What They Don’t Teach in Med School about Menopause

They can’t diagnose what they don’t know.

By Joan Naidorf DO

When my friend Linda started having symptoms of peri-menopause around age 50, she spoke to her general internist about it. Her physician offered medication to address anxiety. After discussing some of the same problems with her regular gynecologist, she was told extensively about peri-menopause with advice on what to expect and some options on what she might do to address the issues.

Why such a difference in the diagnosis and approach? One likely explanation is the spectacular lack of menopause-related education offered during medical school. Medical school curriculum is generally divided into two years of basic sciences, followed by two years of moving through hospital based clinical rotations. Deep within the curriculum subject of obstetrics and gynecology, after the lessons on pregnancy, eclampsia, ectopic pregnancy, pelvic infections, and contraception, might be a lecture or two on menopause.

During most clinical rotations, students and residents become part of a team with an attending physician, taking care of hospitalized patients. Menopause and peri-menopausal problems are generally not seen in patients who are hospitalized. Students and residents do participate in outpatient clinics where peri-menopausal patients may or might not present for care. Most of the outpatient OB-GYN care I recall from my own training centered on monthly obstetric visits and contraceptive treatments.