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Everyday lifestyle changes are a more realistic and effective way than dieting to manage weight and prevent long-term weight gain.
Health professionals Management
Management
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A thorough assessment of a menopausal woman should culminate in a management and/or treatment plan, outlining to the woman her options so that she may decide on choices to improve or maintain her quality of life, at the same time developing an empathic, communicating and ongoing relationship for the woman with her doctor.
In every case the woman should be advised about improving her lifestyle by having a healthy eating plan, maintaining consistent and individually appropriate physical activity and managing stress.
Smoking is particularly associated with postmenopausal morbidity and mortality.
Alongside lifestyle improvements, a therapeutic regimen may be developed which may include non-prescription or complementary therapies as well as prescription medicines.
Management plans may include:
- Therapy for symptom relief, either hormonal or non-hormonal
- Contraceptive advice
- Preventative therapy for e.g. osteoporosis - including lifestyle, calcium, vitamin D, hormone therapy
- Therapy for osteopenia or osteoporosis, either hormonal or non-hormonal, such as the bisphosphonates, SERMS, strontium ranelate, denosumab
- Therapy for present cardiovascular risk, e.g. hypercholesterolaemia
- Referral for surgery for either pelvic or breast pathology
- Counselling, either psychosexual or psychotherapeutic
- Assessment of Incontinence, referral to pelvic floor rehabilitation physiotherapist
- Lifestyle, nutrition, exercise advice as well as giving information or providing educational resources
Regular follow-up, with two visits in the initial six months after commencing a treatment plan, provides an opportunity for both the woman and her practitioner to discuss her progress, side effects to medication or difficulties in management and treatment.
Yearly assessments should then occur. If therapy is necessary long term, annual review should occur to re-examine risks and benefits and to discuss any new options.
Further reading
Hickey et al. 'Hormone replacement therapy' - BMJ 2012;344:e763
HRT and risk of myocardial infarction
Recommendations on postmenopausal HT
Menopause - a management algorithm
Testosterone therapy for women
Tibolone and breast cancer risk
Content updated 27 March 2012
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