Feature Article

How to conduct a ‘heartsink’-free menopause consultation

Jane Elliott



After more than a decade of confusion, HRT can be confidently prescribed again to healthy women who have significant symptoms at menopause. Structuring consultations enables GPs to identify the women’s concerns and individualise their treatment (if it is needed), and helps women to understand the fluctuations in symptoms they are experiencing and the treatment they would like to receive.

Key Points

  • Plan to manage the woman’s concerns about menopause over two or three long consultations.
  • Take time to listen to the patient’s individual list of menopause symptoms and concerns so you can personalise advice. Initially focus on the woman’s top three symptoms of concern.
  • Use a menopause rating scale to evaluate symptoms.
  • Update routine checks and perform any required tests based on symptoms. Hormone blood tests are unnecessary.
  • Include information and lifestyle advice for all women and hormone replacement therapy (HRT) or nonhormonal options for symptomatic women.
  • Review all women taking HRT or any other therapy at menopause at least yearly.
  • Use the 45- to 49-year-old health check to proactively educate women about menopause.
  • Remember about the increased risk of osteoporosis after menopause.

    Picture credit: © Phanie/Burger/Diomedia.com