Menopause Takes Center Stage

Menopause care and research are having a long-awaited moment in the spotlight. Gaining serious momentum, this important aspect of women’s health had Pauline Maki, PhD, professor of psychiatry, psychology, and obstetrics-gynecology at the University of Illinois College of Medicine on a plane to Davos, Switzerland. The 2025 annual meeting of the World Economic Forum had notably made menopause a key agenda item.

“The field has reached a tipping point,” says Maki, an internationally recognized menopause expert who has spent more than two decades at UIC pioneering novel menopause research and understanding its impact on cognition. “Women are demanding answers and seeking menopause care that improves their health and well-being.”

One-third or more of a woman’s life will be spent grappling with the pre- and post-effects of menopause. Yet a surprising lack of knowledge has left most women to muddle through this stage of life without adequate medical guidance. The scarcity of evidence-based tools often leaves many to endure debilitating hot flashes, sleep disturbances, or mood disorders. Untreated symptoms in the U.S. account for an estimated $1.8 billion in lost work productivity, according to a 2023 Mayo Clinic study .

Maki participated in two Davos 2025 roundtable discussions. The first addressed the profound impact of menopause on the workplace, citing a new report that shows 25 percent of the country’s workforce is in menopause transition. Senior director of research at UIC’s Center for Research on Women and Gender, Maki shared that women with severe symptoms are eight times more likely to report low workability, impacting job performance, absenteeism, and turnover. The second key discussion focused on closing the women’s health gap to improve lives and economies for all. Due to the loss of estrogen, menopause affects every part of the body— from head to toe. Menopause counts among the top nine conditions impacting women’s health and quality of life.

Women have a higher risk of developing dementias and disorders like Alzheimer’s disease. Among the factors potentially contributing to this gender disparity are living longer and having typically stronger immune systems than men. Decreasing sex hormones such as estrogen during menopause may also play a major role in accelerated brain aging and/or “brain fog,” according to Maki’s groundbreaking NIH-funded research. This work has implications for possibly lowering the risks of Alzheimer’s disease.

As postdoctoral psychiatric neuroimaging fellow at Johns Hopkins University, Maki began connecting the dots that launched her early menopause research and career. In 1998, she contributed to one of the first studies using brain imaging techniques to show that estrogen influenced, if not enhanced, memory performance on tests. The brain worked differently in study participants on hormone replacement therapy compared to nonusers. “This work has supported estrogen’s important role in the memory system,” she stated. In later studies using advanced neuroimaging techniques and skin sensors, Maki found that hot flashes, night sweats, and sleep disruptions may have much to do with poor memory recall.

At UIC, the Maki team has conducted a number of groundbreaking menopause studies published in high impact journals such as the American Journal of Obstetrics and Gynecology, Neurology, and Gynecologic Oncology. Recently published findings have included links between frequent menopausal hot flashes and increased Alzheimer’s disease biomarkers, prevalence of stroke-like lesions found in the brain, and decreased cognitive function in BRCA+ patients who entered early menopause after undergoing prophylactic ovary removal for breast cancer prevention.

Ongoing studies continue to focus on better understanding the impact of menopause on brain functioning. Funded by the National Institutes of Health (NIH), Maki co-leads one of the largest longitudinal multi-site studies of brain alterations and the role of menopausal symptoms known as the Adult Aging Brain Connectome Project.

On March 13, 2025, the Center for Health, Awareness, and Research on Menopause (CHARM) hosted “The Menopause Imperative: Advancing Care, Research, and Policy” at UIC. Featuring menopause advocate and actress Halle Barry as well University of Illinois Chicago Chancellor Marie Lynn Miranda and Illinois Lieutenant Governor Juliana Stratton, this event served as a launch for the Center for Health, Awareness, and Research on Menopause (CHARM)—a new research center focused on transforming menopause care for all women and led by Maki. Its mission is to bridge critical gaps in knowledge and healthcare by addressing them through medical training, research, and global data.

Eighty percent of women undergoing menopause experience symptoms. Yet healthcare professionals receive little formal training to effectively help patients with this inevitable aspect of growing older. The consequences of lack of information and misinformation about menopause treatment has led to a crisis situation that calls for awareness and action around the globe, according to Maki, who serves on the executive board of the International Menopause Society.

“We believe it is an economic imperative to tackle head on menopause workforce issues, access to care, and investment in research,” she says. “Through the efforts of CHARM and many partners across a variety of sectors, we intend to make a difference.”