Two Awareness Months, One Big Conversation
October carries two awareness campaigns that rarely get discussed together: Breast Cancer Awareness Month and World Menopause Awareness Month. For many women they meet in the same exam room. Screening decisions and hormone therapy decisions often land on the same calendar, and the policies behind both decide whether care is within reach.
Breast Cancer: Getting to the Finish Line
The screening guidance is clear. The US Preventive Services Task Force now recommends mammograms every two years for women ages 40 to 74.1 But a screening test is only the first step. When a mammogram turns up something unclear, a woman needs follow-up imaging, and that is where cost has too often stopped people. A surprise bill can be enough to keep someone from coming back.
Menopause: From the Shadows to the Senate
Menopause policy moved quickly this year. In February, the FDA approved label changes that removed cardiovascular disease, breast cancer, and probable dementia language from the boxed warnings on six hormone therapy products.2 The agency did not call hormone therapy risk-free. Systemic estrogen alone still carries a boxed warning for endometrial cancer in women with a uterus, and risks still vary with age, timing, and formulation.3
On September 16, the Senate Special Committee on Aging held the first congressional hearing devoted to menopause.3 Senators Kirsten Gillibrand and Rick Scott then asked the Government Accountability Office to review how federal agencies fund and coordinate menopause research and care. Separately, the Advancing Menopause Care and Mid-Life Women's Health Act has been reintroduced. It would authorize $275 million over five years for research, clinician training, and public education.3 For context, NIH estimated its fiscal year 2025 menopause research spending at $78 million, compared with $314 million for prostate cancer.3 Awareness is growing, and the funding is still catching up.
Virginia Spotlight
Virginia has done something concrete. Under HB 1828 and SB 1436, signed in 2025, state-regulated health plans may no longer charge copays, coinsurance, or deductibles for diagnostic and supplemental breast exams, including diagnostic mammograms, ultrasounds, and MRIs. The law took effect January 1, 2026.4,5
Here is what that means in practice:
Diagnostic imaging is follow-up after something is seen or suspected. Supplemental imaging is for women at higher risk when nothing abnormal has been found.4,5
The law covers fully insured, state-regulated plans. Medicare, Medicaid, and self-insured employer plans fall outside it.6
In August 2026, the Virginia Bureau of Insurance clarified that the protection also reaches breast biopsies done as part of diagnostic follow-up after an abnormality is found.7 Earlier guidance had said biopsies were not included, so this is a meaningful update.
If you or someone you love has a plan through work, it is worth asking whether it is fully insured, because that decides whether the law applies.
What You Can Do This Month
Check your screening schedule and ask your insurer whether your plan falls under Virginia's law. If you are in midlife, bring up menopause symptoms at your next visit rather than waiting for a crisis. And if you are moved to, tell your representatives that research and clinician training on menopause deserve real investment.
References
1. US Preventive Services Task Force. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918-1930. doi:10.1001/jama.2024.5534
2. FDA approves labeling changes to menopausal hormone therapy products. News release. US Food and Drug Administration. February 12, 2026. Accessed September 30, 2026. https://www.fda.gov/news-events/press-announcements/fda-approves-labeling-changes-menopausal-hormone-therapy-products
3. Rahmanan A. Menopause just went mainstream. Newsweek. September 17, 2026. Accessed September 30, 2026. https://www.newsweek.com/congress-menopause-hearing-research-hormone-therapy-12456058
4. VA SB 1436: health insurance; cost sharing for breast examinations. 2025 Regular Session. BillTrack50. Accessed September 30, 2026. https://www.billtrack50.com/billdetail/1792894
5. Six months after Virginia's new breast imaging law: what patients should know. Virginia Breast Cancer Foundation. July 9, 2026. Accessed September 30, 2026. https://www.vbcf.org/six-months-after-virginias-new-breast-imaging-law-what-patients-should-know/
6. New Virginia law eliminates out-of-pocket cost for breast cancer imaging. Virginia Breast Cancer Foundation. Accessed September 30, 2026. https://www.vbcf.org/imaging-law/
7. New guidance clarifies Virginia's breast imaging law, including coverage for biopsies. Virginia Breast Cancer Foundation. August 27, 2026. Accessed September 30, 2026. https://www.vbcf.org/new-guidance-clarifies-virginias-breast-imaging-law-including-coverage-for-biopsies/
Comments