The British Menopause Society (BMS) educates, informs and guides Healthcare professionals on menopause and all aspects of post-reproductive health.
They provided a summary of 10 recommendations from NICE to primary care doctors, i.e. GPs on the diagnosis, treatment and management of Menopause.
We think every woman should be aware of them too, so we’ve put them on our website for you and explained a little about what they mean.
1: Provide evidence-based information about menopause and treatment options and help women make informed, individual decisions about menopause management.
This is about putting you in control of your own menopause management, with information based on the latest evidence. Your GP should help you make an informed decision about your own menopause that’s individually tailored to you.
2: Do not use blood tests to diagnose perimenopause or menopause in women over age 45
The best way to diagnose perimenopause and menopause is through talking and listening to you – your description of your own experiences is vital to getting the right treatment. Blood tests are usually not needed to accurately diagnose and recommend menopause treatments.
3: Offer HRT first line for menopause-related vasomotor symptoms and low mood.
If you’re suffering from debilitating symptoms that significantly affect your quality of life, your GP should offer Menopause Hormonal Treatment (MHT), you should be given all the information you need about what to expect from treatment including any risks or side effects.
4 Do not routinely offer clonidine or antidepressants
If you’re experiencing low mood or anxiety symptoms, treating the menopause itself is the more efficient and effective treatment. Antidepressants only mask the symptoms, and do not treat the root cause of them.
5 Do not use Fluoxetine or Paroxetine in women taking Tamoxifen
Some antidepressants can’t be offered to women who have had breast cancer and are taking medication called tamoxifen. This is because they might reduce the effectiveness of the tamoxifen – obviously not a good idea!
6 Offer long term vaginal oestrogen for urogenital symptoms, even if taking HRT
Symptoms like vaginal dryness and any urinary symptoms should be treated with what is known as “intra-vaginal oestrogen” – this is a low-dose oestrogen treatment applied directly to the vagina to ease symptoms. It’s very safe, even if patients are also using HRT and so should not be avoided if needed.
7 Understand appropriate review and when to refer
It’s important that you undergo regular review during the menopause, as symptoms change over time. Your GP should offer you regular review and also refer you to a specialist if appropriate.
8 Support women to choose when to stop HRT, do not choose arbitrary limits
It’s important for you to end your treatment when you feel ready. Your GP shouldn’t set a specific date in the future. Instead, you should come to a decision for yourself about when you feel ready to stop or begin to stop.
9 Use pictorial charts to discuss long term risks and benefits of HRT
Your GP should help educate and inform you as well as provide treatment, so visual aids and charts to demonstrate long term risk and benefits should be used to help you better understand the treatment you’re getting.
10 Do use blood tests to confirm diagnosis of POI and offer hormonal treatment up to average age of menopause at least
Premature Ovarian Insufficiency happens when a woman’s ovaries stop working normally before the age of 40. In this case, the BMS recommends that blood tests are appropriate for accurate diagnosis and that hormonal treatment is offered up to the average age of menopause.
If you’re interested, here is the British Menopause Society Tool For Clinicians – NICE Guidelines
https://thebms.org.uk/wp-content/uploads/2019/04/09-BMS-TfC-NICE-Menopause-Diagnosis-and-Management-from-Guideline-to-Practice-Guideline-Summary-01-April2019.pdf
