Health-care providers’ views of menopause and its management: a qualitative study

Introduction to paper

Between 2001 and 2003 there was a dramatic decline in the prescribing of menopausal hormone therapy (MHT) globally following the first publication of findings from the Women’s Health Initiative (WHI) estrogen–progestin study linking MHT use to an increase in breast cancer risk [1]. The use of MHT fell by approximately 40% in Australia [2], with even greater declines in Canada [3] and the USA [4]. Concomitantly, a hiatus developed in training of medical trainees and clinicians, and allied health professionals, in the management of menopause. A 2017 survey of trainees in family medicine, internal medicine, and obstetrics and gynecology in the USA reported that 20% had not had lectures on menopause in their residency and only 6.8% felt ‘adequately prepared to manage women experiencing menopause’ [5,p.242].

While approximately one-third of postmenopausal Australian women under the age of 55 years experience moderate to severe vasomotor symptoms [6], only 11% of women in this age group use MHT [7]. Our recent qualitative study revealed that although most Australian women understand what happens at menopause, few were aware of the long-term health consequences such as bone loss and increased risk of cardiovascular disease [8]. Furthermore, women generally viewed MHT in a negative light, particularly in relation to breast cancer risk.

The aim of the current study was to explore the understanding and views of Australian health-care providers, specifically general practitioners (GPs), gynecologists (GYs) and pharmacists (PHs), about menopause and its management. We were also interested in how confident health practitioners were in managing menopause with respect to immediate symptoms as well as their role in reducing the risks of osteoporosis and cardiovascular disease.

See the full paper here 

Abstract