New Study Finds Low Initiation, Persistence With Menopause Hormone Therapy

Only 21.7% of more than 318 000 women initiated systemic hormone therapy (HT) within 12 months of a natural menopause diagnosis, and fewer than 40% of those who started treatment remained on their initial treatment episode at 1 year, according to late-breaking research presented at The Menopause Society 2026 Annual Meeting in San Diego.

The retrospective study, presented by Intira Sriprasert, MD, PhD, of the University of Southern California, analyzed MarketScan Research Databases from 2009 to 2022 to examine patterns of systemic HT initiation and treatment duration among women aged 45 to 60 years.

Of the 318 621 eligible women, 69 203 (21.7%) initiated systemic HT within 12 months of menopause diagnosis, while 249,418 (78.3%) did not. The most common initial treatment was estrogen plus progestogen (52.5%), followed by estrogen alone (32.4%) and progestogen alone (15.1%).

Treatment persistence was also limited. The median duration of the first HT episode was 202 days, and only 16.9% of women who initiated treatment continued that episode at 36 months.

Investigators identified several factors associated with HT initiation. Women aged 45 to 49 years were more likely to initiate therapy than those aged 55 to 60 years (adjusted odds ratio [aOR], 2.17; 95% CI, 2.12-2.23). Conversely, women with obesity (aOR, 0.78; 95% CI, 0.75-0.81) or diabetes (aOR, 0.69; 95% CI, 0.66-0.72) were less likely to initiate treatment.

In an interview with Patient Care Online, Sriprasert discussed the findings, the substantial decline in treatment persistence during the first 2 years, and patient characteristics associated with earlier discontinuation.

The results highlight the importance of examining not only whether women initiate menopause HT, but also how long they remain on treatment and which factors may influence continuity of care.

Sriprasert has no relevant disclosures.

References

1. Sriprasert I, Huang Y, Shoupe D, et al. Patterns of systemic hormone therapy initiation following natural menopause. Abstract S-8. Presented at: The Menopause Society 2026 Annual Meeting; October 2026; San Diego, CA.
2. Menopausal hormone therapy use among postmenopausal women. JAMA Health Forum. 2024. https://pubmed.ncbi.nlm.nih.gov/39331372/
3. Menopause hormone therapy prescribing in ambulatory care visits among midlife and older U.S. women from 2018 to 2019. 2024. https://pubmed.ncbi.nlm.nih.gov/38664135/