Term
| 1. How do you introduce a menopause consultation? |
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Definition
1. "Good morning, I'm Dr [Name]. May I confirm your name and age? I understand you've come about irritability. Could you tell me more?" |
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Term
| 2. What focused questions assess irritability? |
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Definition
- "When did the irritability start?"
- "Is it constant or intermittent?"
- "Is it worse during specific times of the month?"
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Term
| 3. What 4 symptom categories should you explore? |
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Definition
3.
1. Emotional: "Any low mood, anxiety, or tearfulness?"
2. Physical: "Hot flushes? Night sweats? Palpitations? Sleep issues?"
3. Menstrual: "Are periods regular? Lighter/heavier? Last period date?"
4. Urogenital: "Vaginal dryness? Urinary frequency?"
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Term
| 4. What does MAFTOSA cover? |
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Definition
4.
- Medical history
- Allergies
- Family history (early menopause, osteoporosis)
- Travel
- Occupation
- Smoking/Alcohol
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Term
| 5. How do you assess life impact? |
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Definition
5. "How do these symptoms affect your daily life, work, or relationships?"
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Term
| 6. What ICE questions are essential? |
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Definition
6.
- Ideas: "What do you think is causing this?"
- Concerns: "Any particular worries?"
- Expectations: "What were you hoping we could do?"
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Term
| 7. What examinations would you perform? |
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Definition
7.
- Basic observations (BP, HR, temperature, BMI)
- General inspection (signs of anemia/thyroid issues)
- Verbalize: "I'd check for these to rule out other causes"
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Term
| 8. How do you differentiate perimenopause from menopause? |
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Definition
8.
- Perimenopause: Periods within last 12 months (irregular)
- Menopause: No periods for 12 consecutive months
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Term
| 9. What first-line management options exist? |
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Definition
9.
- Lifestyle: Exercise, calcium/Vit D diet, reduce caffeine/alcohol
- Symptom diary for 2-3 months
- HRT discussion if symptoms disruptive
- Non-hormonal options (CBT, evening primrose oil)
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Term
| 10. What bone health advice is crucial? |
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Definition
10. "Weight-bearing exercise and monitor bone density - menopause increases osteoporosis risk"
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Term
| 11. What safety netting advice is essential? |
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Definition
11. Return if:
- New heavy bleeding
- Worsening mood symptoms
- Suicidal thoughts (seek immediate help)
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Term
| 12. How do you address HRT refusal? |
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Definition
12.
1. Validate choice: "It's fine to decline - we'll find alternatives"
2. Explore reasons: "What worries you about HRT?"
3. Tailor alternatives:
- Hot flushes: SSRIs (venlafaxine), CBT, clonidine
- Vaginal dryness: Local estrogen
- Mood issues: CBT, antidepressants
4. Lifestyle focus: Exercise, vitamin D, smoking cessation
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Term
| 13. What if patient refuses vaginal estrogen? |
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Definition
13.
1. Address concerns: "It's low-dose, locally acting - different from systemic HRT"
2. Offer alternatives:
- Vaginal moisturizers (Replens)
- Water-based lubricants
- Pelvic floor physiotherapy
3. Reassure: "We can revisit this later if needed"
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Term
| 14. What long-term health planning is needed? |
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Definition
14.
- Fracture risk assessment (FRAX/QFracture)
- DEXA scan if high risk
- Calcium/vitamin D supplements
- Bisphosphonates for osteoporosis
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Term
15. How do you conclude the consultation? |
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Definition
15.
- Offer menopause information leaflet
- "Anything else you'd like to ask?"
- Schedule follow-up in 3 months
- "You can always reconsider HRT later"
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