“All women in their 40s are miserable” - health care provision throughout the menopause in the UK: a mixed-methods study

Martin-Key, Nayra A; Funnell, Erin; Spadaro, Benedetta; Bahn, Sabine

doi:10.21203/rs.3.rs-3189118/v1

Cited by 3 publications

(3 citation statements)

References 38 publications

(30 reference statements)

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“…The increased awareness of menopause care attributed to the Channel 4 documentary 'Sex, Myths and Menopause', ('The Davina effect') along with the efforts of campaigners, have also played a significant role in fuelling this demand. 3 However, the lack of specialist services 4,5 poses a significant challenge in meeting this increased demand. The current state of menopause care in the UK is characterized by a lack of specialist services, which can be attributed to several factors.…”

Section: Introductionmentioning

confidence: 99%

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A retrospective audit of general practitioner’s referrals to Guys and St Thomas’ specialist menopause clinic between 2021 and 2022

Tedajo Tsambou,

Bruce,

Holloway

et al. 2024

Post Reprod Health

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Purpose: We performed a retrospective audit of General Practitioners’ (GPs) referrals to the specialist Menopause Clinic at Guys and St Thomas’s (GSTT) between 2021 and 2022. We aim to establish the indication for the referrals and whether they were compliant with the National Institute for Health and Care Excellence Guidance NICE. Background: GSTT is a teaching hospital in central London that educates gynaecologists in training as well as (GP) for specialist certification in Menopause. The menopause clinic receives approximately 580 GP referrals per month from South East London practices. The current waiting time for an initial appointment is up to 1 year. This delay reflects an increase in demand for menopause care and a deficit in service provision in many areas of the UK. NICE has recommended that GPs refer complicated cases to menopause specialists, with 11 specific criteria. Study Sample and Data Collection: We randomly selected 50 patients referred to the GSTT clinic by a GP between 2021 and 2022. Patient data were collected, including patient demographics, date of referral, indication for referral, date of consultation, waiting time, past medical history, investigations, and treatment instigated during the appointment. Results: The majority of referrals to the GSTT menopause Specialist clinic met the NICE guidelines (76%). One-sixth of the referrals could have been prevented or managed through alternative routes. Finally, although this is a small study, some patient unmet needs (PUNS) and GPs’ educational needs have been identified.

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Section: Introductionmentioning

confidence: 99%

“…However, the lack of specialist services 4 , 5 poses a significant challenge in meeting this increased demand. The current state of menopause care in the UK is characterized by a lack of specialist services, which can be attributed to several factors.…”

Section: Introductionmentioning

confidence: 99%

A retrospective audit of general practitioner’s referrals to Guys and St Thomas’ specialist menopause clinic between 2021 and 2022

Tedajo Tsambou,

Bruce,

Holloway

et al. 2024

Post Reprod Health

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“…Critically, despite several professional bodies recommending psychological interventions as a primary treatment option for menopause-related mental health concerns [10][11][12], access to these treatments is often limited [13], even in high-income countries like the UK. There is also evidence to suggest that mental health screening is not consistently integrated into menopausal healthcare in the UK [14], indicating a missed opportunity to identify and address potential mental health concerns that may arise during this challenging phase of life.…”

Section: Introductionmentioning

confidence: 99%

Intention to use a mental health app for the menopause: a Health Belief Model approach

Martin-Key,

Funnell,

Benacek

et al. 2023

Preprint

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Background The menopause presents a period of heightened vulnerability for mental health concerns. Web and smartphone apps may facilitate and improve mental healthcare provision. However, little is known about users’ intention to use such technologies. Objective To examine users’ experiences with and intention to use a mental health app during the menopause using the Health Belief Model (HBM). Methods Participants completed an online survey. Structural equation modelling was conducted to explore whether the HBM is a good fit for predicting intention to use a mental health app for the menopause. Results We found a good model fit (χ2(278) = 790.44, p < 0.001; CFI = 0.933, RMSEA = 0.047, SRMR = 0.056). Cues to action was the most significant predictor of intention (β = 0.48, p < 0.001), followed by perceived barriers (β=-0.25, p < 0.001), perceived susceptibility (β = .15, p < 0.001), and perceived benefits (β = 0.13, p < 0.001). Conclusions This study emphasises the need to address barriers to app usage, while highlighting the impact of credible endorsements and psychoeducation.

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Using network analysis to understand the association between menopausal and depressive symptoms: a survey study

Martin-Key,

Funnell,

Benacek

et al. 2023

Preprint

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Background The menopause appears to heighten women's susceptibility to mental health issues, particularly depression. It has been proposed that depressive symptoms occurring throughout the menopause may be linked to specific menopause symptoms. Notably, previous studies have merely examined the severity and prevalence of menopausal and depressive symptoms using summed scores and/or individual item scores, as opposed to understanding how these symptoms interconnect and overlap. The aims of the current study were to: (i) use network analysis to explore the symptom structure and interconnectivity of a broad range of menopausal and depressive symptoms, and (ii) to compare the symptom structure of menopausal and depressive symptoms between the perimenopause and the post-menopause. Methods Online survey data from 858 respondents were analysed. Network analysis was used to explore the symptom structure of menopausal (as measured using the Menopause-specific Quality of Life (MENQOL) questionnaire) and depressive (as measured using the eight-item Patient Health Questionnaire (PHQ-8)) symptoms. Results A network was constructed comprising the 37 variables of interest (MENQOL: 29 symptoms; PHQ-8: 8 symptoms). Decreased stamina, decreased physical strength, feeling depressed, and change in sexual desire were the most central symptoms. The estimated network had a good level of stability (CS-strength = 0.75 and CS-influence = 0.75). The clique percolation analysis revealed 10 communities of symptoms. There were no significant differences in the network structure-distribution of edge weights or global strength between the peri- and post-menopausal groups. Conclusions The findings from this research suggest that addressing decreased stamina could prove instrumental in managing menopausal symptoms. Similarly, psychosocial symptoms were seen to be core symptoms of the menopause experience. Undoubtedly, the menopause is a multifaceted phase that encompasses not only physical changes but also significant psychological challenges, and recognising the holistic nature of the menopause experience is crucial for providing comprehensive care. The findings from the current study also underscore the importance of early intervention, particularly in the perimenopausal stage, where women may face additional barriers in accessing essential support. Early intervention not only aids in alleviating menopausal and depressive symptoms but also contributes to overall well-being during this significant phase of life.

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“All women in their 40s are miserable” - health care provision throughout the menopause in the UK: a mixed-methods study

Cited by 3 publications

References 38 publications

A retrospective audit of general practitioner’s referrals to Guys and St Thomas’ specialist menopause clinic between 2021 and 2022

A retrospective audit of general practitioner’s referrals to Guys and St Thomas’ specialist menopause clinic between 2021 and 2022

Intention to use a mental health app for the menopause: a Health Belief Model approach

Using network analysis to understand the association between menopausal and depressive symptoms: a survey study

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