Menopause Largely Missing from Electronic Health Records Despite Its Health Impact

Menopause is a natural midlife transition that significantly influences future risks for heart disease, osteoporosis and other conditions, yet it remains inconsistently documented in electronic health records (EHRs). Researchers analyzing EHRs from almost 240,000 women in the NIH’s All of Us Research Program found that just 12% of records included any mention of menopause, despite more than half of participants reporting they were experiencing the transition.

The study, published in Menopause, revealed gaps not only in whether menopause was recorded, but also in details like age at onset and symptom presence, such as hot flashes or sleep disturbances. Discrepancies existed between patient self-reports and EHR entries, with variations by age, education, race and income. Researchers noted that menopause is often overlooked in clinical practice, possibly because it is not a disease and clinicians may not see it as requiring a diagnostic code.

To address this data gap, the team is piloting a brief patient-completed questionnaire integrated into clinic check-ins, developing algorithms to infer menopause status from existing data, and exploring how social and systemic factors influence documentation practices.