Women undergoing the menopause and perimenopause should be encouraged to seek help with managing their symptoms, according to a group of prestigious medical charities who today set out a list of 11 new practice standards for menopause care.
The standards, drawn up by six key medical organisations including the British Menopause Society and Royal College of Obstetricians and Gynecologists, also suggest women who ask for help to manage symptoms should be offered holistic and individual advice on their treatment options.
This could include support to change their diets, quit smoking and reduce their alcohol consumption, alongside information on hormone replacement therapy (HRT) and other hormonal treatments.
The guidance comes in response to growing concern that millions of women are suffering menopausal symptoms without being diagnosed or seeking treatment. Even when women do visit a doctor to discuss their symptoms, around one third are not offered treatment such as HRT, according to the charity Menopause Support.
The other standards cover everything from diagnosis without the use of blood tests, to the use of testosterone to boost libido. Many of them are already in line with current guidelines from the National Institute for Clinical Excellence (NICE), although the British Menopause Society says its standards put more emphasis on tailoring treatment options for individuals, and allowing treatment to continue for as long as necessary.
They come as NICE is in the process of updating its guidance on caring for people experiencing menopause. In May it said it was considering including cognitive behavioural therapy to help manage menopausal symptoms, and said the new guidance will cover women, non-binary and trans people with menopause aged 40 and older.
Women aged 45 or over presenting with menopausal symptoms do not need a blood test to confirm diagnosis, according to the new standards. The diagnosis of menopause or perimenopause should be considered on the basis of a womans symptoms alone, unless there is uncertainty about the diagnosis, the standards suggest. That is in line with current NICE guidelines.
A dry or itchy vagina, or a sudden need to urinate, can be one symptom of menopause. About 50 per cent of menopausal women report experiencing genitourinary problems of this kind those suffering should be offered vaginal estrogen, the standards say.
Women having treatment for menopausal symptoms should ideally have a review three months after starting treatment and should continue to be reviewed at least annually after that, according to the standards. That review should include an assessment of symptom management and standard health check up, including weight and blood pressure checks.
Most menopause symptoms last for about seven years, and a fifth of women experience symptoms for up to 15 years. Women should be able to continue with HRT treatment for as long as they feel necessary, after weighing up the risks and benefits, according to the standards.
As women age the level of testosterone in their system can fall, causing a slump in sexual desire. Testosterone supplements can be issued for women with low libidos to redress this, if HRT alone has not proved effective, the standards say.
Early menopause can happen naturally if a womans ovaries stop making normal levels of certain hormones, particularly the hormone oestrogen. This is also known as primary ovarian insufficiency (POI). Women presenting to with a picture suggestive of POI should have a blood test to confirm the diagnosis, the standards say.
Women with POI are at increased risk of cardiovascular disease, osteoporosis and cognitive impairment. Taking hormone replacement until the natural age of the menopause can lower these risks, the standards stress.
Women who experience an earlier than usual menopause should be offered support in a similar way to women with POI, and should also be advised to take hormonal replacement until the natural age of the menopause, according to the standards.
If specialist input is required women should be referred to specialist menopause services, for example if HRT is not alleviating symptoms, where they have had an inconclusive diagnosis, or where a woman gas a complex medical background.
The rest is here:
New guidelines for menopause care say women should be offered personalised treatment including diet and HRT - iNews
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