The Menopause Questions Nobody’s Answering — Our Conference Experts Weigh In

Menopause is finally having its moment in the conversation. But only part of it. The hot flashes get airtime. The night sweats get memes. And the rest? The questions about money, dating, work, partners, and bodies changed by surgery get the same treatment they’ve always gotten: silence.

At Kiss & Tell, silence is not our thing.

So we went to the experts speaking at our fourth annual conference, Menopause Redefined: Integrating Medicine, Mind & Intimacy (October 1–2, 2026), and asked each of them one question, deliberately chosen from outside their conference sessions. Seven experts answering the menopause questions nobody else  will. The ones you’ve typed into a search bar at 2 a.m. and closed the tab on.

Here’s what they told us.

“When should I worry about peri-menopause? Are my 30s too soon?”

Answered by…Shannon Cothran, MD, MSCP, FACOG

This is a common question, and the answer isn’t simple… it depends! The average age of menopause is 51, and it’s a clinical diagnosis made by looking back and finding no period for a year. Peri-menopause typically spans the 7–10 years before menopause and has been linked to up to 70 different symptoms throughout the body. With such vague timing, it can feel impossible to know if you’re in peri-menopause or not.

To understand the symptoms, start at the ovary…the organ that releases eggs but also secretes estrogen, progesterone, and testosterone. It’s both reproductive and endocrine. Before menopause, the ovary begins acting abnormally, shown clearly in LOOP (Luteal-Out-Of-Phase) cycles: high FSH recruits a new follicle too early, causing irregular cycles and high estrogen, since cells around the follicle secrete estrogen. Essentially, it’s a time of major month-to-month variation in estrogen, and some people with estrogen receptors throughout the body feel these swings more than others.

Symptoms can start as early as the late 30s, complicating fertility decisions. Irregular periods, hot flashes, sleep or sexual issues…especially pain with penetration…or contraception questions are all reasons to see a doctor. Treatments exist, but what works post-menopause doesn’t always work in perimenopause.

At the conference, Dr. Cothran is presenting on Genitourinary Syndrome of Menopause — treatment and strategies.

“What does a partner need to understand about menopause that nobody ever tells them?”

Answered by…Stephanie Zwonitzer, DNP

Menopause isn’t a switch that flips — it’s a slow, hormonal renovation that can last a decade, and it rewires far more than periods and hot flashes. It touches memory, libido, sleep, patience, identity, and more. The partner watching from the sidelines often feels like they’re losing the person they married, and that grief is real and rarely named.

Here’s what nobody says out loud: this isn’t personal, even when it feels personal. When she snaps, when she pulls away, when sex changes or disappears for a while — that’s physiology, not rejection. Partners need permission to stop taking it as a litmus test on the relationship.

What actually helps isn’t fixing — it’s staying curious instead of defensive, asking “what do you need right now” instead of “what’s wrong with you,” and understanding that showing up consistently during this season is what rebuilds intimacy on the other side. Menopause doesn’t have to be the end of connection. Handled with patience and honest communication, it can be the beginning of a completely new, more honest chapter together.

At the conference, Dr. Zwonitzer is presenting on Peri/Menopause & Relationships: Navigating Hormonal Change at Work, at Home, and in Partnership.

“Should women disclose menopause symptoms at work — and what rights do they have if symptoms affect their job?”

Answered by…Angela Wright, MBChB MRCGP DFSRH Dip Pall Med FECSM DIPM Reg(COSRT)

I don’t think there’s a right or wrong answer to whether you tell your employer you’re going through the menopause — it really depends on your workplace and how comfortable you feel. Many women worry they’ll be judged, overlooked for promotion, or dismissed as “just menopausal,” so those concerns are very real.

That said, if your symptoms are starting to affect your work — perhaps you’re struggling with poor sleep, brain fog, anxiety, or finding it harder to concentrate — it can be worth having an honest conversation with someone you trust. You don’t have to suffer in silence, and often simple changes at work can make a huge difference.

In the UK, we don’t have a law that’s specific to menopause, but women are still protected. Depending on how severe the symptoms are, the Equality Act 2010 may apply, and employers also have a legal duty to consider your health and wellbeing at work. That might mean making reasonable adjustments, such as flexible hours, better temperature control, regular breaks, or temporary changes to your workload.

I always remind my patients that menopause isn’t something you simply have to put up with. If your symptoms are affecting your confidence, your work, or your quality of life, please seek help. There are effective treatments available, and with the right support — both medically and in the workplace — most women can continue to thrive in their careers.

At the conference, Dr. Wright is presenting on Navigating Through Career Burnout, Feeling Overwhelmed, Hormone Sensitivity, and Sex.

“For women re-entering the dating world during or after menopause — what do they need to know about intimacy with a new partner?”

Answered by…Claire Rumore, Intimacy Coach

For women re-entering the dating world during or after menopause, intimacy may require a different pace than it once did. Desire may not appear as immediate chemistry, responsive desire, or a sense of urgency for fulfillment. It may emerge more gradually through trust, emotional safety, curiosity, and feeling at ease with someone.

A new partner is also meeting a body that may have changed with menopause, and you may still be getting to know that body yourself. This can be an opportunity to explore rather than perform. Honest communication about comfort, boundaries, desire, and what feels good can absolutely create connection rather than diminish it. Trust that!

It is also helpful to pay attention to nervous system compatibility with someone new. Do you feel rushed, self-conscious, or pressured around this person? Or do you feel more relaxed, present, and able to be yourself?

One of the gifts of dating after menopause is the opportunity to become less interested in performing intimacy and more interested in experiencing it. The question may no longer be, “How do I get my old sexual response back?” but rather, “What kind of intimacy is this version of me ready to create now?”

At the conference, Claire is presenting Slow(er) Is Not Broken: Slow, Attuned Intimacy & Subtle Sexuality in Peri- and Menopause.

“What’s different about surgical or medically induced menopause — and why does nobody prepare women for it?”

Answered by…Rachel Gelman, PT, DPT, CSC

The obvious difference is that this is menopause that occurs due to a medical intervention — this could be from a surgery, such as a hysterectomy, or other treatments like chemotherapy, radiation, or medications that suppress estrogen production. As it is medically induced, it usually is a more sudden onset, which means the symptoms can be more severe.

Chances are people are not properly prepared because the focus of their healthcare providers is on treating whatever illness requires surgery or medical treatment. There is no reason that healthcare providers shouldn’t inform patients of what to expect, because more data shows that the same treatment options are available for women who are going through medically induced menopause. But obviously everyone’s case is different, and that is why people should work with their doctors to determine the best approach for their situation.

At the conference, Dr. Gelman is presenting on Pelvic Floor Health During Peri-menopause/Menopause: What People Should Know and How It Impacts Sexual Function.

“What’s the real financial cost of managing menopause — and what won’t insurance cover that women should budget for?”

Answered by…Linda Maggio Sussman, MPH

It is estimated that approximately 6 million women in the United States suffer from some level of peri-menopausal symptoms. The costs associated with the diagnosis, care, and treatment of menopause are significant and vary widely based on the types of care chosen and the state you live in. Some states have laws requiring insurance companies to cover medically necessary treatment for menopause, while other states leave coverage decisions up to the individual insurance providers.

Some of the treatment options one might consider are prescription hormone replacement therapy (HRT), which can vary from $10 to $100/month, and over-the-counter treatments, such as gels, patches, dietary supplements, vitamins, cooling products, skin care, and hair thinning treatments, which can cost anywhere from $50 to $200/month.

Alternative therapies, such as acupuncture, pelvic floor physical therapy, and even mental health counseling are also available in a range of $60 to $250/session, depending on location and how long the therapy is recommended.

Finally, the costs for medical provider visits will vary widely too, and can involve any combination of consultation, lab testing, and specialized treatment. Some procedures, like bone density scans to check for the presence and extent of osteoporosis, can run anywhere from $700 to $1,000 per scan depending on the provider and your coverage — and for women monitoring osteoporosis, those scans may be recommended as often as every six months.

Treating menopause is complicated and costly. And while studies are limited on the exact dollar amounts, experts agree that financial concerns should not prohibit women from seeking care to treat and alleviate the symptoms of menopause.

At the conference, Linda is co-presenting Treating the Signs and Symptoms of Peri-Menopause and Menopause through Hypnosis with Bennett Solberg, PhD, LCPC, NCC.

“What’s the connection between menopause and grief — for the body, identity or life stage women feel they’re losing?”

Answered by…Bennett Solberg, PhD, LCPC, NCC

For a lot of women, menopause lands as a series of quiet losses that never get named as losses. The most obvious is the end of fertility — and it matters even for women who never wanted children, or finished having them long ago. What closes is the option, and with it a particular sense of the body as generative and forward-facing.

But the grief usually runs wider than reproduction. The body changes in ways you can see and feel — weight, skin, hair, sleep, sexual response. When your sense of self has been bound up, often without fully realizing it, with youthfulness or a body that behaved predictably, these changes can feel less like symptoms and more like the erosion of a self you recognized. Add the cultural script of “woman” that centers youth and reproduction, and the transition can feel like being quietly retired from a role before you decided whether you wanted to leave it.

Here’s what makes this grief so hard: it’s what grief researchers call disenfranchised — a loss the culture around you doesn’t ritualize, mourn, or even reliably acknowledge. There’s no ceremony. No casserole. No bereavement leave. Often the message is that you should feel relieved to be done with periods and contraception. That silence can leave women feeling their sadness is irrational or self-indulgent, which only compounds it.

One important distinction: peri-menopause does carry a genuinely elevated vulnerability to depression, partly tied to fluctuating hormones. But grief over what’s changing is a meaningful response to real loss — not a symptom to be medicated away. The two can amplify each other, and they’re worth teasing apart with a professional.

And it’s not universal. Plenty of women move through menopause with neutrality, relief, even a sense of liberation. But for those who do grieve, the timing rarely helps — menopause tends to arrive alongside children leaving, parents aging or dying, and a sharpened awareness of your own mortality. So the grief often isn’t about menopause alone. It’s about standing at a life stage where several forms of “before” are ending at once.

At the conference, Dr. Solberg is co-presenting Treating the Signs and Symptoms of Peri-Menopause and Menopause through Hypnosis with Linda Maggio Sussman, MPH.

The Conversation Doesn’t End Here

Seven questions. Seven honest answers. And not a single referral required.

If this is the kind of conversation you’ve been waiting for, and you have more menopause questions…you’re going to want to be in the room. Every expert featured in this article is speaking live at Menopause Redefined: Integrating Medicine, Mind & Intimacy.

Because menopause deserves better than silence. And so do you.