Menopause: identification and management

Overview

NICE recommends a review of patients on hormone replacement therapy (HRT) after 3 months, and then annually. The practice looked to pilot an efficient way of running reviews as a group consultation, to save clinical time, but crucially to enable women to share their experiences and learn from each other.

Inspired by a demo of a group consultation for women's health by ELC Works, presented at the Primary Care Women's Health Conference in February 2025, a pilot group consultation was held at the practice for HRT review in April 2025 for 8 women who had been on HRT for 3 months or longer. The session was led by a GP and co-facilitated by a healthcare assistant, who also conducted NHS health checks and bone health assessments using the FRAX score. Another GP supported the session.

The group discussed common menopausal symptoms, with participants sharing their own experiences. The discussion included symptom management strategies, lifestyle modifications (such as exercise, nutrition and mindfulness), and managing issues such as bleeding on HRT and weight gain. Peer support within the group was particularly strong, with participants encouraging and positively influencing each other.

At the end of the session, each participant had a brief one-to-one consultation with a GP to review and personalise their menopause care plan, including any necessary medication adjustments. Feedback was overwhelmingly positive, with participants expressing enthusiasm for future group consultations.

HRT review group consultations will now be held on a regular basis at the practice. Subject to further consultation with patients, it is possible that eventually all such reviews will be done as group consultations.

The lead GP is a British Menopause Society (BMS) accredited Advanced Menopause Specialist certified to train other GPs to obtain the qualification. A trainee assisted at the pilot group consultation, and this will form part of the training programme going forwards to spread the technique in the area.