Inconsistent health records limit care and research for menopausal women

More attention than ever is being paid today to midlife women's health, including the menopause transition. However, a new scoping review reveals that ongoing inconsistencies and gaps in documentation of symptoms, menopause status, and reproductive stage in electronic health record (EHR) systems are preventing consistent quality care, research analysis, and positive health outcomes. Scoping review results are published online today in Menopause, the journal of The Menopause Society.

Approximately 1.3 million US women enter the menopause transition each year, with an estimated 1.1 billion women globally classified as postmenopausal. Although menopause is a normal life stage, it is associated with a wide range of symptoms and long-term health consequences affecting cardiovascular, musculoskeletal, neurologic, and mental health systems. Common symptoms, including hot flashes, sleep disturbances, mood changes, joint pain, and genitourinary symptoms, are frequently reported but are often inconsistently documented in clinical records.

Accurate classification of reproductive aging is essential for both clinical care and research. However, in routine clinical practice, menopause status and symptoms are often inferred from proxy indicators such as age ranges, diagnosis codes, or medication use rather than documented through structured staging approaches. Electronic health records offer significant potential to support longitudinal monitoring of menopause-related health, yet menopause data are frequently incomplete, inconsistently coded, or embedded in unstructured clinical notes data.

Several validated symptom-assessment tools exist, but these instruments are not routinely incorporated into structured EHR workflows or mapped to standardized clinical terminology. As a result, menopause-related information in EHRs may be fragmented across providers and institutions, limiting longitudinal tracking, care coordination, and secondary use of clinical data for research.

A new study sought to examine how menopause status and symptoms are identified and represented in EHR-based studies and to synthesize current documentation practices, limitations, and opportunities for developing standardized menopause data elements. It concluded that menopause remains inconsistently represented in EHRs, reflecting structural documentation gaps that constrain longitudinal tracking, clinical decision-making, and research reproductivity due to heterogeneity. It suggests that the development of standardized menopause-common data elements, including structured stage and symptom documentation, will require coordinated, multidisciplinary efforts to improve data quality and support scalable menopause research. The scoping review concludes that such consistency is critical to advancing menopause care.

Study results are published in the article "Bridging the menopause data gap: a scoping review of status, symptoms, and trends in electronic health records."

The authors conclude that broader standardization and implementation of validated screening tools within EHRs can enhance clinical care by standardizing staging, informing treatment protocols, facilitating early recognition and management of symptoms, enabling assessment of treatment response, and educating patients about modifiable risk factors during a critical period in women's lives. In addition to the clinical relevance, addressing the menopause data gap can also inform research by improving the comparability of treatments and interventions across more homogeneous populations."

Dr. Monica Christmas, associate medical director, The Menopause Society