Chapter 11 – Menopause

The menopause consultation

History

Patients will often present to discuss bodily changes that are occurring at this time.

Allow the patient to lead with their concerns. Discuss the patient’s presenting symptoms and enquire about other common symptoms of menopause. It is important to validate their experience. Determine the level of distress these symptoms are causing. Explain the physiological and hormonal changes that are happening. Talking through issues and normalising them may be all that is required.

It can be very useful to provide information sheets or websites to your patient. Excellent resources can be found on the websites below:

Australasian Menopause Society (AMS) Jean Hailes Foundation

Important areas that may require discussion with your patient include:

changing contraceptive requirements loss of fertility (see Infertility in Chapter 8: Fertility Problems) symptoms of pelvic floor dysfunction e.g. prolapse, bladder and bowel dysfunction (see Chapter 6: The Bladder and the Pelvic Floor). Urinary incontinence can sometimes be exacerbated by menopausal hormonal therapy. changes in the patient’s sense of sexuality and decrease of libido (see Chapter 17: Female Sexual Interest and Arousal Disorder). social context and stressors, such as children leaving home and change of role, problems of ageing parents, relationship with spouse or partner past medical history. Ask ... Buy now

Examination

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Lifestyle advice 

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Contraceptive advice in the perimenopause

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Management of menopausal symptoms

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Non-pharmacological treatment options

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