The need to do better – Are we still letting our patients down and at what cost?

Abstract

There has been negativity and confusion regarding HRT management since the beginning of the millennium. Our findings suggest that we, as health professionals, continue to let our patients down with poor provision of information, inaccurate or wrong information, or access to the right care. The cost of this is women living with preventable sequelae associated with the menopausal transition with a consequent adverse impact on health and the health economy. The importance of the menopause consultation as part of a life course approach is highlighted as well as the emerging discipline of Health Web Science.

The dangers of compounded bioidentical hormone replacement therapy

“…1 Frustratingly, despite this evidence, only around 10% of women in the UK are currently taking HRT. 10 Although some women choose not to take HRT or cannot take it for medical reasons, a large proportion of women are declined a prescription for HRT for no valid medical reason. 11 This is either because the doctor does not know enough about it and been frightened out of prescribing, or the fact that some practices do not prescribe HRT as a cost saving exercise.…”

What the Women's Health Initiative has taught us about menopausal hormone therapy

“…Despite the fact that the risks of MHT in young, early menopausal women are now more clear, women are still not being treated for their menopausal symptoms. Many women feel that their clinicians do not recognize the impact of menopause symptoms on quality of life and also report reluctance of clinicians to prescribe MHT . This is not surprising, considering that both internal medicine and obstetrics and gynecology residents acknowledge a low comfort level with managing menopause symptoms and have limited training opportunities in this area .…”

“…As expected, there were improvements in vasomotor symptoms, sexual function, mood, and bone quality of life and also report reluctance of clinicians to prescribe MHT. 32 This is not surprising, considering that both internal medicine and obstetrics and gynecology residents acknowledge a low comfort level with managing menopause symptoms and have limited training opportunities in this area. 12,33,34 Fortunately, more recent analyses from MHT trials have somewhat increased clinicians' comfort with prescribing MHT.…”

Barriers to the Care of Menopausal Women

“…Indeed, menopausal women feel that their doctors do not recognize the importance of menopause, with one-third feeling resistance to being offered HT. 5 Therefore, "teaching the teachers" is the linchpin in ensuring that residents acquire a state-of-the-art approach to HT. Finally, the health care team must respect and accommodate the needs and pace of learners, the learner's stage of knowledge, and learning style.…”