Electronic Health Records Note Menopause in Just 12% of Cases Despite Over Half of Women Self-Reporting It

Researchers compared self-reported menopause status from All of Us enrollment surveys against structured EHR fields and diagnostic codes across nearly 240,000 participants. They also assessed documentation of age at menopause and symptoms such as hot flashes. Discrepancies were consistent across age, race, education, and income strata, with age at onset and symptom details absent in the vast majority of records. This pattern aligns with prior smaller audits showing menopause rarely coded because it is not treated as a disease state.

The absence of routine menopause data limits large-scale investigation of timing effects on cardiovascular risk, bone density loss, and cognitive changes, as well as how social determinants modify symptom burden. Earlier observational studies in UK Biobank and Kaiser Permanente similarly found low capture rates, confirming the gap is systemic rather than program-specific. Without structured fields, researchers cannot readily examine longitudinal trajectories or test interventions targeting under-recognized symptoms.

The team is piloting a brief check-in questionnaire to capture status and symptoms directly into records. If scaled, this could raise documentation to levels seen for other reproductive milestones such as last menstrual period queries. Next steps include validation across diverse health systems and linkage to outcome data to quantify whether improved capture alters clinical decision-making or research power.