HSMC.Menopause Health Assessment

Streamlined Menopause Health Assessment Template Demographics Patient is married, has two children aged 10 and 12, works full-time as a teacher, and does not smoke or drink alcohol. Family History Mother experienced menopause at age 52. No family history of breast, ovarian, or uterine cancer. Menopausal Status & Symptoms LMP (Last Menstrual Period): 01/08/2024 Periods: Periods have become irregular over the past 6 months, with cycles ranging from 25 to 40 days. Flow is lighter than usual, and there is occasional spotting. No pain. Current Menopausal Status: Peri-menopausal Modified Greene Climacteric Scale Score: 28 Most Impactful Symptoms (Patient Identified Top 2–3): * Hot flushes * Sleep disturbances * Mood changes Hot Flushes/Night Sweats: Experiencing hot flushes several times a day, lasting for a few minutes each time. Night sweats are also frequent, disrupting sleep. Mood Changes (Anxiety/Irritability/Low Mood): Patient reports increased irritability and occasional low mood. Sleep Disturbances: Difficulty falling asleep and staying asleep due to night sweats. Vaginal Dryness/Dyspareunia: Patient reports some vaginal dryness. Brain Fog/Memory: Patient reports some difficulty with concentration and memory. Overall Impact on QoL Menopausal symptoms are impacting the patient's sleep, mood, and ability to concentrate at work. She feels tired and less able to cope with daily stressors. Brief Medical History & Contraindications History of Breast Cancer? N Undiagnosed Vaginal Bleeding? N History of DVT/PE/Stroke/Heart Attack? N Active Liver Disease? N Physical Examination Blood Pressure: 130/80 mmHg Height: 165 cm Weight: 70 kg BMI: 25.8 General Observation: Well-appearing Investigations & Referrals Cervical Screening Test (CST): Due Mammogram: Due Bone Densitometry (DEXA): Not Indicated Other Investigations: FSH, TSH Referrals: Referral to a gynaecologist for further evaluation and management. Management Plan & Preventative Health Advice Non-Pharmacological Strategies Agreed: Advised on regular exercise, a balanced diet, and stress management techniques. Recommended avoiding triggers for hot flushes, such as spicy foods and caffeine. Discussed the importance of good sleep hygiene. Pharmacological Strategies Agreed: Discussed the benefits and risks of hormone replacement therapy (HRT). Patient is keen to explore HRT. Discussed the risks of breast cancer and clotting. Prescribed low-dose HRT. Patient Preference: Patient is keen to start HRT and has agreed to the treatment plan. Management Plan Summary Patient will start low-dose HRT. Follow-up in 3 months to review symptoms and assess the effectiveness of treatment. Will also follow up on the results of the FSH and TSH tests. Patient to follow up with gynaecologist.