Disparities in Clinical Management of Menopause Within China’s Hierarchical Medical Framework

Background: This study aimed to investigate the differences in the current clinical practice of menopause in China’s hierarchical medical system, with the goal of informing policy development and optimizing health promotion strategies for menopausal women in China. Methods: An epidemiological survey was conducted using an online questionnaire distributed through China’s largest obstetrics and gynecology academic training platform between April and May 2020. Results: A total of 4458 questionnaires were collected, with 3853 meeting the criteria for analysis. Physicians’ familiarity with menopausal syndrome varied significantly across hospital tiers (χ2 = 69.24, p < 0.001), with limited awareness in grade 3 hospitals (48.25%) and highest in community hospitals (69.47%). More than half (60.42%) had less than five years of clinical experience in menopause management (χ2 = 26.75, p < 0.001). The proportion of physicians who often or occasionally recommended hormone therapy (HT) was 84.12% in grade 3 hospitals, 79.20% in grade 2 hospitals, and 77.16% in community hospitals, while the proportion of physicians who never recommended HT was the lowest in grade 3 hospitals and the highest in community hospitals (7.58%). Use of traditional Chinese medicine (TCM) was also widespread, reported by 84.12% of grade 3, 79.38% of grade 2, and 67.58% of community hospitals. Chinese patent medicines were the most commonly recommended form of TCM. Conclusions: The understanding of menopause among Chinese physicians remains limited, an issue that is particularly pronounced among doctors in primary care institutions compared to those in higher-level hospitals. Both HT and TCM are widely utilized in clinical practice. Doctors from community hospitals require further education and training in menopausal management.