Identifying and Advising on the Menopause in Secondary Mental Health

AIMS: Women aged 45 to 55 years can suffer psychological symptoms during the menopause including low mood, increased anxiety and poor memory. NICE guidelines recommend that hormonal replacement therapy (HRT) is considered to alleviate low mood symptoms that arises as a result of the menopause. It is not currently routine for perimenopausal symptoms to be explored during consultations and physical health checks with female patients in the community. Additionally, in secondary mental health settings the option of HRT is not routinely discussed. The aims of my completed initial audit are to improve the psychological symptoms in women experiencing the menopause or perimenopause. I aim to encourage doctors and nurses to routinely screen for perimenopausal symptoms of women aged 45 to 55 years. I aim to encourage doctors and nurses to routinely ask if women in this age category have used HRT or would consider discussing HRT options with their GP. METHODS: I performed retrospective data collection of 30 women aged 45 to 55 years in an Outpatient Clinic setting. I referred to the clinic letters of these women over the past 12 months and recorded if there was any documentation of HRT or perimenopausal symptoms. I used the progress note search feature to screen for any further documentation of the discussion of HRT or perimenopausal symptoms. I referred to the most recent completed PHIT (physical health) questionnaire for these women. I recorded if the sexual health section of the PHIT questionnaire had been completed and if any discussion of HRT or perimenopausal symptoms had been documented. RESULTS: I found that 3 out of the 30 women had discussions regarding HRT and/or perimenopausal symptoms documented in their clinic letter or progress notes. I found that 17 out of the 30 women had the sexual health section of their PHIT questionnaire completed in full. I found that 0 out of the 30 women had documentation of the discussion of HRT or perimenopausal symptoms in their PHIT questionnaire. CONCLUSION: My results displayed that only a small percentage of women aged 45 to 55 years are having discussions in secondary mental health setting regarding HRT and perimenopausal symptoms. Therefore, there is a clear need for the further education and training on the menopause for doctors and nurses working in these settings. This will encourage the routine screening of perimenopausal symptoms in women of this age category so that HRT can be considered.