Quality statement 4: Reviewing treatments for menopausal symptoms

Quality statement

Women having treatment for menopausal symptoms have a review 3 months after starting each treatment and then at least annually.

Rationale

A review 3 months after starting a treatment for menopausal symptoms ensures that changes to dosage or formulation can be made if there are persistent side effects such as bloating, nausea and breast discomfort. Once treatment is established, further review is needed to assess new or pre-existing health problems, to carry out basic health checks (for example, measuring weight and blood pressure), and to inform and engage women in national screening programmes. Review should take place at least once a year, but may be needed more often if there are clinical indications for this. For most women, the symptoms of menopause respond well to treatment. However, for some whose symptoms do not improve or side effects are troublesome, review will identify if they need to be referred for help and support from a healthcare professional with specialist training and expertise.

Quality measures

Structure

Evidence of local arrangements to ensure that women having treatment for menopausal symptoms have a review 3 months after starting each treatment and then at least annually.

Data source: Local data collection.

Process

a) Proportion of women having treatment for menopausal symptoms who have a review 3 months after starting treatment.

Numerator – the number in the denominator who have a review 3 months after starting treatment.

Denominator – the number of women having treatment for menopausal symptoms.

Data source: Local data collection.

b) Proportion of women receiving treatment for menopausal symptoms who have an annual review within 12 months of the 3-month review or last annual review.

Numerator – the number in the denominator who have an annual review within 12 months of the 3-month review or last annual review.

Denominator – the number of women receiving treatment for menopausal symptoms.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers (primary care) ensure that women having treatment for menopausal symptoms have a review 3 months after starting each treatment and then at least annually.

Healthcare professionals (such as GPs and practice nurses) ensure that they offer women a review 3 months after starting each treatment for menopausal symptoms, and then at least annually.

Commissioners (clinical commissioning groups and NHS England) ensure that they commission services in which women having treatment for menopausal symptoms have a review 3 months after starting each treatment and then at least annually.

Women having treatment to help with symptoms of the menopause have a review 3 months after starting each treatment, and then have a review at least once a year. The aim of a review is to check that the treatment is working and that side effects are not a problem.

Source guidance

Menopause (2015) NICE guideline NG23, recommendation 1.4.19

Definitions of terms used in this quality statement

Menopausal symptoms

Symptoms include the following:

  • hot flushes

  • night sweats

  • mood changes

  • memory and concentration loss

  • vaginal dryness

  • lack of interest in sex

  • headaches

  • joint and muscle stiffness.

[Adapted from NICE's guideline on menopause, context section and recommendation 1.3.2]