At 53, Alyssa Milano Feels More Empowered Than Ever

Milano believes the study of perimenopause and menopause has historically received inadequate resources, though that tide is starting to turn. “The silence around this stage of life hasn’t been accidental — it’s been structural,” she says. “This is not a transition we need to ask women to handle privately when it affects half of the population and lasts nearly a decade.”

That sentiment is echoed by Dr. Heather Hirsch, an internal medicine doctor featured in Balance who practices consultative menopause at Boston’s Brigham and Women’s Hospital and is on the faculty at Harvard Medical School.

“The norm for so long has been to treat women like men, but women are entirely different physiologic creatures. Men have steady sex hormones every day of their lives,” Hirsch says. “Our physiology is so unique, and that’s never been honored.”

Another of the film’s experts, Dr. Jessica Shepherd, a board-certified ob-gyn and founder and CEO of Sanctum Med + Wellness, agrees with the idea of offering women both education and help. In Balance, she says, “This is the perfect time to get people the tools so the transition is easier and more pleasant.”

Eager for a new normal

Milano says we live in a culture that’s obsessed with youth, so rather than seeking to help women achieve their best mental and physical health, the focus can be misplaced. “I think a lot of menopause content asks how we get [women] back to normal. What if thinking ‘normal’ was part of the problem?” she wonders. “I don’t want to be restored to who I was. I want to continue to explore this person that I am now.”

Milano didn’t know much about perimenopause when it started to impact her. “When I look at those lists of perimenopause symptoms now, I had every single one of them,” she says. Some of the most acute indications, including brain fog, hot flashes and insomnia, were present when she was just 41, after the birth of her daughter. Even though she had a capable and sympathetic doctor, she recalls being told such things as “You just had a baby; go for a hike, take a yoga class.” Her experience isn’t surprising: A survey sent to 145 OB-GYN residency program directors and published in 2023 found that most OB-GYN residency programs in the U.S. lacked a dedicated menopause curriculum.

Instead of being content with those inadequate answers, Milano kept pressing forward and sought out hormone replacement therapy (HRT). “A week after starting hormone replacement therapy, I felt like a whole new person,” she says. As the Balance docuseries explores through insights from more than 20 medical professionals, starting HRT during perimenopause (when hormones are falling) can have a positive impact on health conditions that tend to impact older women, such as osteoporosis-related fractures, cognitive issues and cardiovascular disease.

Dr. Mary Claire Haver, a board-certified ob-gyn and author of the bestselling book The New Menopause, says in the docuseries: “The longer your body is without hormones, the less healthy you are.” Haver also notes that lifestyle is a vital component of supporting perimenopausal and menopausal health, emphasizing a whole-foods-based diet with plenty of protein, micronutrients and fiber. Other doctors interviewed emphasized weight-bearing exercises and activity to support bone and muscle health, as well as sleep optimization and stress reduction.

Dr. Mary Claire Haver, author of the best-selling book “The New Menopause,” shares the science, solutions and hope for better menopause care.

Cesar Ramos Ortiz/BALANCE

As Milano reveals in Balance, she opted to take progesterone, estrogen and testosterone while under the care of a hormone specialist. “I feel hormonally balanced in a way I never did before,” she says, adding that there’s no one-size-fits-all approach. “This isn’t about something that needs to be ‘fixed.’ I think it’s about reshaping the narrative and really listening to women.”

Silver linings in this stage of life

The Balance documentary is informative, but most of all, it’s hopeful. Both filmmakers, through the course of the multiyear filmmaking process, began taking HRT and made significant lifestyle changes. Sadhvi Anubhuti, who was diagnosed with osteopenia (a lower-than-normal bone density that can be a precursor to osteoporosis), began prioritizing weight-bearing exercise. When she came to the 2024 Spartan Race to film Dr. Vonda Wright, an orthopedic surgeon and author of Unbreakable: A Woman’s Guide to Aging With Power, Anubhuti was inspired to join in, completing a physical challenge she never imagined possible. “I can’t believe I just did that whole race,” she said. Her feelings of euphoria and accomplishment are why Wright encourages women, including some she works with, to challenge themselves. “[It proves] midlife women are not done yet. We’ve always done hard things, and we still do hard things,” she says in the series.

For Milano, there have been many silver linings to this stage of life. For example, she was diagnosed with generalized anxiety disorder in her 20s but is happy to report, “I haven’t had a panic attack in years.” Plus, she says, “not worrying what other people think anymore is a huge bonus.” 

She’s also finding this season creatively fulfilling. In addition to raising her two children and hosting her podcast, Sorry, Not Sorry, she carves out time for herself. “After I did Chicago on Broadway, I rediscovered my love of dance. So a bunch of my mommy friends get together every Tuesday night to dance,” she says. “There’s a lot of resistance training in dance. There’s something so magical about coming together in community and moving your body.” 

While she can’t share details just yet, Milano has written a screenplay — something that wasn’t on her mid-life bingo card. “I’m not sure that I would’ve had the confidence to do that had I not gone through menopause and come into my power,” she says.

Milano encourages women to watch Balance with their friends and partners and to approach this season of their life with an open mind. “This isn’t failure. It’s a transition,” she says. “Don’t fear it. It’s coming for you regardless, so you might as well enjoy it.”