Improving Access to Menopause Therapies: A Discussion of the Current Landscape and Potential Solutions

This article reviews the burden of vasomotor symptoms (VMS) during the menopause transition and highlights persistent underuse and inequities in evidence-based treatment. Although menopausal hormone therapy (MHT) is the most effective and evidence-based first-line therapy for VMS, utilization remains strikingly low, particularly among publicly insured, Black, rural, and underserved populations. The authors synthesize evidence that low and inequitable MHT use is multifactorial, driven by patient beliefs, misinformation, insurance and reimbursement structures, workforce limitations, and care delivery contexts. Finally, the article proposes scalable solutions including group-based menopause care and risk-based, tiered care pathways to expand equitable access to high-quality menopause care.