NICE guidelines on menopause your doctor should follow
What the National Institute for Health and Care Excellence (NICE) recommend for menopause diagnosis and management
For some of us, as we reach our late forties (or earlier), feeling below par but not being able to put our finger on what is happening, may lead us to the doctor’s door. Perimenopause has arrived.
Sit down, grab a cuppa and enjoy a NICE biscuit whilst you read this article. It’s time to take a note of what you should expect when talking to your doctor about your menopause symptoms to ensure you receive the correct treatment. The NICE Guidelines is the go-to reference tool for the support you should expect, it’s also there to advise and empower you to get the appropriate menopause management you deserve.
It’s hard to believe, yet until fairly recently, there were no formal guidelines for health professionals to follow when advising women about how to manage their menopause. It was the luck of the draw in terms of how much a doctor or practice nurse knew, or what they could be expected to know.
In theory, this changed when The National Institute for Health and Care Excellence (NICE) document, ‘Menopause: diagnosis and management’, was issued to health care professionals in November 2015 with the aim of improving the consistency of support and information provided to women in menopause.
It was last updated in 2021 but it’s anticipated that a new draft will be issued in 2023 for expected publication in 2024. The positive is that it will incorporate more details on ethnicity, gender, Socio-economic status, disability, and younger people’s treatment.
By encouraging women to look for help in accessing safe and effective treatments for menopause symptoms the hope was that women would feel more in control. In the UK alone, roughly 1.9 million women are undergoing menopause so it’s essential that inform ourselves and talk about menopause more.
However, a survey published in 2106 by the British Menopause Society found that only 3% of the respondents, women 45+ (the target market for such guidance), were aware of the NICE guidelines, despite the huge publicity they generated on publication.
In the same survey, more than 2 out 5 women reported that symptoms of the menopause had been worse than expected, with women reporting on average seven symptoms! Half of the respondents said that they had not consulted a doctor, feeling that they have to ‘put up with’ menopause. We don’t put up with a dodgy washing machine so we shouldn’t put up with a dodgy menopause. The survey found that there is still little awareness about the support and treatment options available. Doctors have warned that women are missing out on advice about lifestyle changes that could ease their symptoms.
So, what’s in this guidance? It includes recommendations on diagnosis and the range of short and long-term treatment options available. Every woman’s menopause experience will be different with symptoms kicking in, (or not for the lucky ones) at different stages. Individualised care is emphasised with the recommendation that women are offered a choice in how they deal with their symptoms.
Hopefully your doctor has read the NICE guidance but before consulting your doctor read it for yourself to find out more and:
Identify what your GP is able to do to help you to manage your menopause.
Make a list of your symptoms and most importantly, the impact they are having on your life.
Don’t be fobbed off by being told that this is a natural stage and there’s nothing to be done - you’ll see from the guidance that this is not the case.
Diagnosing menopause symptoms in NHS
Is there a blood test to check your hormone levels?
Basically, women aged over 45, will NOT be offered a blood test to measure hormone levels, due to the unreliability of fluctuating hormone levels, as this is the average age for entering perimenopause. That said, thyroid problems present similar symptoms so there may be reasons to insist on a blood test to check for other underlying health concerns.
However, those under 40 experiencing unusual period changes, or noticing mood swings or anxiety, should talk to their doctor about getting a blood test to measure their hormone levels which may need supplementing, as early menopause poses a risk to long-term health, especially your hearts and bones.
We say, make yourself aware of your treatment options so you can make informed decisions about how you’ll manage your menopause.
