Patient-Centered Approach to Menopause Management

UH psychologist receives project award to further objective

Innovations in Obstetrics & Gynecology | Summer 2025

More than 1.3 million women enter menopause each year. It’s a transition that spans an average of four years, but may last up to 10 years for some women. Because we are living longer, women may spend as much as 30 percent of their life in menopause or post menopause. The need for patient awareness, education and medical proficiency is significant.

Erika Kelley, PhD

While menopause is a natural phenomenon, it may present challenges for women, such as hot flashes and difficulties sleeping. It also has implications for long-term health, particularly around cardiovascular disease and osteoporosis. Many women are not even aware they are in the menopause transition due to lack of available information, lingering stigmas and misinformation, medical gaslighting or limited access to healthcare.

Finally, few medical school curricula adequately prepare physicians to appropriately care for menopausal women. A recent survey found that menopause-related healthcare was included in fewer than one-third of OB/GYN residency training programs.

“There’s a lot of confusion around safe and available management options for women in the menopause transition,” says Erika Kelley, PhD, a psychologist in the Division of Behavioral Medicine in the Department of OB/GYN at University Hospitals. “For example, widespread fear of hormone replacement therapy makes it an underutilized and under prescribed option for some women who could benefit. Likewise, Cognitive Behavioral Therapy for vasomotor symptoms is proven effective, but most women don’t know it exists, and most therapists don’t have training in this area.”

Advancing Menopause-related in Healthcare

Dr. Kelley, who is also an Associate Professor at Case Western Reserve University School of Medicine, has been awarded the Eugene Washington Engagement Award from Patient-Centered Outcomes Research Institute (PCORI), which funds comparative clinical effectiveness research. The funding award is a one-year project aimed at convening a broad advisory board to understand the challenges surrounding menopause-related healthcare and to develop a prioritized project agenda to address the gaps.

“This initiative is innovative in that we are convening an advisory board that includes a wide cross section of stakeholders, including women in the community who both have–or have not–engaged in healthcare related to menopausal health,” she says. “Similarly, we’re also recruiting healthcare providers who have–or don't have–experience in menopausal health. Two key organizations, Let’s Talk Menopause and the National Menopause Foundation, are also partnering with us on this project. We aim to bring all these differing perspectives together to develop a research agenda and to identify critical next steps that focus on patient-centered menopause healthcare.”

Dr. Kelley envisions this as an iterative process. Over the course of the year, the advisory board will hold four stakeholder meetings to gather perspectives and feedback from stakeholders. In between meetings, they will integrate what they learn, develop stakeholder educational material, conduct a literature review and present findings back to the advisory board so members are aware of what information and tools are available, and what’s still missing. Once the advisory board prioritizes key needs, they will disseminate the findings to the broader healthcare and public community.

Giving Women a Voice

“Since I am in academic medicine, I recognize that I am overexposed to people who show up for healthcare,” Dr. Kelley notes. “However, we’re not necessarily talking to individuals who have barriers to healthcare. This initiative gives us the opportunity to talk to those women as well, and to be able to hear from women who’ve had a wide range of healthcare experiences. If we only look at one perspective, we’re missing important information.”

So many factors stand in the way of ensuring all women who want and need menopause-related healthcare receive it, including lack of insurance, culture, fear, lack of knowledge, language barriers, distrust of the medical system, competency of providers and the unique needs of transgender patients.

“It’s important to have a platform to support women and to allow them to speak for themselves in their own experiences – and to learn what’s important to them –  regarding menopause-related health,” Dr. Kelley says. “We anticipate a lot of empowerment, collaboration and interdisciplinary work will result from this project.”

For more information about this initiative, contact Dr. Erika Kelley at Erika.Kelley@UHhospitals.org or 440-720-4845.

Contributing Expert:
Erika Kelley, PhD
Clinical Psychologist
Division of Behavioral Medicine
Department of Obstetrics & Gynecology
University Hospitals
Associate Professor
Case Western Reserve University School of Medicine

The Patient-Centered Outcomes Research Institute® (PCORI®) is an independent, nonprofit organization authorized by federal law in 2010. Its mission is to fund research that will provide patients, their caregivers, and clinicians with the evidence-based information needed to make better-informed healthcare decisions. PCORI is committed to continually seeking input from a broad range of stakeholders to guide its work.

The project discussed in this article was funded through a Patient-Centered Outcomes Research Institute ® (PCORI®) Eugene Washington PCORI Engagement Award (EASCS-42326).