Fiona Clark on Menopause Research, MREF & Meno Wars: Evidence-Based Care & What Needs to Change

In this crucial episode of Women of a Certain Stage, host Lauren speaks with Fiona Clark, Australian journalist, medical publisher, and founder of the Menopause Research & Education Fund (MREF). Fiona pulls back the curtain on the menopause landscape, revealing why doctors are openly arguing on social media, how a £15 trillion market is driving commercialization, and why the UK's National Institute for Health Research has allocated just 0.3% of funding to menopause—despite it affecting 100% of women.With a degree in anatomy and physiology and 20 years in medical publishing, Fiona experienced firsthand how fragmented and under-researched women's health truly is. After spending COVID evenings interviewing menopause experts and repeatedly hearing "the studies haven't been done," she founded MREF with Dr Vikram Talaulikar and Diane Danzebrink to fund the research that no one else will.This conversation tackles uncomfortable truths: discrimination in emergency rooms, the 2,004 women who must take HRT to prevent one case of dementia, why toothpaste doesn't belong in the "menopause aisle," and how peak brain function occurs at 55-60—precisely when we're losing women from the workforce.Key Timestamps[00:01:00] Fiona's background: anatomy, physiology, mainstream publishing, then medical journalism [00:02:00] COVID interviews with experts: "The studies haven't been done" [00:02:30] Founding MREF with Vikram and Diane 18 months ago [00:03:00] Meno Wars: Why doctors are arguing publicly on social media [00:04:00] Women live 25% longer in chronic illness than men [00:05:00] Misinformation, disinformation, and conflicting "truths" from medical professionals [00:06:00] Everyone has an opinion about women's bodies—from birth to death [00:07:00] Two polarized views: "snowflake" vs "you'll be demented in a wheelchair" [00:08:00] Going to the GP prepared: symptom trackers and knowing your options [00:09:00] When your GP says "I don't believe in HRT" [00:10:00] Fiona's A&E experience: 185/120 blood pressure dismissed as alcoholism [00:11:00] Rosacea mistaken for drinking—prescribed thiamine, no BP advice [00:12:00] Two years arguing with GP to increase blood pressure medication [00:13:00] Medication reviews: contradictions from the same prescribing doctor [00:14:00] Two women in their 80s/90s: one on HRT, one not—both living well [00:15:00] Pauline Mackey on dementia: realistically, HRT is neutral [00:15:30] 100% go through menopause, 20% get dementia (19% of men too) [00:16:00] What makes that 20% vulnerable: vasomotor symptoms, sleep disruption, BP, cholesterol [00:16:30] 2,004 women must take HRT to prevent one case of dementia [00:17:00] Mike McClung on osteoporosis: identifying women at risk pre-menopause [00:18:00] Lauren's background: psychology, personal training, sports therapy, nutrition [00:19:00] The intersectionality between lifestyle and genetics/DNA [00:20:00] International Menopause Society 2025 theme: lifestyle [00:21:00] Bone mineral density peaks in late teens/early twenties [00:22:00] The commercialization of menopause: only just beginning [00:23:00] US 50+ market: $15 trillion; menopause market: $600 billion [00:24:00] Menopause toothpaste: no different from the one next to it [00:25:00] America as research powerhouse—and current threats to funding [00:25:30] Women barely make up 40% of research cohorts—even in conditions we suffer more [00:26:00] NIHR funding scandal: 8,000+ studies since 1993, only 33 mention menopause [00:27:00] Six-figure sums for initial research projects—just to get ideas scoped [00:28:00] MREF's peer review system (once funding allows) [00:29:00] The governance and paperwork required for charity status [00:30:00] Economic argument: menopause costs businesses in presenteeism and retention [00:31:00] Peak brain function at 55-60: emotional intelligence and moral reasoning [00:32:00] Organizations doing culture change work see women asking for help earlier [00:33:00] The "will you reach your KPIs?" conversation that makes women quit [00:34:00] What line managers should say instead: specific support options [00:35:00] Employers shooting themselves in the foot without proper supportKey TakeawaysMREF founded after repeated "studies haven't been done" conversations during COVIDUK funding crisis: 0.3% of NIHR funding to menopause from 8,000+ studies since 1993Only 33 studies even mention the word "menopause" in NIHR researchMeno Wars reflects broader women's health fragmentation and distrustWomen live 25% longer in chronic illness than men later in life100% of women go through menopause; 20% develop dementia (similar to men's 19%)2,004 women must take HRT to prevent one case of dementiaVulnerable 20%: untreated vasomotor symptoms, poor sleep, high BP, cholesterol, sleep apneaPerimenopause bone loss: up to 20% in just 2-3 years around menopauseUS market: 50+ age group worth $15 trillion; menopause alone $600 billionCommercialization just beginning—menopause toothpaste is hereIntimate products with ingredients you wouldn't use on your facePeak brain function occurs at 55-60: emotional intelligence and ethical reasoningDiscrimination in healthcare affects everyone: 185/120 BP dismissed as alcoholism due to rosaceaResearch costs millions and takes 3-10 years minimumWomen barely make 40% of research cohorts even in conditions affecting us more2025 Menopause Action Plans voluntary, mandatory by 2027Lifestyle theme for 2025 International Menopause SocietyBone density peaks in late teens/early 20s—next generation at serious riskGood research requires ring-fenced funding and long-term commitmentFiona Clark's Powerful Insights"Every night I'd be interviewing menopause experts and we'd get to a point where I'd say, 'What do we know about the evidence for this?' And they'd say, 'Well, we don't really, because the studies haven't been done.'""What started as a very collegiate group has really fractured... What does this menopause landscape say about women's health in general?""Everyone has an opinion about what we should do with our bodies from the moment we are born to the moment we die.""There are 1,000,001 ways to go through menopause. So there are 1,000,001 ways that you can choose for yourself.""Your health and your decisions are yours and yours alone. It doesn't matter what anybody else thinks. This is between you and your doctor and your individual health risk.""100% of us go through menopause, 20% or so will end up with dementia. The question is: what makes that 20% vulnerable?""If you want to prevent one case of dementia, you have to treat 2,004 women.""There's no amount of HRT that's gonna make up for a bad lifestyle.""When a toothpaste appears in the menopause aisle, there's absolutely no difference between that Colgate and the Oral-B next door.""We are lucky if we make up 40% of a cohort in research studies—in conditions that we are more likely to suffer from. And if you're Black or Asian, you don't even really get a look in.""Since 1993 to January this year, the NIHR has done over 8,000 studies. Just 33 mention the word menopause. The funding is 0.3%.""I hate that we have to phrase everything in economic cost all the time, but it costs the economy an awful lot to have us in ill health.""The 55 to 60 year olds—their brain is at its peak for emotional intelligence, for moral and ethical reasoning. You don't want to get rid of them just because they're having difficulty remembering where they put their glasses."Take Action!Support Menopause Research:Website: MREF.ukEmail: [email protected] Media: Instagram and Facebook @MREFukLinkedIn: https://www.linkedin.com/in/fiona-clark-8826929/Corporate Organizations: Consider MREF for your annual charity contributions:Investing in menopause research reduces presenteeism costsImproves attraction and retention of experienced talentDemonstrates genuine menopause support beyond tick-box exercises2025 Menopause Action Plans are voluntary but mandatory by 2027Peak brain function occurs at 55-60—retain this invaluable...