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Hyperprolactinemia

Menopause


Diagnosing Menopause 

Menopause is diagnosed after 12 months of amenorrhoea; the final menstrual period is retrospectively defined.1

Onset of the menopause transition is best determined by menstrual-cycle monitoring. Vasomotor symptoms may begin well before the last menstrual period.2

Hormone testing is generally not recommended as a way to determine a woman’s menopausal status, as ovarian function is erratic during the menopause transition.3 If premature ovarian insufficiency (POI) is suspected in a woman < 40 years, then follicle-stimulating hormone (FSH) levels can be tested to diagnose the condition (requires a minimum of 2 elevated FSH results [> 40 IU/L] at least 4-6 weeks apart).1
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Consultation tips for Menopause

It is vital to have effective communication skills during a menopause consultation. A few things to bear in mind:
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Menopause Symptoms Score Sheet

Download a Symptoms Score Sheet to help diagnose menopause and understand the patient's symptoms. This can be a useful tool to complete together in order to understand the impact HRT is having on the patient.


References
1.Baber RJ, Panay N, Fenton A; IMS Writing Group. 2016 IMS Recommendations on women's midlife health and menopause hormone therapy. Climacteric. 2016;19(2):109-150.
2.Shifren JL, Gass ML; NAMS Recommendations for Clinical Care of Midlife Women Working Group. The North American Menopause Society recommendations for clinical care of midlife women. Menopause. 2014;21(10):1038-1062.
3. NICE NG23, 2015, updated December 2019. Available at: https://www.nice.org.uk/guidance/ng23 [Accessed June 2022].
4. Brook et al. 2013. UK national guideline for consultations requiring sexual history taking. International Journal of STD & AIDS 2014, Vol. 25(6) 393-394
5. Chapman, E. 2013. Physicians and Implicit Bias: How Doctors May Unwittingly Perpetuate Health Care Disparities. JGIM.
6. Rocque, R. 2015. A Systematic Review of Patients’ Experiences in Communicating with Primary Care Physicians: Intercultural Encounters and a Balance between Vulnerability and Integrity. PLoS ONE 10(10): e0139577. doi10.1371/journal.pone.0139577
7. Nappi, R and Kokot-Kierpa, M. 2012. Vaginal Health: Insights, Views & Attitudes (VIVA) - results from an international survey. International Menopause Society. 2012:15:36-44
8. Shahawy, S et al. 2015. Cross-Cultural Obstetric and Gynaecologic Care of Muslim Patients. Vol 126. No. 5.
9. R. E. Nappi, S. Palacios, N. Panay, M. Particco & M. L. Krychman. 2015. Vulvar and vaginal atrophy in four European countries: evidence from the European REVIVE Survey, Climacteric, DOI: 10.3109/13697137.2015.1107039
10. Janssen, M. 2012. Physician’s gender, communication style, patient preferences and patient satisfaction in gynecology and obstetrics: A systematic review. Netherlands. 221-226
11. McAllister Jr, R.g. Franson, T and Kraus, C. 2013. The Practicing Clinician and Regulatory Safety Concerns.

Common Symptoms


Discover common symptoms of menopause to help understand the condition and reassure patients

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Managing Menopause


Learn recommendations to support patients with their lifestyle, diet and exercise, core recommendations regarding hormone replacement therapy (HRT), appropriate candidates for HRT, benefit-risk profile of HRT and Bioidentical Hormone Therapy

Learn more

Treatment Options

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Discover an overview of options with systemic and local therapies

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