Quality statement 5: Information for women having treatment likely to cause menopause

Quality statement

Women who are likely to go through menopause as a result of medical or surgical treatment are given information about menopause and fertility before they have their treatment.

Rationale

Some medical or surgical treatments can affect fertility and induce menopause. Women should be given information so that they know about these long-term consequences of treatment. Women who go through menopause as a result of medical or surgical treatment may be younger than women having natural menopause, and so are less likely to know about menopausal symptoms. Awareness of symptoms ensures that women access treatment and services as soon as they need them. This is important because these women are at higher risk of psychological and physical morbidity.

Quality measures

Structure

Evidence of local arrangements to ensure that women who are likely to go through menopause as a result of medical or surgical treatment are given information about menopause and fertility before they have their treatment.

Data source: Local data collection.

Process

Proportion of women having medical or surgical treatment that is likely to cause the menopause who are given information about menopause and fertility before they have their treatment.

Numerator – the number in the denominator who are given information about menopause and fertility before they have their treatment.

Denominator – the number of women who have medical or surgical treatment that is likely to cause the menopause.

Data source: Local data collection.

Outcome

Women having medical or surgical treatment that is likely to cause the menopause are aware of the symptoms of menopause.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers (secondary care) ensure that systems are in place for women who are likely to go through menopause as a result of medical or surgical treatment to be given information about menopause and fertility before they have their treatment.

Healthcare professionals (such as secondary care consultants) ensure that before treatment they give information about menopause and fertility to women who are likely to go through menopause as a result of medical or surgical treatment.

Commissioners (clinical commissioning groups) ensure that they commission services in which women who are likely to go through menopause as a result of medical or surgical treatment are given information about menopause and fertility before they have their treatment.

Women having treatment or surgery that is likely to cause the menopause are given information about menopause and effects on fertility before they have their treatment. This is so that they have all the information they need before deciding to go ahead with the treatment. Treatments that are likely to cause the menopause include chemotherapy and radiotherapy to treat cancer, and surgery that involves the ovaries.

Source guidance

Menopause (2015) NICE guideline NG23, recommendation 1.3.6

Definitions of terms used in this quality statement

Medical or surgical treatment

Treatments that are likely to cause menopause include:

  • radiotherapy and chemotherapy for cancer

  • gynaecological surgery that involves the ovaries.

[Adapted from NICE's guideline on menopause, recommendation 1.3.6]

Information

Information should include:

  • risk of impaired or loss of fertility

  • risk of early menopause

  • common menopausal symptoms

  • longer-term health implications of menopause

  • contraceptive advice.

[Adapted from NICE's guideline on menopause, recommendations 1.3.1 and 1.3.5, and full guideline]

Equality and diversity considerations

All information should be culturally appropriate and accessible to women with additional needs, such as physical, sensory or learning disabilities, and to women who do not speak or read English. Interpreters and advocates should be provided if needed.