Among study participants, 64.4% were seen by obstetrics and gynecology (ob-gyn), 17.6% by internal medicine (IM), 12.4% by family medicine (FM), and 4.5% by endocrinology. Only 17.1% of the women received pharmacologic treatment for menopause symptoms. Of those treated, 34% received systemic estrogen, 47% received vaginal estrogen, and 16% received selective serotonin reuptake inhibitors (SSRIs).
Patients were most likely to receive systemic estrogen if treated by an ob-gyn. When compared with ob-gyn, patients seen by IM, FM, or endocrinology providers were significantly less likely to be prescribed systemic estrogen (odds ratios [ORs], 0.43 [95% CI, 0.29-0.64]; 0.50 [95% CI, 0.33-0.76]; and 0.16 [95% CI, 0.05-0.52], respectively). Conversely, patients seen by IM and FM providers were more likely to receive SSRIs (ORs, 1.89 [95% CI, 1.24-2.87] and 2.66 [95% CI, 1.77-3.99], respectively) compared with OB/Gyn providers.
Differences also emerged based on provider type. Patients were more likely to receive systemic estrogen from midwives (OR, 2.32 [95% CI, 1.42-3.77]) and nurse practitioners (NPs) (OR, 1.88 [95% CI, 1.43-2.48]) than from attending physicians. SSRIs were more often prescribed by physician assistants (PAs) (OR, 2.60 [95% CI, 1.70-3.97]), NPs (OR, 2.99 [95% CI, 1.95-4.60]), and residents (OR, 2.10 [95% CI, 1.06-4.20]) than by attending physicians.
These results suggest that provider specialty and training substantially affect the likelihood and type of pharmacologic treatment prescribed to women seeking care for menopause-related symptoms. The study authors concluded that this variation may reflect differences in provider education, comfort level, and institutional practice patterns.
Need for standardized menopause education
In the accompanying press release, lead author Anna Caroline Cochrane, MD, MSCR, of Wake Forest University School of Medicine, said, “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.”
The findings underscore a broader need to strengthen menopause-related education across medical disciplines. “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,” said Stephanie Faubion, MD, MBA, medical director for The Menopause Society. “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.”
References
- The Menopause Society. Likelihood of Being Prescribed Hormone Therapy May Depend on the Type of Provider Seen. Press release. October 21, 2025. Accessed October 21, 2025.
- McAllister VM, O’Connell NS, Jensen ET, Cochrane AC. Provider-Level Factors Related to Receiving Treatment for Menopause Symptoms. Abstract. Presented at: The Menopause Society’s 2025 Annual Meeting. October 21–25, 2025. Orlando, Florida.
