AI, Algorithms and Healthcare Inequality for Perimenopause and Menopause

By Jennifer Upton

Recently we here at mySysters had a social media post for a blog article flagged by Meta’s Facebook app as being “adult content.”

The article in question explored the causes of increased inclination towards intimacy, which sometimes occurs in women during perimenopause and menopause, but is rarely discussed.

Notice the words I used there in the last sentence.

In the flagged article, I used a word that begins with “L” and rhymes with torpedo.

Meta doesn’t like the “L” word. Libido.

There, I said it.

It’s a real thing that exists for older people as much as younger folks.

It’s not a morality issues, it’s a healthcare issue.


The algorithms controlling what content is flagged are suffused with gender bias.

Older men currently enjoy the freedom to read ads for the little blue pill all over social media while women see no ads for gels or lubricants despite ads running for them on American television during the Superbowl.

In January of 2022, the non-profit organization Center for Intimacy Justice published a report describing Facebook’s censorship of sexual health and wellness ads for women and people of diverse genders.

This included ads for lubricants and lotions that included the words “vaginal dryness.”

Over one year later and there has been relatively zero progress.


Let’s take a look at Meta’s current Ad policies.

Facebook Ads can’t:

  • Promote products or services that focus on sexual pleasure or enhancement, such as sex toys or sexual enhancement products
  • Contain content that focuses on sexual pleasure or enhancement

Facebook Ads can: Promote sexual and reproductive health or wellness, as long as the focus is on health and not sexual pleasure or enhancement, and they target people aged 18 or older.

This includes ads for:

  • Birth control products, including condoms
  • Family planning
  • Products addressing the effects of menopause
  • Erectile dysfunction products
  • Pain relief during sex
  • Prevention of premature ejaculation
  • Reproductive health products or services
  • Promote sex education, as long as there’s no sexualised or suggestive content and the focus is on health and not sexual pleasure or enhancement


Being that lubricants and lotions fall under the category of both “pain relief during sex” and “sexual pleasure or enhancement,” they get an automatic ban.

Simultaneously, products that prolong sex for men are allowed.

The point of having sex for longer periods of time is that it feels good.

The policy’s bias towards men shows not only a fundamental lack of understanding of female biology in all its phases, but also assumes that health and sexual pleasure are two separate aspects of human sexuality when studies show they are not.

Since 2006, The World Health Organization’s definition is:

“Sexual health is a state of physical, emotional, mental and social well-being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.”

In other words, Meta’s policies regarding “adult content” violate the concepts of fairness and equality regarding sexual health for women.


The effects of these policies are wide-ranging and harmful.

According to CIJ CEO Janet Rotman, “Facebook is the single biggest driver of business.”

The fact that these policies are not implemented with any consistency makes the situation all the more detestable.

The policies change almost weekly and several companies complained to the CIJ that their ads were banned while their direct competitors were not.

In 2015, Facebook was called out for allowing ads for condoms, lubricants and massagers while banning ads for pelvic floor strengtheners, device which can improve issues such as Stress Urinary Incontinence, cramps and pelvic pain.


With people relying more on their computers and phones to guide them to products and services, it is more important than ever to make sure the content we see is not biased.

In particular, women in rural areas with no or limited access to pharmacies rely more on the internet for ordering sexual health products.

If ads for products are blocked, there will be less awareness of the variety of products available in the marketplace.

This will lead to more people living with painful or annoying symptoms that might easily be controlled.

The mySysters’ Facebook post was eventually approved.

After dealing with these algorithms for so many years we’ve learned one hack to getting approved on the second round—put a man or men in the photo and leave out women altogether.

In other words, to reach women in menopause we have to convince Facebook’s AI we’re a product for men.

The flip side is that Facebook’s AI then placed our post about menopause and libido, with a photo of an attractive man asking ‘Is that a hot flash or are you just happy to see me?’, in men’s news feeds.


The CIJ found that of the 60 health businesses (all in the small to mid-sized range) studied that serve women’s health and health for people of diverse genders, all (100%) had experienced Facebook rejecting an advertisement.

Many eventually had their accounts banned outright, severely limiting their audience and potential profits.

According to research by Simply Business, women only run 29% of small businesses in the UK, and this number drops to 4% in the trades.

However, the independent Rose Report commissioned by HM Treasury found women owned and women led businesses provide a total of 23.85% of private sector employment.

It also found women owned and women led businesses contribute a total of £221bn Gross Value Added (GVA) to the UK economy, representing 13.3% of GVA, and supporting women entrepreneurs could add £250 billion ($326.4 billion) to the UK’s economy.

With numbers like those, we don’t need anyone, whether they be human or robot, blocking the path to prosperity.


Tech, AI and bots only execute the rules put in place by humans, so the solutions to the problem of bias lies within humans.

Social media companies should hire more female developers.

If there aren’t enough, then programs should be put in place in schools to encourage girls and young women to study web and tech at university level.

The argument that girls aren’t interested in STEM will find no traction here.

mySysters’ founder CM Carr is the parent of two daughters. The oldest has a degree in computer science and studio arts.

The youngest is finishing a degree in computer engineering at a large university. Almost half of the students in her CE program are women.

The data sets companies work with need to include women.

Social media companies should hire older female consultants when shaping their ad policies.

Businesses should present cost-benefit analyses to the tech and social media platforms to show them how much money they are losing by banning ads targeted at women over 40.

mySysters’ founder Carr was amused but not surprised when a tech investor confidently told her ‘women over 50 don’t use tech.’

He was slack-jawed when she replied she was 50 when she launched the beta version of the app and not only owned several computers but knew how to use them.

Governments should provide funding for menopause-focused and female-healthcare-focused startups.

Greater transparency on behalf of social media companies for how the algorithms work.

Show us the code so we can fix it!


Most importantly, women must not stop talking about this issue!

Post, comment and share!

Talk about it with your friend who works for the local media.

Tweet your local representative.

It’s how we won voting rights, economic rights and educational rights and it’s how we’ll make progress in this arena.

Over the past 15 years, we’ve all seen how AI and social media can be a force for equality as well as oppression.

It’s how we, the people, wield it that determines the future of healthcare equality.

mySysters is an app for women in perimenopause and menopause. Good Housekeeping and Woman’s Day named mySysters the Best App for Women in Perimenopause and a Must Have App for Women.

The information and other content provided in this blog, website or in any linked materials are not intended and should not be considered, or used as a substitute for, medical advice, diagnosis or treatment.

Jennifer Upton is an American (non-werewolf) writer/editor in London. She currently works as a freelance ghostwriter of personal memoirs and writes for several blogs on topics as diverse as film history, punk rock, women’s issues, and international politics. For links to her work, please visit or send her a Tweet @Jennxldn