MD Training, Specialty Affect Menopause Treatments

Two studies presented at ASRM 2014 look at the differences in how symptoms of menopause are treated by physicians in different specialties. Timing of physician training and perception of patient knowledge were significant factors in the treatments offered.

In the first study, physicians were asked about Shared Decision Making (SDM) in regards to their menopausal patients. The 200 physicians given the survey had treated menopausal patients in the past year. They overwhelmingly agreed that having their menopausal patients be well-informed was important. Overall, however, they perceived that only about half of their patients were, in fact, well-informed.

When the physician surveys were analyzed based on specialty, there were differences found between primary care and OB/GYN. Approximately 26% of primary care physicians, but 69% of OB/GYNs, reported that their patients could be characterized as well-informed or extremely well-informed. The authors of the study wanted to show the "significant gaps" between perceived and self-reported SDM.

A second study looked at the difference in treatment for symptoms of menopause between family physicians and OB/GYNs. The authors gave a survey, to be completed anonymously, to residents and faculty of the Departments of Family Medicine (FM) and of Obstetrics and Gynecology at Montefiore Medical Center-Albert Einstein College of Medicine in New York. The results from the 184 practitioners showed a stark contrast between those who had trained prior to when the landmark Women's Health Initiative (WHI) study in 2002 was published, and those who had trained after. The WHI study authors concluded that risks of estrogen/progesterone therapy outweighed benefits and that it was not an effective primary prevention method for congestive heart disease. In this group of physicians, menopausal hormone therapy was given more often by physicians who had trained before the WHI study was published. For those who did not prescribe systemic hormone therapy, 96% of FM and 25% of OB/GYN physicians reported concern over adverse effects as being the reason.