NICE issues first guideline on the Menopause

Thursday 12th November 2015

Anticipating the release of the new and first NICE guidelines on menopause, the Primary Care Women’s Health Forum have developed ‘ten top tips’ designed to make understanding the changes to the recommendations for the management of menopause as simple as possible. The importance of educating Primary Care healthcare professionals in menopause has been proven to be paramount after the release of several studies which show time and again that female patients suffering the effects of menopause consult their GPs or practice nurses.

The tips contain helpful and most importantly practical advice from the boards own primary care clinical experts, who regularly practice in the area of women’s health and have extensive knowledge of prescribing for and treating menopausal women.

The Forum plans to publish the tips on their website and through their monthly e-bulletin. The tips were first unveiled at the PCWHF’s annual conference, held on the 5th November 2015 after the topic had been hotly debated. The PCWHF registered as a stakeholder early on in the developments of the new menopause management guidelines and has maintained a strong interest in the progress and are therefore well placed to aid Primary Care healthcare professionals in adjusting to these recommendations.

10 Top Tips for everyday practice

  • 1. The diagnosis of menopause in women aged > 40 is clinical. It does not require confirmation with an FSH level.
  • 2. Remember that contraception is needed until infertility can be assumed
  • 3. Consider menopause as a possibility in women < 45 who have amenorrhea and are not using hormonal contraception
  • 4. HRT should be recommended routinely to women who are menopausal aged < 45, even if they are asymptomatic
  • 5. Provide/signpost good patient information (e.g.www.menopausematters.co.uk) to allow informed and shared decision making between the woman and her HCP
  • 6. Prescribing is not difficult and decision making guides are available.
  • 7. HRT is much safer than you think. NICE clinical Guidance (2015) will provide the evidence and reassurance.
  • 8.Support the woman to initiate and continue treatment and review at 3 months. If stable, annual review is recommended to reassess the risk/benefits of ongoing HRT use for her. There is no arbitrary limit to length of use
  • 9. The benefits of HRT outweigh the risks for most women who start treatment aged < 60
  • 10. Low dose vaginal oestrogens are safe to use for as long as required in all women who do not have breast cancer.