For many women the menopause transition can bring confusion and uncertainties. Getting the right advice from health professionals is crucial. Some women were happy with the advice and service they received, others worried that the menopause is being overlooked. Several women felt that, as older women, they were “invisible, with very little voice” (see Getting older).
Judy talks about the lack of services for menopausal women in her GP practice
Dr Sally Hope explains why the menopause has become a Cinderella subject in general practice
To remedy this, women believed that their GP practice could provide a more comprehensive service to support them through the menopause. As well as up-to-date leaflets in the waiting room, they wanted time to talk to their GP face-to-face; dedicated menopause practitioners and clinics; and opportunities to share experiences with other women.
1. Time to talk face-to-face with GPs
Women value the opportunity to talk to their doctor face-to-face. They want in-depth advice and support and also greater access to medical expertise. While acknowledging that time is limited, they want GPs to listen, be sympathetic and adopt more of a counselling role rather than simply dismissing the menopause as “all part of your life journey.” They described a good GP as one who “tunes into the difficulties” women are trying to get across and accepts that even though the menopause “isn’t going to kill us” it can be debilitating (see Consulting the doctor). Women want their GP to “be experienced and really knowledgeable” about HRT and to guide them through the conflicting evidence and the “forest of newspaper scares about HRT” so that they can make an informed decision about treatment options (see Hormone replacement therapy (HRT)).
Carole compares her experience with two GPs. She stresses the importance of doctors listening and…
Barbara urges GPs to treat each case individually
Dr Sally Hopes patients want reassurance that theyre not going mad
Women suggested that doctors start discussions about the menopause and not wait until patients come with debilitating symptoms. One woman recommended “a health check round about fifty” where doctors could ask about symptoms; another, who admitted she “knew nothing about the menopause” proposed that women be sent literature and invited to “come in and talk about it” before they reached the menopause.
Rebecca believes that doctors should raise the subject of the menopause and discuss it when women…
2. Up-to-date leaflets and information
Rather than just doing their own research, women want to be directed to reliable information, resources and websites about the menopause As well as information on HRT, they want leaflets which explain “what’s normal and what isn’t”, and advice on complementary therapies and diet and exercise (see Complementary therapies, Non-HRT and lifestyle options and Changes in the body and keeping healthy). Leaflets in doctors’ surgeries alone, however, are not enough. One woman complained that, being dyslexic, she couldn’t read the leaflets. Another wanted “more than a five minute appointment” so that she could go over in detail what she’d read and ask questions (see Sources of information).
Marcia says that literature would help at an early stage
Margaret feels that pharmacists are an underused resource for information about the menopause
3. Dedicated menopause practitioners
Women recognise that listening to their needs, showing empathy, answering questions, giving information and discussing a range of treatment options may not always fit into a five or ten minute GP consultation. Despite good intentions, GPs and practice nurses can find it hard to deliver the type of specialised care women seek during the menopause, especially when guidelines and targets prioritise other aspects of health care.
Women suggested the need for dedicated practitioners in each practice who have training in the menopause and can advise women. They want doctors who are “very interested in female health”, willing to give them time, and prepared to refer them to a consultant or counsellor if necessary. Some women would like to see a menopause clinic set up in their practice, along similar lines to clinics for asthma and diabetes, where women can talk about their symptoms and concerns and get expert advice.
Joyce highlights the need for a specialised service for menopausal women
4. Opportunities to share experiences with other women
Some women felt it would be helpful to have opportunities to share experiences of the menopause with other women at their GP surgery. Their suggestions included a support network “with informed input from the professionals”; a drop-in centre staffed by a “dedicated nurse or trained person”, with a waiting area where women can “have coffee and a chat to other women”; and counselling groups focusing on the emotional and mental aspects of the menopause.
Charlotte believes there is scope in her health care centre for a well-woman clinic dedicated to…
One woman believed more people would be encouraged to attend support groups if meetings “lost their clinical aspect” and became more social “like mother and toddler groups.” Another wondered whether meetings in a community venue such as the village hall might be a better option but was unsure whether women would attend. With the majority of women working, one woman stressed the need for evening meetings but doubted that health professionals would participate (see Support networks and Work).
Denise outlines the pros and cons of a menopause clinic
Although some people would benefit from these clinics, others would not want to “listen to everybody being wretched.” Indeed, many women have few if any problems going through the menopause and little reason to consult their GP let alone attend support groups. For them, the menopause is not a big deal but simply a fact of life.
Carolyn had no adverse effects at all during the menopause. She thinks its important to remember…
Not all women seek help from their GP or practice nurse during the menopause. Those who do want reassurance, advice, guidance, and timely referral to consultants if necessary. Providing a more comprehensive service which recognises the specific needs of women at midlife is essential if they are to feel well-informed, valued and supported during the menopause.