In recent years, menopause has become a more prominent topic in public discourse and medical research. This shift comes after decades of limited progress in the field, which was largely due to concerns raised by a 2002 study linking hormone therapy to chronic diseases. Dr. Rajita Patil, an OB-GYN at UCLA Health, described the impact of that study: “Progress in this field ground to a halt for 20 years,” she said. “It made people fearful to where doctors basically stopped writing prescriptions.” By 2020, fewer than one in twenty women in midlife used hormone therapy.
Interest in menopause is now increasing, with more attention from media and social platforms. Dr. Patil noted, “I definitely think menopause is having a moment. More women have realized that they don’t have to stay silent and they don’t have to suffer. That increased awareness has driven a huge increase in demand for care.”
To address these needs, Dr. Patil launched the Comprehensive Menopause Care program at UCLA, which aims to provide evidence-based, multidisciplinary care for women going through menopause.
Reflecting on why menopause is receiving more attention now, Dr. Patil pointed to several factors including renewed debate about the original Women’s Health Initiative (WHI) study from 2002: “One was a 2023 New York Times article, ‘Women Have Been Misled About Menopause,’ summing up the debate around the landmark Women’s Health I Initiative study from 2002. It found increased risk of cardiovascular disease, stroke, breast disease and blood clots among women taking hormone therapy.”
Dr. Patil explained some limitations of the WHI study: “For one thing, it wasn’t really studying the population of people who used hormone therapy to treat menopause symptoms — people in their 40s and 50s, mainly. The average age of study participants was 65… Even so, the absolute increased risk of heart attack, stroke, blood clot and breast disease was less than 10 per 10,000 women. We classify that as a very low increased risk.” She added that when data were analyzed specifically for women in their early fifties there was no increased risk observed.
Discussing the effects on patients who lacked access to treatment during this period, Dr. Patil said: “Menopause happens at this time in life when people are juggling enormous responsibilities… And just at an age when people feel like they have themselves figured out, suddenly there’s this hormone shift that can totally rock that equilibrium.”
Access to appropriate care remains challenging due to a shortage of specialized providers. Dr. Patil observed: “We have knowledgeable providers who are practicing evidence-based medicine, but not nearly enough of us… The lack of access to competent providers has created a space for major confusion, misinformation and misconception.”
She also addressed common misconceptions: “One is this idea of hormone testing and balancing hormones through individualized medication formulas… But it’s just not based in science.” According to her experience: “There’s no magic hormone level we’re trying to achieve… That’s why the best evidence-based care is still focused on managing and treating clinical symptoms.”
The Comprehensive Menopause Care program at UCLA uses an assessment system called MAPSS (Menopause Assessment and Pathways Support System) designed so all patients receive consistent evaluation regardless of background or prior access to care. The approach involves multidisciplinary collaboration across various specialties such as cardiology and mental health.
Describing how MAPSS works during appointments with patients she stated: “By the time I walk into the room for a 30-minute appointment, I already have a synthesized snapshot of the patient’s health and priorities… Instead of spending the visit gathering history, we can focus almost entirely on shared decision-making, education and personalized recommendations.”
On expanding access statewide within California’s healthcare system Dr. Patil explained new initiatives including training programs for OB-GYN residents and continuing medical education opportunities for clinicians already practicing: “Through what we call ‘education percolation,’ every clinician we train goes on to train others… raising the standard of care far beyond our own clinic walls.” Additionally there are efforts underway at both state government level—such as proposed incentives for physicians—and across University of California campuses through consortium efforts supported by dedicated funding.
Last year California allocated three million dollars in its state budget toward expanding perimenopause and menopause services throughout University of California health centers; these measures aim to broaden access across communities statewide.
