The role of GPs in menopause management

It is said that nothing is certain but death and taxes. For women, provided they live long enough, another certainty is menopause. Most women have their final menstrual period between the ages of 45 and 55, though there are women with early menopause who have unique needs.

Although menopause is a natural event it is not necessarily easy for women. Women can experience a range of symptoms in the perimenopausal and postmenopausal years. In addition to changes in the menstrual cycle, symptoms include hot flushes, mood changes and anxiety, sleep issues, and genitourinary symptoms. Some women experience few symptoms, but others have severe and debilitating symptoms. Whether symptomatic or not, menopause has important and ongoing consequences for all women, including an increase in risk of cardiovascular disease and osteoporosis.

In spite of improvements in education and understanding about women’s health, menopause still remains a poor cousin and is the subject of embarrassment and stigma.

How can GPs help perimenopausal and menopausal women? We hear that GPs are ‘well-placed’ to do all sorts of things, often said by ‘experts’ who exhort GPs to squeeze more and more into our already crowded consultations.

The reality is that menopause cannot be addressed adequately in a typical ‘standard’ consultation. Women presenting to their GP with concerns around the time of menopause need:

• A comprehensive history including a menstrual history, family and personal history of medical conditions and risk factors. An important part of this is an exploration of the women’s individual needs and concerns. ...

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