Docs in All Specialties Need More Menopause Education, Experts Say

WASHINGTON — Doctors in all specialties need more education on menopause and hormone therapy so that they don’t give women conflicting recommendations, several speakers said here Friday at the HHS National Conference on Women’s Health.

“When you look at ob/gyn, only 30% of residency programs have any structured education in menopause, and normally that’s only one to three lectures,” said Suzanne Fenske, MD, an ob/gyn and integrative medicine specialist at the Icahn School of Medicine at Mount Sinai in New York City. “It starts at medical school and goes straight through to residency, to fellowships as well too … It comes down to [the fact that the] physician has to seek out the knowledge.”

Barbara Levy, MD, an ob/gyn and chief medical officer at Visana Health, a virtual women’s health company, agreed. “If you’re a cardiologist, an endocrinologist, an oncologist — please find someone in your community or someone you can trust to have the knowledge, background, and education to help you manage your [menopause] patients,” she said. “I don’t expect a cardiologist or an oncologist to go to the Menopause Society [to be educated], but they are, every single day, transmitting misinformation to women, and it’s really harmful.”

Fenske said it was frustrating to fight with other specialists over hormone therapy, for example. “Their dermatologist is saying they can’t be on hormones,” she said. “Their cardiologist is saying they can’t be on hormones. Their surgeons are saying to hold their hormones for a month ahead of surgery. So it has to be education across all specialties.”

The FDA announced in November that hormone therapy products for menopause would no longer carry a black box warning about cardiovascular disease, dementia, and blood clots, among other serious risks.

An expert panel selected by Commissioner Marty Makary, MD, MPH, had unanimously urged the agency in July to remove the black box, arguing that the strong warnings had likely discouraged countless women from using a treatment that may provide benefit. The panel — which included Levy — was one of several such panels convened by Makary that critics charge have sidestepped legal procedures and ethics guardrails, raising concern about cherry-picking of experts and evidence.

Conference attendees also heard from Chris Klomp, director of Medicare and deputy administrator at the Centers for Medicare & Medicaid Services. Klomp noted that his father is a now-retired ob/gyn and his mother died of cancer when Klomp was 13.

“But it was a little more complicated, because she had had cancer as a function of a cellular mutation on the basis of an experimental trial to treat really severe, debilitating rheumatoid arthritis that was triggered by my birth,” he said. “I carried a little bit of a chip on my shoulder, and that led into a journey of understanding the disproportionate healthcare challenges that women face — that my mother faced — and the fact that 80% of autoimmune disease is borne by women, not men, and the fact that cardiovascular disease is the number one killer of women in the country.”

“So I started to learn about these issues at an early age, and I was frustrated about it,” said Klomp. “I’m frustrated by the fact that we still don’t have answers to many of these questions about why women disproportionately bear so much of the disease burden.”

Several things need to be fixed about the healthcare system as it relates to women, and one of them is data, he noted; Klomp earlier founded Collective Medical, a health data-sharing platform.

“There’s a reason we keep beating the drum on interoperability” for health records, Klomp pointed out. “At the Center for Medicare, we funded $10 million of enforcement agents and attorneys last year to strengthen promoting interoperability standards that were passed by [former CMS] Administrator [Seema] Verma but weren’t enforced yet.”

“Why do we care about that? Because it’s 2026 and patient data belongs to a patient, no one else,” he said. “Everyone else in the ecosystem is a steward … We cannot be held hostage by public stakeholders who will not allow that data to go exactly where the patient needs and wants it to go.”

Another issue is reimbursement, Klomp added. “In women’s health in particular, we have to do this too many times,” he said. “A breakthrough in women’s health means an absence of a [payment] code because the code set wasn’t designed for women, so there’s no mechanism to reimburse.”