Menopause
Most midlife women with menopause symptoms don’t seek care, research finds
More than 80 per cent of women with menopause symptoms do not seek medical help, despite the impact on daily life, according to new research.
The study surveyed nearly 5,000 women aged 45 to 60 across four Mayo Clinic primary care sites, finding that more than three-quarters had experienced symptoms affecting work productivity and overall wellbeing.
Conducted by the Mayo Clinic, the research found that menopause symptoms remain underrecognised, undertreated and inadequately addressed within the healthcare system, despite the availability of effective treatments.
Lead author Ekta Kapoor is an endocrinologist and menopause specialist at the Mayo Clinic in Rochester.
The researcher said: “Menopause is universal for women at midlife, the symptoms are common and disruptive, and yet, few women are receiving care that could help them.
“This gap has real consequences for women’s health and quality of life, and it’s time we address it more proactively.”
More than one-third (34 per cent) the survey respondents reported moderate to very severe symptoms.
Sleep disturbances and weight gain were among the most common issues, affecting more than half of participants.
Only about one in four women were receiving treatment at the time of the survey.
While some preferred to manage symptoms independently, others said they were too busy or unaware that effective treatments exist.
Without proper treatment, menopause symptoms can negatively affect sleep, mood and cognition, as well as productivity at work and home.
The study noted that women often do not raise menopause-related concerns during medical appointments.
Researchers emphasised the need for strategies to destigmatise menopause care and make it more visible and accessible.
Work is underway to develop questionnaires, digital tools and smartphone apps that help women identify symptoms, learn about treatment options and have more productive discussions with their healthcare professionals.
Dr Kapoor said: “Our goal is to educate women and healthcare professionals about menopause.
“By making it easier to recognise and understand symptoms, we can close the gap between need and care – and help midlife women live healthier, more fulfilling lives.”
Flex partners with Clue to make Clue Plus eligible for HSA and FSA spending in the US, letting users pay for menstrual health tools with pre-tax funds.
HSAs and FSAs are US pre-tax accounts for eligible health costs. Announced on 16 December 2025, the move makes Clue Plus available via these benefits, with Flex citing potential savings of 30 to 40 per cent.
Clue Plus offers personalised cycle tracking, deeper analysis, advanced predictions and hormone insights, with options for pregnancy and perimenopause. It includes 12-month forecasting and clinician-backed guidance.
“At Clue, our mission is to empower women and people with cycles with trustworthy, science-based information about their menstrual and reproductive health,” said Rhiannon White, CEO of Clue. “Partnering with Flex allows us to make Clue more accessible to the millions of people who rely on our app for insights into their bodies. We’re thrilled to expand access through HSA/FSA eligibility.”
Flex says more than US$150bn is held in HSA and FSA accounts, and the partnership brings reproductive health purchases into standard benefits checkout.
“At Flex, we believe everyone should have affordable access to women’s healthcare,” said Sam O’Keefe, CEO of Flex. “After my own pregnancy and postpartum experience, I saw firsthand how confusing and hard to navigate women’s health can feel. Making Clue eligible for HSA and FSA spending is one way we are helping more people use their pre-tax dollars to access tools that provide meaningful data and insights into their health.”
HRT (hormone replacement therapy) may not increase breast cancer risk in women with BRCA mutations, new research suggests.
Women who inherit harmful mutations in the BRCA1 or BRCA2 genes, which help repair DNA, face elevated risks of ovarian and breast cancer.
They are often advised to have their ovaries and fallopian tubes surgically removed (bilateral salpingo-oophorectomy, removal of the ovaries and fallopian tubes) at relatively young ages to reduce ovarian cancer risk, but this brings on early menopause.
The study was led by Joanne Kotsopoulos, a scientist at the Women’s College Hospital Research and Innovation Institute and a professor at the Dalla Lana School of Public Health at the University of Toronto in Canada.
She said: “We cannot simply recommend a drastic surgery like oophorectomy for young women without offering a way for them to manage the well-established short- and long-term outcomes of surgical menopause.
“I believe we should educate patients and their health care providers on how we can safely balance the risks and benefits of MHT use to ensure longevity and improve quality of life.”
She noted there has been reluctance and misinformation regarding HRT, largely due to studies in the general population showing an association between HRT use and increased breast cancer risk.
The researchers conducted a matched prospective analysis, an observational design that pairs similar participants to mirror clinical trial conditions.
They created 676 matched pairs of women who did and did not use HRT after menopause.
Participants were matched by BRCA1 or BRCA2 status, birth year and age at menopause. The women ranged in age from 22 to 76, with an average age of 43.8.
Patients with a history of cancer, those who had received a bilateral mastectomy (removal of both breasts), and non-menopausal patients were excluded from the study.
After an average follow-up of 5.6 years, breast cancer cases were significantly lower in women who used HRT, with 87 cases in the HRT group compared with 128 cases in the non-HRT group.
Analysis by formulation showed most types of HRT were not associated with breast cancer risk.
However, two formulations were linked to decreased risk. Women who received oestrogen-only HRT were 63 per cent less likely to develop breast cancer than those who did not use HRT.
Of the 43 women who received conjugated oestrogen and bazedoxifene (a selective oestrogen receptor modulator), none developed breast cancer.
“Although based on smaller numbers, this is definitely an exciting and interesting area for future research,” Kotsopoulos said.
“Hypothetically, conjugated oestrogen and bazedoxifene could be used to mitigate breast cancer risk by avoiding progesterone, which is thought to be the breast cancer risk-associated component of MHT. Future trials will be necessary to test this hypothesis.”
There were no significant differences in results between BRCA1 and BRCA2 carriers.
“Our findings suggest that clinicians should take a personalised approach to menopause management for women with BRCA mutations who are suffering from the impact of surgical (or natural) menopause, if there are no contraindications for them,” said Kotsopoulos.
Most Americans are unaware that midwives provide women’s healthcare beyond pregnancy and birth, a new survey has found.
The survey of 1,006 Americans found that 93 per cent think midwives only deliver babies and were surprised to learn they can be a trusted partner in all aspects of women’s health.
The research was conducted by The Ohio State University Wexner Medical Center. It found that only one in five Americans are aware midwives can provide women’s annual gynaecology exams.
Michaela Ward, a certified nurse-midwife at Ohio State Wexner Medical Center, said: “We take care of women across the lifespan. We are highly trained and we’re highly skilled.
“We can take care of you even if there is something more complex about you or your health.
“If I need to consult with one of our physicians at Ohio State, I can call them right away and discuss the patient’s case.
“We all work together to provide the best care possible for our patients.”
While services such as pregnancy and birth support and water births were correctly identified as midwife services by over half of adults, other services like medication management, menopause care and annual women’s health exams are known by far fewer.
Both men and women were equally unaware of the full breadth of services provided.
Survey respondents’ knowledge of women’s health services provided by midwives included pregnancy and birth support (93 per cent), water births (69 per cent), medication management including birth control (26 per cent), menopause care (23 per cent), annual women’s health exams including pap smears and STI testing (20 per cent), caesarean sections (13 per cent) and ‘don’t know’ responses (1 per cent).
According to the Department of Health and Human Services, the US is expected to face a significant shortage of obstetrician-gynaecologists in the next five years.
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