My mom told me for years that her hot flashes and brain fog were “just part of being a woman.” She was 44 when it started. She was 55 when someone finally told her it didn’t have to be that way. That’s eleven years of suffering no one should lose.

I became an OB/GYN partly because of her. I trained at Northwestern, practiced for eight years at a major academic hospital, and I thought I was going to spend my career catching babies and writing pap-smear charts.

Then, at 39, I started waking up at 3 a.m. with my heart pounding. My cycles got weird. My joints ached. I gained 14 pounds in four months doing nothing different. I forgot the word “refrigerator” during a meeting.

And I realized that in four years of OB/GYN residency, I had received exactly four hours of dedicated menopause training. Not four weeks. Four hours. I checked with colleagues. It was about the same across programs.

The system isn’t broken. It was never built for us.

Your current doctor isn’t bad. They just weren’t trained on this. The Women’s Health Initiative study in 2002 scared an entire generation of physicians away from prescribing HRT — based on data that was later re-analyzed and largely reversed. But by then, most OB/GYN programs had already stopped teaching it.

So a generation of women hit their 40s, told their doctors something was wrong, and got handed an antidepressant and a pat on the shoulder. That’s not a conspiracy. That’s just medicine being slow.

I became MSCP-certified through The Menopause Society. I started a small tele-practice for friends. Then friends of friends. Then I left the hospital.

Forty & Free is what I wish I’d had at 39.
— Dr. Nora Kessler, MD