Worse menopause symptom burden reported in rural women

In a recent interview with Contemporary OB/GYN, Susan Reed, MD, MPH, MS, professor emeritus of obstetrics and gynecology at the University of Washington, discussed the findings of a study examining menopause symptom burdens among women in rural, urban, and suburban areas.

The study involved 1,531 participants, focusing on those identifying as female and categorized by their place of residence. It explored symptom prevalence, access to care, and disparities in menopause experiences across different demographics.

The study found that rural women, especially those in late perimenopause or late menopause transition, reported higher rates of muscle aches, pains, and panic attacks compared to their urban and suburban counterparts. Among postmenopausal women, mood swings, urinary problems, and vaginal dryness were more commonly reported. A notable finding was that only 11% of respondents across all regions were using hormone replacement therapy (HRT), despite significant rates of hot flashes at 71% during late transition and 20% post-menopause. Rural participants often opted to endure their symptoms without treatment, citing concerns about HRT risks and limited access to care.

Reed emphasized the importance of these findings as the first large-scale US study to evaluate menopause symptom disparities between rural and urban populations. Previous research primarily focused on racial disparities in select groups. The study highlighted potential links between symptom differences and factors such as occupation, socioeconomic status, obesity rates, and mood disorders. A key concern was access to care, with rural women frequently needing to travel over 2 hours for short appointments, often facing additional obstacles such as childcare and work absences. Additionally, rural health care providers were less likely to be equipped with sufficient training on menopause-related issues, exacerbating the challenges for rural women seeking education and treatment.

Reed stressed the need for further research to explore and address the disparities in menopause symptom management and health care access. Rural populations face higher risks for conditions such as cardiovascular disease, obesity, mood disorders, and smoking-related issues. Improved understanding of these challenges is critical to tailoring care for underserved communities.

The study serves as a starting point for addressing health equity in menopause care. Reed concluded by advocating for larger studies to develop effective strategies for delivering care to rural populations, emphasizing the need for better provider education and systemic changes to reduce barriers to access.