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

Abstract

Objective

This study aimed to explore Australian health-care providers’ knowledge of menopause and its consequences, and their views about menopause-related health care.

Methods

This was a cross-sectional qualitative study of Australian general practitioners (GPs), gynecologists (GYs) and pharmacists (PHs). Recruitment was ultimately achieved through professional networks and cold calling.

Results

There were equal numbers of GPs, GYs and PHs, and equal numbers of males and females in each group. All participants demonstrated sound understanding of menopause and its consequences. A strong theme was recognition of high usage of complementary and alternative medicines (CAMs) by women for menopausal symptoms. Most participants highlighted lack of efficacy evidence for most CAMs, but the majority of GPs and PHs considered CAMs to ‘have a role’. Most supported menopausal hormone therapy (MHT) when symptoms impaired quality of life. Limitations to comprehensive care included knowledge gaps and lack of time.

Conclusions

Australian health-care providers appeared knowledgeable about menopause, but uncertain about its management. MHT prescription appeared limited to women with severe symptoms despite lifestyle modification and a trial of CAMs. The upskilling of clinicians providing care for women at midlife, with respect to the indications for and prescribing of MHT, urgently needs to be addressed.

卫生保健从业者对绝经及其管理的看法：一项定性研究 摘要

目的：本研究旨在探讨澳大利亚卫生保健从业者对绝经及其影响的认识, 以及他们对绝经相关卫生保健的看法。

方法：这是一项针对澳大利亚全科医生（GPs）、妇科医生（GY）和药剂师（PHs）的横断面定性研究。通过专业网络和电话进行招募。

结果：各组纳入GPs、GYs和PHs数量相等, 男女数量相等。所有受试者都对绝经及其影响有很好的理解。一个重要主题是女性认可针对绝经症状进行补充替代治疗(CAMs)。大多数受试者强调大多数CAM缺乏有效性证据, 但大多数GPs和PHs认为CAM“有效果”。当症状影响生活质量时, 大多数人支持绝经激素治疗（MHT）。综合保健的局限性包括认知差距和缺乏时间。

结论：澳大利亚卫生保健提从业者似乎对绝经很了解, 但对绝经管理并不清楚。尽管改变生活方式并进行了CAMs试验, 似乎仅有严重症状的女性才应用MHT。迫切需要为中年女性提供保健措施的临床医生提高MHT适应症的认识和用药方面的技能。

Keywords:

• Menopause
• menopause management
• menopausal hormone therapy

Acknowledgements

The authors wish to thank the following organizations who supported recruitment to the study: the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, the Royal Australian College of General Practitioners, the Australian College of Rural and Remote Medicine, the Pharmaceutical Society of Australia and Health Ed Australia.

Potential conflict of interest

S.R.D. reports having received honoraria from Besins Healthcare and Pfizer Australia, and has been a consultant to Roche Pharmaceuticals, Mayne Pharmaceuticals, Lawley Pharmaceuticals and Que Oncology. No other potential conflicts of interest, relevant to this article, are reported.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This study was funded by NHMRC APP 1152778.