Melinda French Gates used a June 4, 2026 appearance on The Excerpt podcast to argue that menopause care has been underfunded and underprioritized—while outlining her $215 million investment to expand women’s health work into midlife and menopause. She tied the
When women can’t sleep. can’t function. or can’t get timely answers. the cost often doesn’t stay in the exam room. In a June 4. 2026 episode of The Excerpt podcast. philanthropist and author Melinda French Gates described what happens when menopause care lags behind what women experience—especially during the years when many are still building their careers.
The stakes, she said, show up in the workplace and beyond. “If you have chronic insomnia… it is very hard to function,” Gates said during the conversation. She linked those symptoms to leadership loss. arguing that when midlife health needs go unmet. women are forced out of jobs or away from pathways that could have carried them further.
Gates’ new push centers on a $215 million investment in women’s health. expanding her foundation’s long-running work on contraceptive access and maternal care into a new area: midlife and menopause. She said the effort targets a problem she describes as longstanding—women’s health “underprioritized and underfunded”—and she framed the move as both a doubling down on known gaps and a correction for where support has been missing.
The podcast discussion anchored the investment to workforce consequences. Gates cited figures that “one in 10 women” are leaving their jobs because of menopause and “another one in five” are retiring early. She described how those pressures can hit during the prime of careers. including around age 40 and the early 50s—when. she said. many women are poised to move up the leadership track.
“I think we want that put into the workforce not taken out. ” Gates said. explaining why she sees midlife health as tied to women’s “power.” Her argument was not abstract. She pointed to practical barriers: without good care. she said women may struggle through intense symptoms and miss the chance to keep moving forward at work.
In the same conversation, Gates criticized a healthcare system that expects women to work around its shortcomings. She referenced research and stories about delays and difficulty getting diagnosed—one study she discussed said one in five women waits a year before a doctor diagnoses menopause. and another said 5% of women seeking help saw 11 doctors before getting help.
Gates said the solution shouldn’t be “women… to solve these problems for themselves.” Instead. she argued for training across the healthcare system—OBGYNs. mental health providers. and primary care practitioners—so that medical professionals can recognize perimenopause and menopause signs and connect patients to appropriate care.
Her remarks also emphasized that many women never reach the specialist they need. She said women may go to clinics without making it to an OBGYN. and she described “a lot of bias in the system. ” saying people of color “may not be listened to in terms of your symptoms” and that women often feel “dismissed.” Gates said that should not be the default—especially in what she called “the highest income country in the world.”.
A key thread in the interview was the training gap itself. Gates said she looked at data and was surprised that only a third of OBGYNs were trained on menopause. She connected that number to a pattern she’d heard anecdotally: women go to primary care. get referred to OBGYNs. and still don’t receive the help they expect. “And I thought, ‘Oh, that’s why so many women are having trouble here,’” she said.
Gates’ midlife focus is part of a larger scale of giving she said totals $600 million invested in improving women’s health. from research to training. She described her approach as an effort to accelerate progress in a space she says has been chronically underfunded. She said the evidence base lags on how hormonal changes unfold and on how information and tools are shared with women.
She also tied the investment to affordability and access. Asked about a recurring concern that menopause care can be out of reach—through doctors not taking insurance or operating concierge programs—Gates said the goal is to train providers “across the board. ” including OBGYNs. primary care. and practitioners in other points of the system. She said that includes ensuring that women who previously relied on doula or midwife support during their reproductive years also get consistent. correctly informed guidance.
In her closing remarks, Gates widened the lens beyond menopause and midlife. She said research is underfunded across women’s health generally. pointing to an earlier $600 million investment effort involving a program with Welcome Leap around women’s heart disease. She cited that “50% of women” are misdiagnosed around the time they are having a heart attack. and said that work is being done under a proven model. Gates added that future efforts should include more research into chronic disease for women.
She also argued that women’s mental health needs more attention. saying women face mental health and distress and that services should be holistic—screening and catching issues whenever women touch a provider. In the interview. she described her view of responsibility as shared: women speaking out. government funding more research and services. companies supporting better research and solutions. and philanthropy and civil society playing roles.
Gates’ personal story sat alongside the policy argument. She said her own midlife experience. including her divorce and new beginnings. informed her perspective in her book. The Next Day Transitions. Changes. and Moving Forward. which came out after she turned 60 last year. She described how her view was shaped by friendships—her “three closest friends” are older than her by a few years—and by what they told her about symptoms. misinformation. and the lack of clarity they encountered before diagnosis.
She also pushed back against a grim perception of aging. In response to a doctor who hoped women going through menopause would talk about it so it becomes less scary. Gates said her own 50s and even her early 60s have been “some of the most satisfying and productive years” of her life. describing them as enriching whether working. serving on boards. working with nonprofits. or spending more time with family.
For Gates, the message was not only that midlife care needs money and training. It was that those changes can prevent women from being pushed out of the workforce and can help them keep living—at work and at home—in the years she described as full of opportunity.
Melinda French Gates Pivotal women’s health menopause care midlife maternal care contraceptive access workforce healthcare training OBGYN primary care investment philanthropy U.S. economy healthcare inequality