Integrative medical group visits for menopause (MENOGAP): results of a pilot single-site feasibility study

Up to 82% of midlife women experience vasomotor and other symptoms during the menopausal transition and post menopause. Midlife women express interest in both conventional and integrative health approaches to symptom management. MENOGAP is an intervention with evidence-informed conventional and integrative health education content and acupuncture therapy delivered in a group medical visit, thus enabling clinicians to provide much-needed care to more women simultaneously. Women also learn self-care for stress management and wellness promotion. Limited research has been conducted on integrative group medical visits for women in perimenopause or postmenopause. This single-arm study was conducted in one site to ascertain the feasibility of recruiting and retaining participants, and the acceptability of study procedures, including data collection, and to assess participants' outcomes.

MENOGAP was co-delivered by a menopause-certified physician and an acupuncturist. The primary outcome was level of feasibility, acceptability, and appropriateness, as measured by the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM). Secondary outcomes include changes in menopause-related symptoms, assessed with the Menopause Rating Scale (MRS), menopause self-efficacy, self-care behaviors, and menopause knowledge. Descriptive statistics were used for demographics and feasibility scales. Paired t tests and McNemar tests were used to assess changes between measures at baseline and post-intervention. Qualitative data were coded using thematic content analysis.

No enrolled participants withdrew and 90.4% attended three or more sessions. Participants reported high rates of acceptability, appropriateness, and feasibility. Statistically significant differences between pre-scores and post-scores were observed in MRS (P=0.005), somato-vegetative subscale (P=0.026), and psychological subscale (P=0.050), with overall MRS scores decreasing by 0.294 points and the somato-vegetative subscale by 0.300 points, suggesting modest but potentially clinically relevant improvement; knowledge of the menopausal transition increased by 1.727 points (95% CI: 0.729-2.725, P=0.002), and menopause self-efficacy increased by 0.612 points (95% CI: 0.139-1.085, P=0.013). Themes from the qualitative data included positive experiences and enjoyment, empowerment and emotional support, time constraints and travel challenges, useful information delivery and materials, environment and comfort concerns, and follow-up and communication needs.

MENOGAP was found to be feasible, acceptable, and effective from the perspectives of the enrolled participants. Physical and psychological symptoms improved significantly after the 4-week visits compared with baseline, and participants' knowledge of menopause and its management also increased significantly. Qualitative results suggested that participants experienced improved symptom burden, benefits of social support, and increased menopause self-efficacy. Lessons learned from this pilot study will inform future research on efficacy and, if merited, subsequent implementation of MENOGAP.