Menopause

Consulting the doctor

No one has to see their doctor when they go through the menopause - women may see the menopause as a normal phase of life and have few if any problems. Others may use self-help measures such as diet and exercise or complementary therapies to relieve the symptoms. Some may mention the menopause in passing when they see their practice nurse. It is often only when women become concerned about symptoms, cannot cope and are at their ‘wits end’ that they see their doctor. Women talked about going to the doctor during the menopause and described positive and negative experiences.


What women say about their doctors
A woman may consult her doctor during the menopause for reassurance, support, information and/or advice about treatment options, HRT prescriptions, and/or for referral to a specialist. Women’s experiences vary greatly. At one end of the spectrum, women had only praise for their doctors. They enthused about GPs who were approachable, well informed, supportive, understanding, sympathetic, open and honest. Good doctors made them feel at ease; they explained the menopause process and could discuss various treatment options and possible risks and benefits. Women felt supported in making well-informed choices.
Others found consultations with the doctor disappointing. Some GPs had a casual, dismissive attitude about the menopause, offering inappropriate or unhelpful suggestions and advice. Women felt that their concerns weren’t taken seriously.
Satisfaction with the service provided in primary care can depend not only on the personality and expertise of the doctor, but on the relationship between women and their GPs.

The doctor-patient relationship
Traditionally, doctors in our society have been respected for their expertise and ability to heal. Some women have remained loyal to their GPs, unwilling to question or challenge the advice given. More recently, however, as information has become more freely available, some women prefer a more equal partnership with the doctor so that they can discuss symptoms, share ideas and negotiate possible treatments. Conflicts can arise when doctors appear to lack expertise or don’t listen. However, even a woman who is dissatisfied with her GP may be reluctant to move to another doctor or practice.

Women felt that doctors work within constraints which can affect their relationship.

The NHS, health professionals and the menopause
A major problem was limited consultation time. This made it hard for women to talk through how they felt, describe their symptoms and discuss treatment options. Some women thought that limited budgets, time pressures, targets and guidelines restricted the service, help and support health professionals could give menopausal women (see ‘What is the menopause?’). They also noted problems in making appointments and a lack of continuity with GPs. It seemed that the menopause was considered less important than other reasons for consulting the GP.

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The complexities of the menopause meant that it did not fit easily with the priorities of primary care. While trusting their GP’s ability to treat illnesses, some women felt their doctors lacked the specialist knowledge and training they thought was needed to help women with the menopause. Some women thought that GPs tended to make assumptions and adopt a ‘one size fits all’ approach, rather than listening to the concerns of women as individuals and offering a variety of choices.

With access to the internet and information about the menopause readily available, some women felt they knew at least as much as, if not more than, their GP. Dr Sally Hope agreed, saying she often has ‘women coming in who are actually much better informed than the average GP and that’s nice because you educate us as you come into the surgery’.

Women wondered whether the GP was the best person to help with menopausal symptoms. Some felt that apart from prescribing HRT, GPs could do little to help. Some women came away from consultations feeling that they hadn’t had a chance to open up and fully explain their concerns. Others decided to find their own solutions by consulting a herbalist or a specialist (see ‘Hormone replacement therapy (HRT)’ and ‘Complementary therapies’).
Although some women spoke highly of their male GPs, many preferred to see a female doctor if possible. Unsure whether male doctors could empathise with the way they felt, women were more comfortable talking about emotional and sensitive issues with another woman. Some women asked specifically to see a female doctor.
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Some practice nurses were a further source of information and support, particularly when women came for routine cervical screening or blood pressure and weight checks. Time pressures, lack of specialist knowledge and inability to prescribe, however, meant they couldn’t provide more than a basic service.
Despite general satisfaction with the standard of primary care, many menopausal women feel that their needs are not being sufficiently met. In ‘Advice to health professionals’ women suggest ways in which this could be improved.

Last updated February 2015.

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