Racial Disparity Found in Menopausal Hormone Therapy Prescribing: Daily Dose

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On October 22, 2025, we reported on a study presented at The Menopause Society 2025 Annual Meeting that was designed to assess whether patient-level demographic factors, including race and ethnicity, are associated with receipt of prescription medication for menopause symptoms.

The study

For the retrospective cohort study, researchers tapped clinical data from the electronic health record (EHR) of a large academic health care system from January 1, 2016, through December 31, 2023. They identified women aged 40–55 years seeking care for menopause symptoms using ICD-10 codes from any outpatient encounter with family medicine, internal medicine, endocrinology, or OB/Gyn clinicians. They extracted prescriptions for systemic estrogen, vaginal estrogen, and selective serotonin reuptake inhibitors (SSRIs) associated in the EHR with menopause ICD-10 diagnoses.

Investigators used bivariate and multivariable logistic regression to evaluate associations between patient demographic characteristics and receipt of prescription treatment. The minimally sufficient variables for the association of prescription treatment with insurance status were race and age.

The findings

The analysis included 5491 women with an eligible outpatient encounter. Relative to White women, Black women were 21% less likely to receive any prescription treatment for menopause symptoms (OR 0.79, 95% CI: 0.67-0.95). The disparity proved most pronounced for systemic estrogen, whereas Black women faced 36% lower odds of receiving prescriptions (OR 0.64, 95% CI: 0.47-0.87). Also, the results showed women with Medicaid were less likely to receive any treatment for VMS (OR 0.67, 95% CI: 0.48-0.94) compared with study participants who had managed care insurance.

Authors' comments

"Our results underline the need for equitable care for women experiencing menopause symptoms and lay the groundwork for future interventions."

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