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Menopause

It is estimated that around 75% of menopausal women experience symptoms and around 25% of women experience severe symptoms that are having a negative effect on their lives, often affecting their family and work lives.

The vasomotor symptoms of the menopause are the ones that are most obvious when thinking about the menopause, but these are not the symptoms that affect women the most. It is the symptoms of low mood, anxiety, reduced self-esteem, poor memory and concentration, reduced libido and vaginal dryness that affect them the most.

 

All the guidelines support the notion that for the majority of women starting HRT when they are under 60 years old, the benefits of taking HRT usually outweigh any risks.

 

Useful links for menopause management:

 

https://pcwhf.co.uk/wp-content/uploads/2019/01/PCWHF-Easy-HRT-prescribing-guide-31_01.pdf

 

http://www.pulsetoday.co.uk/clinical/clinical-specialties/womens-health/diagnosis-and-management-of-menopause/20037103.article

 

https://www.berkshirewestccg.nhs.uk/media/2315/apc-clindoc-010-hrt-formulary-and-treatment-guidance.pdf

 

https://www.earlymenopause.com/hrt-equivalencies/

 

https://www.menopausematters.co.uk/symptoms.php

 

https://www.menopausematters.co.uk/prematuremenopause.php

 

Perimenopause Symptoms Chart

 

Most women with menopausal symptoms can be managed in primary care. There is currently no NHS provision for patients to be seen within Cornwall. Patients can be referred to Mr Tim Hillard- a gynaecologist with special interest in menopause management in Poole, DORSET- if they meet the following criteria:

 

  1. Primary care management has been proficient but failed to provide sufficient relief in symptoms. Management to-date needs to be adequately documented in the referral letter OR
  2. Management is too complex to be undertaken in primary care. Reasons for this need to be carefully documented in the referral letter OR
  3. Where there is Premature Ovarian Failure (<40y) and the patient would like to conceive. In this case use:

http://rms.kernowccg.nhs.uk/rms/primary_care_clinical_referral_criteria/primary_care_clinical_referral_criteria/gynae/infertility

 

Date reviewed 24/04/19

Next review due 24/04/20

Sifter name Dr Jo Parry

Contributors: Dr Sarah Gray

 

Version 1.0

 

 

 

1. National Institute for Health and Care Excellence. NICE guideline NG23 – Menopause: diagnosis and management 2015 [May 2017]. Available from: https://www.nice.org.uk/guidance/ng23

 

2. Baber RJ, Panay N, Fenton A, Group IMSW. 2016 IMS Recommendations on women’s midlife health and menopause hormone therapy. Climacteric 2016;19:109-50

 

3. Hamoda H, Panay N, Arya R, Savvas M. The British Menopause Society & Women’s Health Concern 2016 recommendations on hormone replacement therapy in menopausal women. Post Reproductive Health 2016;22:165-83 4. Rossouw JE, Anderson GL, Prentice RL,