Provision of menopause information must improve.

The most important aspect of menopause management is providing women with accurate information about the process of ovarian failure (natural or induced) and consequences of estrogen deficiency, or the effects of ovarian removal and consequences of sudden estrogen deficiency, along with treatment options. The menopause affects all women differently and so women need accurate information about estrogen deficiency, diet and lifestyle recommendations and treatment options so that they can make informed choices about managing their menopause. Sadly it appears that this essential information is not being provided. Lyons reported on the low level of documentation of provision of information to women undergoing hysterectomy with or without oophorectomy and Yulia et al. reported similar findings in a poster presented at the 2011 British Menopause Society annual conference. A further poster from the 2011 annual conference from Cumming et al. demonstrated results of a survey asking what information women feel that they would like to be given and whether or not this information was received, showing failure in terms of advising about diet, lifestyle and alternative therapies. If women choose to take hormone therapy to manage their menopause, they then need ongoing review and advice about risks and benefits, which is the most appropriate type, and how long this should be taken. A survey looking at women’s reasons to stop taking hormone replacement therapy (HRT) and the effects of stopping shows that in fact many women decide to stop therapy without discussion with their health-care professional, and that often their decision is influenced by the media. For many women, this may indeed be the correct decision, but it appears that many young women, who are most likely to benefit from continuing HRT, stopped therapy without discussion, and that many have recurrence of troublesome symptoms on stopping. If women rely on information from the media, then this too needs to be accurate, yet a presentation at the International Menopause Society annual conference suggested that in respect of HRT, osteoporosis and menopause in general, the knowledge of media personnel, at least in Sri Lanka, was unsatisfactory. A similar survey in other countries would be of great interest. A previous issue included the British Menopause Society recommendation that all women should be invited for a health check around the time of their 50th birthday. This would be an ideal opportunity to provide up-to-date, essential information and advice that could transform her future health risk. Until this process is in place, we must all keep in mind the consequences of estrogen deficiency in the intermediate and long term, not just short term, when seeing women in the postmenopausal years, for whatever reason, so that we can provide required information opportunistically. We suggest therefore, that education about menopause, the consequences of estrogen deficiency and treatment options should extend well beyond interested general practitioners, practice nurses and gynaecologists, but should include all general practitioners, practice nurses and gynaecologists, psychiatrists, psychologists, physiotherapists, cardiologists, rheumatologists, surgeons and pharmacists, to name just a few; all may be dealing on a daily basis with patients experiencing consequences of estrogen deficiency. Further, those providing information about women’s health issues in the popular media should also ensure that the information is accurate. Of course, not all can be specialists, but a general understanding is essential. Even for menopause specialists, keeping up to date is difficult, as became clear at the recent International Menopause Society conference when exciting new information about many aspects of menopause was presented, previously held views were challenged and the need for further knowledge was highlighted. Despite the difficulties of time constraints, an ever changing and increasing knowledge base and yet the need for more research, it behoves us all to keep up to date and to pass on accurate information to women in the postreproductive years. Provision of information about the process, consequences and treatment options for menopause is essential and must improve.