Menopause Care Varies by Provider, Highlighting Need for Standardized Education

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Provider type and specialty significantly impacted the receipt of prescription medication treatment among women seeking care for menopause, wrote investigators of research presented at The Menopause Society 2025 Annual Meeting. The inconsistencies demonstrated in these data indicate a need for standardized education on menopause care for all provider types and specialties to improve the quality of care.¹

Menopause represents a time of significant physiological and psychosocial transition with symptoms that affect up to 80% of women, according to the investigators. Menopausal hormone therapy has demonstrated its effectiveness when managing menopause-related symptoms; however, the investigators wrote that use has declined, with recent research showing MHT is utilized by about 3.8% of women aged 45 to 59 years in 2023.^1,2

For their retrospective cohort study, the investigators utilized clinical data derived from the electronic health record (EHR) of an academic health care system from Jan. 1, 2016, to Dec. 31, 2023, to describe provider-level factors associated with the receipt of pharmacologic management of menopause symptoms among women aged 40 to 55 years seeking care. Patients who had any outpatient encounter with family medicine

(FM), internal medicine (IM), endocrinology, and obstetrics/gynecology (OB/GYN) were identified by ICD-10 codes associated with the encounter, and prescriptions associated with the identified ICD-10 codes were extracted from the EHR. Descriptive statistics were used to summarize demographic and clinical characteristics, and multivariable logistic regression was used to evaluate the association of provider type and specialty with receipt of prescription treatment. Additionally, minimally sufficient variables for the association of prescription treatment were diabetes, hypertension, and insurance status for provider specialty, and insurance and provider specialty for provider type.¹

Clinical data from 5491 women with an outpatient encounter with a menopause-related ICD-10 code were extracted from the EHR and analyzed. Among this cohort, approximately 64.4% were seen by OB/GYNs, 17.6% by IMs, 12.4% by FMs, and 4.5% by endocrinologists. Of these, only 17.1% received treatment for menopausal symptoms, of whom 34% received systemic estrogen, 47% received vaginal estrogen, and 16% received selective serotonin reuptake inhibitors (SSRIs).^1,2

Patients were most likely to receive systemic estrogen if seen by an OB/GYN provider (p < .01) and less likely to be prescribed systemic estrogen by IM (OR 0.43 [95% CI 0.29–0.64]), FM (OR 0.50 [95% CI 0.33–0.76]), and endocrinology providers (OR 0.16 [95% CI 0.05–0.52]). Conversely, patients were more likely to receive SSRIs when seeing IM (OR 1.89 [95% CI 0.24–2.87]) and FM (OR 2.66 [95% CI 1.77–3.99]) relative to OB/GYN. Further, patients were more likely to receive systemic estrogen from midwives (OR 2.32 [95% CI 1.42–3.77]) and nurse practitioners (OR 1.88 [95% CI 1.43–2.48]) than from attending physicians. SSRIs were also more likely to be prescribed by physician assistants (OR 6.0 [95% CI 1.70–3.97]), nurse practitioners (OR 2.99 [95% CI 1.95–4.60]), and residents (OR 2.10 [95% CI 1.06–4.20]) than attending physicians.¹

“Menopause is finally gaining traction in mainstream media, which is rightfully empowering our patients who suffer from menopause symptoms to come to us for help. Unfortunately, menopause is a topic that is often only minimally covered during our training, with less than 10% of residents in internal medicine, family medicine, and [OB/GYN] feeling prepared to manage menopause after graduation. This lack of standardized or adequate training translates downstream into highly variable care for our patients. We need to do a better job preparing our providers with the evidence behind treatment options so our patients can get the care they need,” lead author Anna Caroline Cochrane, MD, from Wake Forest University School of Medicine in Winston-Salem, NC, said in a news release.²

The findings emphasized the importance of implementing standardized menopause education in all areas to ensure all providers are capable of treating patients seeking menopause-related care.^1,2 Pharmacists play a key role in menopause care by helping ensure safe, evidence-based medication use, counseling patients on treatment options such as hormone therapy and SSRIs, and supporting standardized education across providers to improve consistency and quality of care.

“Education in menopause management is lacking in most medical training programs, so it’s no surprise that clinicians may lack the skills needed to adequately care for women in the menopause transition,” Stephanie Faubion, MD, MBA, FACP, medical director for The Menopause Society, said in the news release. “That’s why easily accessible, evidence-based education is needed, including standardized training curricula and utilizing advanced educational technologies that will enable clinicians to develop and enhance their clinical skills. The Menopause Society is committed to providing menopause education to clinicians that will help improve the health of women everywhere.”²

REFERENCES

1. McAllister VM, O’Connell NS, Jensen ET, Cochrane AC. P-28 – Provider-Level Factors Related to Receiving Treatment for Menopause Symptoms. Presented at: The Menopause Society Annual Meeting; Orlando, Florida. October 21–25, 2025.

2. The Menopause Society. Likelihood of Being Prescribed Hormone Therapy May Depend on the Type of Provider Seen. News release. October 20, 2025. Accessed October 24, 2025. https://menopause.org/press-releases/likelihood-of-being-prescribed-hormone-therapy-may-depend-on-the-type-of-provider-seen