In the U.S., approximately 1.3 million women enter menopause each year. Despite its prevalence, people experiencing menopause receive startlingly little support from their healthcare providers and workplace. This lack of comprehensive care leaves people to navigate challenging physical and mental changes alone. 

What’s more, studies suggest menopause leads to $2,100 in direct and indirect healthcare costs per person per year. These costs stem from an increase in healthcare utilization for menopause symptoms, including hospitalizations, physician visits, gynecologist visits, and a higher likelihood of receiving a hysterectomy. To combat rising costs and improve outcomes, health plans need to give better support to members experiencing menopause. Here’s what health plans need to know and how they can help. 

What is menopause and how is it treated?

Menopause officially begins one year after a person’s last period. But the time leading up to that point—referred to as perimenopause—typically lasts between three and seven years. Within this time, members experience fluctuations in their levels of estrogen and progesterone. These varying hormonal levels drive many of the symptoms associated with menopause, including hot flashes and mood swings. Studies show that 75% of perimenopausal and menopausal women will experience some vasomotor symptoms, the most common among them being hot flashes and brain fog.

Treatments for symptoms can include pharmaceuticals and hormone replacement therapies, as well as homeopathic approaches to lessen the impact of some symptoms. Unfortunately, stigma around the condition makes people wary about asking for help from their provider. A Fawcett Society study found that 45% of women have not talked to their doctor about their symptoms, and 31% of women said it took “many appointments” for their physician to associate their symptoms with menopause or perimenopause. The numbers rose even higher for Black women: 45% had to seek multiple appointments before a menopause diagnosis. 

Understanding the impact of menopause on your members

Menopause represents a time of transition for your members, but few resources exist to help them. Supporting members experiencing menopause can ensure your plan provides equitable care for all members, regardless of age, while lowering costs. And understanding the effects of menopause can help your plan identify ways to improve support during this phase of life. 

Vasomotor symptoms

Hot flashes and brain fog, two of the most common symptoms of menopause, can majorly impact your members’ well-being. Hot flashes can occur sporadically throughout the day, lasting for three to four minutes at a time, causing unpredictable distress and discomfort. Brain fog, which impacts sleep quality, can similarly sap members of their energy. 

Mental health

Menopausal symptoms put members at a higher risk of mental illness for several reasons. On one hand, vasomotor symptoms can impact their quality of life: discomfort, poor sleep, and intimacy struggles can cause stress. On the other hand, fluctuating hormone levels can also impact and trigger mental health issues. Studies show that over a third of women who experience menopausal symptoms also experience depression. They also reported significant reductions in their quality of life and productivity.

Lack of support

The experience of menopause can be isolating, especially since support is often lacking. Menopause is still a nascent field of study in the healthcare system: 80% of OB-GYN residents indicate they are “barely comfortable” discussing or treating menopause. This means that the majority of members don’t receive the care they need, further contributing to increased healthcare costs for members and health plans.

A defining phase of life

Because menopause is so rarely discussed, your members may often feel alone or unsupported during this pivotal phase of life. While symptoms and severity vary, feelings of loss, shame, and isolation can prompt your members to make drastic changes in response to their symptoms. A recent study found that nearly 1 million women in the U.K. quit their jobs because of menopausal symptoms, indicating the significant role this experience plays in the lives of your members.

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Introducing Menopause & Ongoing Care

How to support menopausal members

As research into menopause advances, members clearly need more support than they currently have. Health plans can be there for menopausal members in three ways:

1. Providing access to specialty care

Because symptoms can be so diverse, and providers often feel untrained or unprepared to treat menopause, many members will need access to specialty care providers like reproductive endocrinologists or mental health specialists. Adding a digital benefit for women’s and family health can help your members get the support they need, supplementing the in-person care they receive with your plan providers. 

2. Educating members

Even among people going through menopause, few understand the symptoms and treatments for this phase of life. A survey by Bonafide found that 39% of people lack awareness of treatment options for menopause symptoms, and 27% don’t know common signs and symptoms of perimenopause. On top of providing increased access to specialty care, health plans can support menopausal members by ensuring they have access to clinically-vetted content, classes, and forums where they can get the information they need to navigate through their changing physical and mental health. 

3. Ensuring equitable access to menopause care

Black people going through menopause often experience worse symptoms, yet are less likely to receive the treatment they need to allay these symptoms. A SWAN analysis found that Black women are 50% more likely to report hot flashes compared to white women. Despite this, SWAN found that Black women are less likely to receive treatment for hot flashes and depression, compared to white women. Connecting Black menopausal members with healthcare experts who share their same cultural background and identity can help members get the education and treatment they deserve, regardless of race. 

Maven can help support your age-inclusive health benefits

Maven is the complete digital family health platform for health plans and employers seeking to provide more inclusive, cost-effective care to women and families. By providing members with high-touch care navigation, specialized care teams, and evidence-based care management programs, Maven can deliver the right care for menopausal people at the right time, all within a seamless virtual experience. Learn more about how Maven supports members experiencing menopause.

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