On September 8, 2026, the University of Colorado Anschutz Medical Campus published findings from a study of nearly 396,000 women in the NIH's All of Us Research Program showing that menopause is documented in electronic health records for only about 7% of them. The work, led by CU Anschutz bioinformatics associate professor Audrey Hendricks and published in the journal Menopause, compared what participants reported in surveys against what their EHRs actually recorded. The gap is roughly sevenfold: about 193,000 menopause observations in survey data versus about 28,000 menopause diagnoses in the health records.

Why It Matters

Menopause is the fastest-growing segment of femtech by investor attention, and this study exposes the foundation it is being built on. Every efficacy claim in the category — every "clinically validated" vaginal moisturiser, every red-light pelvic device, every menopause telehealth platform pitching payers on downstream cost savings — ultimately wants to point at real-world evidence. Real-world evidence in the US runs through electronic health records. If 93% of women in a 396,000-person NIH cohort have no menopause documentation, that evidence base has a hole in the middle of it. The consequences compound in three directions. For researchers, it caps statistical power and makes population definitions mushy. For companies, it means claims substantiation stays expensive and bespoke — you fund your own trial because you cannot lean on the record. For payers and employers now being asked to cover menopause benefits, it makes ROI arguments harder to verify, which slows reimbursement, which slows the whole category. It also sits pointedly alongside the other menopause infrastructure news of the past week: ISO published ISO 45010, the first international workplace standard for menstruation and menopause support, and the estradiol patch supply crunch continues without a formal FDA shortage designation. Standards and supply are getting attention. The data layer — the boring, unsexy question of whether anyone writes "menopause" in the chart — is the one that quietly determines whether any of the rest can be proven to work.

Directionally, the records that do exist are accurate. Nearly all participants with a menopause diagnosis in their EHR also reported menopause in survey data — so when clinicians write it down, it lines up with what women say. The problem is that they overwhelmingly do not write it down. And when they do, supporting detail is frequently absent, including age at menopause, which is one of the most useful variables researchers have for linking the transition to downstream chronic disease risk.

"Ultimately, we cannot study what we do not measure. We cannot treat what we do not know," Hendricks said in the CU Anschutz release. "Menopause has enormous implications for women's health, but if we don't consistently capture when menopause occurs and other important reproductive health information, we limit our ability to understand how this transition affects disease risk and health outcomes."

The practical output of the paper is guidance for anyone building research on All of Us data: how to define menopause-related study populations, how to design around the documentation gap, and how to calculate the sample sizes actually needed given that most of the cohort has no EHR record of the transition at all. FemTech World covered the findings on September 9.

Menopause is a physiological transition with established links to cardiometabolic health and a long list of other outcomes — including the sexual health consequences the pleasure and wellness industries have spent the past three years building product lines around, from vaginal dryness and genitourinary syndrome of menopause to changes in libido and pelvic floor function. Yet as the researchers note, relatively little is known about how the timing and type of menopause influence outcomes across diverse populations, because the underlying data largely isn't collected.

Sources

Update — 2026-09-11

{Initial entry — story first created.}