‘Healthy Menopause’ sets out a tiered, prevention-oriented model of care for the next decade
The European Menopause and Andropause Society (EMAS) has published an updated Position Statement, ‘Healthy Menopause’, in the journal Maturitas. Authored by the full EMAS Board and published open access, the framework sets out a structured, prevention-oriented model of midlife care for the coming decade, integrating digital health tools, tiered care pathways, and recommendations for health systems, clinicians, employers, and policymakers across Europe.
The original EMAS model of care for healthy menopause was published in 2016. Since then, the scientific and technological context has changed considerably. Advances in precision medicine, wearable-derived biomarkers, AI-supported triage, and hybrid care delivery have expanded what is clinically possible. At the same time, population ageing, rising multimorbidity, and growing public and employer awareness have repositioned menopause as a broader public health concern. The 2016 framework, while foundational, no longer fully reflects the realities of contemporary menopause care.
“Women now spend more than a third of their lives in the post-reproductive period. During that time, vulnerability to cardiometabolic disease, osteoporosis, cognitive decline, and mental health disorders rises substantially. For most health systems across Europe, care has not kept pace with that reality. This framework is our response.”
A four-tier care architecture
The ‘Healthy Menopause’ framework introduces a scalable, tiered care architecture designed to support equitable access across health systems with varying levels of capacity.
- Tier 1 provides digital first-access pathways, including structured symptom assessment, validated patient-reported outcome measures, and AI-supported triage where appropriate.
- Tier 2 comprises certified menopause clinicians in gynaecology, primary care, and related disciplines, responsible for evidence-based management and longitudinal follow-up.
- Tier 3 consists of multidisciplinary specialist centres for women with complex needs, including premature ovarian insufficiency, cancer-related menopause, or significant multimorbidity.
- Tier 4 represents national and European policy frameworks required to sustain, govern, and scale menopause care over time.
Digital health, AI, and governance
The framework addresses digital health and artificial intelligence in detail, distinguishing between established applications such as teleconsultation and symptom tracking, and emerging tools such as AI-supported triage and personalised risk estimation, which require further validation before routine use. Core governance principles include transparency, validation in relevant clinical populations, continuous performance monitoring, and mechanisms to detect and reduce bias, particularly for underserved groups.
Menopause and the workplace
‘Healthy Menopause’ integrates workplace health as both a clinical and societal priority. Vasomotor symptoms, sleep disturbance, mood changes, and cognitive complaints have been associated with reduced work performance, increased absenteeism, and in some cases premature exit from the labour market. The framework calls for evidence-informed workplace interventions and closer collaboration between healthcare providers, occupational health professionals, employers, and policymakers.
EMAS recommendations for 2026–2030
The Position Statement includes nine recommendations for clinicians, health systems, policymakers, employers, and researchers. These cover menopause as a public health priority, tiered care implementation, competency-based accreditation, access to evidence-based treatments, prevention of long-term morbidity, care for women with complex needs, governance of digital tools and AI, and integration of menopause support into occupational health strategies.
“EMAS calls on clinicians, health systems, policymakers, employers, and researchers to engage with this framework and consider how its recommendations can be operationalised within their own contexts. Menopause care is a shared responsibility, and this framework is designed to support everyone involved in delivering it.”
The full Position Statement is available open access in Maturitas.
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