Menopause care and research are experiencing renewed attention after a long period of stagnation that began in 2002. That year, the Women’s Health Initiative study raised concerns about hormone therapy, which led to a significant drop in its use among women in midlife. According to Dr. Rajita Patil, an OB-GYN at UCLA Health, “Progress in this field ground to a halt for 20 years. It made people fearful to where doctors basically stopped writing prescriptions.” By 2020, fewer than one in twenty women used hormone therapy.
Recently, menopause has become more visible in popular culture and on social media platforms like TikTok. Dr. Patil attributes this shift to increased awareness: “I definitely think menopause is having a moment,” she said. “More women have realized that they don’t have to stay silent and they don’t have to suffer. That increased awareness has driven a huge increase in demand for care.”
Dr. Patil launched the Comprehensive Menopause Care program at UCLA to address the growing need for evidence-based and multidisciplinary support during menopause. She explained that the 2002 study had limitations: “For one thing, it wasn’t really studying the population of people who used hormone therapy to treat menopause symptoms — people in their 40s and 50s, mainly. The average age of study participants was 65.” She noted that later analysis showed little or no increased risk from hormone therapy among younger women.
The lack of access to effective treatment has been challenging for many women managing both family and work responsibilities while experiencing disruptive symptoms such as hot flashes, sleep disturbances, mood changes, and cognitive difficulties.
Accessing competent care remains difficult due to a shortage of trained providers. Dr. Patil said, “There’s been a rise in direct-to-consumer platforms that sell compounded medicines, celebrity doctors with big social media presences who pushing their own products… So, women might be receiving care that’s unsafe and misguided.” She emphasized that individualized hormone testing marketed by some clinics is not supported by scientific evidence: “There’s no magic hormone level we’re trying to achieve… That’s why the best evidence-based care is still focused on managing and treating clinical symptoms.”
Dr. Patil described her own journey into menopause specialization: “Earlier in my career, I didn’t want my patients to ask me questions about menopause because I didn’t know how to answer them.”
The UCLA Comprehensive Menopause Care program uses an assessment system called MAPSS (Menopause Assessment and Pathways Support System), which collects detailed patient information before appointments so clinicians can focus on shared decision-making during visits. The approach brings together specialists from various fields—cardiology, sleep medicine, mental health—to provide coordinated care across eleven clinical pathways.
Training efforts are expanding as well; menopause education is now part of OB-GYN residency programs at UCLA and included within medical school rotations for OB-GYN students. The number of specialized providers at UCLA has grown to fourteen, with over two thousand patients treated using this model over two years.
To broaden expertise beyond UCLA’s clinic walls, continuing medical education opportunities have been created so clinicians can share knowledge with colleagues—a process Dr. Patil calls “education percolation.” Statewide momentum is also building: Governor Newsom has proposed incentives for physicians treating women over forty who complete additional training in menopause care.
Collaboration among University of California campuses is increasing following the creation of a systemwide consortium aimed at replicating successful programs across all UC academic health centers. Last year California allocated three million dollars from its state budget specifically for expanding perimenopause and menopause services throughout the UC system.
“Our shared goal across UC now is to reach as many Californians as possible,” Dr. Patil said.
