Menopausal hormone therapy in Türkiye: physician knowledge and practice gaps

The aim of this study was to evaluate physician awareness, attitudes, and prescribing practices regarding menopausal hormone therapy in Türkiye and to identify specialty-related practice gaps in the context of evolving evidence.

A cross-sectional online survey was conducted between January and June 2025 among physicians in obstetrics and gynecology, endocrinology, and internal medicine. A 15-item structured questionnaire assessed menopausal hormone therapy knowledge, attitudes, and prescribing behaviors. Descriptive statistics and chi-square tests were used, with p<0.05 considered statistically significant. Multivariable logistic regression was performed to identify factors associated with willingness to initiate menopausal hormone therapy.

A total of 235 physicians participated. Overall, 53.2% reported familiarity with menopausal hormone therapy guidelines, with significant differences across specialties (p<0.001); internal medicine physicians demonstrated the lowest awareness and the highest self-reported inadequate knowledge (94.4%). Willingness to prescribe menopausal hormone therapy for symptomatic women aged 50-59 years differed significantly by specialty (p<0.001), highest among obstetrics and gynecology physicians and lowest among internal medicine physicians. In adjusted analysis, internal medicine (aOR 0.179, 95%CI 0.067-0.474; p=0.001) and endocrinology (aOR 0.252, 95%CI 0.120-0.531; p<0.001) were independently associated with lower willingness to initiate menopausal hormone therapy.

Significant specialty-dependent gaps in menopausal hormone therapy knowledge and prescribing confidence persist in Türkiye. Targeted education and improved dissemination of contemporary guidelines may help reduce undertreatment of symptomatic menopausal women.