Significant racial disparities seen in hormone therapy prescription Image Credit: © Pixel-Shot - © Pixel-Shot - stock.adobe.com.
This is part 3 of our 3 part series on diversity in obstetrics. Part 1 can be found here. Part 2 can be found here.
According to a study highlighted at The Menopause Society 2023 Annual Meeting, there is a significant association between race and hormone therapy prescription.
- Racial Disparities in Menopause Symptoms: There is a significant association between race and the experience of menopause symptoms, with Black women more likely to suffer from severe hot flashes compared to White women.
- Psychiatric Conditions and Menopause Symptoms: Women with psychiatric conditions were found to be more likely to experience menopause symptoms, including mood disturbances and severe hot flashes.
- Low Rates of Reporting Menopause Symptoms: The study revealed a relatively low rate (11%) of documented menopause symptoms among patients, which may be attributed to factors like underreporting by patients, lack of physician inquiry, or insufficient physician documentation.
- Correlation Between Menopause Symptoms and Psychiatric Conditions: The data indicated a correlation between menopause symptoms and psychiatric conditions, highlighting the need for integrated care in addressing the mental and physical aspects of menopause.
- Racial Disparities in Hormone Therapy Prescriptions: Black women with psychiatric conditions were significantly less likely to receive hormone therapy prescriptions compared to White women with similar psychiatric conditions, revealing racial disparities in treatment access.
No 2 women share the same menopause symptoms, and data has indicated race has an impact on symptoms, with Black women more likely to experience severe hot flashes than White women. Psychiatric conditions may also be impacted by the menopause transition, often worsening moods and severe hot flashes.
In a recent study, data was obtained from almost 66,000 midlife women to determine the presence of racial disparities in obtaining hormone therapy prescriptions for patients with and without psychiatric diagnoses.
Documented menopause symptoms were reported in 11% of patients, while prior reports had a rate of up to 80%. This low rate could be because of a lack of patient reporting, physician inquiry, or physician documentation of symptoms.
Data indicated menopause symptoms were more common in women with psychiatric conditions. A psychiatric condition was also more likely in women with menopause symptoms compared to those without symptoms, indicated a correlation between menopause symptoms and psychiatric conditions.
Low rates of hormone therapy prescriptions were found across all groups evaluated, but Black women with psychiatric conditions were significantly less likely to receive a prescription than White women with a psychiatric condition. White women with psychiatric conditions were 40% more likely to receive a hormone therapy prescription than Black women.
"Menopause education alone can help women feel like they are not going crazy due to the changes they are experiencing in their bodies or dismissing what they are experiencing because they think it is just another depressive or manic episode,” said Danette Conklin, PhD, lead author and assistant professor of psychiatry and reproductive biology at Case Western Reserve University School of Medicine.
“This study is an example of the importance of psychology and gynecology working together to educate and treat peri- and postmenopausal women,” Conklin added.
Race matters when prescribing hormone therapy for menopausal women. The Menopause Society. September 27, 2023. Accessed September 15, 2023.