Why It’s So Hard to Find a Good Menopause Doctor

More than half of humans go through menopause, and more than 85 percent of women experience symptoms like hot flashes, night sweats, and urogenital problems like vaginal dryness and recurrent UTIs.¹ Yet recent research found that less than 5 percent are treated with hormone replacement therapy (HRT), the most effective way to relieve these symptoms. ²

One reason why: Doctors don’t learn much about menopause in medical school. A national survey published in the journal Menopause revealed that only about 30 percent of residency programs offer a dedicated menopause curriculum. ³ A 2019 Mayo Clinic survey found that only seven percent of OB-GYN residents felt “adequately prepared” to manage patients in menopause.⁴

The same survey found that approximately one-third of the residents said they wouldn’t offer hormone replacement therapy (HRT) to a symptomatic, newly menopausal woman without contraindications. This is despite research showing that HRT is generally low risk for healthy women under 60 and those who start taking hormones within 10 years of their last period. ^{5 6}

As a result of this education gap, many women struggle to get the care they need—and deserve—in perimenopause and menopause. 

A small 2023 study found that menopausal patients felt disbelieved, ignored, and dismissed by healthcare providers, and that the providers failed to give guidance on the risks and benefits of HRT.⁷ 

Women in Hone’s online community also report feeling dismissed, gaslit, and ignored by doctors:  

“I was not sleeping at night with night sweats and hot flashes… my doctor told me everything was normal and to just get used to it or have a hysterectomy.”

“I was still struggling with symptoms daily. I asked my PCP to run [hormone] tests, but he said ‘Let’s not read more into your symptoms.’ I felt so unheard and dismissed.”

“I’ve talked to several doctors about my symptoms, mostly the 20 pounds I seemed to put on overnight. They brushed me off, saying that I just need to eat less and move more.”

About the Experts:

Mache Seibel, M.D., M.S.C.P., is a menopause coach, physician, and menopause expert, and former 25-year Harvard Medical School faculty member.

Tina Zhang, M.D., M.S.C.P., is a physician, assistant professor of medicine, and director of the Academic Women’s Health Fellowship in General Internal Medicine at Johns Hopkins.

Heather Hirsch, M.D., M.S., M.S.C.P., is a physician, CEO of Health by Heather Hirsch, and founder of The Collaborative, a concierge service for managing menopause.

A Leading Cause of Major Menopause Misinformation

Lack of physician education isn’t the only reason women are shortchanged. Fallout from the 2002 Women’s Health Initiative (WHI), a major national research study, created lasting misconceptions about the safety of HRT and derailed momentum toward better menopause education and access to HRT for decades. 

“The Women’s Health Initiative study came out, and it incorrectly reported that hormones would increase a woman’s risk of breast cancer and heart disease, and a lot of other things,” says Mache Seibel, M.D., a women’s health and menopause expert. “The number of [menopausal women in the US] who were on estrogen went from over 50 percent to about 5 percent, a tenfold drop, which hasn’t recovered.” 

“The fact that the study was terminated early and the way the findings were publicized by the media led to widespread fear around hormone therapy, both among patients and physicians,” says Tina Zhang, M.D., director of the Academic Women’s Health Fellowship in General Internal Medicine at Johns Hopkins. “Unfortunately, the data was misunderstood, and that significantly impacted menopause care for women.” 

It also resulted in two generations of clinicians losing out on getting to hear their attending physicians talk about prescribing HRT in patient settings, says physician Heather Hirsch, M.D. “There’s an art and a science to prescribing hormone therapy,” she explains. “It’s based entirely on what the person in front of you is saying, and they’re going to ask you many questions that aren’t in any textbook, and you really need to know what all the options are, and then feel comfortable deploying them.” When you haven’t had those kinds of conversations with another doctor, she says, it’s really hard to learn how to have them with patients. 

How the Menopause Education Gap Impacts Patients

A study published in Menopause in 2024 suggests that menopause symptoms aren’t being appropriately treated by healthcare professionals in primary care settings. Less than 14 percent of women who self-reported moderate or severe hot flashes received any treatment (HRT or nonhormone treatment) for vasomotor symptoms.⁸ 

Preliminary results from a large, ongoing survey—presented at the Menopause Society’s 2024 annual meeting—suggest that when women report symptoms like hot flashes, sleep issues, and fatigue, their doctor may not identify them as being associated with perimenopause or menopause. Only 25 percent of women were identified by their providers as being in perimenopause or menopause during their first visit; 35 percent had to see their providers four or more times before their symptoms were linked to hormone changes.⁹

Such experiences can leave women feeling confused, unheard, and untreated. In a recent survey of Hone’s Women’s Community, members said that they tend to Google health information rather than relying on their doctors for it, and that the conflicting information on the internet leaves them feeling frustrated.

The lack of good menopause care has real implications for women’s short- and long-term health.

 “In the short term, untreated menopause symptoms like hot flashes, brain fog, sleep disturbance, low libido can drastically reduce quality of life and affect work, relationships, and mental health,” says Zhang. “Long term, the menopausal transition is associated with decreased bone density, increased cardiovascular risk, and increased risk of UTIs.”

It’s also going to affect how symptomatic your perimenopause and menopause experience will be, says Seibel. “Your list of symptoms is going to be a lot shorter if you’re on hormone therapy,” he says. “Your quality of life and the impact on your work life will be noticeably improved.”

Fixing the Broken Menopause Healthcare System 

The WHI’s negative fallout is starting to dissipate. Subsequent analyses and follow-up studies have helped create a more nuanced understanding of the data. In recent years, menopause organizations, healthcare professionals, doctor influencers, and celebrities have also been steering cultural conversations about menopause in new directions. 

As a result, more women are talking about menopause and they’re eager to find relief for their symptoms. But they can’t get care if there aren’t enough well-trained, menopause-informed clinicians to provide it. That’s where physician education and healthcare innovations like telehealth practices come in, say the doctors we talked to.

Better menopause education for providers

Zhang notes that there are devoted menopause providers around the country who’ve worked tirelessly to build menopause curricula for their trainees. There is also advocacy work being done by national organizations like The Menopause Society, American College of Obstetricians and Gynecologists, Society of General Internal Medicine, and others. 

She believes they deserve most of the credit for any recent improvements to the system. “It’s still not where it needs to be,” says Zhang, “but it is definitely getting better and there are a lot of efforts currently in place to try to improve menopause training for both trainees and practicing physicians.” 

Seibel places the responsibility squarely on educators to bring the next generation of healthcare providers up to speed: “There’s a lot of medicine to know, and doctors only have limited time with patients. The medical community needs to put a value on getting menopause information into postgraduate programs. Today only 30 percent of gynecologists get any training at all in menopause.” 

Hirsch strongly agrees: “No matter what specialty you’re in—other than pediatrics—you’re going to meet women who are going through perimenopause or menopause, or who are postmenopausal, and you need to understand that these hormonal changes impact every field of medicine,” she says. 

At a 2025 FDA panel on HRT, Mary Jane Minkin, M.D., clinical professor of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine, advocated for updated training standards to better equip nurse practitioners and physician assistants with the knowledge needed to navigate hormone therapy and symptom management.

Zhang also thinks it’s important for individual providers to educate themselves on the diagnosis and management of menopause, as well as raise their awareness of conditions associated with the menopause transition. 

“There are now a lot of great continuing medical education courses on menopause for providers that are available across the country, led by various medical societies and medical institutions,” she says. “Finally, I think it’s important to educate the public on what to expect during the menopause transition, and [encourage them] to advocate for themselves.”

Finding new ways to deliver good care

Investing in emerging healthcare models is another way to get menopause care to the women who need it. Some doctors have decided to leave the traditional healthcare system for telehealth, for example, in hopes of spending more time counseling their patients. Hone’s Medical Director, James Staheli, D.O., made this choice. Hirsch has also moved her practice to a telehealth model.

“The system is broken, and insurance-based models are not set up to help support women,” says Hirsch. “With the insurance model, not only do patients wait for menopause care, which can derail their health, but visits are protocolized and unsatisfying.” Women want better, she says. “And if they can pay for it, they’re willing to.” The insurance-based system is not set up to support clinicians either, she says, adding that it causes stress and leads to burnout.

How to Get Good Menopause Care Now 

Women deserve informed, compassionate care in perimenopause and menopause. While physicians and educators continue to improve provider education and innovate the healthcare system, here are six things every woman can do to get better menopause care right now.

1. Learn about menopause. As they say, knowledge is power. Developing a better understanding of menopause and related symptoms will help you communicate your concerns to your doctor, and share knowledge with other women. “The more we normalize these conversations around menopause, the more pressure we place on the healthcare system to catch up,” says Zhang.
   
   Get information from trusted sources like The Menopause Society, the National Menopause Foundation, the American College of Obstetricians and Gynecologists, and the International Menopause Society.

2. Seek out providers who offer evidence-based menopause care. There are an increasing number of dedicated clinics for menopause and women’s midlife health in the U.S., says Zhang. The Menopause Society also offers a menopause certification exam, and “you can go on their website to find practitioners who completed their menopause certification and are considered Menopause Society Certified Practitioners,” she says. Otherwise, look for providers who list M.S.C.P., which stands for Menopause Society Certified Practitioner, in their credentials. 

3. Don’t settle. “If your provider is reluctant to engage in a conversation about menopause, it’s okay to find someone else,” says Zhang. “There are providers who want to help and who have the expertise to provide evidence-based guidance on how best to manage these symptoms.” You can also consider seeing a menopause specialist (in person or through telehealth) while still going to your main healthcare provider or gynecologist for primary care and routine exams like pelvic exams and pap smears. 

4. Prep for appointments. Keep a symptom log and a list of questions, and bring them to your appointment. Be sure to mention if you are experiencing hot flashes, irregular periods, sexual discomfort, brain fog, or any other symptoms (even if you’re not sure they’re related to menopause)—and ask about lifestyle changes and treatment options that may help. 

5. Listen to your body and mind. “Perimenopause can present in a lot of different ways, so if something doesn’t feel right or you don’t feel like yourself, it’s important to talk to your doctor,” says Seibel. “You don’t have to wait until you’re absolutely in menopause to be treated.”

6. Reject the stigma. Don’t be afraid to talk about menopause or ask questions. Check in with your friends and find out what they’re doing to manage symptoms, suggests Seibel. It’s a significant change, but it’s one that all women transition through. And while it has its challenges, it’s not all negative. “Try to look at it as a life cycle transition into wisdom, maturity, and experience,” says Seibel. And remember, you’ll get through it.

Improving menopause education and patient care isn’t about prescribing one solution for all women—it’s about developing and providing science-backed, evidence-based guidance and treatment options, listening to women, and helping them understand what options might be most helpful to them. 

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About the author

Jen Laskey is a veteran health and wellness journalist with over a decade of experience and a member of the Association of Health Care Journalists. Her work has appeared in outlets including NBC News, MSN, and The Healthy. With a gift for translating complex science into clear, engaging content, she helps readers make sense of their health and take informed action.

About the reviewer

Dr. Kimberly Hood is a board-certified OB/GYN and functional medicine provider specializing in men's and women's hormone health, weight management, longevity, thyroid health, and sexual wellness.