Why The Five & One?
Because women make up 51% of the population, yet still get treated like a special interest group. This newsletter flips that script. Each issue gives you 5 smart takeaways from the world of research, policy, health, wellness, and trends +1 bonus topic just for you.
You’re receiving this because you’re part of our community — as a 51& member or a Five & One subscriber. Every other week, you’ll get news, policy updates, and actions that put your voice at the center of changing women’s health. Once a month, Members receive exclusive deep dives into policy, practical health guides, and resources to help you take action.
We’re building a member-driven network to rebuild the foundation of women’s health.
Not a member yet? Want to know more? Now’s the time to join us. We still have lifetime memberships available.
We’re always learning about the women’s health system, even after decades of working in it. If we miss something or misspeak below, please reply and let us know so we can correct it in our next issue.
01. More Menopause Relief is on the Way
Menopause affects all women, and symptoms like hot flashes, night sweats and sleep disruption have major quality-of-life and health-risk implications. Hot flashes aren’t just a brief annoyance, and they affect more than just comfort. They impact sleep, mood, work productivity, and overall quality of life.
Yet treatment options have been lacking or under-used. The recent approval of Elinzanetant (brand name Lynkuet) offers an example of what’s possible, and shines another light on how much the system has been failing women.
The Breakdown:
Many women do not receive care: one study found that approximately 75% of women did not seek medical advice for menopausal symptoms; about 50% delayed for more than six months. Lippincott Journals+1
Few OB-GYNs or residents feel adequately prepared to manage menopause; many symptoms are poorly documented in primary care. Axios+1
The consequence: Women’s midlife health is rarely considered a core part of care, resulting in quality-of-life loss and possibly increased risk of comorbidities.
The Breakthrough:
If you’re in the midlife range, track symptoms (hot flashes, nightsweats, mood/sleep changes) and bring them up with your clinician.
Ask your provider about new treatment options (such as Lynkuet) and whether you might be a good candidate for this or other options.
Share information with women peers: normalization of menopause care helps break the stigma.
02. Pain Relievers in Pregnancy - What you Should Know
Pregnancy is one of the most vulnerable windows in women’s health. The recent acetaminophen (brand name Tylenol) debate shows how evidence, communication, and regulatory clarity can create confusion instead of clarity. Let’s unpack this.
After Secretary Robert F. Kennedy Jr. previously linked the use of Tylenol to neurological conditions in children when taken during pregnancy, he recently confirmed there is insufficient data to support those claims.
The Breakdown:
In September 2025, the U.S. Food and Drug Administration (FDA) initiated label-change process for acetaminophen during pregnancy, citing association (though no confirmed causality) with neurological conditions such as autism/ADHD.
Major medical professional groups still caution that acetaminophen remains the safest OTC option in pregnancy for pain and fever - and lowering fever quickly matters in pregnancy. and the science is inconclusive. PBS+1
The regulatory and communication systems have been reactive rather than proactive; clearer guidance sooner could improve maternal decision-making vs sending mixed messages.
The Breakthrough:
Women’s health stakeholders should push for clearer, accessible communication about what to consider when taking medication in pregnancy.
Label-changes and risk-communications for medications taken during pregnancy should be grounded in evidence, and coordinated with obstetric professional societies and patient advocacy groups for better clarity.
If you’re pregnant or planning pregnancy, discuss acetaminophen use (and alternatives) with your clinician: when it's needed, how long, what dose.
Source: USA Today
03. Walmart Makes Big Food Moves
What we eat has a big impact on women’s health across the lifespan—from fertility to menopause to chronic disease risk. When a major retailer like Walmart Inc. commits to removing synthetic dyes and 30+ additives from its store-brand foods, it signals that food supply chains and ingredient transparency are of increasing importance to their consumers. Given that women often serve as gate-keepers for family food choices, ingredient safety in foods obviously has broader implications for the entire family. Here’s how we’re looking at this step and what it means for women’s health.
The Breakdown:
A 2024 review observed that certain food dyes (e.g., Red 3, Tartrazine) have shown endocrine-disrupting effects in animal studies. PubMed Central
There is very little direct research studying how synthetic food dyes affect women (distinct from children) or how they impact specific life-stages (pregnancy, menopause, etc).
Causal links between synthetic dyes and major women’s health outcomes (e.g., fertility, hormonal disorders, menopause symptoms, cardiovascular risk in women) are not well established.
The Breakthrough:
Women’s bodies go through different phases (menstrual cycles, pregnancy, menopause) where hormonal dynamics may interact differently with chemical exposures like dyes or additives. If studies don’t consider sex differences these risks won’t be understood.
Research on processed foods notes that synthetic dyes often come packaged inside wider “ultra-processed foods” environment (high sugar, low nutrients) which themselves are linked to poorer health outcomes (metabolic, cardiovascular). MD Anderson Cancer Center+1.
Focus on reducing ultra-processed food intake (dyes often accompany high sugar/salt/low-nutrient foods) which has broader benefits for women’s health.
04. Technology, Data and Diabetes care in Women
Diabetes is a major chronic condition with serious implications for women’s health (including during pregnancy, menopause, and aging). Systems failures in research and care for women with diabetes mean that solutions may not fit their needs.
The partnership between the Tidepool Project and Oura Ring is a promising case of how research partnership and innovation can close gaps: they’re creating a large dataset combining wearables and diabetes device data, with an explicit focus on women. This announcement is timely - November is National Diabetes Awareness Month.
The Breakdown:
Diabetes research historically under-represents women’s physiology (hormonal cycles, menopause, etc.) and the ways these affect glucose and insulin management.
Many digital health tools are designed around male or “general” physiology and may not account for women's cyclical hormonal changes.
The Tidepool-Oura collaboration specifically says: “For too long, diabetes research has overlooked critical physiological factors that impact health, especially for women.” Business Wire+1
Without better data, therapeutic algorithms and management, pathways will continue to under-serve women.
The Breakthrough:
This new dataset (from wearables + CGMs + insulin pumps + menstrual tracking data) will potentially unlock sex-specific patterns in diabetes management
This could lead to new care platforms and tools for diabetes management for women.
If you are a woman living with diabetes or pre-diabetes, ask your clinician about potentially integrating wearable data (sleep, cycle, activity) into your diabetes tracking.
Source: Business Wire+1
05. When Efficiency Hurts Care
CMS has finalized a policy that will cut physician payments by reducing work Relative Value Units (RVUs, which are how the system puts a price tag on medical care ) by 2.5% starting in 2026, with additional reductions every three years. But when the math behind those adjustments doesn’t reflect the complexity of women’s care, efficiency quietly becomes inequity. The result? Fewer minutes per patient, shrinking access to prenatal and preventive care, and fewer clinicians choosing fields like OB-GYN, endocrinology, or primary care — exactly where women need them most.
The Breakdown:
The efficiency formula assumes shorter visits and lower costs mean better care. But women’s health visits often take longer, and for good reason. They involve counseling, coordination, and prevention that don’t show up as quick cost savings.
OB-GYNs and primary care clinicians already face thinner margins than many high-procedure fields. A 2.5% cut, followed by repeated reductions, will hit these providers hardest.
Lower reimbursement can force practices to shorten visits, limit new patients, or stop taking Medicaid and Medicare altogether — all of which reduce access for women who already face barriers to care.
When OB-GYNs are underpaid, fewer medical students choose the specialty. The workforce shortage deepens, and women wait longer for basic appointments. We’re already seeing maternal health care deserts emerge in rural areas.
The Breakthrough
If you’re a clinician: Track how the cuts affect visit time, staffing, and patient volume — data will be critical in advocacy efforts.
If you’re a policymaker: Ask CMS to publish sex- and specialty-specific impact analyses before implementing further RVU reductions.
If you’re a patient: When you experience shorter visits or reduced access, share your story. Policymakers need to hear that “efficiency” shouldn’t come at the expense of women’s health.
If you’re an advocate: Support legislation that ties payment reform to equity and outcomes, not just cost-cutting.
Your +1: Our Next Members Event: Designing the Hormone-Literate Future
Join 51& founder Jodi Neuhauser, and CEO of Oova, Aparna (Amy) Divaraniya, PhD, and one of Oova's top physicians, Dr. Mary Parman, DO, FACOG, MSCP (OB/GYN, Stanford) , for a members-only conversation redefining hormone health as essential, preventive care.
This virtual Lunch & Learn explores what happens when we treat hormones as vital signs — essential measures of women’s health, not side notes. Together, we’ll unpack how real-time hormone data, emerging research, and clinical innovation are reshaping everything from fertility to perimenopause. Because women deserve a healthcare system built to understand our biology in motion, not only when it breaks.
November 12, 12PM ET
Members-only virtual event
51& members, check your emails for the registration link!