Melinda French Gates is shining a light on a problem a lot of women know too well: perimenopause can be hard to pin down, and even harder to get treated properly. In a new podcast interview, she said it took three doctors before she got the right diagnosis and care, and her story is putting a spotlight on how thin menopause training still is across women’s healthcare.
French Gates said the symptoms started in her early 40s, a time when plenty of women first start noticing their bodies changing in ways that do not make much sense at first. She said older friends helped her recognize what was going on, but even with access to quality care, the process was frustrating and slow.
“It was kind of unbelievable to me that, even in this, you know, unbelievably privileged situation I’m in, where I feel like I can get some of the best healthcare, it took me three doctors to really diagnose what I was going through and to get the right treatments for where I was,” she said during the interview.
She also pointed out that the problem was not necessarily bad medical care, but a bigger training gap that leaves many doctors underprepared. “It wasn’t because anybody was doing the wrong thing. It’s because of what I now know, which is, only one-third of OB-GYNs in this country are trained in menopause,” she said.
That claim lines up with research that has been building for years. A 2023 national survey published in the journal Menopause found that only about one-third of U.S. obstetrics and gynecology residency programs include a formal menopause curriculum, which means a lot of doctors are entering practice without much hands-on teaching in this area.
More recent findings point in the same direction. A 2024 study reported that residents in OB-GYN, family medicine and internal medicine often have low knowledge and little confidence when it comes to treating menopausal symptoms, which is not exactly reassuring for patients trying to get answers fast.
The training gap can show up in very practical ways. In a 2026 Kansas study, more than half of residents said they received fewer than five hours of menopause education, and most did not feel residency fully prepared them to treat menopausal patients on their own.
That matters because perimenopause is common, and it is not some rare corner case. About 1.3 million U.S. women reach menopause every year, according to The Menopause Society, and most begin perimenopause in their 40s, though it can start earlier.
The symptoms can be all over the map, which is part of why women sometimes get bounced around before someone finally connects the dots. Irregular periods, hot flashes, night sweats, sleep troubles, mood shifts, vaginal dryness, brain fog and joint pain can all show up as hormone levels fluctuate.
French Gates said hearing from other women helped her avoid feeling completely lost, but that kind of guidance should not have to come from the sidelines. In a national survey of 2,000 women, only 25% said their healthcare provider had adequately informed them about perimenopause, which says a lot about the size of the knowledge gap.
There is also evidence that better education would make a real difference. Researchers found that knowledge scores climbed from 61% to 79% among people who received a structured menopause curriculum, a pretty clear sign that more training can translate into better care.
For women dealing with symptoms now, the bigger issue is getting someone to take them seriously before the problem drags on. Perimenopause can feel confusing, isolating and easy to dismiss, especially when the signs are subtle at first and the answers seem to keep changing with each appointment.
