Navigating Menopause TogetherA Clinical Course for Healthcare Providers

Menopause is not a single event but a years-long transition that can affect sleep, mood, sexual health, work productivity, and long-term health. Patients commonly present to primary care seeking relief from these symptoms, yet many remain untreated despite the availability of effective evidence-based therapies.

Nurse practitioners are often the clinicians women turn to for menopause care, yet structured menopause education remains limited across health professions training. A 2023 national survey of U.S. obstetrics and gynecology residency program directors found that only 31.3% of programs included a dedicated menopause curriculum despite widespread agreement that menopause education is essential. Similar educational gaps have been identified among nurse practitioners, who report important deficits in menopause terminology, patient counseling, and evidence-based management. In the largest published survey of nurse practitioners focused on menopause care, more than 80% of respondents were unfamiliar with the term genitourinary syndrome of menopause despite routinely caring for patients with these symptoms, and many reported difficulty counseling patients regarding the boxed warning on vaginal estrogen products. These knowledge and competence gaps contribute to variation in clinical practice and may limit patients' access to evidence-based menopause care.

Outdated prescribing patterns continue to contribute to the gap. For two decades after the Women’s Health Initiative, the FDA boxed warning led many clinicians to avoid hormone therapy altogether. In November 2025, the FDA revised that labeling for systemic menopausal hormone therapy, reflecting current evidence. Despite these changes, many clinicians continue to rely on outdated prescribing practices that do not fully reflect current evidence.

These published findings are consistent with the author's clinical experience caring for women seeking evidence-based menopause management after previous unsuccessful evaluations and with requests from nurse practitioner colleagues for additional education in menopause management and hormone therapy prescribing.

Professional practice gap. Variability in clinician knowledge and confidence results in inconsistent evaluation, counseling, prescribing, and longitudinal management of menopausal patients.

Educational Need. This activity addresses identified gaps in clinician knowledge and competence related to the clinical evaluation of menopause, appropriate selection and interpretation of laboratory testing, patient selection for hormone therapy, evidence-based prescribing, longitudinal management, and patient counseling using current clinical guidelines.

How This Activity Addresses the Gap. The activity is designed to improve learner competence by providing a structured, evidence-based framework for evaluating menopausal patients, selecting individualized treatment strategies, prescribing hormone therapy safely, managing common follow-up concerns, and counseling patients using current evidence. The activity emphasizes practical application through clinical scenarios and evidence-based decision-making that learners can immediately incorporate into practice. Content incorporates recommendations from The Menopause Society, the International Menopause Society, the British Menopause Society, ACOG, the Endocrine Society, and the FDA's 2025 revisions to systemic menopausal hormone therapy labeling.

Target Audience. This activity is intended for nurse practitioners and other advanced practice clinicians involved in the evaluation and management of patients during the menopause transition.

Upon completion of this activity, the participant will be able to:

1. Differentiate the stages of the menopause transition (perimenopause, menopause, and postmenopause) using STRAW+10 criteria and clinical presentation.
2. Diagnose menopause and perimenopause using clinical findings and identify the limited circumstances in which laboratory testing is appropriate.
3. Determine a patient's candidacy for menopausal hormone therapy by evaluating age, time since menopause, contraindications, and individual risk factors.
4. Select an appropriate estrogen formulation, route, and starting dose based on patient-specific cardiovascular, thrombotic, metabolic, and symptom profiles. (pharmacology)
5. Differentiate FDA-approved menopausal hormone therapies from compounded hormone preparations and apply current evidence to treatment selection. (pharmacology)
6. Prescribe evidence-based continuous and cyclic progestogen regimens for endometrial protection and adjust therapy when higher estrogen doses are used. (pharmacology)
7. Apply a patient's gynecologic history, including hysterectomy status and a history of endometriosis, to determine appropriate progestogen management.
8. Evaluate the appropriate role of testosterone therapy for postmenopausal hypoactive sexual desire disorder, including patient selection, physiologic dosing, monitoring, and its off-label status. (pharmacology)
9. Manage menopausal hormone therapy over time by titrating treatment, evaluating unscheduled bleeding, addressing common adverse effects, and counseling patients on continuation or discontinuation of therapy. (pharmacology)
10. Counsel patients on long-term follow-up, including routine breast cancer and osteoporosis screening recommendations, expected monitoring, and individualized duration of hormone therapy.

Mallory Jones, MSN, APRN, FNP-C, CWHS, is a board-certified family nurse practitioner with a clinical focus on women's health, menopause management, and hormone therapy. She is certified by the American Academy of Nurse Practitioners Certification Board (AANPCB) and holds the Certified Women's Health Specialist (CWHS) credential.

Mallory Jones is the founder of Lighthouse Everlucent Health, a telemedicine practice she established in November 2024 to provide accessible, evidence-based care in hormone therapy, sexual health, weight management, and mental wellness. She is licensed in 46 U.S. states with applications pending for Michigan, Hawaii, Georgia, Rhode Island, and the District of Columbia.

Over the past two years, Mallory Jones has completed more than 50 hours of advanced continuing education focused on menopause and hormone therapy, including the 20-hour Women's Hormones: Menopause and Hormone Therapy Advanced Practice Training Program through the George Washington University School of Medicine and Health Sciences. She maintains active membership in The Menopause Society and regularly reviews primary literature, clinical guidelines, and position statements to ensure her clinical practice and educational content reflect current evidence. The George Washington program is an advanced course designed to build clinicians' knowledge and clinical decision-making in menopausal hormone therapy.

In her clinical practice, Mallory Jones evaluates and manages women throughout the menopause transition, including the treatment of vasomotor symptoms, genitourinary syndrome of menopause, sexual health concerns, and menopausal hormone therapy. She began prescribing hormone replacement therapy in primary care from 2015 to 2021 and expanded this focus after founding her own practice in 2024. Her experience providing telemedicine care has informed the practical, evidence-based, and patient-centered approach used throughout this educational activity.

Faculty and Planner Financial Disclosure. Mallory Jones, MSN, APRN, FNP-C, CWHS, serves as both the faculty member and planner for this educational activity. She has no relevant financial relationships with ineligible companies to disclose. This activity was developed independently and received no commercial support.

Off-Label Use Disclosure. This educational activity includes discussion of certain off-label medication uses, including testosterone therapy for women with hypoactive sexual desire disorder (HSDD), use of the levonorgestrel intrauterine system for endometrial protection during menopausal hormone therapy, and selected nonhormonal medications for the management of vasomotor symptoms. Off-label uses are identified within the activity at the point of discussion, and recommendations are based on the available evidence and current clinical guidelines.

Artificial Intelligence Disclosure. Artificial intelligence (AI) tools were used during the development of this educational activity to assist with drafting, editing, formatting, organization, and literature identification. AI was not used to develop clinical recommendations or interpret medical evidence. All clinical content, treatment recommendations, medication dosing, and references were independently reviewed and verified by the author against primary literature and current clinical guidelines. The author assumes full responsibility for the accuracy, completeness, and clinical integrity of this educational activity.

Completed online after the post-test

Learners fill out the evaluation inside the course platform, not on this page. The interactive form collects required AANP feedback: learning-objective achievement, content quality, commercial-bias attestation, practice-change plans, and open-ended comments. Responses are saved automatically and must be submitted before the certificate is issued.

A printable PDF version of the evaluation was submitted to AANP with the accreditation application and is available on request.

AANP enduring materials use the Mergener word-count formula: total word count of the assembled final reading document divided by 180 words per minute, plus any video minutes, converted to hours and rounded to the nearest 0.25 hour. Pharmacology hours are the subset of that time spent on pharmacology objectives.

Applied to this activity. The assembled final reading document contains 57,084 words, which yields 57,084 ÷ 180 = 317.1 minutes, or 5.29 hours of reading time. Adding the post-test time credited at the 15-minute cap brings the calculated figure to 5.54 hours. The activity's interactive components — case simulations, step-by-step clinical decision guides, and validated instrument scoring exercises — are offered as optional practice and are not claimed for credit.

Pilot validation. Three independent NP pilot reviewers completed the full activity in 338, 269, and 405 minutes — a mean of 337.3 minutes (5.62 hours), with all three individual times inside the ±25% band AANP expects. Using a 60-minute contact hour rounded down to the nearest quarter hour, the validated request is 5.50 contact hours, including 3.66 pharmacology hours (Parts III–VII).

AANP set the final award on approval: 5.50 contact hours, including 3.66 pharmacology hours (Activity ID# 260800057).

This is the certificate learners receive after passing the post-test and completing the evaluation.

AANP Accredited · Activity ID# 260800057

Certificate of Award

This certifies that [ Participant full name and credentials ] has successfully completed

Navigating Menopause Together: A Clinical Course for Healthcare Providers

on [ Date of completion ].

Total contact hours

5.50

Pharmacology contact hours

3.66

Mallory Jones, MSN, APRN, FNP-C, CWHS

Activity Coordinator / Nurse Planner

Activity coordinator: Mallory Jones, MSN, APRN, FNP-C, CWHS

Sponsor / provider: Everlucent Vault LLC — everlucentvault.com; Indiana domestic LLC, sole member Mallory A. Jones. No commercial support.

Location / format: Online · enduring material (self-study)

This activity is approved for 5.5 contact hour(s) of continuing education (which includes 3.66 hour(s) of pharmacology) by the American Association of Nurse Practitioners®. Activity ID# 260800057. This activity was planned in accordance with AANP Accreditation Standards and Policies.

Approval issued August 12, 2026; valid through August 31, 2027. All changes to faculty, objectives, session topics, overall time, or activity dates must be approved by AANP before they take effect.

When I began practicing as a family nurse practitioner in primary care in 2015, I referred nearly every menopause-related concern to gynecology. It wasn't because I believed menopause care belonged somewhere else — it was because I had never been taught how to manage it. Like many clinicians, I understood the physiology, but I lacked a practical framework for evaluating patients, prescribing hormone therapy, and managing treatment over time.

My perspective changed because of something deeply personal. Over several years, I watched someone close to me struggle with profound fatigue, low motivation, and symptoms that affected nearly every aspect of daily life. Those symptoms were repeatedly attributed to stress, depression, or lifestyle. When appropriate hormone evaluation and treatment finally happened, the improvement in quality of life was remarkable — and it made me start studying hormone health seriously.

As I learned more about hormone therapy and began caring for patients, I saw similar improvements in many people. It also led me to ask a question that changed the direction of my career: If appropriate hormone evaluation and treatment could make such a meaningful difference for some patients, why were so many women struggling through menopause without receiving the same thoughtful evaluation and care?

That question led me to menopause medicine. Over the past several years, I have completed advanced continuing education in menopause and hormone therapy, joined The Menopause Society, and immersed myself in current clinical guidelines, landmark studies, and primary literature. Every patient I care for teaches me something new. One of the things I love most about this field is that no two patients are alike. Every week presents a new clinical question, another opportunity to learn, and another reminder that medicine is always evolving.

This course is the result of that journey. My goal was to create the educational resource I wish I had early in my career — a practical, evidence-based guide that translates current guidelines into everyday clinical decision-making. If this course helps another clinician feel more confident caring for women during the menopause transition, then it has accomplished exactly what I hoped it would.

— Mallory Jones, MSN, APRN, FNP-C, CWHS