Factors associated with receipt of prescription medication for menopause-related symptoms

OBJECTIVE: To evaluate the association of patient- and clinician-level factors and receipt of prescription medication for menopause-related symptoms in a large academic health care system. METHODS: We conducted a retrospective cohort study of women aged 40-55 years seeking care for menopause-related symptoms in any outpatient encounter with family medicine, internal medicine, endocrinology, and OB/Gyn from 2016 to 2023. Prescriptions associated with menopause-related ICD-10 diagnoses were extracted. Bivariate and multivariable logistic regression were used to evaluate the association of patient- and clinician-level characteristics and receipt of prescription treatment. RESULTS: We identified 5,491 women with an outpatient encounter with an associated ICD-10 code for menopause-related symptoms. Relative to White women, Black women were less likely to receive any prescription treatment for menopause-related symptoms (OR: 0.79, 95% CI: 0.67-0.95), including systemic estrogen (OR: 0.64, 95% CI: 0.47-0.87); however, were more likely to receive SSRIs (OR: 1.49, 95% CI: 1.04-2.14). Relative to patients seeking care within OB/Gyn settings, patients were less likely to be prescribed any treatment by internal medicine (OR: 0.45, 95% CI: 0.36-0.56), family medicine (OR: 0.52, 95% CI: 0.14-0.40), and endocrinology clinicians (OR: 0.23, 95% CI: 0.14-0.40). CONCLUSION: Our study demonstrates differential prescribing patterns for menopause-related symptoms with respect to race, insurance status, and clinician specialty. Our results underscore the need for equitable care for women experiencing menopause symptoms.