The perspective of general practitioners on menopause management and hormone replacement therapy in primary care: a cross-sectional study

Background A large group of middle-aged and elderly women has emerged. Menopause management and hormone replacement therapy(HRT) poses a huge public health challenge in China. General practitioners(GPs) are gatekeepers of the health system. But there is a noticeable deficiency regarding GPs’ perspective on menopause management and HRT. Method This cross-sectional study was conducted at fifty-six randomly selected community health service centers in Shanghai, China, from March 1 to August 31, 2025, targeting licensed GPs. We employed convenience and snowball sampling methods to recruit participants, and data were collected through a 22-item questionnaire covering demographic and occupational information, perspective on menopause management and HRT, barriers. Statistical analyses were performed in SPSS(IBM V26.0), using descriptive statistics and χ2 test. P<0.05 showed that the differences in responses were statistically significant. Results A total of 828 GPs participated. Few indicated they were “very familiar” with the indications and contraindications of HRT(2.5%), different administration routes of HRT(1.9%). Lifestyle adjustment was the most participants(97.8%) thought menopausal women need to focus on. 97.3% of GPs indicated that HRT could relive menopausal symptom. Only 6.9% of GPs indicated that HRT was risk-free, and high-risk population was the most common reason for increasing some disease related to HRT. 6.6% of GPs hold the overall attitude of “very recommended” towards HRT. In fact, only 4.3% of GPs always recommend HRT and 5.4% of GPs have prescribed HRT prescriptions for menopausal women. The training experience is a crucial factor that influences their familiarity with menopause management and knowledge related to HRT, their overall attitude towards HRT, the degree of recommendation, and the prescription they provide. Lack of knowledge among GPs(41.0%) and residents(11.0%), insufficient experience(5.8%) were barriers of menopause management and HRT usage in primary care according to 173 respondents’ opinions. Conclusion There are gaps between the awareness and behavior toward menopause and HRT among GPs. GPs lack relevant knowledge and they are hesitancy in the use of HRT. Strategies aiming to improve menopause management and HRT usage among GPs in primary health institutions must consider education experience and gynecologists experience variation.