Resident training to optimize patient-focused menopause management: a multispecialty menopause curriculum to enhance knowledge and preparedness

Association of insurance type with unmet need for menopause care in Oregon

OBJECTIVE

To determine unmet need for menopause care in Oregon and evaluate if insurance type is associated with receipt of care.

METHODS

We conducted a cross-sectional survey of patients using an Oregon Listserv. Our primary outcome was use of medication for the treatment of moderate or severe symptoms of menopause. We used the Menopause Rating Scale to evaluate respondents' symptoms: 0-4 none or little symptoms; 5-8 mild symptoms; 9-16 moderate symptoms; and 17+ severe symptoms. We abstracted demographic and clinical information including age, rurality, race, ethnicity, primary language, and insurance type. We used a regression model to determine the association between public insurance and treatment for moderate to severe menopause symptoms. We examined reasons for nonuse of therapy.

RESULTS

Our sample included 845 perimenopausal or postmenopausal individuals who were predominantly White (93.0%), aged 45-49 (32.8%) or 50-54 years (39.1%), and privately insured (81.3%). Overall, 62.4% of individuals with moderate and severe symptoms of menopause were not receiving any therapy. After adjustment for age and rurality, public insurance was associated with an average of 47% increased odds of nontreatment for moderate or severe menopause symptoms (adjusted odds ratio: 1.47, 95% CI: 0.99-2.19). The most common reasons for nontreatment in both groups were "therapy was not recommended by a provider" (43%) and worries about safety or side effects (40%).

CONCLUSIONS

Even in well-insured persons, the majority of people with moderate and severe symptoms of menopause are not receiving treatment. People who are publicly insured are more likely to go untreated than privately insured individuals.

Menopause Decoded: What's Happening and How to Manage It

Menopause marks a significant transition in a woman's life, typically occurring between the ages of 46 and 55 years, characterized by the cessation of menstruation and a decline in ovarian function. This article provides a comprehensive overview of menopause, examining its physiological, psychological, and social dimensions. It explores the hormonal changes, including decreased levels of estrogen and progesterone, and how these changes contribute to common symptoms such as hot flashes, sleep disturbances, and mood fluctuations. Additionally, it highlights contemporary approaches to management, including lifestyle modifications and hormonal and non-hormonal therapies. By synthesizing current research and clinical insights, this overview aims to enhance understanding and support for women navigating menopause and the healthcare professionals assisting them.