Menopause Challenges Across Rural, Suburban and Urban Communities

A recent and groundbreaking study published in Menopause sheds light on how women in rural, suburban and urban areas experience menopause differently, with differences in symptoms and resources.

As previously reported in Managed Healthcare Executive, the study, which analyzed data from a 2019 survey of 3,197 U.S. women, highlights many disparities.

For rural women, the menopause journey appeared to be significantly challenging due to higher rates of mood swings, urinary incontinence and vaginal dryness during post-menopause, compared to women in suburban and urban communities.

Although there were differences, the study found a consistently low use of menopausal hormone therapy (MHT) across all groups, with only 11% of women utilizing this treatment.

Study authors Susan D. Reed, MD, MPH, MS, past president of The Menopause Society and professor emeritus in the Department of Obstetrics and Gynecology at the University of Washington School of Medicine, and Erin Dwyer, MPH, analyst in the Research Division at the University of Washington School of Medicine, attribute some of these differences to underlying health disparities.

"The baseline prevalence of anxiety and depression was higher among rural-residing women in our study, which could drive the increased prevalence of mood swings in rural women during menopause,” they explained. “This could also contribute to a different subjective experience of the changes that occur during the late perimenopause.”

Other contributing factors could include socioeconomic barriers, such as limited access to healthcare, they shared. Rural women often face challenges in obtaining care, with many needing to travel long distances to see specialists.

“We know that some patients have to drive more than an hour for a 15-minute appointment,” they added. “The likelihood of making an appointment in the first place drops dramatically as distance, time, work obligations, and childcare intervene.”

The study also uncovered differences in how women access information about menopause.

Suburban women were more likely to turn to social media, while rural women relied more on healthcare providers.

However, relying on healthcare providers doesn’t always mean rural women get all the information they need, because these communities often have fewer resources catered to them.

“There are preconceptions and stereotypes about rural women and their approach to health and wellness,” Reed and Dwyer said.

Aside from these challenges, their research suggests that rural women are just as likely as their urban and suburban peers to explore MHT as a treatment option.

Given the low overall use of MHT and its potential benefits, the researchers highlight the need for targeted education and outreach.

Reed and Dwyer suggest that healthcare organizations adopt tailored communication strategies to address the unique challenges faced by women in different communities.

“More research is needed to explore the explanations behind these differences,” they said.

Understanding the factors causing disparities in menopause experiences could pave the way for more equitable healthcare solutions, ensuring that all women can navigate this natural stage of life with confidence and support.