Health systems, lawmakers and primary care providers are answering a call coming from women to provide more menopause care.
Every year, 1.3 million American women reach menopause, which has an average onset age of 52. Most women experience perimenopause, a transition period that typically lasts four to eight years. This transition can trigger hot flashes and night sweats, vaginal and vulvar issues, painful sex, urinary tract infections, incontinence, mood changes and insomnia, among other symptoms.
However, less than one-fifth of women are correctly diagnosed early with menopause. Even when diagnosed correctly, many women are subjected to wasteful testing and care before getting appropriate treatment, a 2023 report from Elektra Health, a digital women’s health platform, found. Women with a clinical diagnosis of menopause incur about 45% more healthcare costs annually. Even for those who are correctly diagnosed, less than half of women ages 50-64 report that their healthcare provider educated them on what to expect during the menopause transition.
This can have adverse effects for working women and society. About 13% of women reported at least one adverse work event due to menopause symptoms, and nearly 11% reported missing work in the past year, according to a 2023 study published in Mayo Clinic Proceedings. Researchers estimated that the annual cost associated with lost work due to menopause symptoms is $1.8 billion. This figure did not include factors such as reduced hours of work, loss of employment or early retirement.
“My mom’s generation used to refer to menopause as ‘the change,’ and that was the end of the discussion,” Kristen Toth, vice president of women’s services at AdventHealth for Women, told Becker’s. “But it’s not just a change, it’s years of changes. Women are now speaking up, seeking help and refusing to suffer in silence. We’re working on a holistic program that supports them physically and emotionally through this time. We want them to feel strong, empowered and not alone.”
Systems, lawmakers step up
Health systems and lawmakers have taken notice of the increased demand for menopause and perimenopause services as more women become vocal about needing treatment and care options.
Thirteen states and many hospitals are starting to tackle the need for menopause care by better educating clinicians. Less than one-third of OB-GYN residency programs offer training in menopause. A 2019 Mayo Clinic study found 6.8% of obstetrics and gynecology, family medicine and internal medicine residents felt adequately prepared to manage menopause needs.
States are taking action by introducing bills that aim to improve menopause care and education. New Jersey and California are weighing legislation that would make menopause education part of physicians’ continuing education credits and licensing renewals. Other states, such as Arizona and Massachusetts, are eyeing efforts to provide more information on menopause to providers and patients. In Illinois and Louisiana, bills would mandate insurance coverage for some menopause treatments. California is considering two bills that would require a state agency to find and fill education gaps and mandate menopause coursework for physicians to renew their licenses if at least 25% of their patients are women younger than 65.
More clinicians are also taking it upon themselves to join societies and gain certifications in menopause care. The ranks of the Menopause Society have grown from 2,000 to nearly 12,000 in five years, according to the Association of American Medical Colleges. Currently, there are about 4,100 Menopause Society-certified menopause practitioners, up from about 1,000 a decade ago.
A growing number of academic medical centers and hospitals are launching dedicated centers for women’s midlife and menopause health. These include the Women’s Health Specialty Clinic at Mayo Clinic in Jacksonville, Fla.; the Center for Midlife Health and Menopause at NYU Langone Health in New York City; the UCLA Comprehensive Menopause Program in Los Angeles; the Women’s Wellness and Healthy Aging Program at multiple locations of Baltimore-based Johns Hopkins Medicine; and the Midlife Women’s Health and Menopause Program at the University of Utah Health in Salt Lake City.
This year, Orlando, Fla.-based AdventHealth for Women opened a dedicated program to meet the increased need for care during perimenopause and menopause. It has created a multidisciplinary model to address the needs of older women. This includes hormone therapy, care coordination and holistic care.
Winston-Salem, N.C.-based Novant Health has launched a virtual menopause clinic to ensure care is convenient, affordable and accessible.
Amazon’s primary care provider, One Medical, launched new appointments nationwide Sept. 25 for perimenopause and menopause. The visits connect patients with primary care providers in all regions where One Medical has offices.
Insurance companies also are expanding offerings for women experiencing menopause. Mass General Brigham Health Plan added programs to support pregnancy, child care and menopause. UnitedHealthcare, the nation’s largest insurer, recommends employers offer benefits to support women throughout life, including peri- through post-menopause. In 2024, SCAN Health Plan launched a Medicare Advantage plan designed specifically for women, including estrogen therapy without a copay and enhanced over-the-counter benefits for women’s health and wellness products. According to Mercer data, 46% of employers offer at least one health benefit specifically for women in 2024, up from 37% in 2023.
“It’s been so exciting and enlightening to see these conversations happening. Menopause, pelvic health support — these are conversations that were not happening 10 years ago,” Lisa Scarfo, MD, senior medical director at Mass General Brigham Health Plan, told Becker’s.
Exploring menopause treatments
With increased education and programs come better treatment options. Many systems are working to provide more hormonal treatment for menopause. Generally, this treatment is appropriate for women younger than60 or within 10 years of menopause and can lower risk of heart disease, breast cancer and venous thromboembolism. These hormone treatments can be delivered as oral tablets and capsules, estrogen patches, gels and vaginal rings.
Currently, only 1.7% of women are on systemic hormone regimens. This could be because 41% of women believed it was unsafe, had been advised against using it by their physician or did not think they needed it, a Cleveland Clinic survey found. Meanwhile, 29% said they currently use it and 33% said they did not know enough about it to form an opinion.
Some women are turning to GLP-1 drugs to help reduce weight, which can reduce menopause symptoms and risks. The Menopause Society recommends weight loss as a nonhormonal treatment for menopausal women. Most women gain up to 1.5 pounds each year during menopause, which can last up to a decade. This weight gain can lead to a higher risk of diabetes and cardiovascular disease and is correlated with more hot flashes and night sweats.
However, some physicians have raised concerns about the long-term effects of GLP-1 drugs. One of the big questions is whether these drugs could exacerbate a studied side effect: the loss of muscle mass and bone density that is common with menopause.
