Commercial Menopause Testing Undermines Evidence-Based Care, Experts Warn

Medical experts have sounded the alarm over the rapid proliferation of direct-to-consumer menopause services, warning that many commercial hormone tests marketed to menopausal women are unnecessary and potentially harmful to patient care. In an editorial published in The BMJ today, healthcare professionals express concern about the growing commercialization of women’s health that may be steering patients away from evidence-based treatments.

The surge in commercial menopause services has given rise to what experts describe as a “troubling trend” — the promotion of routine hormone panel testing for evaluating menopausal symptoms. These tests, often costing hundreds of dollars, are marketed to both patients and clinicians as essential tools for personalizing hormone therapy regimens.

However, according to the editorial, such tests offer limited clinical value. There is no clearly defined therapeutic window for menopausal hormone therapy, and certain testing methodologies fail to provide accurate assessments of hormone levels. More importantly, hormone testing cannot reliably determine which patients will benefit from treatment, when a woman’s final menstrual period will occur, or when it becomes safe to discontinue contraception.

“Until we can establish individualized target hormone levels, there is no role for commercial hormonal panel testing to guide therapy,” the authors argue, adding that such testing currently provides only “a false sense of precision” rather than actionable medical information.

This position aligns with established clinical guidelines from respected medical organizations including the British Menopause Society, the National Institute for Health and Care Excellence, and the American College of Obstetricians and Gynecologists. These guidelines consistently advise that for women over 45 presenting with validated menopause symptoms and menstrual irregularity, hormone testing is unnecessary as menopause can be diagnosed clinically.

Despite these recommendations, an increasing number of women are arriving at medical appointments with detailed hormone panels obtained from wellness providers or online services. The authors note these test results are frequently used to justify custom-made hormone preparations or supplements based on minor hormone deviations that lack scientific foundation.

The experts express particular concern about compounded hormone regimens, which aren’t regulated like standard menopausal hormone therapy and haven’t undergone rigorous testing for safety and efficacy. Inconsistent quantities of estrogen or progestogen in these preparations could potentially cause abnormal cell growth or cancer in the uterine lining.

The editorial suggests that the rising popularity of hormone panel testing may reflect broader issues in women’s healthcare, including inadequate attention to women’s symptoms and concerns. The commercialization of menopause care has emerged in this vacuum, offering what appears to be scientific precision but may instead be moving patients away from evidence-based practice.

For middle-aged women seeking relief from menopausal symptoms, the authors emphasize that effective treatment begins with thorough clinical assessment rather than laboratory numbers. They advocate for prioritizing a patient’s reported symptoms, with treatment decisions guided by clinical response and individual preferences.

“For midlife women, effective treatment begins not with numbers, but with listening,” the authors conclude, highlighting the importance of patient-centered care in addressing menopausal symptoms effectively.

The editorial serves as a reminder that while innovation in women’s health is needed, it must be grounded in scientific evidence rather than commercial interests that may ultimately compromise patient care.