VA Menopause Care: Actions Needed to Help Ensure Quality Care and Patient Education

Summary

What GAO Found The Department of Veterans Affairs’ (VA) Veterans Health Administration (VHA) offers menopause care—treatments to manage symptoms of menopause—at its medical facilities through a wide array of treatment options, including medications and medical services. Primary care and gynecology providers are the key clinicians for veterans seeking to address menopause symptoms and can refer to other specialists such as mental health and physical therapy as needed. Common Menopause Symptoms To assist those providing menopause care, VHA is developing a clinical practice guideline. It is intended to provide evidence-based recommendations for providers on how to assess, diagnose, and treat menopause. However, the guideline was not complete at the time of GAO’s review. As part of the guideline development process, VHA plans to identify related performance measures. However, officials from the Office of Women’s Health, the sponsoring office for the guideline, could not confirm whether or how they plan to monitor the performance measures. Officials said it is difficult to make plans for monitoring before the recommendations and measures have been identified. Using performance measures to monitor implementation of the guideline’s recommendations could help VHA better achieve the objective of providing equitable, high-quality, and comprehensive health care services at all VHA facilities. VHA has developed patient education about menopause care, which include brochures and a website to help educate women veterans on menopause care. However, this information may not be reaching many women veterans. More than half (60 percent) of the 348 women veterans who responded to GAO’s questionnaire reported that they had not encountered any VHA menopause resources. VHA facility officials reported challenges finding time to discuss menopause education and print brochures. VHA does not have a strategy to ensure that menopause education is regularly communicated to veterans. This information would help women become more knowledgeable about the changes occurring in their bodies and would help them be more empowered to approach their providers about their symptoms. Furthermore, this could help VHA better meet its goal of providing women veterans with comprehensive health care. Why GAO Did This Study Almost half of women veterans served by VHA are aged 45-64, the age range most likely to experience menopause, or the permanent cessation of menstruation. According to VHA research, veterans may experience worse menopause symptoms compared to non-veterans due to aspects of their service. GAO was asked to review VA’s provision of menopause care. This report examines how VHA offers menopause care and educates veterans about menopause, among other topics. GAO analyzed VHA data on menopause care from fiscal years 2019 through 2024. GAO interviewed VHA officials with roles related to menopause care and officials from six VHA medical facilities, selected to represent variation in geographic area, among other criteria. GAO also administered an online questionnaire and conducted discussion groups with women veterans about their experiences with VHA menopause care. Their responses are not generalizable to all women veterans but provide perspectives about VHA’s menopause education efforts and care offerings.