A high proportion of women with vasomotor symptoms (VMSs) remain untreated even when experiencing bothersome symptoms of menopause status. Improved management of VMSs is required to provide relief from the symptoms effectively and safely.

Objective: To document health care providers' views regarding treatments for symptoms associated with menopause and discussions with patients about symptoms and treatment decisions. Results informed development of a data collection form for a retrospective medical record review (reported separately).Methods: Registered US gynecologists or primary care providers from all US regions were identified from local association directories and an in-house database and were invited to participate in a qualitative interview if they consulted with three or more patients per week presenting with menopausal symptoms. Participants provided demographic data, information about patients' symptoms, and health care provider and patient views on prescription and nonprescription therapies. Key concepts/themes from interviews were identified.Results: Participating health care providers (10 gynecologists, 10 primary care providers) agreed there are effective treatment options for menopausal symptoms, particularly vasomotor symptoms and vaginal dryness and/or atrophy. Health care providers reported that treatment was generally dictated by symptoms that interfered with quality of life and/or daily activities, although patients often had symptoms for months before presentation. All health care providers said they prescribe hormone and/or nonhormone therapies for treatment of menopausal symptoms; half stated that they typically inquire about patients' nonprescription therapy use, and 45% recommend specific nonprescription therapies. The most commonly cited barriers to initiation of any therapy for menopausal symptoms were patient concerns about risks and financial considerations (ie, insurance or cost).Conclusions: US health care providers reported prescribing therapies for menopausal symptoms and noted that these therapies were perceived as generally effective; however, barriers to initiation of prescription therapy exist, and new treatment options are needed.

INTRODUCTION:Vasomotor symptoms are the most common menopausal symptoms for which women seek treatment. We describe current treatment use by practitioner type (gynecologists versus primary care providers [PCPs]) and U.S. geographic region.METHODS:This subgroup analysis of a noninterventional, observational study used a convenience sample of 283 practitioners (131 gynecologists, 152 PCPs) who abstracted data on menopause-specific therapy from medical records of women aged 40‒60 years who initially presented with menopausal symptoms between January 1, 2016, and December 31, 2019. Data were summarized descriptively.RESULTS:Practitioners provided data for 1,016 women (from gynecologists: 512; PCPs: 504). About half the women overall experienced symptoms for ≥6 months before consultation. Patients of gynecologists had more vaginal and sexual symptoms recorded than patients of PCPs. Gynecologists’ patients more commonly had prescription medications (63% versus 57%) but less commonly had nonprescription therapies/interventions (59% versus 66%) documented than PCPs’ patients. They more often received hormone therapy (HT; 76% versus 64% of patients with any prescription) and compounded HT (17% versus 7%) and less often received selective serotonin reuptake inhibitors (SSRIs; 11% versus 19%) and serotonin-norepinephrine reuptake inhibitors (2% versus 12%) than PCPs’ patients. Black cohosh was the most frequently documented nonprescription therapy by gynecologists (24%) and PCPs (35%); gynecologists more commonly documented Estroven (16% versus 10%). Compounded HT use was more common in the U.S. Southeast and Southwest (∼20%), and SSRI use was more common in the Northeast (22%) than other regions.CONCLUSION:Prescribing patterns for menopausal symptoms vary by practitioner type and U.S. region.