Researchers compared enrollment surveys and electronic health records from nearly 240,000 participants in the NIH's All of Us program and found menopause explicitly recorded in just 12% of EHRs, despite more than half self-reporting the transition. Age at menopause and symptom details were largely missing. The authors propose brief patient questionnaires and computational methods to improve documentation and support better research and personalized midlife care.
Menopause Is Routinely Missing From Medical Records — New Study Exposes Big Data Gap
There is enormous variation in how menopause unfolds across different people.Morsa Images/DigitalVision via Getty Images
Menopause is an inevitable midlife transition for people with ovaries and can strongly influence quality of life and future risks for conditions such as heart disease and osteoporosis. Yet new research shows that this key life-stage is rarely captured in clinical records, limiting research and personalized care.
Study Overview
Researchers analyzed electronic health records (EHRs) from nearly 240,000 women drawn from about 400,000 participants in the NIH's All of Us Research Program. By comparing participants' enrollment surveys with their clinical records, the team assessed how often menopause status, age at menopause and symptom details (such as hot flashes, sleep disruption and cognitive complaints) were recorded and whether documentation varied by age, education, race and income.
Key Findings
Major documentation gap: Menopause was explicitly recorded in only 12% of the EHRs, even though more than half of the same participants reported experiencing menopause on surveys.
Missing details: Information on age at menopause and symptom severity was generally absent from both clinical notes and the survey fields used for this analysis.
Variation likely by sociodemographic factors: The study also found differences in documentation practices across groups, suggesting that social determinants and health-system practices may influence whether menopause is captured.
Why Menopause Is Under-Recorded
- Clinicians may view menopause as a natural life event rather than a diagnosis that needs coding.
- Reproductive-history questions (like last menstrual period) are often asked but not consistently entered into EHR fields.
- Patients may not mention symptoms unless they are severe, and clinicians may not prioritize documenting them.
Proposed Solutions
The authors propose practical steps to close this gap:
- Introduce a brief, standardized questionnaire at clinic check-in to capture menopause status and key symptoms for EHR entry.
- Develop computational tools to infer menopause-related information from other clinical data and genetic markers.
- Use the All of Us dataset to identify system-level, cultural and socioeconomic factors associated with under-documentation and to design targeted interventions.
Why This Matters
Accurate, routine recording of menopause in health records would enable large-scale research into symptom trajectories, links with cardiovascular and bone health, and disparities in care. Without measurement, it's difficult to study or treat health issues that are tied to the menopause transition or to provide personalized midlife care.
Bottom line: Capturing menopause status and symptoms in EHRs is a low-cost, high-impact step that could accelerate research and improve individualized care for people in midlife.
Authors and Disclosures
This article summarizes work by Audrey Hendricks and Nanette Santoro of the University of Colorado Anschutz and is republished from The Conversation. Audrey Hendricks receives funding from the NIH and the Foundation for Women's Health. Nanette Santoro serves on scientific advisory boards for several companies, consults for Ansh Labs, receives research funding from the NIH and the Cohen Foundation, and is currently President of the Endocrine Society.
Help us improve.
