MENOPAUSE SYMPTOMS discussed in online forums differed substantially from those documented in clinical notes, with emotional wellbeing and cognitive concerns appearing far more frequently in patient generated discussions than in healthcare records, according to a cross-sectional analysis.
Researchers compared menopause related content from two sources to examine differences between clinical documentation and patient reported experiences. The analysis included a randomly selected sample of clinical notes containing the term menopause from more than 2 million electronic health record records, alongside the top 999 posts from a menopause focused online forum. After excluding content that was not related to personal menopause experiences or discussions, the final analysis included 577 online posts and 646 clinical notes.
A predefined taxonomy of medically recognised symptom domains was informed by topic modelling and refined through review of representative records. A large language model was then used to assign each record to one or more symptom domains before percentage distributions were compared between the two datasets using χ² testing. Statistical significance was defined as P<0.05.
The distribution of menopause symptoms differed significantly between online discussions and clinical documentation across several domains. Emotional wellbeing was reported in 77.30% of online posts compared with 26.01% of clinical notes (P<0.001). Cognitive impairment also appeared more frequently online at 19.58% versus 4.80% in clinical documentation (P<0.001). Weight change was discussed in 20.62% of online posts compared with 11.30% of clinical notes (P<0.001).
By contrast, clinical notes more commonly documented hot flashes and night sweats, hormone replacement therapy treatments, lifestyle changes, sexual health, non-hormone replacement therapy menopause treatments, herbal remedies, and uncategorised content. No statistically significant differences were observed for sleep disturbances, hormonal skin and hair changes, or bone and joint health, suggesting these domains were represented similarly across both data sources.
The investigators concluded that patient generated discussions captured psychosocial and cognitive aspects of menopause symptoms at substantially higher rates than clinical documentation, whereas healthcare records placed greater emphasis on vasomotor symptoms and treatment related topics.
They noted that differences between the datasets should be interpreted with regard to the populations represented and the ways in which the data were generated. Online forums reflected self-selected communities, while clinical notes represented individuals seeking healthcare whose experiences were filtered through clinical documentation. The findings suggested that incorporating insights from online patient discussions alongside clinical data could support a more patient centred understanding of menopause symptoms and help identify under recognised concerns that may otherwise remain undocumented.
Reference
Mehta T et al. Divergence in menopause symptom narratives between online and clinical settings. JAMA Netw Open. 2026;9;(7):e2623217.
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