is, as I said, it's affecting something. It's something that is system-wide, that is body-wide. And a moisturizer is not going to change hot flashes or insomnia or any of the 50-plus symptoms. So you want health care. That is what you need to get through parenthood.

perimenopause and menopause in a truly supported way. Listen, if you want to try those products, go ahead. It certainly can't hurt. But you want to, if it's a supplement that you're looking at, dig deep to see if there's decent science behind it. And honestly, make sure that you're getting your care through an actual product.

professional trained clinician. That's the person who's going to connect you with something that is science-based. You mentioned how many of us don't have great health care anymore, which is really sad, but also really true. And as a result, we end up spending a lot of money on prescriptions and different medical solutions. Have you all tapped into

ways that people can get more of the cost of the patches or the pills or whatever they're on covered? That is actually something our clinicians take on. There are people who have been supporting patients with health care for years and years, and they know that part of taking care of a woman is taking care of her wallet as well.

So, for example, they will look at the formulary associated with your specific insurance. They'll figure out if the patch is covered or which brand of the patch is covered. Right now, I'm wearing on my stomach a generic patch because that's covered by my insurance. And I would much rather get it for $15 a month than pay, and it works just exactly the same. If you're talking about hormone replacement therapy, a lot of that is covered by insurance. These are drugs that have been

around for decades and decades. They are FDA approved, etc. So for the most part, though, you know, you will be able to land on a covered solution. But our clinicians spend a lot of time working on

on a care plan that includes medications that are covered for you. We are all about access at Mitty, so we take your insurance and then we figure out how to max out your insurance to get your symptoms relieved. I know there's another class of therapy, a class of hormones called bioidenticals. What are those and are they typically covered?

So bioidentical is actually a marketing term. It's not a medical term. And the standard of care now is for all hormones to be bioidentical. All of the hormones that MIDI prescribes are bioidentical. And so I think you don't need to get too fixated on that. And yes, insurance will cover that.

One study from Electra Health found that overall people who have been diagnosed as menopausal, they spend 45% more on healthcare costs to treat their symptoms each year than those who are not menopausal. I don't want to go as far as to suggest that you need to start a college savings fund for menopause, but do we need to prepare for this? Do we need to prepare for the possibility that we might need to take a work break and what's

What's the sort of best practice these days as you hit your 40s for getting the tests and the treatment that you need? Yeah. So, I mean, instead of emphasizing putting away a war chest to deal with your symptoms, I would emphasize education, like getting to a place where you know what the symptoms are and you know to look out for them.

There are a lot of them, and it can be confusing. Every woman's basket of symptoms is unique to her. So you may not have any hot flashes, but you may have terrible insomnia or anxiety or, I mean, really, it is truly an individual experience.

So what I would say is get familiar with all the symptoms out there. So as soon as they begin, you understand what's going on with you and then seek out a trained clinician because you shouldn't have to incur any extra expenses if you're going to someone who's trained. It's the poly shopping. It's the going to a million different specialists to get someone to connect the dots and tell you, oh, yes,

This is perimenopause or menopause, and there's a simple solution for you. In the few minutes we have left, I just want to touch on the non-medical solutions that women should know about. There are changes to diet, changes to exercise. I mean, I love my Chardonnay, but it definitely did not help the hot flashes or the sleep. What can we do to make our trip through this part of life easier?

Lifestyle is so important and it's part of every care plan we give patients. This is absolutely a time to lean into your health. You want to go into this transition giving your body the best possible shot of weathering it well. So aside from getting the medical treatment that you might need, you do want to optimize your diet. You want to optimize your sleep.

You want to establish an exercise routine that you can, you know, that you can stick with and that you enjoy because you'll do the thing you enjoy. You'll quit the thing you don't like. So those things could not be more important. It sounds kind of boring, but they make such a huge difference at midlife. And it's not just the immediate benefits you get in improving your symptoms, those sort of

really pressing symptoms that are making life miserable. It's the long-term benefits you get down the line to your bone health, your heart health, your cognitive health. This is the time to establish those habits that will pay off for a long time to come. Jill Herzig from MidiHealth, thank you so much for doing this with us today. It's been a pleasure and we'll be right back.

And we're back for Mailbag. Catherine Tuggle is with me. I think you produced the very first show that we ever did on menopause. I think I definitely did. I have been preparing for menopause since I was like 30. I find it so fascinating. And now I'm like almost there, like perimenopause symptoms creeping in. But you know, I just think

there's just been no dollars and no time spent on women's health and no dialogue being had about women's health in the workplace. And this has just made me want to devour every possible thing I can find. Yeah. No, I mean, it all came around a little bit late for me. I did have the hot flashes in the workplace. And as I talked about with Jill, I was very, very fortunate that I had a doctor who knew exactly what I needed and

But going through that, I just want all the women to have all the information possible so that they don't have to sweat through meetings and deal with the other symptoms unnecessarily that there are treatments to handle. Yeah, yeah, absolutely, Jean. We've got a bunch of questions. Let's just dive in.

Our first question today comes from Susan. She writes, hello, I have three separate retirement accounts from three different jobs. Is that okay? Or are there benefits to consolidating them if I'm not sure if I will stay in my new job? Well, this is a quick and dirty one. The benefits, Susan, to consolidating these accounts are that if you consolidate, you won't have to sign on to three different screens to look at them. You will be able to rebalance them automatically.

in one move rather than in three moves, and you'll be able to keep your asset allocations much straighter. I'm a big fan of consolidating. If you're not sure that you're going to stay at your current job, I wouldn't consolidate into your current plan. I would just roll it all over into an IRA, perhaps at the same firm where you have your current plan if you like that firm, and that's all you have to do. Super, super easy.

Amazing. Is there any strategy on timing here? No. Does it matter? Sooner is better than later. I mean, the number of orphaned retirement plans is growing by the week, month and year. People are just leaving jobs. They're leaving plans. They're forgetting about them, which is scary enough. And why we have enough to do in our days. Just make your life easier and consolidate. Yeah.

And this is random. You might not know the answer to this. If you forget an account and you hit 59 and a half or whatever,

Does anybody like let you know, like, hey, Catherine, remember 30 years ago when you had that job for two years? Like you have some retirement money or is that just on you completely? You know, there are these new companies that are popping up to help you find accounts that might be orphaned and to help you with the rollover. I mean, any firm will.

where you are moving your money to will help you with the rollover because they're eager to have the money. But when it comes to finding these accounts, one of them is called Capitalize. We've been hearing a little bit about that. There are resources out there for you, but take care of it before you forget. Yeah, absolutely. Being proactive is far preferable here. Our next question comes to us from Sage who has timeshare woes. Those are her words.

She writes hygiene a bunch of years ago. My aunt and uncle were getting out of their Santa Fe, New Mexico timeshare. My mom bought it from her and gave it to my husband and me who live eight hours away in Colorado. We thought it'd be amazing because we love Santa Fe, but we have three teenage kids.

We never know what sports are going to be when summer camps will be, and we're locked into the school calendar. Plus, our family doesn't live nearby, so we often use vacation time to visit them. Our youngest is in seventh grade, so we have a while until we're empty nesters. I tried renting it out, and that was a bust. So we bought our two-week shares and couldn't even use them this year. It's about $1,500 a week. Last year, I used one week and gave away the other week to my kid's teacher. I'm attempting to sell them through Red Week, but that process feels as likely as a lottery ticket.

Is there any way to get out of a timeshare without ruining our credit? Is there a way I could donate them for a tax write-off when we can't use the weeks? Should I just lower the price ridiculously so it sells? We each may only get about $6,000 if we're lucky. I'm 51 and my husband is 58. He will retire within the next five years and we will have more flexibility to use the timeshare since I'm able to occasionally work remotely. But at the end of the day, selling or otherwise gracefully getting out of it would feel best.

If you need more intel, we have two two-bedroom floats, which means we aren't locked into any date and can stay in any two-bedroom unit. But it also means we have to book about a year ahead for peak times and just hope we're available. So the timeshare market is one of those markets. I wrote about this.

for AARP. I had somebody who needed to get out of a timeshare and I helped her get out of her timeshare and wrote about it. And then my editor at AARP was inundated with letters from people who are looking to get out of their timeshare because this is a very common problem.

Red Week may feel like the lottery. Red Week is like an eBay for timeshares where you can sell your weeks, you can trade your weeks, you could try to sell your shares, your fractional shares completely. It may feel like the lottery, but it actually is the best lottery.

of the after markets. So I wouldn't discount it automatically. What I would say, because it doesn't sound like this is a Marriott timeshare or a Disney timeshare, because those are sort of name brand, they're a lot easier to move in and out of. They have more value on the secondary market.

Because you're locked into one location, it doesn't sound to me like this is that. I would call the timeshare company itself and ask them what the process is for getting out of this timeshare. You may have to just give it back. You could try to sell it for a little bit of money and at that point give it back, but

But if you're truly not going to use it and you have to continue to pay the fees on it every single year, it's eventually going to cost you money and just build additional resentment. And then you're going to be stuck passing it along to your kids or some other relative who may or may not want it. So.

Call the timeshare company, ask them what the process is. There usually is some sort of a process where you might be able to just deed it back to the timeshare company. But if you do think that there's value in it, even if it's just $6,000 a week or some other ridiculously low price,

List it on Red Week, get rid of it, and plan the vacations that you want to plan rather than feeling like you are stuck in a vacation that somebody else essentially locked you into. I think this is the problem with timeshares in general. And it's that in so many cases, and the

The Marriotts and the Disneys that have many locations are often the exception to this because you can decide to use your time to go to a variety of places in the world. But you really have to think carefully about if you're going to be happy there.

going to one place again and again and again. It's kind of the same question that you have to ask yourself if you buy a vacation home and then you feel like you are obligated to take your vacations all there because you've got such sunk cost into it already. So that's what I would do. Let me know what happens. The other thing I would not do is...

answer one of those ads on the radio for companies that say they can get you out of your timeshare. Those typically cost a whole lot of money and take a whole lot of time. - Yeah, this is great advice. I feel for her when she says that she spends all her vacation time visiting family. I think so many of us are in that position.

And it looks like you're not going to use this much at all. So good luck. Yeah, ditch it, ditch it and go to Paris. If you've got any other money related questions, we would love to hear from you. You can send them to us by emailing us at mailbag at her money dot com. Catherine, thanks so much. Thanks, Jean. Thanks to Jill Herzig as well for her advice for making the financial and emotional side of menopause more manageable.

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Her Money is produced by Haley Pascalidis. Our music is provided by Video Helper and our show comes to you through Megaphone. Thanks for joining us and we'll talk soon.