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A major analysis of data from nearly 396,000 women suggests that menopause is frequently absent from electronic health records, even when women themselves report having experienced it.
Researchers at the University of Colorado Anschutz examined information from participants in the National Institutes of Health's All of Us Research Program and found a striking gap between what women reported in surveys and what appeared in their medical records. The findings highlight a widespread lack of menopause documentation that researchers say could limit efforts to better understand women's health and disease risk.
Menopause is a normal stage of life, yet the study found it was rarely documented in electronic health records (EHRs). Across the entire dataset, only about 7 percent of women had menopause recorded in their medical records.
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Lead author Audrey Hendricks told Newsweek that one of the biggest reasons for the gap is simply that menopause is not routinely captured during medical visits.
"The biggest reason is we don't ask," she said. "In the doctor's office, menopause is often only recorded because a woman brings it up."
She added that unlike measurements such as blood pressure or weight, menopause is not consistently documented in standardized fields and may only appear in physicians' notes, making it harder for researchers to access and study.
The gap became even more apparent when researchers compared survey responses with EHR data. Among women who said in surveys that they had gone through menopause, only around 14 percent had menopause documented in their electronic health records.
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The numbers revealed a large mismatch between the two data sources. Researchers identified roughly 193,000 reports of menopause in participant surveys but found only about 28,000 menopause diagnoses in electronic health records. Put another way, menopause appeared nearly seven times more often in survey responses than in medical records.
Importantly, the researchers say the issue was not that medical records were routinely inaccurate. Instead, the problem was that menopause information was often missing altogether.
When menopause was documented in an electronic health record, it generally matched what women reported in surveys. Women who had a menopause diagnosis in their records almost always also reported menopause themselves. This suggests that the available records were usually consistent with participant reports, but many women simply had no menopause-related information recorded.
The findings raise concerns because menopause can play an important role in health research. According to the investigators, menopause is a normal physiological transition that can influence cardiometabolic health as well as many other aspects of women's health.
Despite its importance, researchers say there are still significant unanswered questions. Scientists are continuing to investigate how the timing of menopause affects health, how different types of menopause may influence outcomes, and how menopause-related experiences vary across different populations and backgrounds.
Hendricks said missing information on age at menopause poses a particular challenge for researchers trying to understand the relationship between menopause and disease.
"Without knowing age at menopause, it becomes much harder to separate the effects of menopause from simply getting older," she said. Using heart health as an example, she noted that while the risk of heart disease increases after menopause, researchers still do not fully understand how much of that increase is driven by hormonal changes versus the aging process itself.
The study also found that several key pieces of information were frequently missing. In many cases, records did not clearly indicate whether a woman had gone through menopause.
Information about age at menopause, an important factor for researchers studying health outcomes, was often absent as well. Other reproductive health details related to menopause were also lacking.
Those gaps can create challenges for research. Large programs such as All of Us combine a range of information sources, including participant surveys, electronic health records, and genomic data. These extensive datasets have the potential to help scientists answer important questions about menopause and its relationship to health.
However, researchers noted that such studies depend on the availability of high-quality information. If menopause status, timing, or related reproductive health details are missing, it becomes more difficult to investigate links between menopause, disease risk, and long-term health outcomes.
The study's authors argue that incomplete data can limit the scientific community's ability to fully understand the role menopause plays in women's health over time. Without information about when menopause occurred or other relevant reproductive health factors, important patterns may remain difficult to detect.
Beyond identifying a problem, the researchers say their findings can help guide future studies using the All of Us database. The work may assist scientists in defining menopause-related study groups, designing research projects, and estimating how many participants are needed to answer specific questions.
The researchers also say the findings point to a broader gap in the collection of women's health data. They argue that menopause and reproductive health information should be gathered more consistently and more completely.
According to Hendricks, one practical way healthcare systems could improve menopause data collection would be to ask standardized questions on forms women already complete during routine appointments.
"Start asking and keep asking. Ask systematically and consistently," she said. Hendricks suggested including one or two questions about menstrual cycles and menopause status during annual physicals, OB-GYN visits, and mammogram appointments to ensure the information is collected consistently across patients.
Better documentation, they suggest, could help researchers examine how menopause is linked to health and disease, explore how age at menopause relates to disease risk, and study outcomes across diverse populations. Ultimately, improving the availability of menopause-related information may help advance knowledge and support better care for millions of women in the future.
Reference:
Staples et al. Menopause.
DOI: 10.1097/GME.0000000000002884
Contact Newsweek editors on this story: Kara Dolman and Paul Donnelley.
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