Documentary Series · Perimenopause · Women's Health
BALANCE: A Perimenopause Journey
Rosie is an Executive Producer of BALANCE, a documentary series about perimenopause and the misinformation that has surrounded women's hormonal health for two decades. She also appears on screen, sharing her own experience — alongside Alyssa Milano, Jeannie Mai and others.
Quick answerBALANCE: A Perimenopause Journey is a documentary series following two monks who discover their symptoms are caused by perimenopause, and who then confront the misinformation, gaps in medical education, and inequality that surround women's hormonal health. Rosie Acosta is an Executive Producer and appears in the cast, sharing her own perimenopause story. It is a four-part series, released in 2026, and you can watch it now on Apple TV, Amazon Prime Video, Plex and Vimeo.
The Series
What BALANCE Is About
Two monks discover that their sleeplessness, fatigue, anxiety and mood swings are caused by perimenopause. Looking for answers, they run into the same walls most women do: misinformation, thin medical education, and a system that has not taken the question seriously.
Much of the series turns on the 2002 Women's Health Initiative study — the research that shaped a generation of fear around hormone therapy, and whose findings have been widely re-examined since. The filmmakers bring in experts across disciplines to separate what the evidence actually shows from what has simply been repeated.
The two monks are also the filmmakers. Sadhvi Siddhali Shree directed BALANCE and Sadhvi Anubhuti co-directed it, and the series' executive producers include Alyssa Milano, Jeannie Mai and Rosie.
It is produced by Siddhayatan Tirth Productions, a 501(c)(3) non-profit.
Most women are not short on willpower. They are short on information nobody gave them.
Episodes
The Four Episodes
BALANCE is one season of four episodes.
- Ep. 1(Un)Balanced
Siddhali and Anubhuti learn that what they are going through is perimenopause and set out to get their hormonal balance back — and run straight into misinformation, uncertainty and conflicting advice.
- Ep. 2The Misinformation Crisis
The monks take on misinformation directly: one of the biggest obstacles to getting perimenopause and menopause treated at all.
- Ep. 3Losing the Self
Women describe the bias built into their care, including being called “crazy” for their symptoms, and the monks travel to the UK to find out whether it is a leader in menopause care.
- Ep. 4(Re)Balanced
The bias in medicine and in the public conversation about menopause has not gone away, but Siddhali, Anubhuti and their fellow patients begin to benefit from their new lives.
Cast
Who Is in BALANCE
The series follows its two directors, and sets their story alongside other women living through the same transition and more than twenty doctors, clinicians and advocates.
The stories
- Sadhvi Siddhali ShreeJain monk, author, activist and filmmaker; the first North American Jain female monk
- Sadhvi AnubhutiJain monk, spiritual teacher and filmmaker; co-creator of the series
- Alyssa MilanoActress, activist, producer and author
- Jeannie MaiTelevision host, producer and advocate, with her mother, Mama Mai
- Marcella HillPerimenopause advocate and author of Wake Her Up
- Camille RobinsonFounder of a nonprofit for families affected by autism and host of the Moments of Joy podcast
- Cindy FloresAdvocate raising awareness about medical dismissal
- Lilah McNealBegan having early perimenopause symptoms at 27
- Gabriela RojasFounder and CEO of Sin Reglas, Mexico's first FemTech company focused on menopause care
- Rosie AcostaWho shares her own perimenopause story, with her partner
The experts
- Mary Claire Haver, MDBoard-certified OB/GYN; author of The New Menopause
- Louise Newson, MDGP and menopause specialist; founder of the Newson Clinic
- Heather Hirsch, MDFounder of Health by Heather Hirsch; author of The Perimenopause Survival Guide
- Rachel Rubin, MDBoard-certified urologist and sexual medicine specialist
- Vonda Wright, MDDouble-board-certified orthopedic sports surgeon; author of Unbreakable. Also a guest on Rosie's podcast.
- Sharon Malone, MDChief Medical Advisor at Alloy Women's Health; author of Grown Woman Talk
- Kristi Funk, MDBoard-certified breast surgeon; founder of Pink Lotus Foundation
- Corinne Menn, DOBoard-certified OB/GYN; menopause and breast cancer survivorship specialist
- Lauren Streicher, MDBoard-certified OB/GYN and certified menopause practitioner
- Suzanne Gilberg-Lenz, MDFounder of The Menopause Bootcamp; Chief Clinical Officer at Monarch
- Jessica Shepherd, MDBoard-certified OB/GYN; founder and CEO of Sanctum Med + Wellness. Also a guest on Rosie's podcast.
- Michelle Sands, NDLicensed naturopathic doctor; co-founder of GLOW Natural Wellness
- Sameena Rahman, MDBoard-certified OB/GYN; faculty at Northwestern University Feinberg School of Medicine
- Neal Barnard, MDPhysician and clinical researcher; founder of the Physicians Committee for Responsible Medicine
- Julie Brush, NDNaturopathic doctor in integrative mental health and women's health at Amen Clinics
- Judith Joseph, MDBoard-certified psychiatrist; Clinical Assistant Professor at NYU Grossman School of Medicine
- Dina Peralta, MDPediatrician and obesity medicine specialist
- Bryce Gates, DDSDentist; founder of Custom Dental of McKinney and Custom Dental of Bonham
- Jason Muscari, FNPNurse practitioner in aesthetics and hormone replacement therapy
- Stephanie Collins, RNNurse and patient advocate; founder of Eido Bio
- Kate MuirJournalist, campaigner and documentary filmmaker
- Sarah Gibson, MPASPhysician assistant; founder of Vitality Health Matrix
- Jeff Barstad, MDFamily medicine physician; founder of BeauxMD
- Jaclyn Piasta, DNPFounder and lead practitioner at Monarch Health
The full cast and their biographies are on the official BALANCE site.
The Research
The Study at the Heart of It
In July 2002, the Women's Health Initiative published the first results of its trial of combined hormone therapy. It had enrolled 16,608 postmenopausal women aged 50 to 79 and was planned to run for eight and a half years. It was stopped early, after an average of 5.2 years, because invasive breast cancers in the hormone group had crossed a safety threshold set in advance, and the authors concluded that for this estrogen-plus-progestin combination the overall health risks outweighed the benefits.1
Practice changed almost overnight. In the first half of 2003, compared with the first half of 2002, prescriptions for Prempro, the combination studied in the trial, fell by 66%, and prescriptions for estrogen-only Premarin fell by 33%.2 In the early 2000s, boxed warnings about cardiovascular disease, breast cancer and probable dementia were added to hormone therapy labels, and they stayed there for more than twenty years.3
The findings have been re-examined many times since. The women in the trial were, on average, 63, and took a formulation no longer in common use.3 An 18-year follow-up of the same trials found that hormone therapy was not associated with a higher risk of death from any cause, from cardiovascular disease or from cancer.4 In 2022, the North American Menopause Society concluded that for women under 60, or within ten years of menopause, with no contraindications, the benefits outweigh the risks for treating bothersome hot flashes and night sweats and for preventing bone loss.5
In November 2025, the FDA began removing the boxed warnings about cardiovascular disease, breast cancer and probable dementia from menopausal hormone therapy labels; the warning about endometrial cancer remains for systemic estrogen-only products.3 The first six updated labels were approved in February 2026.6
None of this is a recommendation for or against any treatment. It is the history BALANCE puts on screen, and part of why a conversation with a doctor about perimenopause can sound very different now from the one many women had ten years ago. What is right for you is a question for your own clinician.
Sources (6)
- Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA. 2002;288(3):321–333. PubMed
- Hersh AL, Stefanick ML, Stafford RS. National use of postmenopausal hormone therapy: annual trends and response to recent evidence. JAMA. 2004;291(1):47–53. PubMed
- U.S. Food and Drug Administration. HHS Advances Women's Health, Removes Misleading FDA Warnings on Hormone Replacement Therapy. November 10, 2025. FDA
- Manson JE, et al. Menopausal hormone therapy and long-term all-cause and cause-specific mortality: the Women's Health Initiative randomized trials. JAMA. 2017;318(10):927–938. PubMed
- The 2022 Hormone Therapy Position Statement of The North American Menopause Society Advisory Panel. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022;29(7):767–794. PubMed
- U.S. Food and Drug Administration. FDA Approves Labeling Changes to Menopausal Hormone Therapy Products. February 12, 2026. FDA
Rosie's Part
Executive Producer — and On Camera
Rosie is an Executive Producer of BALANCE, and she also appears in it as herself — talking about her own perimenopause, the symptoms that arrived earlier than expected, the rage nobody warned her about, and the long stretch of not knowing what was happening to her body.
Her partner appears as well, offering the view from the other side of it. That perspective is rare on film and it matters: perimenopause happens inside relationships, not in isolation.
She took it on for a straightforward reason. Most of what she now teaches came out of a period when she could not find a clear answer anywhere, and a series like this reaches people who would never book a coaching call.
Coverage
BALANCE in the News
The series has drawn national coverage, with attention from outlets including:
- People
- NBC
- CBS
- Variety
Where to Watch
Watch the Series
BALANCE is an on-demand title. On Apple TV and Amazon Prime Video it is a one-time rental or purchase rather than part of a subscription, and what you can use depends on where you live:
- Apple TV — US, UK, Canada and Australia. In the Apple TV app, look in the Store tab rather than Watch Now.
- Amazon Prime Video — US and UK.
- Plex — free to stream.
- Vimeo On Demand — for every other country.
- Also on Kanopy, Fandango at Home and Relay.
Groups can also host a community, theater or virtual screening. Full viewing options and screening details are on the official site.
Where to WatchVisit the Official Site
If the series raised questions for you
That is usually the point at which people start looking for help. Rosie works with women navigating perimenopause — anxiety, sleep, rage, brain fog, and the parts nobody prepared them for.
FAQ
Questions About BALANCE
Is BALANCE a documentary or a series?
Both. BALANCE is a documentary series — one season of four episodes — rather than a single film.
How many episodes are there?
Four: (Un)Balanced, The Misinformation Crisis, Losing the Self, and (Re)Balanced.
Where can I watch BALANCE?
On Apple TV in the US, UK, Canada and Australia, on Amazon Prime Video in the US and UK, free on Plex, and on Vimeo On Demand everywhere else. On Apple TV and Prime Video it is a one-time rental or purchase. The official site lists every option.
Who is in BALANCE?
The series follows Sadhvi Siddhali Shree and Sadhvi Anubhuti. It also features Alyssa Milano, Jeannie Mai, Marcella Hill, Camille Robinson and Rosie Acosta, along with more than twenty experts, including Dr. Mary Claire Haver, Dr. Louise Newson, Dr. Sharon Malone and Dr. Lauren Streicher.
Who made BALANCE?
It was directed by Sadhvi Siddhali Shree and co-directed by Sadhvi Anubhuti, and produced by Siddhayatan Tirth Productions, a 501(c)(3) non-profit. Its executive producers include Alyssa Milano, Jeannie Mai and Rosie Acosta.
What is Rosie Acosta's role in BALANCE?
She is an Executive Producer of the series, and she appears on camera talking about her own perimenopause.
Is BALANCE medical advice?
No. The filmmakers describe the series as educational and not a substitute for professional medical advice, and the same is true of this page. Questions about treatment belong with your own clinician.
If the Series Put Words to Something You Are Living
Practices help. Sometimes they are not enough on their own, and there is nothing wrong with wanting someone alongside you for this part.
Rosie works privately with women navigating the symptoms BALANCE documents — anxiety, anger, sleep loss and the wider disorientation of midlife. It is not medical care and it is not therapy — it is practical support for the emotional side of a physical transition, from someone who has spent two decades doing this work.