Rockpool Publishing

Menopause: A must read for all health care providers

Book Review: “Menopause,Change Choice and HRT” Dr Barry G Wren and Margaret Stephenson Meere

This book ‘Menopause Change, Choice and HRT’ is a timely reminder that for many women transitioning through this important marker in their ageing process, there is sound advice and guidance at hand that will enable most women to make informed choices. There are many women who have been confused about the symptoms of menopause, and who are still concerned about the treatment regimens and their perceived risk of Breast Cancer if they agree to take HRT. The analysis provided by the Author in this regard is reassuring and confirms that HRT in the 21st century has merit, is safe in low doses if not taken more than 5 years and women attend their GP appointments at least on a yearly basis for review and management.

The Author explains in easy to understand terms the impact of relevant research in relation to all forms of treatment and notes that in some so-called treatments research is scarce and needs further scrutiny and attention. Women need to be aware of the efficacy of treatment regimens and this is well explained throughout the chapters of the importance of level one trials.

Each chapter provides a comprehensive overview of all aspects of the physical, emotional and hormonal changes, medical treatment and alternative options that women may experience with a summary for future reference at the end of each chapter. This summary is a useful tool which will enable practitioners to give advice on the relevant menopause symptoms by merely reviewing what is stated in it which is advantageous in a busy practice.

Women generally are becoming more informed about their bodies and the changes experienced through the ageing process as one ages and will seek widely a plethora of information from which to make informed choices. The use of simple language, appendices and glossary make this book a valuable resource and easy to understand for any service provider.

I think there are some gaps to be identified which could be included re health care providers who are well informed in women’s health that are not mentioned. This group of service providers are the Women’s Health Nurses(WHN’s) and Nurse Practitioners in Women’s Health who are highly skilled and play an important role in supporting and advising women across their lifespan. WHN’s adopt a holistic approach toward their clients which is comprehensive and not only includes advising women about menopause symptoms but also WHN’s act as advocates for women who attend specialist appointments to support them in understanding treatment options. Women are also advised by WHN’s to seek appropriate information from either the Australasian Menopause Society or The Jean Hailes Foundation as reliable sites and are well informed from these sources rather than from their hairdressers as was mentioned. WHN’s work from a primary health care approach, which is evidence based with an emphasis on health promotion, prevention, partnerships and which encourages women’s self-reliance and empowerment .Local needs , local wisdom and local experience are all valued in this approach as well as the education of women on all matters relating to their health per se. Therefore women empower themselves, because of their own well informed decisions. WHN’s are aware that for some women around the time of the menopause, there are other factors to be considered that may impact on a women’s experience of her menopause transition such as children leaving home, divorce or the impact of domestic family violence, all of which can exacerbate a women’s mental , emotional and physical health and needs to be addressed. WHN’s work closely with Social Workers and Psychologists to appropriately refer these women.

In conclusion this book is a must read for all health care providers as a valuable resource to provide women with accurate advice and information and to be able to understand the effects of medication and the risks associated with it.

The only other comment is to raise the issue of including Culturally And Linguistically Diverse women receiving this information in an appropriate manner. This information is best disseminated via a Health Care Interpreter either face to face or by telephone. Some women from new and emerging communities do not read or write so again information would need to be discussed with a health care provider in such a way that the woman understands and has the opportunity to ask questions. A possible suggestion could be a fact sheet at the end of the book with links to specific language groups to be totally inclusive. For Aboriginal women, there may be some who would read and absorb the information but again WHN’s are well placed to provide this information to them at a clinic visit and via health promotion activities and support groups in the community.

The Authors nevertheless are to be commended in collaborating to write such an insightful book that most health care providers will be able to use as a sound resource for their clients.

Finally for some women, menopause is viewed as a celebration and an opportunity to acknowledge the significance of all the nuances of reproductive health and beyond. For those who need appropriate guidance as the symptoms of menopause take their toll to a greater or lesser degree, its good to know that there are renowned practitioners shining an explanatory light and reassuring women that menopause is a transition and an important marker in a women’s life.

Linda Oliver, RN,CM, B.A. M.H.Sc.

Women’s Health Nurse Consultant

President, Australian Women’s Health Nurse Association Inc.,

Linda Oliver, RN,CM, B.A. M.H.Sc. – 04 February, 2014