Related Experiment Video
Updated: Jun 2, 2026
06:18
An In Vivo Estrogen Deficiency Mouse Model for Screening Exogenous Estrogen Treatments of Cardiovascular Dysfunction After Menopause
Published on: August 13, 2019
United States Menopausal Hormone Therapy Usage Trends: An Observational Study
Stephanie S Faubion1, Nancy Safwan1, Mariam Saadedine1
1Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, USA; Mayo Clinic Center for Women's Health, Rochester, MN, USA.
Mayo Clinic Proceedings
|June 1, 2026
Summary
Systemic menopausal hormone therapy (HT) use has significantly declined in women aged 40+ from 2007 to 2023. Despite proven benefits, HT usage remains low, even for those experiencing menopause symptoms.
Area of Science:
- Reproductive Endocrinology
- Public Health Trends
- Pharmacotherapy Utilization
Background:
- Menopausal hormone therapy (HT) is a recognized treatment for menopausal symptoms.
- Established guidelines support the efficacy and safety of HT, especially when initiated early in menopause.
- Understanding current HT usage patterns is crucial for women's health management.
Purpose of the Study:
- To analyze nationwide trends in systemic menopausal hormone therapy (HT) use.
- To evaluate HT utilization among women aged 40 and older in the United States.
- To examine HT usage patterns from 2007 to 2023.
Main Methods:
- Retrospective, population-based cohort study utilizing de-identified medical and pharmacy claims data.
- Analysis of data from commercially insured and Medicare Advantage women aged 40+ in the U.S. (2007-2023).
- Definition of annual HT use rate based on at least 180 days of filled prescriptions; stratification by age, year, formulation, dose, and route.
Main Results:
- Systemic HT use decreased from 4.4% in 2007 to 1.7% in 2023 among women aged 40+.
- Oral HT remained the most common administration route.
- HT use declined across all age groups (45-49, 50-54, 55-59) and was highest among White women.
Conclusions:
- Despite evidence supporting HT efficacy and safety, usage rates have declined and remain low.
- Low HT utilization persists even in age groups most likely to experience bothersome menopausal symptoms.
- Further investigation into barriers and facilitators of appropriate HT use may be warranted.
Related Concept Videos
01:28Menopause
Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
01:22Hormonal Regulation of the Menstrual Cycle
The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH release.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH release.
01:33Hormonal Regulation
The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
01:40Hormonal Regulation
Hormones regulate a significant portion of digestion through activation of the neuroendocrine system. The neuroendocrine system of digestion contains many different hormones all with multiple functions that are both, directly and indirectly, involved in digestion.
01:29Therapeutic Drug Monitoring: Affecting Factors
Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
01:30Hormonal Control of the Ovarian Cycle
The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...