A growing number of direct-to-consumer menopause services are offering costly tests and treatments that add little value to women’s care, according to experts writing in The BMJ.
They caution that the rapid expansion of commercial services targeting women with menopausal symptoms raises questions about both the accuracy of the information provided and potential commercial bias. Instead, experts stress that effective management should rely on a detailed clinical history, patient preferences, and response to treatment—not unnecessary testing.
One of the most concerning trends, the authors note, is the routine promotion of hormone panel testing. Marketed as a way to “individualise” hormone therapy, these panels can cost hundreds of dollars. However, experts argue the tests have limited clinical relevance, as there is no established therapeutic window for hormone replacement in menopause and current testing methods often lack precision.
Guidelines from the British Menopause Society, the National Institute for Health and Care Excellence (NICE), and the American College of Obstetricians and Gynecologists are clear: in women over 45 with typical symptoms such as menstrual irregularity, menopause is a clinical diagnosis. Hormone testing is unnecessary.
Despite this, many women are turning to wellness providers or online platforms offering detailed hormone panels. These results are often used to justify custom-made hormone regimens or supplements—treatments that lack strong scientific evidence and are not subject to the same safety regulations as standard hormone therapy.
Experts warn that inconsistencies in compounded hormone preparations may lead to unsafe variations in hormone levels. This could increase the risk of abnormal cell growth or cancer in the womb lining.
Until reliable individualized hormone targets can be established, the authors conclude, hormone panel testing provides little more than a false sense of precision. They argue that the rise of such testing reflects a broader issue: the commercialization of women’s health and a drift away from evidence-based care.
“Effective treatment for midlife women begins not with numbers, but with listening,” they emphasize.
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