Menopause practice standards

Hamoda, Haitham; Moger, Sara; Morris, Edward; Baldeweg, Stephanie E; Kasliwal, Asha; Gabbay, Flic; Wright, Heidi

doi:10.1177/20533691221110001

Cited by 6 publications

(5 citation statements)

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“…The future design of menopause care services should be holistic and our findings suggest this should be a hybrid of face-to-face and virtual interactions. Post-reproductive health is a growing speciality, and although a national practicing standard exists, 3 further cross-discipline consensus, particularly around virtual consultations, would be invaluable.…”

Section: Discussionmentioning

confidence: 99%

An evaluation of menopause service delivery during the COVID-19 pandemic

Pedder

Robinson

Abernethy³

et al. 2023

Post Reprod Health

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Objective To investigate the experience of remote outpatient menopause service delivery by clinicians and patients during the COVID-19 pandemic. Methods Two surveys explored the experiences of patients and clinicians separately. Patients attending menopause clinics in the UK were directed to an online survey which included questions on demographics and on their experience of their most recent appointment. A clinician survey was shared to members of the British Menopause Society (BMS) via email and was made available on the BMS website. It contained questions on clinic characteristics and clinicians’ experience of delivering remote menopause consultations. Surveys were available for completion between 01/12/2020 and 10/02/2021. Results Of 180 patients who completed the patient survey, 52% felt remote consultations were the same or better than face-to-face consultations, and 90% of patients felt a choice between remote and face-to-face consultations should be offered. Patients overall were satisfied with many aspects of care, though numerous problems were highlighted with appointment administration. Of 76 clinicians who completed the clinician survey, most found remote patient consultations either no different or a bit worse than face-to face consultations but found that they offered more flexibility. In some cases, significant rescheduling was necessary to accommodate for the clinical needs of the consultation. Conclusion A ‘one-size-fits-all’ approach to managing the delivery of menopause care is not supported by patients or clinicians. There must be a robust process in place to avoid problems with appointment scheduling and associated communications. Lessons learned from the pandemic can help to provide holistic menopause care.

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Section: Discussionmentioning

confidence: 99%

An evaluation of menopause service delivery during the COVID-19 pandemic

Pedder

Robinson

Abernethy³

et al. 2023

Post Reprod Health

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“…This may be more acceptable if the woman has become menopausal naturally. However, in early menopause, particularly following surgical menopause, concern over the detrimental impact of hypoestrogenism may make this approach less viable (10). Other approaches include reducing the dose of estrogen, switching from sequential to continuous combined HRT and changing the type of progesterone.…”

Section: Management Of Symptomatic Postmenopausal Women With Endometr...mentioning

confidence: 99%

“…Persistent/recurrent symptoms may be due to hormone replacement therapy (HRT) but some women are still symptomatic despite not being on HRT (9). It is postulated that extra-ovarian (conversion of androgens in the adipose tissue depending on body weight) or locally produced estrogens (due to increased aromatase activity in endometriotic tissue) continue to stimulate endometriotic lesions in symptomatic women (10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Management of menopause in women with a history of endometriosis

Akgün,

Sarıdoğan

2024

J Turkish German Gynecol Assoc

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Due to increasing life expectancy, women spend a significant part of their lives in menopause. Women with a history of endometriosis are more likely to become menopausal at an early age due to bilateral oophorectomy or repeated ovarian surgery. In addition, some medical therapies used for endometriosis, such as gonadotropin releasing hormone agonists or progestins reduce bone mineral density. Furthermore, women with endometriosis have a higher background risk of cardiovascular disorders and hypercholesterolemia. Hence, it is important to recommend the use of hormone replacement therapy (HRT) to these women when they become menopausal, at least until the age of natural menopause. Although based on limited data, there is a possibility of reactivation of symptoms of endometriosis or its lesions, and a theoretical possibility of malignant transformation, although this remains unproven. Therefore, women should be advised in the light of this information before starting HRT after the age of natural menopause and are asked to seek help if they experience symptoms that may indicate these changes. Estrogen only HRT should be avoided and combined HRT preparations should be recommended, even after a hysterectomy.

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“…International medical organisations including the British Menopause Society, International Menopause Society and the Menopause Society have published best practice recommendations for menopause care. [1][2][3][4][5] These provide evidence-based guidance for healthcare practitioners to refer to and are perhaps more accessible to those with a menopause interest. There are currently no guidelines available that provide specific recommendations on the prescription of HRT according to a medical co-morbidity.…”

Section: Introductionmentioning

confidence: 99%

Exploring the potential for a set of UK hormone replacement therapy eligibility guidelines: A suggested proposal on the topic of venous thromboembolism

Laing,

Thomas,

Hillard

et al. 2023

Post Reprod Health

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Objective To explore the feasibility for a set of hormone replacement therapy (HRT) eligibility guidelines that follow a similar structure and appearance to the UKMEC guidance for contraception. To enable non-specialists to feel confident in safely prescribing HRT and to aid selection of the most appropriate first line treatment. Methods A literature review was undertaken with evidence summarised on the topic of venous thromboembolism (VTE) which is an area frequently considered a barrier to prescribing. Medical eligibility tables which separated HRT by type were then produced for a set of VTE-related topics. Results The literature search confirmed the importance of distinguishing between different types and routes of administration when considering the suitability of HRT. Much of the evidence has been based on older synthetic types of HRT and whilst they still have a role in management, these medications carry different risks to the now more accepted use of body identical types. The search also highlighted the nuances involved, increasing the complexity of forming guidelines, with the need for consideration to be given to an individual’s own perception of risks and benefits. Conclusion The demand for HRT has risen in recent years and there is a need for this to be managed effectively, particularly for patients in primary care. The production of this type of guidance will enable the non-specialist to feel confident in safe and evidence-based prescribing. The guidelines are also designed to demonstrate to prescribers which complex patients should be referred onto menopause specialists.

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Menopause practice standards

Cited by 6 publications

References 0 publications

An evaluation of menopause service delivery during the COVID-19 pandemic

An evaluation of menopause service delivery during the COVID-19 pandemic

Management of menopause in women with a history of endometriosis

Exploring the potential for a set of UK hormone replacement therapy eligibility guidelines: A suggested proposal on the topic of venous thromboembolism

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