Menopause Without Borders: An Integrated, Multisystem Framework for Recognition and Care Across Specialties

Authors

• Charlotte K. Mathis MPAS, PA-C, University of LynchburgFollow

Specialty

Women's Health

Advisor

Dr. Blake Rogers

Abstract

Menopause is a universal physiologic transition affecting approximately 47 million women annually worldwide, yet its clinical consequences extend well beyond the vasomotor and reproductive symptoms historically emphasized in practice. The objective of this narrative review was to evaluate whether an integrated, multisystem approach to menopause improves time to diagnosis and treatment and reduces associated morbidity. A qualitative literature review was conducted using PubMed, CINAHL, the Cochrane Library, and OpenEvidence, an AI-based medical information platform, with medical subject headings (MeSH) terms encompassing menopause, cardiovascular, neuropsychiatric, genitourinary, musculoskeletal, and quality of life. Inclusion criteria encompassed primary research articles published between 2016 and 2026, with priority given to studies published within the last five years. The evidence demonstrates that estrogen deficiency drives interconnected, multi-system with measurable consequences across organ systems. Arthralgias, insomnia, fatigue, mood disturbance, cardiovascular changes, and bone loss are well-documented manifestations of estrogen deficiency, yet providers outside menopause-focused specialties do not routinely identify hormonal decline as an underlying etiology. Fewer than 4% of women who qualify for hormone replacement therapy currently receive it, reflecting a systemic failure of clinical recognition across disciplines. These findings support a systems-based reconceptualization of menopause as the unifying driver of multisystem morbidity, with direct implications for clinical education, provider training, and care delivery for women at midlife. Future research should prioritize diverse longitudinal cohorts, quantitative endpoints, standardized hormone therapy exposure data, and integrated multisystem frameworks to advance evidence-based menopause care. Recognizing hormonal decline as a plausible underlying etiology is a clinical competency relevant across orthopedics, psychiatry, cardiology, urology, and primary care.

Recommended Citation

Mathis CK. Menopause Without Borders: An Integrated, Multisystem Framework for Recognition and Care Across Specialties. University of Lynchburg Doctoral Project Assignment Repository. 2026; 8(3).