Mrs Laura Brooks1, Dr Enamul Kabir1, Professor Leah East1
1University Of Southern Queensland, Australia
Biography:
Laura Brooks is a Master of Research candidate at the University of Southern Queensland, where her research examines socioeconomic and geographic disparities in menopausal healthcare utilisation using longitudinal data from the Australian Longitudinal Study on Women's Health. She holds a Master of Women's Health Medicine (UNSW), a Master of Clinical Chiropractic and Bachelor of Science (CQUniversity) and brings extensive experience as a clinician and allied health practice director. Her research applies a health equity lens to women's midlife health, with a focus on structural barriers to menopausal hormone therapy access across generations of Australian women.
Aims:
To synthesise quantitative evidence on how socioeconomic status (SES) influences menopause-related healthcare utilisation, including menopausal hormone therapy (MHT) use, help-seeking behaviour, and healthcare service use and costs.
Methods:
Systematic review of observational studies examining associations between SES and menopause-related healthcare utilisation among women experiencing natural menopause. Searches were conducted in PubMed, Web of Science, Scopus, and CINAHL. Findings were synthesised using Synthesis Without Meta-analysis (SWiM) guidelines. Risk of bias was assessed using Joanna Briggs Institute tools and certainty of evidence using GRADE.
Results:
Eighteen studies met inclusion criteria. Higher SES was consistently associated with greater MHT use and prescribing across healthcare settings, and in some cases with access to specific formulations. In contrast, associations between SES and help-seeking for menopausal symptoms were inconsistent, with symptom severity and healthcare access emerging as stronger predictors. Menopausal symptoms were associated with increased healthcare utilisation and costs. Socioeconomic gradients were more pronounced in insurance-based or user-pay systems than in universal coverage settings.
Conclusions:
Socioeconomic disparities in menopause care are most evident in access to MHT. Evidence for help-seeking and broader healthcare utilisation is more context-dependent. Inequities arise from system-level factors including affordability, provider access, and health system structure.