Devon Sexual Health
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Menopause resources for healthcare professionals

Within this section are details of trusted information sources and recommended reading for clinicians managing patients with menopause presentations.

Key guidelines

The 2019 NICE guideline makes recommendations for diagnosing and managing menopause.This guideline covers the diagnosis and management of menopause, including in women who have premature ovarian insufficiency.

For guidance on investigation and management of unscheduled bleeding, please see the 2024 BMS joint guideline which includes advice regarding HRT prescribing 

We are aware many patients are requesting testosterone prescribing. Testosterone is only indicated in relation to libido in post-menopausal women. This useful guide from The BMS can advise you on who to prescribe for, and how to do this alongside monitoring. 

For information regards prescribable alternatives to HRT, please see the BMS consensus statement.

Key resources

North & East Devon Prescribing Formulary

South & West Devon Prescribing Formulary

The links below are our top resources to support you in managing menopause and prescribing HRT or non-hormonal alternatives:

Devon Menopause Advice & Guidance Pilot

From Monday 21st October, 2024 primary care clinicians in Devon will be able to access menopause advice and guidance for patients as a result of a new pilot service being facilitated by Devon Sexual Health. This Devon Menopause Service (DMS) covers any patient registered with a GP in the county of Devon.

Primary care clinicians can make advice and guidance requests through the electronic referral service (ERS), to support the management of patients with complex menopause presentations who meet specific criteria.

Advice and guidance request criteria;

  • Patients unable to achieve adequate control of symptoms after two HRT preparations – tried for a minimum of three months per preparation
  • Patients with complex medical history when the clinician is not sure if HRT is a safe option
  • Patients with confirmed diagnosis of premature ovarian insufficiency (iatrogenic or spontaneous)
  • People with persistent unscheduled bleeding less than six months after starting HRT or less than six months after changing HRT preparation.

Referrals must include:

  • medical history
  • current medication
  • allergies
  • smoking status
  • relevant family history (breast cancer, ovarian cancer, lynch syndrome, VTE, cowden syndrome, endometrial cancer/hyperplasia)
  • relevant recent investigation results (for example ultrasound, bloods and histology) and clinic letters (DMS does not have access to results, letters or healthcare records)
  • recent blood pressure and BMI

Referrals which do not meet the criteria or are missing the above information will be rejected.

This pilot is providing advice and guidance only and DMS are unable to provide appointments.

In addition to the pilot, Devon Sexual Health has also created new online menopause resources, for both patients and professionals, via its website. The information has been provided to help empower individuals to become more informed about their symptoms and provide easy access to key resources for professionals.

The menopause information can be found here:

Patients/Individuals: https://www.devonsexualhealth.nhs.uk/your-body/menopause-info/

Professionals: https://www.devonsexualhealth.nhs.uk/professionals/menopause-resources/

Signposting for patients:

These sites contain useful information for patients enabling them to feel more empowered about their symptoms, and more confident about managing menopause:

Rockmymenopause

NHS Menopause 

Women’s Health Concern Menopause factsheets

Talkworks – Free CBT course for adults across Devon (excluding Plymouth)

Livewell South West – anxiety and mental health support in Plymouth

The Daisy Network  – a charity to support individuals with POI (Premature Ovarian Insufficiency)

If patients are currently buying more than three HRT prescriptions a year, then it is recommended that they register for a HRT prepayment certificate which offers unlimited prescriptions of specified HRT over one year for a fixed price.

We also have a section for individuals seeking more menopause information here: https://www.devonsexualhealth.nhs.uk/your-body/menopause-info/

 

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