An alarming gap bedevils menopause care in the United States – thanks to enduring myths about hormone replacement therapy and flaws in how new doctors are trained.
Yet while 2 decades have passed since the misinformation first started to spread, people remain woefully uninformed about hormone treatments.
Treating with low-dose estrogen isn’t a radical approach – in fact, it is the standard of care for women experiencing many menopause symptoms, Faubion said. But the topic does have nuance and some people get lost in the specifics. During her 6-year urology residency, she never learned the role of vaginal estrogen on urinary problems, Winter said. Only during a 1-year fellowship on sexual dysfunction did she hear about the treatment.
Urologists are not the only clinicians who lack appropriate training. Obstetrics and gynecology residencies offer little knowledge on menopause treatments, said “What that means in a state like Texas where I’m based, where it is difficult to qualify for Medicaid, is that the people we see who do qualify are pregnant,” she said. “And you’re not on Medicare until you’re 65. So most OB/GYN residents don’t graduate with expansive experience in menopause.”, 80% of the national population covered by Medicaid is age 45 and younger.
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