Objective:

To investigate the association between payer type (Medicaid vs private insurance) and the use of menopausal hormone therapy (MHT) among women aged 45 to 64 years, and to explore disparities in treatment rates among Black or African American individuals.

Approach:

• Study Design: A retrospective cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) to assess MHT use based on insurance type.
• Data Collection: Combined data from NHANES cycles (2013-2014, 2015-2016, 2017-2020) to analyze insurance status and self-reported race and ethnicity.
• Eligibility Criteria: Included women aged 45-64 with Medicaid or private insurance, excluding those with contraindications or other specified conditions.

Key Findings:

• Menopausal hormone therapy (MHT) is the first-line treatment for bothersome vasomotor symptoms (VMS) but has low utilization rates.
• Black or African American individuals report more severe VMS but receive less MHT compared to White counterparts.
• Insurance coverage significantly influences access to MHT, with disparities observed based on payer type.

Interpretation:

The study highlights the potential impact of insurance coverage on MHT utilization and the disparities faced by certain racial and ethnic groups.

Limitations:

• The study relies on self-reported data, which may introduce bias.
• The analysis is limited to a cross-sectional design, preventing causal inferences.

Conclusion:

Further investigation into the role of insurance coverage in MHT utilization and the disparities among different racial and ethnic groups is warranted.

Sources:

• National Health and Nutrition Examination Survey (NHANES)