Patterns of Traditional Korean Medicine and Western Medicine Utilization Among Women with Menopausal Disorders: A 9-Year Nationwide Cohort Study Using National Health Insurance Data

Article information

J Korean Med. 2026;47(1):152-166

Publication date (electronic) : 2026 March 1

doi : https://doi.org/10.13048/jkm.26010

Man Young Park ¹

, Ji Yeon Lee ²^,

¹Division of Digital Clinical Research, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea

²Department of Obstetrics and Gynecology of Korean Medicine, College of Korean Medicine, Daejeon University

Correspondence to: Ji Yeon Lee, Daejeon Korean Medicine Hospital of Daejeon University, 75 Daeduk-daero 176 beon-gil, Seo-gu, Daejeon, Tel:+82-42-470-9139, Fax:+82-42-470-9009, E-mail:jyounl@daum.net

Received 2026 January 12; Revised 2026 February 12; Accepted 2026 February 19.

Abstract

Background

Menopausal disorders impose significant socioeconomic burdens worldwide, with declining hormone replacement therapy (HRT) usage following safety concerns from the Women’s Health Initiative study. This has increased interest in traditional Korean medicine (TKM) and integrative approaches for menopausal symptom management.

Objective

To analyze real-world treatment patterns and healthcare utilization among women with menopausal disorders, comparing TKM monotherapy with combined TKM-Western medicine approaches using nationwide health insurance claims data.

Methods

This retrospective cohort study analyzed 9 years (2015–2023) of Health Insurance Review and Assessment Service data for 71,381 women diagnosed with menopausal disorders. Patients were categorized into TKM monotherapy and combined TKM-Western medicine groups. Treatment patterns, medication usage, and clinical characteristics were compared between groups.

Results

HRT usage rates maintained 15–18% levels with recent decline. The combined therapy group showed significantly higher treatment duration (707.8 vs. 55.3 days), visits (15.5 vs. 5.7), and HRT usage (78.6% vs. 6.2%) compared to TKM monotherapy. Comorbidity prevalence was higher in the combined group: depression (17.7% vs. 11.1%), sleep disorders (22.6% vs. 16.1%), and osteoporosis (17.3% vs. 13.6%). Acupuncture was used in 90.9% of TKM patients, predominantly in combination with cupping (71.9%) and thermal therapy (61.6%). The most common combination was acupuncture+cupping+thermal therapy (26.8%). Western medicine prescriptions were dominated by analgesic-antipyretics (73.4%), gastrointestinal medications (71.3%), and psychotropic drugs (30.9%).

Conclusions

This study revealed distinct healthcare utilization patterns between treatment groups, suggesting that combined therapy patients represent a more complex, treatment-refractory population requiring long-term, multifaceted care. TKM monotherapy patients showed preference for non-pharmacological treatments with shorter treatment durations. These findings support the need for personalized, integrated treatment strategies based on patient characteristics and symptom complexity. Future research should evaluate clinical outcomes and establish evidence-based guidelines for integrative menopausal care within healthcare systems.

Keywords: Menopause; Traditional Korean Medicine; Integrative Medicine; Health Insurance Claims; Treatment Patterns; Healthcare Utilization

Fig. 1

Healthcare utilization trends and hormone replacement therapy (HRT) usage patterns from 2015 to 2023. (A) Overall healthcare utilization showing total visits (blue line, left y-axis) and unique patients (green line, right y-axis). (B) HRT usage patterns displaying the absolute number of HRT users (red line, left y-axis) and HRT user rate as a percentage of unique patients (purple line, right y-axis). The shaded area indicates the COVID-19 pandemic period (2020–2021), which coincided with notable decreases in healthcare utilization. Data represent annual aggregated values from electronic health records.

Table 1

Baseline Characteristics of Women With Menopausal Disorders by Type of Medical Use

Table 2

Most Frequently Prescribed Western Medications for Women With Menopausal Disorders (N=71,381)

Table 3

Frequently Prescribed Western Medicine Therapeutic Classes During the Menopausal Period Among Women Diagnosed With Menopausal Disorders (N=71,381)

Table 4

Utilization of Korean Medicine Therapies Among Women With Menopausal Disorders (N=65,430)

Table 5

Top 10 Most Frequently Prescribed Reimbursed Herbal Medicines (Multi-herb Formulas and Single-herb Preparations) for Menopausal Women in Korean Medicine (N=19,964)

Table 6

Top 10 Most Common Treatment Combinations for Menopausal Disorders in Korean Medicine (N=71,381)

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Article information Continued

Fig. 1

Table 1

Baseline Characteristics of Women With Menopausal Disorders by Type of Medical Use

Variable	KM Only1 (N=56130)	KM+WM1 (N=15251)	Total (N=71381)	p-value
Demographics
Age (mean ± SD)	52.4 ± 5.3	51.9 ± 4.4	52.3 ± 5.1	<0.001

Age group				<0.001
- ≤39	224 (0.4%)	31 (0.2%)	255 (0.4%)
- 40–49	15828 (28.2%)	4322 (28.3%)	20150 (28.2%)
- 50–59	35077 (62.5%)	10107 (66.3%)	45184 (63.3%)
- ≥60	5001 (8.9%)	791 (5.2%)	5792 (8.1%)

Medication & Visits
HRT use: No	52650 (93.8%)	3266 (21.4%)	55916 (78.3%)	<0.001
HRT use: Yes	3480 (6.2%)	11985 (78.6%)	15465 (21.7%)	<0.001
Follow-up duration (days)2	55.3 ± 141.6	707.8 ± 764.7	194.7 ± 460.7	<0.001
Number of visits3	5.7 ± 11.6	15.5 ± 18.1	7.8 ± 13.8	<0.001

Comorbidities
Depression	6203 (11.1%)	2706 (17.7%)	8909 (12.5%)	<0.001
Diabetes mellitus	7897 (14.1%)	2238 (14.7%)	10135 (14.2%)	0.059
Hyperlipidemia	22592 (40.2%)	6765 (44.4%)	29357 (41.1%)	<0.001
Hypertension	10712 (19.1%)	2669 (17.5%)	13381 (18.7%)	<0.001
Musculoskeletal symptoms	45716 (81.4%)	13082 (85.8%)	58798 (82.4%)	<0.001
Osteoporosis	7640 (13.6%)	2640 (17.3%)	10280 (14.4%)	<0.001
Sleep disorder	9016 (16.1%)	3441 (22.6%)	12457 (17.5%)	<0.001

KM: Korean Medicine; WM: Western Medicine. “KM only” refers to patients who received Korean medicine treatment only. “KM+WM” indicates patients who received both Korean and Western medicine during episode.

Follow-up duration is defined as the number of days between the first and last Menopausal Disorders-related visit.

Number of visits includes all outpatient claims with Menopausal Disorders during the episode period.

Table 2

Most Frequently Prescribed Western Medications for Women With Menopausal Disorders (N=71,381)

Treatment category	Total Prescriptions	Unique Patients Prescribed	Percent of Total Patients (%)	Percent of All Prescriptions (%)	Avg. Prescriptions per Patient
Estrogen and progestin therapy	106,426	11,397	15.97%	58.57%	9.34
Urogenital tract medications	15,090	4,803	6.73%	8.30%	3.14
Calcium supplements	9,968	1,756	2.46%	5.49%	5.68
Antipyretic, analgesic, NSAIDs	5,296	1,944	2.72%	2.91%	2.72
Anti-ulcer agents	4,842	1,906	2.67%	2.66%	2.54
Other digestive system agents	4,308	1,870	2.62%	2.37%	2.30
Broad-spectrum antibiotics	3,500	1,532	2.15%	1.93%	2.28
Other chemotherapeutic agents	2,596	1,380	1.93%	1.43%	1.88
Antihistamines	2,530	1,150	1.61%	1.39%	2.20
Psychotropic agents	2,213	725	1.02%	1.22%	3.05
Anthelmintics	2,106	1,265	1.77%	1.16%	1.66
Anti-arteriosclerotic agents	1,702	384	0.54%	0.94%	4.43

This table summarizes prescription patterns among 71,381 patients with Menopausal Disorders with Western medicine. “Total Prescriptions” refers to the total number of prescriptions issued for each drug category; “Unique Patients Prescribed” indicates the number of patients who received at least one prescription in that category; “Percent of Total Patients” represents the proportion of these patients relative to the total cohort; “Percent of All Prescriptions” refers to the share of prescriptions by drug category; and “Avg. Prescriptions per Patient” is calculated by dividing total prescriptions by the number of patients prescribed.

Table 3

Frequently Prescribed Western Medicine Therapeutic Classes During the Menopausal Period Among Women Diagnosed With Menopausal Disorders (N=71,381)

Treatment combination	Total Treatments	Unique Patients Treated	Percent of Total Patients (%)	Percent of All Treatments (%)	Avg. Treatments per Patient
Antipyretics, analgesics, NSAIDs	621,474	52,376	73.38%	14.30%	11.87
Anti-ulcer agents	511,879	50,926	71.34%	11.78%	10.05
Antitussives and expectorants	288,135	33,980	47.60%	6.63%	8.48
Other digestive system agents	287,318	40,993	57.43%	6.61%	7.01
Psychotropic agents	237,362	22,073	30.92%	5.46%	10.75
Antihistamines	216,188	35,530	49.78%	4.98%	6.08
Adrenal hormones	181,574	32,813	45.97%	4.18%	5.53
Broad-spectrum antibiotics	169,973	33,791	47.34%	3.91%	5.03
Ophthalmic preparations	140,958	23,930	33.52%	3.24%	5.89
Estrogen and progestin therapy	134,060	15,475	21.68%	3.09%	8.66
Enzyme preparations	96,748	25,757	36.08%	2.23%	3.76
Local anesthetics	80,883	16,871	23.64%	1.86%	4.79

Table 4

Utilization of Korean Medicine Therapies Among Women With Menopausal Disorders (N=65,430)

Treatment group	Total treatments	Number of unique patients	Percentage of total patients (%)	Percentage within group (%)	Percentage by treatment combination (%)	Average treatments per patient
Acupuncture	990,856	64,857	90.86	99.12	46.76	15.28
Cupping	650,946	51,306	71.88	78.41	30.72	12.69
Hot and cold meridian therapy	458,851	43,976	61.61	67.21	21.66	10.43
Chuna	18,194	3,552	4.98	5.43	0.86	5.12

Table 5

Top 10 Most Frequently Prescribed Reimbursed Herbal Medicines (Multi-herb Formulas and Single-herb Preparations) for Menopausal Women in Korean Medicine (N=19,964)

Herbal formula	Total treatments	Number of unique patients	Percentage of total patients (%)	Percentage within herbal group (%)	Average treatments per patient
GamisoYosan	23,603	8,040	11.26	40.27	2.94
OjeokSan	8,352	2,127	2.98	10.65	3.93
HyangsapyungwiSan	5,791	2,251	3.15	11.28	2.57
PyungwiSan	4,988	1,628	2.28	8.15	3.06
HwangryeonhaedokTang	4,382	1,291	1.81	6.47	3.39
GungHwaTang	4,308	773	1.08	3.87	5.57
BanhasasimTang	4,259	1,676	2.35	8.40	2.54
JaeumganghwaTang	4,241	1,370	1.92	6.86	3.10
Jakyak	3,122	773	1.08	3.87	4.04
IjinTang	3,096	739	1.04	3.70	4.19

This table includes reimbursed herbal medicine products, encompassing both multi-herb formulas and single-herb preparations (e.g., Jakyak). Non-reimbursed decoctions were not included.

Table 6

Top 10 Most Common Treatment Combinations for Menopausal Disorders in Korean Medicine (N=71,381)

Combination type	Total treatments	Number of unique patients	Percentage of total patients (%)	Percentage by combination (%)	Average treatments per patient
Acupuncture + Cupping + Hot and cold meridian therapy	196,562	19,129	26.80	26.38	10.28
Acupuncture + Cupping	174,722	17,354	24.31	23.45	10.07
Acupuncture	143,878	12,629	17.69	19.31	11.39
Western Medicine	96,561	9,662	13.54	12.96	9.99
Acupuncture + Hot and cold meridian therapy	60,250	7,852	11.00	8.09	7.67
Acupuncture + Cupping + Hot and cold meridian therapy + Korean Medicine	20,370	4,686	6.56	2.73	4.35
Acupuncture + Cupping + Korean Medicine	13,618	3,055	4.28	1.83	4.46
Korean Medicine	7,726	2,252	3.15	1.04	3.43
Acupuncture + Chuna + Cupping + Hot and cold meridian therapy	7,647	1,504	2.11	1.03	5.08
Acupuncture + Korean Medicine	5,629	1,594	2.23	0.76	3.53