Abstract
Objectives
Healthcare professionals are poorly educated about menopausal disorders. To address this issue, we launched an online Menopause Instructor Course, which is certified by the Japanese Society of Psychosomatic Obstetrics and Gynecology (JSPOG).
Methods
Courses covering general remarks, hormone replacement therapy (HRT), non-HRT treatments, mental health, decision-making, and healthcare support were held in 2023 and 2024. Cognitive behavioral therapy was included in 2024. JSPOG-member healthcare professionals who completed all on-demand lectures and passed a post-test received certification as Menopause Instructors. In 2024, a questionnaire survey assessed participant feedback and compared Obstetricians and Gynecologists (OB/GYNs) to other healthcare professionals.
Results
A total of 198 and 143 professionals were certified in 2023 and 2024, respectively, with most of them being OB/GYNs. Certified Menopause Instructors were located across Japan. A survey conducted in 2024 showed that 93.7% of respondents were satisfied with the course. OB/GYNs found general remarks, HRT, and non-HRT treatments to be significantly easier. The overall self-assessed understanding was high (8.04 ± 1.01), with OB/GYNs scoring significantly higher than other healthcare professionals (8.29 ± 0.95 vs. 7.87 ± 1.02, P < 0.05).
Conclusions
The course successfully increased the number of trained professionals in menopause in Japan. Enhancing the course content to better serve OB/GYNs and other healthcare professionals is essential.
Keywords: Delivery of health care, Education, Gynecologists, Menopause, Psychosocial intervention
INTRODUCTION
Menopause is the irreversible termination of menstrual cycles due to the decline in ovarian follicular function [1]. Perimenopause, the period around the time of menopause, refers to the period from when the menstrual cycle is > 7 days longer than usual to one year before menopause [2]. The period around menopause is also often called “konenki” in Japan [3]. Many women experience unpleasant symptoms around the time of menopause.
In Japan, where the population is aging rapidly. In 2023, approximately 91 million women were equivalent to the menopausal age (45–54 years), accounting for 7.3% of the total population [4]. Various symptoms of menopause can affect women’s daily lives, including their careers. Indeed, Japan’s Ministry of Economy, Trade and Industry estimates that the economic loss due to menopausal symptoms is 1.9 trillion yen per year [5].
Many women with menopausal disorders visit unspecialized departments, consequently delaying the necessary therapy needed to treat the symptoms [6]. A biopsychosocial approach to the care of menopausal women is also essential [7]. To provide adequate care for menopausal women, there remains an urgent need for comprehensive menopause education for healthcare professionals [8].
The Japanese Society of Psychosomatic Obstetrics and Gynecology (JSPOG) is an academic organization that aims to deepen understanding of women’s specific disorders, focusing on mental health. Menopausal disorders are one of the primary conditions that members manage. In 2023, with the support of Astellas Pharma Inc., we launched an educational program called the Menopause Instructor Course. We hypothesized that hosting this course would allow JSPOG to address the lack of education on menopausal disorders among Japanese healthcare professionals and increase the number of professionals across Japan who can confidently manage these disorders, including those related to mental health. We aimed to investigate the regional distribution, specialization, understanding, and satisfaction of participants who completed the course and obtained certification as Menopause Instructors. Since Obstetricians and Gynecologists (OB/GYNs) and non-OB/GYNs have significantly different educational backgrounds regarding menopause, comparisons were made between these two groups in terms of course understanding and other outcomes.
MATERIALS AND METHODS
Education program
A working group for Menopause Instructor Course consisting of JSPOG directors and secretaries was formed. All matters relating to the program were determined at the working group meetings.
We distributed pamphlets at various academic conferences to encourage medical professionals to participate in the course. The first course was held in September 2023, and the second in October 2024. The eligibility requirement for the course was a healthcare profession with a national qualification in the medical field. Participants watched the lectures on demand for one month after applying in advance. The contents of the lectures and the time are shown in Table 1. Traditional Chinese medicine is commonly used to treat menopausal disorders in Japan. Therefore, the course devotes one lecture to treatments other than hormone replacement therapy (HRT). Additionally, to highlight the unique characteristics of JSPOG, which specializes in psychosomatic medicine and is composed of professionals from various fields, one lecture is devoted to mental health. Also, a lecture on cognitive behavioral therapy was added to the program in 2024.
Table 1. Program and lecture times.
| 2023 | 2024 | Time (min) | |
|---|---|---|---|
| 1 | Health problems in women during and after menopause (general remarks) | Health problems in women during and after menopause (general remarks) | 40 |
| 2 | Basics of hormone replacement therapy | Basics of hormone replacement therapy | 30 |
| 3 | Treatment options for menopausal disorders other than hormone replacement therapy | Treatment options for menopausal disorders other than hormone replacement therapy | 30 |
| 4 | The impact of menopause on mental health and management | The impact of menopause on mental health and management | 30 |
| 5 | Supporting patient decision-making and healthcare | Supporting patient decision-making and healthcare | 30 |
| 6 | Cognitive and behavioral approach to menopausal disorders | 30 |
The lectures were delivered by experts in their respective fields and videos were created using Microsoft PowerPoint (Microsoft Corporation). In the 2024 program, the PDF (Adobe) of the lecture materials was made available for download by participants. All participants took a pre-test before the lecture, which consisted of three questions for each lecture. In addition, a post-test was administered after all lectures were completed, which consisted of five questions for each lecture and included the same questions as the pre-test. Those who passed the post-test with a score of ≥ 80% were considered to have completed the course. The post-test could be taken as many times as necessary. Those who completed all lectures, passed the post-test, and are members of JSPOG were certified as Menopause Instructors and received a certificate.
The e-learning system was constructed by KYOWA KIKAKU Ltd. In 2024, participants were asked to complete a questionnaire at the end of the course. The questionnaire asked about backgrounds, overall and individual lecture satisfaction, time, and difficulty. Participants were also asked to rate their overall understanding on a scale of 1 to 10 (Supplementary, available online).
Ethics
This study was conducted in accordance with the principles outlined in the Declaration of Helsinki. The participants’ backgrounds and survey results were obtained anonymously. The Ethics Committee of Fukushima Medical University determined that an ethical review was not required for this study.
Statistical analysis
Data on participant characteristics were calculated using Microsoft Excel 2025 (Microsoft Corporation) and reported as numbers and proportions. OB/GYNs are specialists in menopausal medicine in Japan, and their level of understanding and satisfaction may differ from that of other healthcare professionals. For this reason, we compared the results of the 2024 survey between OB/GYNs and other healthcare professionals. Categorical variables were analyzed using chi-squared tests or Fisher’s exact tests to compare proportions. To account for multiple comparisons, Bonferroni correction was applied. Overall comprehension was compared using the independent samples t test as a continuous variable. P value of < 0.05 was considered statistical significance. All data were analyzed using SPSS Statistics 29.0 (IBM Co.).
RESULTS
Table 2 lists the number of participants, the number of individuals who passed the post-test, and the number of certified Menopause Instructors for each medical specialty qualification in 2023 and 2024. In 2023, 233 attended and 198 (85.0%) were certified as Menopause Instructors, while in 2024, 177 attended, and 143 (80.8%) were certified. In both years, more than 50% of all participants were doctors.
Table 2. Attendee specializations in 2023 and 2024 and percentage of attendees certified as Menopause Instructors.
| Applicants | Post-test passers | Post-test pass rate | Certified as a Menopause Instructor | Certification rate | ||
|---|---|---|---|---|---|---|
| 2023 | ||||||
| Total | 233 | 214 | 91.8 | 198 | 85.0 | |
| Doctor | 129 (55.4) | 121 (56.5) | 93.8 | 116 (58.6) | 89.9 | |
| Midwife | 43 (18.5) | 38 (17.8) | 88.4 | 31 (15.7) | 72.1 | |
| Nurse | 21 (9.0) | 20 (9.3) | 95.2 | 18 (9.1) | 85.7 | |
| Pharmacist | 14 (6.0) | 13 (6.1) | 92.9 | 12 (6.1) | 85.7 | |
| Acupuncturist | 9 (3.9) | 7 (3.3) | 77.8 | 7 (3.5) | 77.8 | |
| Physiotherapist | 5 (2.1) | 5 (2.3) | 100.0 | 5 (2.5) | 100.0 | |
| Certified public psychologist | 3 (1.3) | 3 (1.4) | 100.0 | 3 (1.5) | 100.0 | |
| Registered dietitian | 3 (1.3) | 2 (0.9) | 66.7 | 2 (1.0) | 66.7 | |
| Public health nurse | 2 (0.9) | 2 (0.9) | 100.0 | 1 (0.5) | 50.0 | |
| Dentist | 1 (0.4) | 1 (0.5) | 100.0 | 1 (0.5) | 100.0 | |
| Others | 3 (1.3) | 2 (0.9) | 66.7 | 2 (1.0) | 66.7 | |
| 2024 | ||||||
| Total | 177 | 168 | 94.9 | 143 | 80.8 | |
| Doctor | 91 (51.4) | 87 (51.8) | 95.6 | 79 (55.2) | 86.8 | |
| Midwife | 32 (18.1) | 30 (17.9) | 93.8 | 25 (17.5) | 78.1 | |
| Pharmacist | 14 (7.9) | 13 (7.7) | 92.9 | 8 (5.6) | 57.1 | |
| Nurse | 13 (7.3) | 13 (7.7) | 100.0 | 10 (7.0) | 76.9 | |
| Acupuncturist | 6 (3.4) | 6 (3.6) | 100.0 | 6 (4.2) | 100.0 | |
| Certified public psychologist | 6 (3.4) | 6 (3.6) | 100.0 | 5 (3.5) | 83.3 | |
| Dentist | 3 (1.7) | 3 (1.8) | 100.0 | 3 (2.1) | 100.0 | |
| Physiotherapist | 3 (1.7) | 2 (1.2) | 66.7 | 1 (0.7) | 33.3 | |
| Public health nurse | 2 (1.1) | 2 (1.2) | 100.0 | 1 (0.7) | 50.0 | |
| Registered dietitian | 1 (0.6) | 1 (0.6) | 100.0 | 1 (0.7) | 100.0 | |
| Others | 6 (3.4) | 5 (3.0) | 83.3 | 4 (2.8) | 66.7 | |
Data are presented as number only, number (%), or %.
The regional distribution of certified Menopause Instructors each year is illustrated in Figure 1. Certified Menopause Instructors were located throughout Japan. There were many certified Menopause Instructors in the Tokyo metropolitan area, including Tokyo, Saitama, and Kanagawa. Meanwhile, there are currently no certified Menopause Instructors in Fukui, Shimane, Tokushima, or Kochi.
Fig. 1. Number in each prefecture of certified Menopause Instructors.
Tables 3 and 4 show the results of a questionnaire given to participants at the end of the course in 2024. The most common profession of the participants, accounting for 40.9%, was OB/GYNs. A total of 36.5% of participants joined JSPOG when they enrolled in this course. Compared with other healthcare professionals, many OB/GYNs were already JSPOG members before the course was held. Participants were mainly in their 40s and 50s, accounting for ~70%. Overall satisfaction was very high, with 93.7% of participants reporting either very satisfied or satisfied; 86.6% indicated that the course was just the right length; 98.1% indicated they could use the course in their future work.
Table 3. Participants’ backgrounds based on responses to 2024 questionnaire (n = 159).
| Total (n = 159) | OB/GYNs (n = 65) | Other than OB/GYNs (n = 94) | P value | ||
|---|---|---|---|---|---|
| Are you a member of the Japanese Society of Psychosomatic Obstetrics and Gynecology? | |||||
| Already a member before taking the course | 58 (36.5) | 30 (46.2) | 28 (29.8)a | 0.013 | |
| Joined in order to attend this course | 77 (48.4) | 31 (47.7) | 46 (48.9) | ||
| Non-member | 24 (15.1) | 4 (6.2) | 20 (21.3)a | ||
| If you are a doctor: tell us your specialty (n = 84) | |||||
| Obstetrics and Gynecology | 65 (40.9) | - | - | ||
| Internal Medicine | 8 (5.0) | - | - | ||
| Psychiatry | 4 (2.5) | - | - | ||
| Psychosomatic Medicine | 3 (1.9) | - | - | ||
| Other than above | 4 (2.5) | - | - | ||
| Age (y) | |||||
| 20–29 | 3 (1.9) | 2 (3.1) | 1 (1.1) | 0.147 | |
| 30–39 | 18 (11.3) | 10 (15.4) | 8 (8.5) | ||
| 40–49 | 57 (35.8) | 28 (43.1) | 29 (30.9) | ||
| 50–59 | 58 (36.5) | 17 (26.2) | 41 (43.6) | ||
| 60–69 | 18 (11.3) | 7 (10.8) | 11 (11.7) | ||
| ≥ 70 | 5 (3.1) | 1 (1.5) | 4 (4.3) | ||
| Overall course satisfaction | |||||
| Very satisfied | 63 (39.6) | 24 (36.9) | 39 (41.5) | 0.684 | |
| Satisfied | 86 (54.1) | 38 (58.5) | 48 (51.1) | ||
| Average | 9 (5.7) | 3 (4.6) | 6 (6.4) | ||
| Dissatisfied | 0 (0.0) | 0 (0.0) | 0 (0.0) | ||
| Very dissatisfied | 1 (0.6) | 0 (0.0) | 1 (1.1) | ||
| Overall course volume | |||||
| Too much | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0.515 | |
| A little too much | 5 (3.1) | 1 (1.5) | 4 (4.3) | ||
| Just right | 133 (83.6) | 54 (83.1) | 79 (84.0) | ||
| A little too little | 20 (12.6) | 10 (15.4) | 10 (10.6) | ||
| Too little | 1 (0.6) | 0 (0.0) | 1 (1.1) | ||
| Do you think this course will be useful for your future activities? | |||||
| Very useful | 101 (63.5) | 39 (60.0) | 62 (66.0) | 0.545 | |
| Fairly useful | 55 (34.6) | 24 (36.9) | 31 (33.0) | ||
| Can’t say either way | 3 (1.9) | 2 (3.1) | 1 (1.1) | ||
| Not very useful | 0 (0.0) | 0 (0.0) | 0 (0.0) | ||
| Not at all useful | 0 (0.0) | 0 (0.0) | 0 (0.0) | ||
Data are presented as number (%).
OB/GYNs: Obstetricians and Gynecologists; -: not applicable.
aStatistically significant compared to OB/GYNs.
Table 4. Impressions of each lecture and overall understanding of the course, based on responses to 2024 questionnaire (n = 159).
| Total (n = 159) | OB/GYNs (n = 65) | Other than OB/GYNs (n = 94) | P value | |||
|---|---|---|---|---|---|---|
| Health problems in women during and after menopause (general remarks) | ||||||
| Lecture satisfaction | ||||||
| Very satisfied | 72 (45.3) | 25 (38.5) | 47 (50.0) | 0.379 | ||
| Satisfied | 74 (46.5) | 35 (53.8) | 39 (41.5) | |||
| Average | 12 (7.5) | 5 (7.7) | 7 (7.4) | |||
| Dissatisfied | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
| Very dissatisfied | 1 (0.6) | 0 (0.0) | 1 (1.1) | |||
| Lecture time | ||||||
| Too long | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0.237 | ||
| A little too long | 9 (5.7) | 5 (7.7) | 4 (4.3) | |||
| Just right | 147 (92.5) | 60 (92.3) | 87 (92.6) | |||
| A little too short | 3 (1.9) | 0 (0.0) | 3 (3.2) | |||
| Too short | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
| Difficulties with the lecture | ||||||
| Too easy | 3 (1.9) | 3 (4.6) | 0 (0.0)a | 0.002 | ||
| Somewhat easy | 25 (15.7) | 17 (26.2) | 8 (8.5)a | |||
| Just right | 126 (79.2) | 44 (67.7) | 82 (87.2)a | |||
| Somewhat difficult | 5 (3.1) | 1 (1.5) | 4 (4.3) | |||
| Too difficult | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
| Basics of hormone replacement therapy | ||||||
| Lecture satisfaction | ||||||
| Very satisfied | 70 (44.0) | 23 (35.4) | 47 (50.0) | 0.234 | ||
| Satisfied | 69 (43.4) | 33 (50.8) | 36 (38.3) | |||
| Average | 19 (11.9) | 9 (13.8) | 10 (10.6) | |||
| Dissatisfied | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
| Very dissatisfied | 1 (0.6) | 0 (0.0) | 1 (1.1) | |||
| Lecture time | ||||||
| Too long | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0.809 | ||
| A little too long | 6 (3.8) | 3 (4.6) | 3 (3.2) | |||
| Just right | 149 (93.7) | 61 (93.8) | 88 (93.6) | |||
| A little too short | 3 (1.9) | 1 (1.5) | 2 (2.1) | |||
| Too short | 1 (0.6) | 0 (0.0) | 1 (1.1) | |||
| Difficulties with the lecture | ||||||
| Too easy | 4 (2.5) | 4 (6.2) | 0 (0.0)a | < 0.001a | ||
| Somewhat easy | 26 (16.4) | 21 (32.3) | 5 (5.3)a | |||
| Just right | 117 (73.6) | 40 (61.3) | 77 (81.9)a | |||
| Somewhat difficult | 12 (7.5) | 0 (0.0) | 12 (12.8)a | |||
| Too difficult | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
| Treatment options for menopausal disorders other than hormone replacement therapy | ||||||
| Lecture satisfaction | ||||||
| Very satisfied | 68 (42.8) | 24 (36.9) | 44 (46.8) | 0.455 | ||
| Satisfied | 75 (47.2) | 35 (53.8) | 40 (42.6) | |||
| Average | 15 (9.4) | 6 (9.2) | 9 (9.6) | |||
| Dissatisfied | 1 (0.6) | 0 (0.0) | 1 (1.1) | |||
| Very dissatisfied | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
| Lecture time | ||||||
| Too long | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0.682 | ||
| A little too long | 7 (4.4) | 4 (6.2) | 3 (3.2) | |||
| Just right | 143 (89.9) | 58 (89.2) | 85 (90.4) | |||
| A little too short | 8 (5.0) | 3 (4.6) | 5 (5.3) | |||
| Too short | 1 (0.6) | 0 (0.0) | 1 (1.1) | |||
| Difficulties with the lecture | ||||||
| Too easy | 2 (1.3) | 2 (3.1) | 0 (0.0) | 0.042 | ||
| Somewhat easy | 18 (11.3) | 11 (16.9) | 7 (7.4) | |||
| Just right | 122 (76.7) | 48 (73.8) | 74 (78.7) | |||
| Somewhat difficult | 17 (10.7) | 4 (6.2) | 13 (13.8) | |||
| Too difficult | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
| The impact of menopause on mental health and management | ||||||
| Lecture satisfaction | ||||||
| Very satisfied | 59 (37.1) | 25 (38.5) | 34 (36.2) | 0.247 | ||
| Satisfied | 73 (45.9) | 31 (47.7) | 42 (44.7) | |||
| Average | 23 (14.5) | 6 (9.2) | 17 (18.1) | |||
| Dissatisfied | 4 (2.5) | 3 (4.6) | 1 (1.1) | |||
| Very dissatisfied | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
| Lecture time | ||||||
| Too long | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0.598 | ||
| A little too long | 11 (6.9) | 6 (9.2) | 5 (5.3) | |||
| Just right | 141 (88.7) | 55 (84.6) | 86 (91.5) | |||
| A little too short | 5 (3.1) | 3 (4.6) | 2 (2.1) | |||
| Too short | 2 (1.3) | 1 (1.5) | 1 (1.1) | |||
| Difficulties with the lecture | ||||||
| Too easy | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0.884 | ||
| Somewhat easy | 12 (7.5) | 5 (7.7) | 7 (7.4) | |||
| Just right | 130 (81.8) | 54 (83.1) | 76 (80.9) | |||
| Somewhat difficult | 17 (10.7) | 6 (9.2) | 11 (11.7) | |||
| Too difficult | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
| Supporting patient decision-making and healthcare | ||||||
| Lecture satisfaction | ||||||
| Very satisfied | 63 (39.6) | 26 (40.0) | 37 (39.4) | 0.727 | ||
| Satisfied | 69 (43.4) | 30 (46.2) | 39 (41.5) | |||
| Average | 26 (16.4) | 9 (13.8) | 17 (18.1) | |||
| Dissatisfied | 1 (0.6) | 0 (0.0) | 1 (1.1) | |||
| Very dissatisfied | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
| Lecture time | ||||||
| Too long | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0.416 | ||
| A little too long | 13 (8.2) | 6 (9.2) | 7 (7.4) | |||
| Just right | 141 (88.7) | 56 (86.2) | 85 (90.4) | |||
| A little too short | 4 (2.5) | 3 (4.6) | 1 (1.1) | |||
| Too short | 1 (0.6) | 0 (0.0) | 1 (1.1) | |||
| Difficulties with the lecture | ||||||
| Too easy | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0.220 | ||
| Somewhat easy | 10 (6.3) | 2 (3.1) | 8 (8.5) | |||
| Just right | 126 (79.2) | 51 (78.5) | 75 (79.8) | |||
| Somewhat difficult | 23 (14.5) | 12 (18.5) | 11 (11.7) | |||
| Too difficult | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
| Cognitive and behavioral approach to menopausal disorders | ||||||
| Lecture satisfaction | ||||||
| Very satisfied | 75 (47.2) | 31 (47.7) | 44 (46.8) | 0.832 | ||
| Satisfied | 64 (40.3) | 27 (41.5) | 37 (39.4) | |||
| Average | 19 (11.9) | 7 (10.8) | 12 (12.8) | |||
| Dissatisfied | 1 (0.6) | 0 (0.0) | 1 (1.1) | |||
| Very dissatisfied | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
| Lecture time | ||||||
| Too long | 3 (1.9) | 1 (1.5) | 2 (2.1) | 0.254 | ||
| A little too long | 13 (8.2) | 7 (10.8) | 6 (6.4) | |||
| Just right | 136 (85.5) | 52 (80.0) | 84 (89.4) | |||
| A little too short | 7 (4.4) | 5 (7.7) | 2 (2.1) | |||
| Too short | 0 (0.0) | 0 (0.0) | 0 (0.0) | |||
| Difficulties with the lecture | ||||||
| Too easy | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0.196 | ||
| Somewhat easy | 6 (3.8) | 1 (1.5) | 5 (5.3) | |||
| Just right | 119 (74.8) | 46 (70.8) | 73 (77.7) | |||
| Somewhat difficult | 33 (20.8) | 17 (26.2) | 16 (17.0) | |||
| Too difficult | 1 (0.6) | 1 (1.5) | 0 (0.0) | |||
| Overall understanding of the course (1: I didn’t understand at all – 10: I understood perfectly) | ||||||
| 8.04 ± 1.01 | 8.29 ± 0.95 | 7.87 ± 1.02a | 0.009 | |||
Data are presented as number (%) or mean ± SD.
OB/GYNs: Obstetricians and Gynecologists, SD: standard deviation.
aStatistically significant compared to OB/GYNs.
Many participants thought the level of difficulty of each course was just right; however, more OB/GYNs felt that general remarks and HRT programs were easier than other healthcare professionals. Although the difficulty ratings for non-HRT lectures showed significant group differences in the unadjusted analysis, these differences were not significant after applying the Bonferroni correction. The overall understanding of the course was high, at 8.04 ± 1.01 (mean ± standard error). In addition, OB/GYNs scored 8.29 ± 0.95, while other healthcare professionals scored 7.87 ± 1.02, indicating that OB/GYNs had a significantly higher level of understanding (P = 0.009).
DISCUSSION
Education on menopausal disorders is inadequate in medical schools. A survey of internal medicine residents in the United States found menopause management to be one of the most important topics, but residents indicated inadequate clinical exposure to it [9].
Research suggests differences in beliefs and attitudes about menopause among general practitioners, which may contribute to negative attitudes toward prescribing treatments for menopausal symptoms [10,11,12]. One reason healthcare providers struggle to deliver the biopsychosocial care essential for managing menopausal women is the insufficient education on menopausal disorders [13]. Therefore, standardized training in the management of menopausal women remains warranted.
In the present study, compared to other professionals, OB/GYNs reported that lectures on general remarks and HRT were easier for them. In Japanese medical education, menopausal disorders are part of the obstetrics and gynecology curriculum. OB/GYNs learn more about menopausal disorders even after graduation. However, those in other specialties have few opportunities to learn about menopausal disorders after graduating from school. In addition, the importance of menopause education for non-physician healthcare professionals is increasingly recognized. Indeed, numerous nurses and midwives expressed interest in learning more about providing care for menopausal women [14]. Our course responded to the interest in menopausal disorders in various healthcare professionals; those who watched all the lectures and fulfilled the conditions were awarded a certificate of Menopause Instructor. Our establishment of the qualification of Menopause Instructor might have increased the motivation of participants to complete the course.
Since the course is online and easily accessible from everywhere, it certifies Menopause Instructors all over Japan. The British Menopause Society has launched an online course for healthcare professionals in the United Kingdom since 2024 [15], which, like our course, allows participants to gain certification by completing the course. The initiatives to increase the number of healthcare professionals who manage menopausal disorders through online courses may expand further. Conversely, some prefectures still lack certified Menopause Instructors. The reason for this is unclear, but these prefectures are all rural areas. Since we primarily promoted the course at academic events, medical professionals in rural areas who have difficulty attending such events may not have received the information. Therefore, it is necessary to provide information through channels other than academic societies, such as social media, in the near future.
During the course, we delivered five lectures in 2023 and six in 2024. The International Menopause Society offers International Menopause Society Professional Activity for Refresher Training (IMPART) as a training course for healthcare professionals regarding menopausal disorders [16]. IMPART is divided into two levels, each consisting of eight modules. IMPART provides more detail about HRT and lectures on osteoporosis, heart disease, and cancer. In addition, the European Menopause and Andropause Society recommended a curriculum for menopause education programs for health professionals in 2022 [17], which includes terminologies, menopause symptoms, assessment and screening, staying healthy, treatment options, long-term health, and delivering menopause health care. In this study, OB/GYNs demonstrated a higher level of understanding compared to other professionals. OB/GYNs typically have more opportunities to learn about menopause disorders during their residency and at medical conferences. However, they do not have sufficient opportunities to learn about internal medicine topics relevant to women’s health. To make the course more satisfying for both OB/GYNs and non-OB/GYNs, we may add more detailed lectures on heart disease and osteoporosis, as referenced in the two aforementioned programs.
Helping health professionals retain knowledge about menopausal symptoms is challenging. A study of menopause education for OB/GYNs and family medicine residents found that specialized menopause curricula produced short-term increases in menopause-related knowledge but did not improve overall knowledge retention at 3 months [18]. In our course, we delivered lectures on menopausal symptoms at annual conferences to update participants’ knowledge. Furthermore, we are also considering setting up a web platform on our website where course participants can watch videos of the lectures. We must evaluate how effectively participants retain the knowledge gained from our course in the future.
This study has some limitations. First, this course was held by a medical society specializing in women’s psychosomatic disorders; therefore, the participants may be biased toward healthcare professionals with an interest in psychosomatic medicine. Second, the 2024 questionnaire analyzed in this study was responded to only by those who completed the course; therefore, it does not reflect the opinions of those who dropped out for any reason. We will reconsider the survey method and ask those who dropped out for the reasons why. Third, the system prevented us from evaluating participants’ knowledge improvement. We are considering rebuilding the system to compare knowledge improvement between OB/GYNs and non-OB/GYNs, which would help us plan future lectures. Additionally, two years is too short to evaluate the course’s effectiveness. We will continue this course and reevaluate the pre- and post-tests, as well as the questionnaire surveys. We will also further investigate the activities of those who have obtained Menopause Instructor certification. This will allow us to continue evaluating the effectiveness of the certification program. Our findings will be reported.
As the strength of this research, to the best of our knowledge, this is the first educational program in Japan specifically for healthcare professionals specializing in menopausal disorders. The results of this study provide insights into the attitudes of healthcare professionals toward menopausal disorders in Japan.
In conclusion, we held the Menopause Instructor Course as an educational course for healthcare professionals on menopausal disorders. Over 2023 and 2024, we certified more than 300 healthcare professionals from all over Japan as Menopause Instructors. Although overall satisfaction with the course was high, there were differences in the perceived level of difficulty and achievement between OB/GYNs and other healthcare professionals. Retention of knowledge by participants and refinement of content to benefit OB/GYNs and other healthcare professionals should be explored.
ACKNOWLEDGMENTS
We would like to thank Ms. Mayuko Miyazaki for her administrative support for this course.
Footnotes
FUNDING: This educational program was funded by an educational grant from Astellas Pharma Inc.
CONFLICT OF INTEREST: Mariko Ogawa received speaker fees from Fuji Pharma Co., Ltd., Otsuka Pharmaceutical Co., Ltd., Bayer Yakuhin Ltd., and ASKA Pharmaceutical Co., Ltd.; Masakazu Terauchi received speaker fees and/or honoraria from Fuji Pharma Co., Ltd., Otsuka Pharmaceutical Co., Ltd., and Astellas Pharma Inc.; Masahiro Hashizume received speaker fees from Daiichi Sankyo Co., Ltd.; Kiyoshi Takamatsu received speaker fees from Fuji Pharma Co., Ltd., Otsuka Pharmaceutical Co. Ltd., Bayer Yakuhin Ltd.; Takashi Takeda received speaker fees from TSUMURA Co., Kuracie Pharmaceutical Ltd. The remaining authors declare no potential conflict of interest relevant to this article was reported.
SUPPLEMENTARY MATERIAL
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