Running a menopause clinic.

Abstract

A menopause clinic can be run either by a general practitioner as a primary referral clinic or in a hospital by a team of specialists and paramedical personnel as a secondary referral centre. Both can be run efficiently and with sensitivity. The importance of giving adequate information and education through combined video, written and verbal information is stressed. The partner should be included where possible. Self-assessment and monitoring of menopausal symptoms facilitates titration of the therapy, control of side-effects and compliance. Although all normal health checks, e.g. cervical smear and mammography should be offered, their frequency is not influenced by the use of HRT and medicolegally no extra laboratory tests are required before or after prescription of HRT. However, some extra selected tests can be useful such as lipid profile, liver enzymes and bone densitometry. A menopause clinic should offer comprehensive counselling on all lifestyle factors such as smoking, exercise, diet, alcohol and stress factors. Liaison with other health professionals such as physicians, psychiatrists, social workers, physiotherapists and dietitians, enhances the opportunity for appropriate counselling in selected cases. However, for most women personalized care by an informed general practitioner over 3-4 visits will allow titration of therapy, adequate counselling and a high rate of compliance. Compliance is also helped by a 5-7 day-a-week question line where telephone queries can be dealt with quickly by trained staff.