The 2026 American College of Obstetricians & Gynecologists (ACOG) annual conference marked the 75th year for the society’s Annual Clinical & Scientific Meeting (ACSM). From May 1 through May 3, the 2026 ACOG ACSM was three days filled with educational presentations and networking opportunities for health professionals in the ob-gyn field.

Hundreds of abstracts were presented during the 2026 ACOG ACSM. Today, we are focusing on a curated selection of abstracts focusing on stages of menopause. Some descriptions and conclusions were edited for clarity and brevity. Abstracts published during the ACOG 2026 ACSM are available in the May 2026 supplement issue of Obstetrics & Gynecology.

Menopausal Stages Abstracts from the 2026 ACOG Annual Meeting

Menopause Symptoms and Cannabis Use in a Nationally Representative Sample of Midlife Women

  • Description: U.S. adults increasingly report using cannabis for symptoms common in the menopause transition, but little is known about the association of menopause symptoms and midlife mental health with cannabis use. We examined these relationships in U.S. midlife women.
  • Conclusion: Mood and menopause symptoms were associated with current cannabis use, frequent cannabis use, and CUD among midlife women. Routine screening for cannabis use may be warranted for women with these comorbidities.

Racial Disparities in Hormone Replacement Therapy Utilization Among Menopausal Women: A Nationwide Retrospective Analysis Using Epic Cosmos

  • Description: Hormone replacement therapy is the most effective treatment for menopausal vasomotor symptoms but remains underutilized with evidence of racial inequities. [The researchers] aimed to quantify national differences in hormone replacement therapy and alternative therapy use across racial groups.
  • Conclusion: Substantial racial disparities persist in menopause treatment. Black, Asian, and Indigenous patients remain undertreated with hormone replacement therapy and disproportionately prescribed hormone replacement therapy alternatives, underscoring systemic inequities and concerns for social determinants of health.

Effect of Hormone Replacement Therapy on Dry Eye Disease in Postmenopausal Women: A Systematic Review of Randomized Controlled Trials

  • Description: This systematic review synthesizes current evidence from randomized controlled trials to evaluate hormone replacement therapy’s efficacy on both subjective and objective dry eye disease outcomes.
  • Conclusion: Despite biologic plausibility, current randomized controlled trial data do not support routine hormone replacement therapy use for dry eye disease management in postmenopausal women. Considerable heterogeneity highlights the need for standardized trial designs.

Sleep Disturbances and Menopausal Symptoms: Findings From the National Poll on Healthy Aging

  • Description: Chronic sleep deprivation is associated with negative downstream effects, including poor quality of life, cardiovascular disease, and even increased mortality. There is a known association between menopause and sleep problems, but this relationship is not fully understood, especially in relation to other menopausal symptoms and sociodemographic factors.
  • Conclusion: The majority of menopausal women experience sleep problems, and this is more likely among women with active menopausal symptoms. Integrating screening and evidence-based interventions for sleep disturbances into menopause management may improve overall health, quality of life, and long-term outcomes.

Menopausal Symptoms, Sexual Activity, and Sexual Satisfaction Among Women Aged 50–80 Years

  • Description: Menopause marks a significant transition in a woman's life, often accompanied by physical and psychological symptoms that affect overall well-being. Sexual dysfunction during menopause is prevalent but underexplored. Understanding the effect of menopausal symptoms on sexual satisfaction is crucial to enhancing care and quality of life in this population.
  • Conclusion: Most menopausal women experience multiple bothersome symptoms, placing them at increased risk for sexual dysfunction and reduced satisfaction due to hormonal changes. Further research should explore how the number, severity, and type of symptoms individually and collectively affect sexual activity and satisfaction.

Comparative Effects of Estrogen Use Status and Route of Administration on Migraine Risk in Postmenopausal Women: A Network Meta-Analysis

  • Description: This network meta-analysis evaluates the association of estrogen use (current, previous, and no use) and administration routes (oral, transdermal, and vaginal) with migraine incidence in postmenopausal women.
  • Conclusion: Although current estrogen use was associated with an increased risk of migraine, no differences were detected across administration routes or when comparing previous with no use. These findings suggest that hormone replacement therapy decisions should be individualized based on patient preference, tolerability, and overall clinical context rather than migraine risk alone.

False-Positive Cervical Dysplasia as One of the Earliest Manifestations of Genitourinary Syndrome of Menopause

  • Description: This study investigates whether local vaginal estrogen therapy can reverse abnormal cytology and reduce false-positive diagnoses.
  • Conclusion: Local estrogen therapy is a safe and effective approach to reduce false-positive results and prevent unnecessary colposcopies, biopsies, and even hysterectomies. Integrating hormone therapy before confirming cytologic abnormalities may improve diagnostic accuracy, reduce health care costs, and spare patients from overtreatment.

Initiation of Hormone Replacement Therapy in Late Menopause

  • Description: Systemic hormone therapy is traditionally limited to women within 10 years of menopause or younger than 60 due to concerns about cardiovascular risk. Since 2008, [the researchers] have implemented a new protocol allowing hormone therapy initiation in postmenopausal women over 60 years old with a coronary calcium score of 0, challenging conventional age-based restrictions.
  • Conclusion: This study supports a shift from age-based to risk-based criteria for hormone therapy initiation in late menopause. Coronary calcium scoring offers a practical and individualized method to safely expand access to hormone therapy in older postmenopausal women.

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