Published in Climacteric, the Toolkit has been updated and enhanced from the original 2014 Toolkit for practitioners with new advice and therapies based on a systematic review of the latest menopause research and best practice.
“For cognitive symptoms, clinical trials have not shown a benefit of MHT for cognitive function,” Professor Davis said. “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 the advice was now much clearer around preventing bone loss and fracture.
“To our knowledge this is the only document that provides guidance for using hormone therapy to prevent fracture,” she said. “Other recommendations have been vague such as ‘can be used to prevent bone loss/fracture’ or ‘use to treat osteopenia’.”
"The 2023 Practitioner’s Toolkit is the most up-to-date evidence-based practical guidance for health care providers to menopause care globally," he said.
Professor Davis said it was important for women to see their GP if they experienced troubling physical or mental health symptoms, and the update aimed to ensure GPs were well equipped.
“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,” she said. “This is a very important feature of this update.”
The paper’s authors said the recommendations needed to be applied in the context of local availability and the cost of investigations and drug therapies. “Most importantly, the Toolkit provides the full spectrum of available options and therefore can be used to support shared decision making, and patient-informed care,” they wrote.
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About the Practitioner’s Toolkit for Managing Menopause
The Toolkit was developed to provide health care providers with a simple assessment and decision-making tool to use during a clinical consultation. It alerts clinicians that women might present with symptoms or concerns, and includes a pragmatic algorithm to assess their menopausal status, including those who had a prior hysterectomy or endometrial ablation, and used hormonal contraception. The assessment, treatment options and symptom management algorithms were derived from published literature.