Objective: To evaluate the association of patient- and clinician-level factors and receipt of prescription medication for menopause-related symptoms in a large academic health care system. Methods: We conducted a retrospective cohort study of women aged 40-55 years seeking care for menopause-related symptoms in any outpatient encounter with family medicine, internal medicine, endocrinology, and OB/Gyn from 2016 to 2023. Prescriptions associated with menopause-related ICD-10 diagnoses were extracted. Bivariate and multivariable logistic regression were used to evaluate the association of patient- and clinician-level characteristics and receipt of prescription treatment. Results: We identified 5,491 women with an outpatient encounter with an associated ICD-10 code for menopause-related symptoms. Relative to White women, Black women were less likely to receive any prescription treatment for menopause-related symptoms (OR: 0.79, 95% CI: 0.67-0.95), including systemic estrogen (OR: 0.64, 95% CI: 0.47-0.87); however, were more likely to receive SSRIs (OR: 1.49, 95% CI: 1.04-2.14). Relative to patients seeking care within OB/Gyn settings, patients were less likely to be prescribed any treatment by internal medicine (OR: 0.45, 95% CI: 0.36-0.56), family medicine (OR: 0.52, 95% CI: 0.14-0.40), and endocrinology clinicians (OR: 0.23, 95% CI: 0.14-0.40). Conclusion: Our study demonstrates differential prescribing patterns for menopause-related symptoms with respect to race, insurance status, and clinician specialty. Our results underscore the need for equitable care for women experiencing menopause symptoms.
Urinary tract infections (UTIs) in women are common, bothersome, and linked to considerable costs for patients and health systems. Patients often experience adverse reactions with antibiotic therapy, and frequent antibiotic use for the treatment of UTIs is a major contributor to growing bacterial resistance to antibiotics worldwide. The development of antimicrobial resistance may limit future treatment options for the individual patient, as well as for the community. Nonantibiotic prevention offers the potential to limit these adverse consequences. Low-dose vulvovaginal estrogen therapy has an important role in preventing UTIs. In this Practice Pearl , UTI will refer to acute bacteria cystitis and associated symptoms.
