The role of the Internet

Abstract

number of body systems and with significant family, social and psychological influences. Menopause is one among many problems that is suited to management in this setting. Can we make it easier to do? Using hypothetical but very typical patients, the issues of presentation, provision of information, assessment and prescribing in this setting will be discussed. Patient review, simple troubleshooting, regime modification and stopping will be considered along with when to refer to a more specialist clinic. Menopause occurs to all women and for those who do suffer as a result, a balanced and reasonable response from their primary care providers should be available as an essential service. Enhanced and specialist services can then provide support and assistance. There would be no dispute that the prescription of hormone therapy to women has greatly reduced in the last five years. This was initiated by publication of the results of both the Women’s Health Initiative and the Million Women Study and has been exacerbated by the style of media reporting. Both women and their healthcare advisers have been subjected to this influence. Hormones are ‘hot topics’ that everyone now has an opinion on, often based on very flimsy information. The problems that women experience around and after menopause have, however, not gone away. Women may be more reluctant to present their problems overtly. Some clinicians have been reluctant to prescribe at all. The essence of primary care is that it deals with a great many issues that are unclear, often involving a