ACOOG members receive exclusive access to this activity as a member benefit, at no charge.
Osteopathic Commentary and Perspective | OC1004
An Osteopathic Commentary on Management of Menopause-Related Vasomotor, Sleep, and Mood Symptoms
Based on ACOG Clinical Practice Guideline No. 13
CME Credit Available
1.0 AOA Category 1-B 1.0 AMA PRA Category 1 Credit™
About This Activity
Vasomotor symptoms (VMS), sleep disruption, and mood change cluster during the menopausal transition and impair work, relationships, and quality of life. Many symptomatic patients go untreated, and many clinicians trained after the early Women’s Health Initiative reports remain reluctant to prescribe hormone therapy.
Clinical Practice Guideline No. 13 from the American College of Obstetricians and Gynecologists (ACOG) replaces Practice Bulletin No. 141 and grades hormonal, nonhormonal, and behavioral treatments for these symptoms. This commentary examines those recommendations through the four osteopathic tenets. It frames the symptom cluster as a whole-person problem, connects thermoregulatory and autonomic physiology to treatment selection, and addresses the midlife musculoskeletal burden often missed in menopause visits.
For the practicing DO, the commentary supports confident use of menopausal hormone therapy (MHT) in eligible patients, matching nonhormonal options to the dominant symptom, and an evidence-based adjunctive role for osteopathic manipulative treatment (OMT) in coexisting spine pain and related sleep disturbance. It also addresses breast cancer survivors, older patients, Black women and other groups facing inequities, transgender and gender-diverse patients, and rural and underserved settings.
Faculty
Sadaf Lodhi, DO, FACOOG, MSCP, IF
Gynecologist specializing in menopause and sexual health, Founder and CEO of Femme Vie Health
Dr. Lodhi is a practicing OB-GYN in New York with more than 20 years of experience helping women achieve sexual, physical, and emotional health. She founded Femme Vie Health, where she provides coaching, telehealth, and in-person care focused on women’s wellness, sexual health, self-discovery, and empowerment.
Matthew Shelnutt, DO, FACOOG
OB-GYN and Assistant Professor of Osteopathic Manipulative Medicine at PCOM South Georgia
Dr. Shelnutt is an assistant professor of Osteopathic Manipulative Medicine at Philadelphia College of Osteopathic Medicine South Georgia and a graduate of PCOM Georgia’s Doctor of Osteopathic Medicine program. He completed his OB-GYN residency at University of Michigan Health-West, served as co-chief resident, and now leads curricular integration between osteopathic principles and clinical medicine.
Disclosures
ACOOG requires each planner and author to identify all financial relationships with ineligible companies and mitigates risk of bias using a series of strategies for relevant relationships. Unless otherwise noted below, ACOOG, ACOOG staff, planners, and faculty for this activity have no relevant financial relationships to disclose.
Neither Dr. Lodhi nor Dr. Shelnutt have a relevant financial relationship with an ineligible company to disclose.
Learning Objectives
After completing this activity, the learner will be able to:
- ✓Apply the eligibility, timing, and risk-assessment criteria in Clinical Practice Guideline No. 13 to select or defer systemic menopausal hormone therapy for a symptomatic patient.
- ✓Differentiate nonhormonal pharmacologic and nonpharmacologic options according to the dominant symptom (vasomotor, sleep, or mood) and patient-specific factors such as tamoxifen use or hepatic history.
- ✓Apply the four osteopathic tenets to the evaluation and longitudinal management of menopause-related vasomotor, sleep, and mood symptoms.
- ✓Identify the evidence supporting and limiting osteopathic manipulative treatment as an adjunct for musculoskeletal pain and related sleep disturbance in midlife patients.
Accreditation and Credit Designation
The accreditation statements cannot be condensed, combined, or altered except for type of activity and credit hours.
CME Accreditation
The American College of Osteopathic Obstetricians and Gynecologists is accredited by the American Osteopathic Association to provide osteopathic continuing medical education for physicians.
The American College of Osteopathic Obstetricians and Gynecologists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
CME Credit Designation
The American College of Osteopathic Obstetricians and Gynecologists designates this program for a maximum of 1.0 AOA Category 1-B credits and will report CME and specialty credits commensurate with the extent of the physician’s participation in this activity.
The American College of Osteopathic Obstetricians and Gynecologists designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™.
Physicians should only claim credit commensurate with the extent of their participation in the activity.
ACOG Cognate Credit(s)
The American College of Osteopathic Obstetricians and Gynecologists designates this activity for Category 1 College Cognate Credits equal to the number of AMA PRA Category 1 Credits™ claimed by the participant. ACOG recognizes AMA PRA Category 1 Credits™ to be equivalent to ACOG Cognate Credits.
NPs, PAs & CNMs
The American Academy of Nurse Practitioners Certification Board (AANPCB) recognizes activities approved for Category 1-A credit through the American Osteopathic Association and Category 1 AMA PRA Category 1 Credits™ as providing advanced practice CE content hours for applicants seeking renewal through continuing education credit.
The National Commission on Certification of Physician Assistants (NCCPA) recognizes activities approved for Category 1-A credit through the American Osteopathic Association and AMA PRA Category 1 Credits™ as Regular Category 1 CME for national certification maintenance.
The Certificate Maintenance Program of the American Midwifery Certification Board accepts AMA PRA Category 1 Credits™ to satisfy its contact hours requirement.
All NPs, PAs, CNMs and other health professionals participating in this activity will receive a certificate of completion commensurate with the extent of their participation in the activity. ACOOG strongly recommends all non-physician health professionals check with their certification/licensing organizations to confirm credit reciprocity.
Commercial Support
This activity is not commercially supported.
Format and System Requirements
This is a text-based activity. An internet-connected device (computer or mobile) with high-speed access is required. Compatible with most popular web browsers. JavaScript and cookies must be enabled.
Requirements for Successful Completion
- ✓Complete the pre-test
- ✓Read the commentary in its entirety
- ✓Complete the post-test (scoring 75% or more) and the evaluation
- ✓Claim credit
Your certificate will be available in the ACOOG learning center under Transcripts after you complete the post-test and evaluation.
Disclaimers
Medical Judgement
This activity is for educational purposes only, offered by ACOOG. Physicians must rely on their medical knowledge, experience, and patient relationships for clinical decisions.
This commentary is an independent work and is not affiliated with, endorsed by, or produced in collaboration with the authors or issuing body of Clinical Practice Guideline No. 13, Management of Menopause-Related Vasomotor, Sleep, and Mood Symptoms.
Use of Artificial Intelligence
The educational content of this activity, including written text and assessment items, was drafted with the assistance of Claude Opus 5.5, a large language model developed by Anthropic, PBC, on October 21, 2026. All AI-generated content was reviewed, verified for accuracy, and approved by qualified human reviewers prior to publication. Final responsibility for content accuracy, clinical validity, and independence from commercial influence rests with the American College of Osteopathic Obstetricians and Gynecologists (ACOOG).
Policies
Grievances: Any registrant finding evidence that the continuing medical education activity presented is inappropriate with regard to facilities, materials, content, or who observes any unacceptable promotion by a commercial interest may submit a grievance in writing to ACOOG, PO Box 17598, Fort Worth, TX 76102. Unresolved issues regarding this activity will require a formal written complaint to the AOA Division of CME, 142 East Ontario Street, Chicago, IL 60611.
Privacy policy: This activity complies with ACOOG’s privacy policies.
Data use: Data collected as part of this activity may be analyzed as part of educational research to study the effectiveness of educational interventions on health care, population health, health care providers and others, or to identify additional needs and gaps for future interventions.
Use of Content: Slides, handouts, recordings, and other materials from this activity belong to the presenter, to ACOOG, or to both. Participants use these materials for personal reinforcement of learning only. Any use, display, or release of these materials on an outside platform, including social media, websites, file-sharing services, and artificial intelligence (AI) tools, is strictly prohibited without written permission from ACOOG and the presenter. This prohibition includes photographing, screen-capturing, or recording any part of a presentation. Registration for this activity confirms your agreement with the ACOOG Policy on Use of Educational Materials.
Refunds: Refunds are not available for this educational product.
ACOOG Education & Professional Development
Questions? Contact ACOOG Education.
Lifelong learning in women’s health. ∞