A Monash University-led toolkit aids health practitioners worldwide in identifying and treating menopausal health concerns. They also emphasize that worldwide care for women should improve.
The 2023 Practitioner’s Toolkit is for managing menopause. It has been endorsed by the International, Australasian, and British Menopause Societies, the Endocrine Society of Australia, and Jean Hailes for Women’s Health. Furthermore, it is intended to be used anywhere in the world.
The Toolkit for Practitioners, published in Climacteric, has been updated and extended from the original 2014 Toolkit for Practitioners. It has new guidance and therapies based on a comprehensive evaluation of the most recent menopause research and best practice.
In addition to outlining the most recent general treatment guidelines. It provides bone health advice as part of a menopause health assessment. In 2014, for example, there were no clear guidelines on whether menopausal hormone treatments (MHT) could be required to prevent bone loss and osteoporosis in asymptomatic women.
What are the updates in the menopause toolkit?
The update also includes new pharmaceuticals such as fezolinetant (hot flushes), ospemifene (painful sex), and vaginal DHEA (vaginal dryness), some of which will be available in Australia shortly.
The first author, Professor Susan Davis, said,
For cognitive symptoms, clinical trials have not shown a benefit of MHT for cognitive function,
The most robust studies have shown it to be no better than placebo.
Regarding depression, menopause may cause symptoms such as low mood, anxiety, irritability, and mood swings, but clinical depression needs to be assessed and managed in its own right. Menopause might exacerbate underlying depression but should not be assumed to be the cause of clinical depression.
Professor Davis said,
To our knowledge this is the only document that provides guidance for using hormone therapy to prevent fracture,
Other recommendations have been vague such as ‘can be used to prevent bone loss/fracture’ or ‘use to treat osteopenia.
Dr Rakib Islam, senior author, said,
The 2023 Practitioner’s Toolkit is the most up-to-date evidence-based practical guidance for health care providers to menopause care globally,
Professor Davis further added regarding the updates,
We have updated this as part of an NHMRC Grant to upskill GPs and to embed the care algorithms into GP practice software in the MenoPROMPT study program, which aims to improve care for women who need it,
This is a very important feature of this update.
