Menopause is rarely coded in the emergency department: A real-world study of 413,414 visits by women aged…

Cohort studyMaturitas· Aug 2026

Menopause is rarely coded in the emergency department: A real-world study of 413,414 visits by women aged 40-65 years (the MIMOSA study).

Caroline Cabral Kanaan, Mateus de Lima Freitas, Adriano José Pereira, Edson Amaro Junior

Menopause & Hormone TherapyCohort studyClinical practiceQ1IF 4.3

Only 0.79% of midlife women had menopause recorded in emergency department visits.

Menopause is rarely coded in the emergency department: A real-world study of 413,414 visits by women aged 40-65 years (the MIMOSA study).

Caroline Cabral Kanaan … Edson Amaro Junior

Maturitas · Aug 2026 · Q1 in Obstetrics & Gynecology

Purpose

To quantify how often menopause is captured by diagnostic coding among women aged 40 to 65 attending the emergency department with potentially menopause-related symptoms, to characterise their presentation, and to identify factors associated with coding, early reattendance (within 72 h) and short-stay admission (under 48 h).

Methods

The incidence cohort (each woman's first recorded visit) was the primary unit of analysis, with the visit level used for sensitivity analysis; cardiometabolic conditions were treated as covariates.

n = 97,105 women

Results

menopause is almost never coded despite matching symptoms, a big missed opportunity

OR by subgroup · 95% CI

More results

We analysed 413,414 visits by 97,105 women (median age 45 years at entry).

Negation handling substantially lowered text-based symptom frequencies (chest pain 20.5% to 5.6%; dyspnoea 30.3% to 6.8%).

Among nonspecific cardiorespiratory presentations, only 1.5% of 72-h reattendances revealed serious cardiovascular disease.

More results

In the incidence cohort, reattendance within 72 h occurred in 3.7% of women and short-stay admission in 0.6%; these analyses were exploratory and showed limited discrimination.

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Conclusion · 1 of 2

Menopause-related diagnostic coding is uncommon in the emergency department among midlife women with compatible symptoms, and it depends more on the presence of other gynaecological codes than on the clinical picture.

Conclusion · 2 of 2

Because coding is not equivalent to clinical recognition, the findings indicate low menopause-related coding and potential missed opportunities for recognition.

Menopause is rarely coded in the emergency department: A real-world study of 413,414 visits by women aged 40-65 years (the MIMOSA study).

Menopause is rarely coded in the emergency department: A real-world study of 413,414 visits by women aged 40-65 years (the MIMOSA study).

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