Swedish physicians' knowledge of and prescribing practices for menopausal hormone therapy: A nationwide cross-sectional survey.

The majority of surveyed physicians reported encountering women with menopausal symptoms, and nearly all of those prescribed systemic MHT.

• 542 physicians answered the survey (67.9% gynaecologists and 32.1% GPs)
• Over 90% reported meeting women with menopausal symptoms in their clinical practice
• Among those who met women with menopausal symptoms, 94.6% prescribed systemic MHT
• Survey was conducted February–September 2023 using a 45-item web-based format

GPs prescribed MHT to a significantly lesser extent than gynaecologists.

• GPs reported a significantly higher level of difficulty in all but one of the examined aspects of MHT prescription
• The difference in prescribing extent between GPs and gynaecologists was statistically significant
• Participants included specialists/residents in obstetrics and gynecology and general practitioners across Sweden

GPs demonstrated significantly lower awareness of current national MHT guidelines than gynaecologists.

• GPs reported significantly lower awareness of current national guidelines compared to gynaecologists
• 47.8% of GPs reported inadequate theoretical education in MHT, compared with 30.6% of gynaecologists (p < 0.001)
• Nearly one-third of gynaecologists also indicated inadequate education in MHT despite their specialty training

Physicians working in metropolitan areas were more experienced in prescribing micronized progesterone and dydrogesterone.

• Geographic location (metropolitan vs. non-metropolitan) was associated with differences in prescribing specific progestogen formulations
• The difference specifically concerned micronized progesterone and dydrogesterone prescribing experience
• This finding suggests regional disparities in MHT prescribing practices within Sweden

GPs reported significantly greater difficulty across nearly all examined aspects of MHT prescription compared to gynaecologists.

• GPs reported a significantly higher level of difficulty in all but one of the examined aspects of MHT prescription
• This pattern of difficulty was consistent across multiple domains of MHT prescribing
• The findings highlight a need for improved guideline awareness and accessible education to support evidence-based menopause care