How Digital Health is Closing the Gap in Perimenopause Treatment
What’s changed for women navigating perimenopause
Even though millions of women each year enter perimenopause, this transitional phase and its potential treatment options have gone largely unaddressed and misunderstood. However, social media, generational shifts, and even the role of telehealth in perimenopause care have brought awareness to a phase of women’s lives that has often been dismissed.
Additionally, recent FDA labeling updates for certain menopausal hormone therapy products have renewed conversations among patients and providers about how HRT risks and benefits are evaluated.
But let’s take a step back and explore how we got here and how telehealth has opened access to perimenopause care.
Perimenopause Care: A History of Limited Access
Back in 1821, when menopause was first defined, physicians began trying various ways to treat women’s symptoms, including opium and acupuncture. Both treatment options shed light on just how severe symptoms could be, but a specific solution for menopause wasn’t FDA-approved until the 1940s.
Premarin: An Early Widely Used HRT Option
The estrogen pill Premarin, a hormone replacement therapy (HRT) derived from pregnant mare urine, was first introduced in the U.S. in 1942. It was marketed as a way to orally “replace” declining estrogen levels and help combat hot flashes, night sweats, and other related symptoms. From the mid-1960s to mid-1970s, estrogen use increased substantially, with some reports describing sales as doubling or tripling during that period.
Decades of Shifting Perspectives on HRT
In the 1970s, HRT use declined after reports linked unopposed estrogen therapy to an increased risk of endometrial cancer.. In response, estrogen product labeling evolved to include stronger risk information, including warnings related to cancer and blood clot risks.
1980s-1990s: Evidence found that adding progestin to estrogen therapy reduced cancer risk concerns, and HRT regained popularity. Almost 15 million U.S. women used estrogen-based menopausal treatment.
2002: The Women’s Health Initiative (WHI) study linked HRT to increased risks of breast cancer, stroke, and blood clots, with use declining by nearly 50% as women’s fears soared.
2002 - 2020s: The WHI findings were later interpreted with more nuance, including consideration of age, timing of treatment initiation, formulation, route, and individual risk factors. Still, the study contributed to decades of uncertainty and caution around HRT.
2025: In 2025, the FDA requested labeling changes for menopausal hormone therapy products to clarify benefit-risk considerations.
2026: In 2026, the FDA approved labeling changes for six menopausal hormone therapy products, including removal of certain boxed-warning risk statements related to cardiovascular disease, breast cancer, and probable dementia.
The Diagnosis Disconnect: Perimenopause or Something Else?
Decades of shifting guidance and public concern around HRT contributed to a knowledge gap, even among healthcare professionals. As a result, women experiencing perimenopause symptoms were often referred to specialists for each individual issue, rather than being treated for an underlying hormonal cause.
Part of this disconnect results from how doctors are trained, with a 2023 study revealing that fewer than one-third of residency programs offer a standardized menopause curriculum. When healthcare providers have limited menopause-specific training, it can create additional barriers for women seeking appropriate care.
The Role of Telehealth in Perimenopause Treatment
In 2020, telehealth use surged out of necessity, but in the years since, it has opened access to perimenopause and many other methods of care.
Accessibility
For many women, geography, transportation, and even clinic availability have determined what kind of care is realistically available to them. In addition to the limited availability of hormonal health specialists, especially in rural areas, women often also have childcare barriers. In one safety-net population study, childcare barriers were identified as the leading reason women delayed or missed healthcare appointments, ahead of transportation and insurance barriers.”
Telehealth helps remove the convenience friction of taking time off, arranging childcare, or traveling to see a provider.
Education
Digital health platforms are primarily known for providing care and streamlining care navigation, but another important component is educational content.
Articles, webinars, and classes help women understand the changes their bodies are going through, with digital health applications making it possible to reach women at scale. Education can make it easier for patients to have informed conversations with licensed healthcare professionals.
Education doesn’t just stop with patients, either. As mentioned in Women’s Health Issues, “digital platforms are well-positioned to unite menopause experts in one place”, creating space for them and other providers to learn from each other.
Privacy
Research has found that shame and stigma around menopause symptoms are widespread, with over 80% of respondents in one national survey reporting stigma associated with their symptoms. This has shown up in other areas of reproductive healthcare too, where research found that telehealth reduced stigma around HIV and STI care by giving patients a more private, convenient option, encouraging those who might otherwise avoid care to seek support.
For some patients, discussing symptoms like hot flashes, low libido, or vaginal dryness may feel easier from the privacy of home than in a clinical setting. In fact, the growing interest in at-home hormone testing reflects this same desire for privacy. In one study, women were asked why they’d use or recommend at-home perimenopause tests, and they cited convenience, privacy, and cost as the top reasons.
Ready to Offer Hormone Therapy at Your Business?
Telehealth hasn’t just expanded access; it’s changing the conversation around perimenopause altogether, allowing providers to meet women exactly where they are.
With recent FDA labeling updates renewing discussion around HRT, more women may seek informed conversations about perimenopause care, symptom management, and available treatment options.
OpenLoop enables you to launch hormone therapy faster, all under your brand, while we handle all the clinical operations behind the scenes:
Nationwide, NCQA-accredited clinician network: Access a large network of clinicians spanning 30+ specialties.
Clinically-compliant infrastructure: HIPAA-aligned and SOC 2-certified technology, workflows, and protocols.
RCM & Billing: Cash-pay and insurance billing frameworks built-in
Lower-lift scalability: Add perimenopause hormone care to your offerings with less operational lift than building a program from the ground up
Ready to scale your telehealth offerings? Chat with us today!
*This content is intended for general informational purposes only and should not be construed as legal advice. For guidance on your specific situation, please consult a licensed attorney.