The NICE 2015 guidelines on the diagnosis and management of menopause provides useful evidence-based guidance on the menopause, but it is unclear if many GPs are able to confidently prescribe appropriate hormone replacement therapy (HRT). This brief article gives an overview of the importance of HRT and aims to help GPs to manage their patients experiencing menopause.
Talking about sex, hormones and the heart
The psychosocial impact of alopecia on women
Alopecia is a non-scarring chronic inflammatory autoimmune disorder that is characterised by patchy or abnormal hair loss. Six women participated in semi-structured interviews on their experiences of living with alopecia and these interviews were analysed using Interpretative Phenomenological Analysis (IPA). Insight into these psychosocial experiences can inform interventions targeted to women with alopecia.
HRT and cardiovascular disease
HRT has been shown to reduce future risk of cardiovascular disease when taken within ten years of the menopause. Some experts recommend that HRT is considered as part of a general prevention strategy at the onset of the menopause. However, some doctors and nurses feel apprehensive about this as they are confused about the association of HRT with cardiovascular disease.
The effect of hormonal contraception on bleeding patterns
The endometrium undergoes a series of well-recognised cycles of proliferation, differentiation and tissue breakdown on a monthly basis, in response to exposure to the circulating sex steroids oestrogen and progesterone.
Can we safely recommend HRT?
Claire Bellone, clinical nurse specialist at the Chelsea & Westminster Hospital NHS Trust, gives her personal view on how primary healthcare professionals can work with women with menopausal symptoms and implement the recommendations of the NICE guideline on the diagnosis and management of menopause.
AF a stronger CV risk factor for women
PCCJ Editor-in-Chief Mike Kirby reviews a recent large observational study in the BMJ which concludes that women with atrial fibrillation are at a higher risk of cardiovascular disease and death than men.
Effect of obsessive-compulsive disorder (OCD) on sexual function and marital satisfaction
Current international literature suggests a high prevalence of sexual dysfunction in female patients with obsessive-compulsive disorder (OCD) and the present study was undertaken to assess the association between sexual dysfunction and marital dissatisfaction in a group of married Iranian women with OCD.
Gender and quality of life in COPD: A systematic review
Morbidity and mortality for women with COPD is increasing. This systematic review uncovers how women seem to experience COPD differently to men, and helps health care professionals to provide an individualised approach to caring for these patients.
A ‘wasted decade’ for hormone replacement therapy?
Over 10 years ago, publication of Women’s Health Initiative (WHI) studies affected both public perceptions and our clinical prescribing of hormone replacement therapy (HRT). Front-page reports of higher risks of heart attacks, stroke and breast cancer led to around a million women in the UK stopping HRT, many without medical advice or clinical assessment. Since then, new evidence has emerged, much of which does not support the earlier alarming headlines.
Editorial
Most people feel better in summer. We are more likely to be active and out of doors, and the sunshine lifts our mood, especially if we are on holiday. But there is a balance. While a holiday helps us relax and recharge our batteries, for some people it can also be an opportunity for unprotected sex or risky amounts of alcohol. So clear messages about benefits and risks are important, especially now that we are all working more closely with public health colleagues to encourage our patients to make healthy choices.
UK medical eligibility criteria for contraceptive use
Understanding and managing recurrent vulvovaginal candidiasis
Vulvovaginal candidiasis (VVC) is extremely common, affecting 70-75% of women at least once in their lives. Recurrent VVC, defined as four or more proven episodes in 12 months, affects 5-8% of these women and can cause a significant amount of discomfort and distress. Some women are referred to tertiary centres but, with good evidencebased treatment, many women could be managed in primary care.