Evidence-based recommendations on menopause management advise individualized care

Best practice recommendations for healthcare professionals providing help and support to women experiencing the menopause have been issued in a joint position statement from the British Menopause Society (BMS), Royal College of Obstetricians and Gynaecologists (RCOG) and the Society for Endocrinology (SfE). The recommendations have been published in Post Reproductive Health.

The statement is in response to growing concerns around hormone replacement therapy (HRT) shortages and provides an expert consensus on best practice for menopause care and treatment, incorporating national and international evidence-based information. The recommendations advise an individualized approach, considering the risks and benefits of therapies as well as lifestyle choices so that women can make informed decisions about their treatment and care.

It is estimated that menopause symptoms affect more than 75% of women, with over 25% of women experiencing severe symptoms. These can include hot flushes and night sweats, vaginal dryness, a change in mood and memory problems, many of which can last for several years. These symptoms can have a detrimental impact on women's quality of life and well-being, as well as pose more serious risks to their bone and cardiovascular health. The menopause for many women has been shrouded in stigma and taboo, however in the past couple of years we have seen an uplift in awareness of the menopause and its symptoms through the media. Recent HRT shortages, as well as a plethora of misinformation about menopause in the mainstream media has prompted the preparation of this statement.

As a group of medical organizations, the BMS, RCOG and SfE aim to provide evidence-based guidance to healthcare practitioners who work with women experiencing the menopause, to ensure that they have access to accurate information and can help women make informed decisions about their treatment and care. It is important to not only consider HRT, but to also offer advice on lifestyle, such as exercise, optimizing weight, stopping smoking, reducing alcohol, as well as the advantages and disadvantages of alternative therapies. The statement advises that the individual needs of each woman be considered, rather than a "one size fits all" approach. It also considers the risks and benefits of hormonal therapies in the context of age, cardiovascular health, cancer status and body weight.

Haitham Hamoda, Chairman British Menopause Society says, "Whilst women can access much information on the internet and social media, there unfortunately remains some misinformation. The importance of applying a holistic and individualized approach in the care of women going through the menopause transition was recognized in the NICE guidance in 2015, as well as other national and international guidance documents. It is essential that women are made aware that help and support is available to them and are provided with access to accurate information."

Professor Stephanie Baldeweg, Consultant Endocrinologist and SfE Clinical Committee Chair says, "In recent years, the mainstream media has provoked much positive discussion over what treatments are available and what more could be done to support women going through the menopause. Some reports and headline have been conflicting, so guidance from independent expert governing bodies, through careful consideration of peer reviewed data from a wide range of high quality sources, is very much needed to empower patients, doctors, practitioners and women to make informed choices."

Dr. Edward Morris, President of the Royal College of Obstetricians and Gynaecologists (RCOG), says, "It's clearly been a really distressing time for many women who have tried to access their regular form of HRT and not been able to as a result of these shortages.

"The aim of this statement is to provide clear recommendations of best practice for healthcare professionals caring for women and people of all ages who have menopausal symptoms. All women will experience the menopause in different ways and that's why it's important they are provided with tailored care that's right for them."

The menopause is a major life event that can affect women in different ways. An individualized approach in assessing women going through the menopause is essential and it's important that women are made aware of the help and support available to them, and that they feel able to consult their GP for trusted advice. This Position Statement is intended to provide useful and accurate recommendations for professionals to guide women in finding what's best for them.