The Menopause Market Is Becoming Mainstream: What Employers, Providers, and Investors Need to Know Now

Once overlooked and under-researched, menopause has become one of the fastest-moving frontiers in health law and investment. With the market projected to reach tens of billions of dollars by 2030 and a growing wave of state coverage mandates prompting employers to add menopause benefits, the opportunities are expanding fast, and so is the regulatory scrutiny. Stakeholders now face various compliance issues related to telehealth, controlled substances, data privacy, advertising claims, and billing. 

Then and Now: The Shift in Menopause Care 

Historically, menopause has been overlooked, under-researched, and underfunded. The early stages of menopause treatment were largely shaped by caution around hormone replacement therapy (HRT). Early studies inaccurately linked HRT to increased health risks, but in recent years, leading medical organizations have found that HRT presents a favorable benefit-risk profile for women under 60 or within 10 years of menopause onset. Simultaneously, menopause care is becoming mainstream as new treatments hit the market, employers continue to roll out menopause-specific benefits, and the femtech boom focuses on mid-life women’s health. 

Key Takeaways

1. Telehealth and HRT. The legal landscape related to prescribing HRT via telehealth varies significantly among states. Prescribers must be mindful of Drug Enforcement Administration (DEA) requirements for controlled substances, Food and Drug Administration (FDA) requirements for compounded hormones, and state laws relating to HRT accessibility, particularly in gender-affirming care. Licensure, supervision, and scope of practice considerations remain significant pitfalls for digital health platforms as well.
2. Coverage variability and fraud risk. As Medicaid programs begin covering menopause treatments, providers need strong billing and documentation controls to mitigate fraud exposure. Without dedicated Current Procedural Terminology (CPT) codes, providers must be cautious about upcoding and what is medically necessary, as the definition varies among states and therapies.
3. Data privacy. Platforms collecting symptom data, cycle-tracking information, or hormone therapy records should assess both Health Insurance Portability and Accountability Act (HIPAA) obligations and state consumer privacy laws, as well as requirements and guidance issued by the Centers for Medicare & Medicaid Services (CMS) related to interoperability and patient access. Additionally, several states have enacted protective laws to shield reproductive health data from being subpoenaed or shared with law enforcement in certain circumstances.
4. Advertising claims. Advertisements and endorsements must comply with Federal Trade Commission (FTC) and FDA requirements. Last year, the U.S. Department of Health and Human Services (HHS) and FDA announced a major reform of direct-to-consumer advertising, aimed at closing many of the loopholes that have allowed advertisers to minimize contraindications. Direct-to-consumer advertising has driven a significant increase in drug spending in the U.S. in recent years. Advertisers should be wary of increasing scrutiny.

State Menopause Legislation 

State legislatures have moved quickly to address the broader shift in menopause treatment and coverage. The following provides an overview of the current legislative landscape.

Coverage Mandates 

1. Illinois: Requires coverage of medically necessary hormonal and non-hormonal menopause therapies. Applies to any group or individual policy of accident and health insurance or a managed care plan.
2. New Jersey: Requires coverage of medically necessary treatment for perimenopause, menopause, and related symptoms including HRT and bioidentical hormones. Insurers must provide clear information on covered treatments. Applies to every individual policy that provides hospital or medical expense benefits.
3. Louisiana: Requires coverage of medically necessary menopause and perimenopause care, and prohibits prior authorization and step-therapy for HRT. Applies to any health insurance issuer offering health coverage plans. Louisiana also mandates hormonal care for Medicaid-eligible persons.
4. District of Columbia: Requires coverage of any HRT prescribed for menopause symptoms. Applies to individual/group health plans and health insurers offering health care coverage that provides coverage for prescription drugs.
5. Maryland: Requires coverage of the evaluation and management of menopause and associated conditions. Applies to insurers, nonprofit health service plans, and health maintenance organizations (HMOs).
6. Massachusetts: Requires coverage of HRT for peri- and post-menopausal women and outpatient contraceptive services/drugs/devices. Applies to most major plan types.
7. Oregon: Requires coverage of perimenopause, menopause, and post-menopause treatment, including hormone therapy, SSRIs/SNRIs, vaginal estrogen, osteoporosis medications, and FDA-approved bioidentical hormones. Applies to all health benefit plans.
8. Virginia: Requires coverage of medically necessary menopause and perimenopause treatment, including for hot flashes, vaginal/bladder problems, bone loss, cholesterol changes, and sleep disruptions. Applies to insurers, corporations, HMOs providing accident and sickness insurance coverage.
9. West Virginia: Preserves insurance coverage for prescription contraceptive drugs when prescribed for non-contraceptive purposes including eliminating symptoms of menopause. Applies to health benefit plans that provide coverage for contraceptive drugs.  

Employment Protections 

1. Washington: Executive Order 26-01, signed on June 1, 2026, calls for accommodations for employees experiencing menopause and perimenopause and training materials for state agencies and other public and private employers.
2. Rhode Island: Requires employers to reasonably accommodate menopause-related conditions unless doing so poses an undue hardship, and prohibits forced leave, denial of opportunities, or failure to provide notice of these rights.  

Public Health, Education & Provider Training 

1. Alabama: The Office of Women’s Health will assist with identifying menopausal and post-menopausal health concerns and priorities.
2. California: The Office of Health Equity will develop strategies and programs regarding menopause. Menopause will be considered in determining related continuing education requirements.
3. Connecticut: UConn Health will develop an evidence-based toolkit for providers on screening, diagnosing, and treating menopause symptoms in consultation with the Department of Public Health.
4. Delaware: The Office of Women’s Health will assist with identifying priorities for women’s health across the lifespan, including menopausal and post-menopausal phases.
5. Indiana: The Office of Women’s Health will assist with identifying priorities for programs relating to menopausal and post-menopausal health.
6. Maine: The Maine Department of Health and Human Services will develop educational materials on perimenopause and menopause symptoms and treatments.
7. Maryland: Certain Maryland health occupations boards will grant continuing education credit for health professionals who complete education regarding menopause and associated symptoms.   
8. Nebraska: The Women’s Health Initiative will serve as a clearinghouse for menopause information and education.
9. New Jersey: The State Board of Medical Examiners will offer continuing education credits for physicians and nurses who complete menopause education programs.
10. New York: The New York Department of Health will establish public education and outreach campaigns covering menopause impact in the context of osteoporosis prevention.
11. Tennessee: The Office of Women’s Health will provide education and advocacy on menopausal health. 

Several key pieces of menopause legislation have been introduced and are currently pending in Illinois (HB 5284; SB 3688), New York (S.7495/A.8542), Pennsylvania (HB 1411/SB 1118), Michigan (HB 4814/SB 717; HB 4815/SB 718), Ohio (HB 767) and California (AB 1940), among others. 

Women’s health and femtech continue to grow substantially, impacting providers, payors, employers, investors, pharmaceutical companies, and digital health platforms. Menopause treatment is experiencing specific attention as benefits expand, the industry shifts toward integrated, longitudinal care models, and stakeholders better understand opportunity associated with closing the gap in mid-life women’s health.

The authors would like to thank summer associate, Kwesil Ezeh, for her contribution to this article. She is not licensed to practice law.