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U.S. measles battle hindered by confusion over health secretary response

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U.S. measles battle hindered by confusion over health secretary response


U.S. pediatricians and infectious disease experts say the fight against rising measles cases nationwide is being hampered by a lack of forceful advocacy for vaccination from government health officials and statements on unproven treatments that are confusing parents.

Since January, 505 people have been infected in Texas and more than 90 total in neighboring New Mexico, Oklahoma and Kansas. Two children0 have died in Texas, including an 8-year-old girl last week, and an adult death in New Mexico is under investigation. The United States has more than 600 known cases and outbreaks in six states, according to the Department of Health and Human Services (HHS).

Sue Kressly, president of the American Academy of Pediatrics, said leaders need to speak with a consistent science- and fact-based message about measles vaccination, calling it the only way to handle an outbreak like this. “That is the number one message we’re trying to put in front of everyone.”

Robert F. Kennedy Jr., who has a long history of advocating against vaccines, has backed vaccination as the best way to prevent measles from spreading since becoming the head of the U.S. Department of Health and Human Services. But unlike previous health secretaries faced with containing outbreaks, his comments are not unequivocal. He has also made misleading claims about nutrition, vitamin A and other treatments, while exaggerating vaccine risks, even as U.S. vaccination rates are falling.

“Our work is becoming harder by the minute,” said Rana Alissa, president of the American Academy of Pediatrics’ Florida chapter, a state where kindergarten vaccination rates last school year were 81%, far below the 95% needed to establish community protection.

An HHS spokesman in a statement disputed that there was a lack of strong federal messaging, saying Kennedy has repeatedly reinforced the important role of vaccines. The spokesman said HHS and the Centers for Disease Control and Prevention have been monitoring the situation and are collaborating with state and local health authorities, including by providing resources.

“Secretary Kennedy remains committed to ensuring Americans have accurate information on all available treatment options,” the statement said.

In an interview on CBS News on Wednesday, Kennedy repeated that it was his and the government’s position that people should get the measles vaccine. On Sunday, however, he followed a post on X championing the vaccine with another praising alternative treatments, drawing fresh criticism from disease experts.

The CDC, the nation’s lead agency on infectious disease outbreaks which reports to Kennedy, has made just two official public statements and provided a weekly tally of cases on its website. HHS said the CDC has issued statements and updates as needed.

Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, said the CDC needs to conduct frequent press conferences and issue multiple press releases urging Americans to vaccinate their children.

In 2019, when a New York measles outbreak recorded 1,274 cases, CDC officials did just that and New York City made the vaccine mandatory, issuing summonses to families who failed to comply.

That year, Health Secretary Alex Azar forcefully endorsed the measles vaccine, calling it “among the most-studied medical products we have”, and launched a national immunization campaign.

Doctors are looking to fill in the communication void. AAP has produced new website content, several press releases, 20 social media posts and launched a misinformation-fighting initiative, aimed at clarifying the safety of vaccines and the role of Vitamin A, which Kennedy has touted.

There is no treatment for the highly contagious vaccine-preventable disease beyond those to address symptoms and complications, AAP’s Kressly said.

Vitamin A is only recommended when administered by a doctor in specific quantities as too much can cause liver damage. Some pediatricians in Texas have reported cases of liver toxicity among children, Kressly said.

In his Sunday X post, Kennedy promoted the inhaled steroid budesonide, which is used to treat asthma, and the antibiotic clarithromycin.

Antibiotics cannot treat a viral infection and using an inhaled steroid to treat measles-related inflammation is risky because it suppresses the immune system, which could make the infection “significantly worse,” said Tina Tan, a professor of pediatric infectious diseases at Northwestern University and president of the Infectious Diseases Society of America.

‘Massive epidemic’

The Texas outbreak likely involves thousands of cases as official case counts only tally laboratory-confirmed cases, Offit said. “This is a massive measles epidemic.”

Measles typically causes one-to-three deaths per 1,000 cases. Three deaths linked with the Texas outbreak suggest there could be as many as 1,000 to 3,000 cases, epidemiologist Katelyn Jetelina wrote in her Substack blog on Monday.

Rising vaccine skepticism and misinformation have resulted in only 11 U.S. states with vaccination rates of 95% or above – the level needed to protect residents unable to receive the vaccine. The measles vaccine is 97% effective after two doses and 93% after one.

Michael Donnelly, who crafts messaging for pediatricians across Medstar Health’s 10 hospitals in the Washington D.C. and Baltimore areas, said Kennedy’s comments set this year apart from the concerns raised by parents in prior years.

“On one side, you have people panicking when they don’t need to. And then on the other side, you have people who are pretty blase.”

Alisa Kachikis, who cares for women with high-risk pregnancies at UW Medicine in Seattle, noted that measles can cause miscarriage and birth defects. She recommends pregnant women who are unvaccinated get the shot right after delivery to protect their baby.

The vaccine can’t be given to children younger than six months and is usually not given until a child reaches 12 months.

Theresa Horton, a pediatrician in Owasso, Oklahoma, said she used to tell parents if they didn’t vaccinate their children, they were relying on others who were vaccinated to protect them.

With vaccination rates among Oklahoma kindergartners hovering around 88%, she now tells them: “We no longer have herd immunity.”



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Paying attention to mind matters in cancer care

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Paying attention to mind matters in cancer care


Cancer treatment and follow-up is not a sprint, it is usually a marathon; it can be physically and psychologically taxing for patients, caregivers and healthcare professionals. Psycho-oncology is nurturing the patient and their family holistically, and ensuring every concern is heard in a compassionate and patient-centred approach

The word psycho-oncology underlines the strong connection between the brain (mind/mood) and the body. This branch acknowledges how a cancer diagnosis affects not only the body, but also the mind and soul of the patient and has a profound impact on the family. In this discipline, the psychological, social, economic and behavioural challenges faced by patients and their families are addressed. This form of support is as essential as medical treatment itself. “Psycho-oncology is the only branch that treats the patient and the family’s psycho-social, emotional and mental health,” says Kalpana Balakrishnan, CEO and Medical Director, Cancer Institute (WIA), Adyar.

The evolution of psycho-oncology

Until the mid-20th century, the primary effort of the oncology discipline was to save human lives and increase the number of survivals. However, the aspect of quality of lifegained prominence, when cancer survivors raised concerns about their feelings of helplessness and their lack of ability to return to their new normalcy. This sparked the movement of psychosocial care for cancer patients and their families in the 1970s. Psycho-oncology addresses a wide range of hurdles in cancer care; commencing from diagnosis acceptance, treatment adherence, fear of recurrence, body image concerns, psychosocial distress (encompasses depression and anxiety), fatigue, trouble in returning to work or education, helping with tobacco cessation, apprehensions in interpersonal and marital relationships during and post treatment and feelings related to sexuality. Other significant concerns that have also emerged are the prolonged duration of treatment and financial toxicity (out-of-pocket expenditures) of cancer care.

Today, distress is recognised as the sixth vital sign, and psycho-oncology is an established sub-specialty of oncology, which offers need-based, customised psychosocial interventions. Specific psychological interventions like psycho-education, cognitive therapies, systematic desensitisation, autogenic and progressive muscle relaxations, and need-based eclectic approaches are offered by trained professionals.Mahalakshmi R. Shetty, ENT specialist, adds that psycho-oncology treatment also reinforces basic self-care: drinking adequate water, adherence to good sleep and circadian rhythms, ensuring diet is nutritious and staying physically active. Positive coping mechanisms are also encouraged in the form of gardening, art therapy, music therapy etc., to help patients destress and offer them solace.

In addition to individual therapies, psycho-oncologists also offer specialised support group therapies.

Sundaramoorthy Chidambaram, assistant professor, psycho-oncology, states, “We are pioneers in organising support groups for patients, the SMILE paediatric cancer support group and the Dr. Muthulakshmi Reddy Women Cancer Support Group, which were established two decades ago.” In addition, other focussed groups for ostomy patients, throat cancer survivors (laryngectomy patients) who do not have their natural voice boxes, and for those undergoing chemo-radiation therapy and tobacco-free association meetings for tobacco users, exist.

When psycho-oncology becomes crucial

Distress can set in at any stage during the cancer continuum, from pre-diagnosis to survivorship or the end-of-life phase. Psycho-oncologists are crucial during the time a cancer diagnosis is revealed (breaking the bad news). “Psycho-oncology professionals play a pivotal role in managing the anticipatory fear, regarding the nature of treatment and side-effects. This enables the patients to make informed, treatment-related decisions and face their treatment with mental strength” says Revathy Sudhakar, assistant professor, psycho-oncology.

Patients are provided with relaxation technique guidelines to handle anxiety and fear before and during the course of the procedure. The effect of cortisol (our stress hormone) on tumour growth has been well established. Paying attention to the mind, and alleviating symptoms of stress has both tangible and intangible benefits and should not be ignored. Arvind Krishnamurthy, Head, Surgical Oncology, adds: “When cancer surgeries and treatments are highly intense, it becomes quite challenging to prepare the patient. Psycho-oncologists help us a great deal in counselling patients pre-treatment, more specifically in body image altering surgical procedures like mastectomy, amputation and head & neck surgeries.” Vidhya Gopalakrishnan, psycho-oncologist adds: “Caregivers also experience significant psychosocial distress, and they too require professional psychosocial help. This becomes important, because they often restrict themselves from an emotional breakdown in front of the patients.”

Divya Rajprabhakar, psychologist, states that the role of psycho-oncology actually begins from the point of cancer prevention. Professionals reach out to communities to screen and identify tobacco users and provide structured interventions to assist them in breaking unhealthy habits. Studies report that only 3% of tobacco users are able to successfully quit tobacco usage on their own. Professional guidance with persistent efforts by the Tobacco Cessation Clinic at the Cancer Institute (WIA) has helped many manage their cravings and sustain their ‘quit’ status. “While the diagnosis of cancer instils a sense of fear and acts as an enabler for quitting tobacco, and a majority quit immediately, a few still struggle and need professional support,” adds Deepika Sankar, psychologist.

Growth of the discipline and future

Psycho-oncology is a strong, emerging discipline, altering lifestyles and providing psychosocial interventions to improve coping among patients and caregivers. Divya Rajkumar, psycho-oncologist, highlights that the discipline has grown extensively, and now has dedicated sub-specialised tracks including paediatric psycho-oncology, survivors psycho-oncology, adolescence and young adult (AYA) psycho-oncology, palliative and end-of-life psycho-oncology. “The availability of psycho-oncology services from diagnosis to treatment completion and the bereavement phase in the paediatric setting is very helpful and is now considered an integral part of primary paediatric cancer care,” states Venkatraman Radhakrishnan, Head, Medical Oncology.

Thus far, there are more than 100 trained psycho-oncology professionals in the country, of which a majority were trained at the Cancer Institute (WIA), with the institute being the first in the country to initiate an MPhil psycho-oncology programme. In order to provide holistic cancer care for every patient and their family, it is critical that we routinely monitor and assess patients and their caregivers’ psychosocial distress and burden.

Cancer treatment and follow-up is not a sprint, it is usually a marathon; it can be physically and psychologically taxing for patients, caregivers and healthcare professionals. Psycho-social issues in cancer care are unique to the nature of disease and treatment. There is a strong need to increase specialised training for psycho-oncologists, counsellors and social workers in our country. Psycho-oncology is about nurturing the whole person and ensuring compassionate, patient-centred cancer care.

(Surendran Veeraiah, is Professor & Head, Department of Psycho-oncology and RCTC, Cancer Institute,WIA. Email: v.surendran@cancerinstitutewia.org)



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It’s common but treatable: busting myths around asthma and its treatment

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It’s common but treatable: busting myths around asthma and its treatment


Breathing is essential for our lives. But for some of us who have asthma, taking a breath becomes a difficult task, and affects quality of life. Asthma has many names in India – Vaayu roga, Dama, Asthma, Saans ki bimari or Eazhai Noi. Though difficulty in breathing can occur due to multiple causes, for example heart failure, Chronic Obstructive Pulmonary Disease (COPD) or interstitial lung disease, Asthma remains one of the most common causes of difficulty in breathing.

Scope of the burden in India

About 6 to 11 people in every 100 persons in India experience breathing difficulties due to asthma, making it a very common problem. Asthma is an inflammatory condition of the airways or breathing tubes inside the lungs, which are called bronchi. These air-tubes are a sensitive structure. When we get exposed to cold air or dust, these air-tubes may decrease a little bit in size, and one may feel a cough or suffocation for a few seconds. But in patients with asthma, there air-tubes are very sensitive due to inflammation, and they shrink in size significantly causing difficulties in breathing, with a wheeze and cough for many hours, days or sometimes weeks.

An asthma diagnosis should be suspected when such wheezing or breathlessness has been occurring in episodes of few hours or weeks for few months or years. In between these episodes, a person could be completely fine. An asthma diagnosis can be confirmed with pulmonary function tests such as spirometry, oscillometry and FENO (Fraction of exhaled nitric oxide). A patient can also easily learn performing peak expiratory flow rate (PEFR) measurements from his or her healthcare provider, and the changes in PEFR readings also help in confirming an asthma diagnosis.

Treatment for asthma

After confirming the diagnosis of asthma, treatment of asthma can be started in the form of corticosteroid inhalers. The dose of the corticosteroid in inhalers is very low (in micrograms) and usually very safe for use over many months and years. Inhaled bronchodilators like Salbutamol can be used as reliever medications for in-between symptoms relief. In a few selected patients with uncontrolled symptoms, newer therapies such as monoclonal antibody treatment or biologicals can help gain control over asthma symptoms.

There are many common queries or myths about asthma in the society. Here, we will try to address these question one by one.

I often develop a cold and cough and sometimes wheeze, which then improves on its own over a few days or weeks. Do I have asthma?

Yes, it can be asthma. But it can be treated easily, and one can live a normal life.

I had a fever and cold. I took antibiotics. The fever subsided, but the cough and wheeze are still persisting. Could it be asthma?

Asthma symptoms cannot be treated with antibiotics. Inhaled corticosteroids are the main treatment for asthma.

If I have asthma, can I eat cold things? Can I eat citrus fruits and curd?

With proper treatment of asthma with inhaled corticosteroids – you can eat all food items. Curd, milk, paneer, citrus fruits, and fruit juices are good for health and they do not cause asthma symptoms.

Can my asthma be cured or do I have to use inhalers for life?

Asthma is chronic disease like diabetes or hypertension. It persists, but with proper treatment with inhaler corticosteroids and PEFR monitoring, one can live a fully normal life.

Does the inhaler have steroids? Will It harm me if I use it for long durations?

Inhalers contain medicines in micrograms and these drugs stay in lung and do not reach blood in high doses. Thus, inhalers are very very safe for use over many years, even in children, pregnant women, and elderly population.

Can you give me tablets? I do not want to get habituated to the inhaler.

The use of inhalers is not habit-forming. Tablets contains medicines in milligrams or grams which is about a thousand times of a higher dose than the inhaler. Inhalers deliver medicines in very low doses and directly into the airways, making them safe and accurate treatment options for asthma.

I do not have any asthma symptoms anymore. Why do I need to use my inhaler if I am doing well?

In asthma, lung function decreases. The aim of treating asthma with inhalers is to bring back the lung function to normal, in order tokeep the person symptom-free. So please do not stop your inhaler just because symptoms have stopped. APFT is needed to check if lung function has also improved to normal. Your asthma physician will help you achieve normal lung function

Can you tell me what am I allergic to? Can I avoid those food or exposure to that substance, and get cured?

Withasthma, our airways become verysensitive to variety of trigger factors such asdust, smoke,strong smells from cooking in the kitchen,paint or perfume and cold air. Some patients may be allergic to a particular antigen like pollen or aspirin. A complete assessment by a physician can help. But all patients of asthma should avoid common triggers factors as mentioned above.

Can I use the air-conditioner?

Yes, you can set the AC temperature to 24 degree or above and can use it.

Asthma is a treatable disease, and with proper monitoring of lung function with spirometry and with regular treatment with inhaled corticosteroids, one can live a fully productive life.

(Dr. Prince James is with the Department of Interventional Pulmonology and Respiratory Medicine, Naruvi Hospitals, Vellore. prince.j@naruvihospitals.com)



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Breaking the silence around menopause in India: how women are coming together to talk about the transition, especially at the workplace

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Breaking the silence around menopause in India: how women are coming together to talk about the transition, especially at the workplace


It was a scenario television presenter and actor Mini Mathur had never imagined. A few years ago, she was facing an audience of almost 5,000 people, narrating a 10-minute unscripted story on stage, at the Spoken Fest in Mumbai. “About 40 seconds in, I completely blanked out. I had no idea what I was going to say next. I lost my train of thought and couldn’t remember the point of my story — nothing.”

“As a television presenter, you could wake me up in the middle of the night, hand me a mic, and I’d be ready to go. But when perimenopausal brain fog started interfering with my work — it really hit me hard”Mini MathurTelevision presenter and actor

Mathur, then 50, was appalled. She was one of India’s most seasoned, experienced television presenters with a three-decade-long career. “It gave me so much anxiety, not knowing what was coming next. I blanked out for just five to seven seconds, but on stage that felt like five hours,” she recounts.

The moment hit her hard. She started hesitating before taking on live, unscripted events for almost six months. “I was so unsure about my memory. I would write my entire script down and have it put on to a teleprompter or use cue cards. For about a year, I couldn’t function on stage without one,” says Mathur. She had never needed one earlier. “As a television presenter, you could wake me up in the middle of the night, hand me a mic, and I’d be ready to go. But when perimenopausal brain fog started interfering with my work — it really hit me hard.”

TV presenter and actor Mini Mathur

TV presenter and actor Mini Mathur
| Photo Credit:
Getty Images

Menopause is having a moment, says a recent headline in The New Yorker. If you are a 45-plus woman in India, your Instagram feed is most likely flooded with ads of mid-life fitness and menopause tips our mothers never discussed but we now happily share (ditch the coffee; get the tofu; stock up on magnesium; sign up for strength training; and so on, depending on your algorithm). Celebrities, from Gwyneth Paltrow to Oprah Winfrey, former news anchor Tamsen Fadal, and actor Naomi Watts, have all written books or spoken extensively about it.

Menopause care is now a booming business. According to Grand View Research, the menopause market in India is expected to reach a projected revenue of $1,632.2 million by 2030.

““I wanted to normalise this new version of myself, but I didn’t have the knowledge or tools to do so. One day, I finally stopped and said, I’ve conquered cancer; now let me conquer menopause! Being in denial was getting me nowhere. Now that I have embraced this stage, I have uncovered valuable insights about myself and I have never felt better.”Lisa RayActor, author and supermodel

Actor, author and supermodel Lisa Ray, who went into a medically induced menopause at 37 after a treatment for multiple myeloma, is vocal about her experience. While it took her time to confront the changes menopause brought, like Mathur, she has become a strong menopause advocate, using her social media to do explainers on midlife, women’s health, emotions and self-love. 

Ray noticed a change in her appearance (thinning hair, lack of energy and focus) after a cancer relapse in 2013. “I wanted to normalise this new version of myself, but I didn’t have the knowledge or tools to do so. One day, I finally stopped and said, I’ve conquered cancer; now let me conquer menopause! Being in denial was getting me nowhere. Now that I have embraced this stage, I have uncovered valuable insights about myself and I have never felt better.”

How Lisa Ray manages symptoms
Acceptance is key
Consult a good doctor to discuss care and treatment, if needed
Add more protein to your daily intake and consult a clinical dietician on supplements 
Do weight training
Sleep is non-negotiable as is doing activities that help regulate sleep, such as meditation at night, journaling, magnesium creams or supplements

Workplace support

With over one billion women globally — including nearly 150 million in India — experiencing menopause in 2025, workplace support is crucial. The transition begins even earlier for Indian women, around the age of 46, possibly due to factors such as geography, socio-economic status and lifestyle, among others, says a study by the Indian Menopause Society. Even a casual chat reveals struggles with concentration, anxiety, brain fog and irritability among women who often have a full plate, with a demanding job, teenaged children, caregiving responsibilities and their own bodily changes.

Despite the scale of this demographic change, most Indian workplaces lack formal mechanisms to support women during this transition. Some companies have initiated wellness programmes and medical support, but stigma and lack of awareness remain barriers to an equitable workplace.

Shunali Khullar Shroff

Shunali Khullar Shroff

“The fear of menopause is often worse than the reality. Yes, the hot flashes are real, and sleep becomes so erratic you worry you’ll never get a full night’s rest again. But my generation of women is entering this phase on our own terms. I do strength training three times a week; I am more mindful of what I eat and I find my fitness levels are better than ever before. I’ve realised that the menopause conversation having gone mainstream is a big support to women today. We know what to expect and how to tackle it. Basically, menopause may be the end of the period but it’s not a full stop for you as a woman. It’s a comma. And we’re not done telling our story.”Shunali Khullar ShroffCo-founder of ‘Not Your Aunty’ podcast

Global take
In the U.K., the Labour Party has pledged that, if elected, it will mandate large companies to publish menopause action plans.
In Europe, the fashion industry has begun to address menopause-related challenges, with companies such as Asos and Burberry implementing supportive measures.
The Indian government acknowledges the absence of a menopause policy for women employees. The Ministry of Women and Child Development says that strong research is needed to draft such a policy.

Ray saw the changes impacting her work. “I do different sorts of work — not just in front of the camera. I give public talks, I wrote a book, I read and research a lot, and my inability to focus impacted all that. I even found myself forgetting common words. Even when I would drop menopause in casual conversations at work — in a humorous way, to gauge the room — it would be met with awkward silence,” she says.

A March 2025 Stanford study called ‘The Menopause Penalty’, conducted among Swedish and Norwegian women, found that those with menopause-related symptoms earned 10% less because they cut back on their hours or quit work. In India, a survey by healthcare firm Abbott in partnership with research and data company Ipsos, among 1,200 women, revealed that 81% women felt menopause affected their work life. 

Bengaluru’s Chaitra Vedullapalli, 52, entrepreneur and president of Women In Cloud — a community-led $1 billion economic access initiative for women innovators in technology — knows first-hand the challenges women face balancing leadership, well-being, and career. After years battling perimenopause symptoms, she openly shares her journey of managing executive functioning — what she describes as the ability to manage oneself and one’s resources effectively to achieve personal and professional goals.

Vedullapalli faced stress, burnout, brain fog, and memory challenges, all of which impacted her ability to lead and parent at her usual high level. “I would forget things, so I started documenting everything because I felt like I was losing my mind,” she recalls. These struggles, compounded by chronic fatigue and cognitive shifts, forced her to rethink how she prioritised self-care, leadership responsibilities, and personal health.

Chaitra Vedullapalli, entrepreneur and president of Women In Cloud — a community-led economic access initiative for women innovators in technology.

Chaitra Vedullapalli, entrepreneur and president of Women In Cloud — a community-led economic access initiative for women innovators in technology.

Challenges of transition

Cheryl S., 48, vice-president at a multinational technology company in Pune, has been struggling with sleepless nights. “I’m on the run from the moment I’m up — packing off children to school, instructing the house help, sorting my day — and all I can think of is how little I’ve slept. I struggle to focus during morning work calls that I often lead. I’m also getting irritable very quickly, and it’s something I need to consciously watch with my team. I’m often tempted to leave it all and sit at home if I could,” she says.

Obstetrician and gynaecologist Nina Mansukhani has come across such challenges often. The template is often similar. “This period coincides with women holding senior positions in the workplace and making important decisions. As a result, the transition can become mentally, physically, and emotionally exhausting. Women may find that their tolerance for mistakes diminishes, and their capacity to handle errors decreases.”

Dr. Mansukhani says sleep deprivation can shorten one’s patience. “Essentially, the capacity to manage errors and mistakes, as well as responsibilities at the managerial level, becomes reduced. Many women tell me that they feel like they are losing control frequently, and this experience is something we all encounter at some point.”

Finding the right work-life balance during this time is crucial, says Dr. Nina Mansukhani, obstetrician and gynaecologist
Start with lifestyle changes such as diet, exercise, and building small, consistent routines.
Seek support through therapy, whether with a life coach or a cognitive behavioural therapist
Take short holidays, or attend healing courses for some much-needed relief
If menopause symptoms significantly strain daily life, menopause hormone therapy (MHT) might be recommended. When carefully selected and used for a short period (under medical supervision), MHT is extremely safe and can dramatically improve relationships, work dynamics, and overall quality of life.

Taboos persist

Menopause discussions are now gaining traction in workplaces globally. Across the U.S., U.K., and Europe, legislative discussions, policy proposals, and corporate initiatives are addressing the issue. In India, a few forward-thinking companies are taking action.

Standard Chartered Bank is one of them. They partnered with the Financial Services Skills Commission in the U.K. five years ago to understand the impact of menopause on career and talent retention. “Learnings from this have been applied across countries, including India,” says Shivshanker S.V., India and South Asia Head of Human Resources at Standard Chartered Bank. 

A signatory to the ‘Wellbeing of Women’s Menopause Workplace Pledge’ and a member of the ‘Menopause Friendly Employer’ organisation, the bank provides counselling and full medical coverage for menopause-related consultations for employees and their partners.

“We take a data-led approach to better understand the challenges. Specific initiatives include wellness resources, flexible work arrangements, awareness sessions with gynaecologists, manager training, and a closed-group ‘Lean-In Circle’ for open conversations,” says Shivshanker.

Shanti Kurupati, Director of Product Development at Intuit

Shanti Kurupati, Director of Product Development at Intuit

Bengaluru-based Shanti Kurupati, Director of Product Development at Intuit, a global software company, thinks the key is in building inclusive environments that enable fearless sharing. At Intuit, this is done through internal communities such as Tech Women at Intuit (TWI) that create safe spaces for discussing sensitive topics such as menopause. Talks with specialists further help normalise conversations, says Kurupati.

Intuit’s ‘Well-being for Life programme’ provides ₹60,000 annually for physical or mental wellness. Employees can access Maven, a 24/7 digital health platform offering menopause support. It’s anonymous and extends to employees’ dependants, too. 

But many women still feel uncomfortable and fear ageism may rear its head. Shuja, 49, works in a Pune-based boutique travel firm, and often accompanies clients on day trips near the city. “My gut health has suffered, I urinate frequently and I’m finding it tough to be out the whole day.” But she would rather endure the discomfort than speak to her boss, fearing reduced responsibilities. “They’ll start viewing me as an old lady,” she laughs. 

Kurupati acknowledges this fear of losing out, across a woman’s life phases — from childbirth to menopause. She thinks sharing experiences resonates with people and ally-ship between women is important. “Intuit’s initiatives aren’t just policies — they are born from the lived experiences of senior women who’ve gone through these life transitions.”

Stage of change
Perimenopause is the phase where periods haven’t completely stopped, but hormonal changes have begun. It typically lasts two to four years before menopause — marked by 12 consecutive months without a period. During perimenopause, oestrogen levels gradually decline, causing hot flashes — sudden spells of intense heat in the face, neck, and upper body — as the brain’s temperature regulation gets affected. Irregular periods and a slowing metabolism are other early signs of approaching menopause, says Dr. Nina Mansukhani.

A recent Women In Cloud survey (Feb-March 2025) of more than 1,000 respondents found that over 60% of women experience cognitive, mood, and stress management challenges — yet few receive targeted care. Only 25% of those seeking medical help for hormonal or stress-related concerns received an accurate diagnosis and treatment, largely due to gaps in healthcare system preparedness. Vedullapalli sees this as a call to action.

“If we want to empower women as innovators, executives, and changemakers, we must address the full ecosystem of support — skills development, economic access, health, and wellness readiness,” she says.

Armed with information

When she first started reading about menopause, Mathur asked her mother when she had gone through it. Her mum’s reply — “maybe at 45, maybe 55” — made her realise how little the older generation understood or catalogued it. When she probed further, her mother admitted not fully understanding what she was going through. “Nobody was sensitive enough to notice how women of her generation felt.”

Even today, Vedullapalli points out, awareness and sensitivity around women’s health challenges is lacking. Early on, many healthcare providers dismissed her symptoms, advising more exercise or stress management without addressing the underlying hormonal shifts. Some even suggested her challenges were psychological rather than physiological.

After finally receiving a clear diagnosis, Vedullapalli took a proactive approach: embracing a holistic lifestyle that included hormone therapy, inflammation-reducing supplements, metabolic and hormonal tracking, and prioritising restorative habits. “I’m fanatic about my eight hours of sleep,” she says.

Women’s health is so under-served, Ray notes. “From the research to finding the best informed doctors, it’s a journey.” It’s probably the reason women are coming together to create platforms, groups and resources that demystify menopause.

Menopause coach Juilee Dandekar 

Menopause coach Juilee Dandekar 

When Juilee Dandekar entered surgical menopause at the age of 37 after battling endometriosis, she felt information could be her rescue. Her Instagram page @livefearlessofficial documents her surgical menopause journey and is a platform to share experiences and insights. “Not too many people talk about menopause, and at 37, it was overwhelming,” says Dandekar, India director for strategy and business development with a leading healthcare company. She got certified by the British Menopause School in 2021 to become a menopause coach. Dandekar believes “education is the first step” and at the moment, offers free support.

The Chennai Menopause Society (CMS) conducts public awareness sessions to help women understand menopausal symptoms and advise them on simple measures. Even incorporating a few menopause-changes at the workplace can be useful, says urogynaecologist A. Tamilselvi, member and former secretary of CMS. “Organising annual health check-ups with a gynaecologist consult is one. Employees should also be able to discuss their health issues, including mental health, without the fear of being labelled, losing their jobs or being passed up for promotions,” she says.

Urogynaecologist A. Tamilselvi, member and former secretary of Chennai Menopause Society

Urogynaecologist A. Tamilselvi, member and former secretary of Chennai Menopause Society

Struggling to find the right information around her symptoms, Mathur, now a certified women’s health coach from the National Board of Health and Wellness Coaches, took a one-and-a-half-year course in the U.S. to find credible information that could help her and other women figure out their bodies. Equipped with knowledge and certification, she is now curating a platform of resources for women over 45. She’s writing a book, planning a podcast, and even working on a documentary, aiming to connect more women to credible resources around fitness, nutrition, hormone therapy and emotional well-being.

“Ours is the first generation of women that is asking questions, refusing to suffer endlessly without solutions behind hushed or subdued narratives around women’s health and midlife,” she says.

Instead, it’s a generation determined to change the narrative — by talking, supporting each other, and refusing to stay invisible. At home and more importantly, at work.

The writer is a freelance journalist and the co-author of ‘Rethink Ageing’.



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