Improving Menopause Care

September 8, 2026

Takeaway: Results from a key informant survey of 60 sites within the national VA Women's Health Practice-Based Research Network provided VA's Office of Women's Health with critical data for informing future efforts to improve clinical services for women Veterans experiencing menopause. The findings also may be used to generate a roadmap for clinical initiatives, research, implementation, and ongoing evaluation to enhance care for women Veterans experiencing all phases of menopause.

Background

Menopause describes the stage of a woman's life when her menstrual periods stop permanently. A normal part of the aging process, menopause can cause various symptoms such as hot flashes, night sweats, insomnia, trouble concentrating, and mood changes. Women may also experience these symptoms during the transition to menopause, called perimenopause. The average age for menopause in the United States is 52, but early and premature menopause can happen naturally or for a medical reason (i.e., removal of ovaries). Recent findings from the Gulf War Era Cohort Study show that women Veterans may be particularly vulnerable to early menopause (younger than age 45).¹

Menopause Practice Scan

The VA Women's Health Practice-Based Research Network (WH-PBRN) Menopause Practice Scan was designed to get "the lay of the land" regarding current menopause-related services and needs within the VA healthcare system. Led by the WH-PBRN (under Susan Frayne, MD, MPH) and HSR investigators Susan Diem, MD, MPH, and Carolyn Gibson, PhD, MPH on behalf of the Office of Women's Health, investigators used the scan to survey all active WH-PBRN site leads. Surveys were completed by 60 of 73 active WH-PBRN sites, with a response rate of 82%.

Findings showed that most sites reported a range of available resources: 88% reported having VA-based consultants (e.g., gynecologists, pharmacists, and/or endocrinologists) available to assist primary care providers with pharmacological management of menopause symptoms. However, sites also reported a need for educational materials, menopause-focused classes or groups, and resources or support for a variety of menopause-associated issues.

VA Menopause Research Group

This work led to the formation of the VA Women's Health Research Network's national VA Menopause Research Group, of which HSR investigators Susan Diem, MD, MPH, and Carolyn Gibson, PhD, MPH, are co-chairs. After two years of investigating and disseminating findings from 60 VA sites, the workgroup's efforts culminated in FY2025 with a publication reporting the practice scan findings. Results showed that WH-PBRN sites overwhelmingly reported that menopause care was made easier by:

• The availability and/or integration of menopause-trained specialty providers in the primary care setting,
• Adequate menopause training for primary care providers, and
• Time in appointments to address complex care issues.²

Implications

Findings provided VA's Office of Women's Health with critical data for informing future efforts to improve clinical services for women Veterans experiencing menopause. The findings also may be used to generate a roadmap for clinical initiatives, research, implementation, and ongoing evaluation to enhance care for women Veterans experiencing all phases of menopause.

Partner

The Women's Health Research Network, and VA's Office of Women's Health.

Investigators

Susan Diem, MD, MPH, part of HSR's Center for Care Delivery and Outcomes Research (CCDOR), and Carolyn Gibson, PhD, MPH, Associate Director of HSR's Center for Data to Discovery and Delivery Innovation (3DI).

Susan Frayne, MD, MPH, is a core investigator with HSR's Center for Innovation to Implementation (Ci2i).

Citation

1. Gibson C, Cao G Inslicht S, et al. Military exposures and early menopause: Findings from the Gulf War Era Cohort Study. Women's Health Issues. July-August 2025;35(4):276-282.
2. Diem S, Miles-McLean H, Carney D, et al. Menopause-related service needs in Veterans Health Administration medical centers: Findings from the Women's Health Practice-Based Research Network Menopause Practice Scan. Women's Health Issues. July-August 2025; 35(4):283-291.