The Guideline Menopause: Diagnosis and Management was published by the National Institute of Health and Care Excellence (NICE) in the UK in November 2015, the aim being to improve the knowledge level of both health care professionals and their patients regarding the menopause and to standardise care across the UK. Recommendations were developed following the systematic review of the current evidence-base. Each review question posed (17 in all) was subject to systematic review and meta-analysis and appropriate recommendations written by a multidisciplinary group.
Recommendations were made on:
Diagnosis of perimenopause and menopause.
Information and advice.
Managing short-term menopausal symptoms (a full range of treatments).
Long-term benefits and risks of hormone replacement therapy (HRT).
Diagnosing and managing premature ovarian insufficiency (POI).
The aim of the guidelines is to give the woman and her doctor as much information and explanation as possible in order to achieve the best individualised care. This should enable her to make an evidence-based choice. There are sections on a normal menopause, specific recommendations for women with POI, and women with vasomotor or other menopausal symptoms for whom standard HRT is contraindicated (e.g. those with breast cancer). This presentation will cover benefits and risks of HRT, diagnosing and managing premature ovarian insufficiency and diagnosis of natural menopause.
Since publication there has been considerable publicity with the development of Quality Standards by NICE against which care can be audited, and which can be used to commission services in the community. With the aid of the media, more women are becoming aware and the level of knowledge of some GPs is improving. As always this is a slow process but increased awareness of menopause and its implications is vital for the doctors and their patients.