A Texas House subcommittee focused on maternal health, menopause and evidence-based medicine heard from physicians Monday about gaps in menopause care, including limited training for doctors and patients’ difficulty getting symptoms recognized and treated. The Oct. 5 hearing was the panel’s second interim meeting. Created in August, the subcommittee is examining women’s health beyond pregnancy and childbirth, including care during perimenopause and menopause. Dr. Mary Claire Haver, an OB/GYN and menopause specialist, told lawmakers that patients may see several clinicians for problems such as sleep disruption, depression or heart palpitations without anyone connecting those symptoms to changes in their menstrual cycles. She cited a study in which 60% of women surveyed said a clinician had dismissed their symptoms and 40% said they received no treatment guidance. “The treatments exist, but the training is lagging,” Haver said. She said her own residency included six one-hour lectures on menopause and no clinical experience treating patients for it. Dr. Jennifer Friedman, an OB/GYN and clinical associate professor at the Texas A&M University Family Medicine Residency Program, also urged broader education. Friedman established a menopause-focused elective and curriculum at the program in 2022. She told the panel that 93% of surveyed OB/GYN residency directors favored access to a standardized menopause curriculum, while only 31% said their programs had one. The discussion included hormone replacement therapy, which replaces estrogen levels that decline as menopause begins and is often combined with progesterone for patients who have a uterus. Haver described hormone therapy as a useful option for perimenopausal symptoms, while saying clinicians’ caution has been shaped by earlier warnings about its risks. Haver said the Food and Drug Administration began removing the black-box warning from hormone therapy labels in February. But, she argued, revising labels alone will not change practices among clinicians trained under earlier warnings or address patients’ concerns. Panelists called for more research into menopause and perimenopause. The subcommittee is expected to meet again during the next Texas legislative session, which begins in January.