A Comprehensive Literature Review of Barriers to Hormone Therapy Utilization: Strategies for Improving Menopause Management in Women Aged 40-60

Menopause is a natural transition marked by the cessation of ovarian activity, often accompanied by vasomotor symptoms (VMS), genitourinary syndrome of menopause (GSM), and psychological changes that significantly impact women’s quality of life. Hormone therapy (HT) has been the primary treatment for managing menopausal symptoms, particularly VMS, providing substantial relief when initiated within 10 years of menopause. Despite its effectiveness, HT usage has declined dramatically over the past two decades primarily due to barriers such as stigma, safety, misinformation, provider hesitancy, financial barriers, and cultural beliefs. This comprehensive literature review explores key factors influencing HT decision-making, including the media’s role in amplifying health fears, physician influence on treatment access, and disparities in education and healthcare. Findings suggest that misinterpretations of the Women’s Health Initiative (WHI) study—a major clinical trial published in 2002—along with media-driven misinformation, inconsistent provider recommendations, insurance limitations, and cultural barriers have led many women to either seek alternative therapies or avoid treatment altogether. Addressing these barriers through evidence-based public health messaging, improved provider education, and greater access to affordable treatment options is crucial to ensuring informed decision-making and improving menopause care.