Experience of a National Health Service Menopause Clinic

Summary

A menopause clinic has been established as part of the National Health Service at the Birmingham and Midland Hospital for Women. An investigation was made into 112 women accepted for treatment during the first year. Treatment consisted of mestranol and norethisterone in a graded 28-day cycle. Treatment was maintained for 6 cycles. Patients were assessed on admission, at intervals during treatment, and 2 months after therapy was completed.

Hot flushes and all other common menopausal symptoms were reduced on treatment. All symptoms returned when therapy was discontinued. The treatment stimulated regular light withdrawal bleeding. No breakthrough bleeding occurred. Two women with other predisposing factors developed superficial thrombophlebitis of the calf. Breast tenderness, nausea and cramps were minor side-effects. Fifteen women dropped out.

Treatment resulted in decreases in the serum values for sodium, urea, total protein, albumin, calcium, alkaline phosphatase, SGOT and cholesterol. Triglyceride values increased. Serum gonadotrophin and oestradiol levels decreased. The proportion of mature vaginal epithelial cells increased. Pre- and post-treatment values for virtually all parameters showed no significant difference.

Pre-treatment screening procedures discovered 3 abnormal cervical smears, 2 breast lumps and 1 case of diabetes mellitus.

Key Words::

• Menopause
• Mestranol
• Norethisterone
• diagnosis
• laboratory