At this point, the eulogies and remembrances have rolled in and the admonitions of “Keep our elder icons indoors and safe” have been delivered. The news cycle has moved on. But losing women who did so much for so long and seemed like they would always just be here still hits hard. Especially as I enter what I presume to be my final third, I have been sitting with this in a way I wasn’t prepared for.
These were not women who simply occupied space in the culture. They built things. Dolly wrote over 3,000 songs, constructed an entire universe at Dollywood, and put books in the hands of millions of children through her Imagination Library, all while being dismissed for decades as a rhinestone joke. She let people think she didn’t notice. Perhaps that was also the strategy.
Gloria co-founded Ms. magazine when no one believed women could run one. She helped build the National Women’s Political Caucus, the Ms. Foundation, the Women’s Media Center. Her foundation’s statement said she “continued working for equality until the very end.” A new memoir was due out this month. She was still writing. Still building. At 92.
I had the extraordinary privilege of meeting Gloria Steinem twice, at her home in New York, at the intimate gatherings she hosted called “couch conversations” in 2022. What I remember most is not what I expected to feel in the presence of a legend. She was present. Curious. Utterly without performance. She wanted to know what *we* thought. She was still building something.
There is real grief in losing both of them within ten days of each other. And a question that follows it: what are we doing with what they showed us?
2018
In 2018, I founded Menopause BootCamp.
No platform. No publishing deal. No guarantee that anyone would show up. Just an idea that would not leave me alone and a conviction that women needed a space to come together around the experience of midlife. Real information about hormones and their changing bodies. A room where they could say the things they’d been embarrassed to say everywhere else.
Nobody was talking about menopause like they are now. Not as a public conversation, not as a cultural moment, not as something a major publisher would put resources behind. The word itself was still something most women whispered, if they said it at all.
I was not famous. Not even a micro-influencer. I was a full-time practicing physician in Los Angeles with two decades of clinical experience, working in an insurance-based, high-volume general OB/GYN practice, with a growing suspicion that what my patients were hungry for wasn’t just information. It was each other.
So I took the leap.
What I understood immediately, even if I couldn’t fully articulate it yet, was that Menopause BootCamp was never really about education. It was about community. And what happened when women got into a room together was something I hadn’t fully predicted. They looked at each other. They laughed with relief. They said *me too* and meant it in the most vulnerable way. They discovered they were not losing their minds. They were not alone. What they had been told was “just aging” had a name, had implications but also a plethora of solutions, and perhaps most importantly had a community of women going through it right alongside them.
That’s transformative. And transformation requires community.
It became apparent to me, standing in those early rooms, that this would become a movement. I knew it the way you know things that are true before you can prove them.
The book. The certification. And the waiting.
I knew I had to write a book about all of this. In retrospect, my naivete about how unrealistic that would be is almost cute. As a first-time unknown author, Menopause Bootcamp was sold to HarperCollins. It still feels unlikely: a physician no one had heard of, a subject the culture hadn’t yet decided was worth its attention, a major publisher taking the bet. It happened because the need was real; the need existed before anyone was paying attention to it. But it also happened because of community: an extraordinary book agent, Brandi Bowles , and a publisher, Karen Rinaldi ( #iykyk), who understood what this meant and championed the work.
Then I built a certification program so that others could bring this to their own communities. I instinctively knew that it would be impossible for me to “spread the word” alone, and that it was inappropriate for me to move into all communities as an outsider, even if I was an “expert.” And for the last three years, I have coached my most dedicated Menopause Bootcamp certified facilitators every quarter. Sitting with these women, watching them grow, hearing what they’re building, seeing the work move into cities and practices and communities I never could have reached with that level of authenticity or commitment, fills me in ways I don’t have adequate language for.
You cannot manufacture that kind of dedication. It grows from real community. From showing up consistently. From making clear: I built this for you to carry further than I can carry it alone.
Puerto Rico
Eight years after that first idea, one of my certified facilitators, Jasmin Contreras, whose commitment to this work has been absolute, did something that lit me up when she shared it with our group.
She helped organize the founding of Puerto Rico’s very first medical society dedicated to “educating, guiding, and promoting the comprehensive health of women during the stages of perimenopause and menopause”: the Sociedad de Menopausia de Puerto Rico. She helped organize its first-ever conference. And she invited me to speak there this October.
She did not wait for a grant. She did not wait for a governing body or an institution or someone in power to decide that Puerto Rican women deserved a menopause society. She looked at what was missing in her community, in her language, in her culture, and she helped build it. Then she extended the invitation back to me.
That is not my success. That is community working exactly as it is supposed to work. One woman, trained and committed, taking what she learned to plant seeds and making them bloom in soil I had never touched.
I think about Dolly when I think about her. And I think about Gloria. Not because of some easy metaphor, but because both of them understood something essential: you do not wait for the culture to decide your work matters. You build the thing. You serve the people in front of you. And if you’re consistent, and it is truly meaningful, the thing outlasts you.
The Sociedad de Menopausia de Puerto Rico will outlast all of us. It started with one woman who decided it should exist.
What I’ve been thinking about: weathering
Bear with me. I promise this is going to make sense.
I am not Latina. Being invited to participate in Latina spaces is an honor that implies a trust I don’t take lightly. When a community that has historically been ignored, or addressed by those who rarely look like its own, chooses to invite someone in, that is a gift. When The Art of Living While Dying Darlene Cordero and Katherine Castro extended invitations to Femme Confab and LatinaFest, my first response was honest: “You know I’m not Latina, right?” “I know. Come anyway” was their response.
So I went. And I’ve been thinking ever since about a framework most clinicians have never heard of: weathering.
It’s a hypothesis first articulated by epidemiologist Arline Geronimus1 - the idea that a body living decade after decade inside systems that grind against it accumulates a specific, measurable physiological cost. Discrimination. Structural poverty. Chronic threat. Stress-response systems running in the background incessantly, without adequate recovery.
The clinical term is **allostatic load**. The biology is measurable. Cortisol stays elevated. Inflammatory markers increase. Cardiovascular, metabolic, neuroendocrine systems remain in a state of chronic emergency.
Data from NHANES suggest that Latina women, as well as other women of color, carry substantially higher risk of elevated allostatic load compared to non-Hispanic white women, and that age-adjusted allostatic load scores among Latinx adults are comparable to those of people several years older.
What this means clinically is that a Latina woman’s body may be biologically older than her chronological age not because of genetics or personal choices, but because of the compounding physiological cost of living at the intersection of race, gender, class, and for some, immigration status, in this country.
And then she hits menopause.
Already weathered. Already carrying excess allostatic load. Already navigating a healthcare system that has historically dismissed her symptoms, doubted her pain, and undertreated her conditions. She hits one of the most hormonally disruptive transitions in a woman’s life - already understudied, undertreated, and misunderstood - with no language for it, no clinical support, and a cultural framework that treats stoic endurance as virtue.
In many Latina communities, menopause isn’t a life stage. It’s something managed privately, endured without complaint. Whispered, if mentioned at all. Hot flashes dismissed. Sleep disruption normalized. Cognitive fog attributed to character. Mood dysregulation made into someone else’s problem to navigate around. This structural failure has enormous clinical consequences.
What I witnessed at both Femme! A Latina Confab and Retreat and LatinaFest were women who had never named their symptoms out loud. Women told by their doctors they were “too young” or “too emotional.” Women holding families together, while their own bodies were in revolt, in complete silence, because they didn’t have resources and didn’t feel like they had permission to ask for them. This is weathering. And the silence around it is real, but starting to dissipate.
So eight years after Menopause Bootcamp’s founding, four years after the book was published, the founding of a menopause society for Puerto Rican women is cause for real celebration. Breaking the silence gives women permission to take their own bodies seriously. It also provides the structure, network, and support for clinicians leading the way in communities that have been ignored and underserved all over the world.
Community is healing and I don’t mean that in a Home Goods knick knack kind of way. Social connection and a sense of belonging are measurable buffers against allostatic load accumulation. The act of women gathering, naming shared experience, refusing the silence, all of it has physiological consequences.
What Dolly and Gloria taught
“Trees grow from the bottom, not the top, so what you and I do every day, what’s possible in our community, is what matters.” Gloria Steinem
” The seeds of dreams are often found in books, and the seeds you help plant in your community can grow across the world.” Dolly Parton
Dolly built things that will be sung forever. Gloria built institutions that changed what women are allowed to be in this country. And the day Gloria died, I was already in the middle of writing about a Puerto Rican woman who built a menopause society because she decided her community deserved one.
I am 60. I used to think that sounded like late middle age. Right now it sounds like the beginning of the most important work I’ve ever done.
One woman can change everything not because of fame, not because of followers, but because she builds something real, holds the door open, and trusts that other women will carry it further than she could carry it alone.
That is the whole point. That is the whole movement.
*Rest well, Dolly and Gloria. We’ll carry it from here.*
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*Dr. Suzanne Gilberg is a board-certified OB/GYN and integrative medicine physician, Chief Clinical Officer at Monarch, and founder of the Menopause Boot Camp. She is the author of Menopause Bootcamp and the forthcoming Plant Medicine. Find her at @askdrsuzanne and @themenopausebootcamp. This is The Modern Heretic.
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¹ NHANES allostatic load data: see Raffoul et al., *BMC Public Health* 2023 (PMC10676285). See also: Geronimus AT, *Ethnicity and Disease* 1992; Forde AT et al., *Annals of Epidemiology* 2019; Gonzalez-Guarda RM & Pearson J, *JAMA Health Forum* 2024.
Thank you for sharing this, Suzanne. The story of Jasmin building something her community needed illustrates what becomes possible when one woman has enough capacity to act on what she sees.
We talk a lot about individual health in midlife, but there is another dimension to capacity: what we are able to create, contribute, and build when we have enough energy and clarity to move beyond simply managing our own lives.
One woman builds the thing. Then another woman finds a door that wasn’t there before. That ripple is powerful.
You are so humble. I hold you up there with the Dolly’s and Gloria’s-building that foundation on unstable ground when it didn’t have the momentum today. Your book is what got me to double down on women’s advocacy just last year when I stepped away from professional life💕. It is a community and I can relate. I’ve held several women’s small groups in Honduras to only teach and share information with them as it’s lacking in a big way. While different than Latina culture, there are synergies around it’s not acceptable for women to talk about their own health and certainly not anything in the way of prevention. Thank you again for what you do and how you do it.