Menopause Mandate is delighted to bring you a series of expert interviews for healthcare professionals. The aim is to support you and your teams in understanding the menopause and HRT from both a prescribing and dispensing point of view. 
 
Dr Juliet Balfour is a GP and a British Menopause Society accredited menopause specialist and trainer. She runs an NHS menopause service and is a Menopause Mandate expert. She has recorded a series of 15-minute films to inform GPs and their teams. 

Subjects covered include the diagnosis of perimenopause and menopause, prescribing HRT (including current indications and contraindications), the genitourinary syndrome of the menopause, prescribing testosterone for women and options for women who have had breast cancer.
 
Highly experienced pharmacist Thorrun Govind is also a Menopause Mandate Expert. She has recorded a series of interviews to help pharmacists and their teams, including SSPs, prescription costs, the HRT PPC and lifestyle recommendations.

With huge thanks to Theramex, whose sponsorship has enabled us to record and share these films. Theramex has had no control over the editorial or expert content within the films. Their involvement has been purely to fund production and publication, and we are very grateful. 
 
Thank you for watching and please do share with your colleagues so we can help as many people as possible.

We are delighted to share that all of our talks have been CPD accredited and you can scan the QR code in the information notes to activate your points per session that you watch. 

NOTES : 

At the time of recording the NICE guidelines (NG23) were under review. Some guidance may change once these are published in early 2024.

Disclaimer : 

To the fullest extent possible by law, Menopause Mandate and anyone else directly or indirectly involved in the creation and provision of these presentations, including but not limited to the presenters and educators themselves, accept no liability howsoever arising from any reliance placed upon the content of these presentations, including any materials provided or information or advice given. Any such reliance is entirely at your own risk for which none of the aforementioned parties accept any responsibility. 



 


THE MENO SERIES

This episode explains how to identify and diagnose menopause from peri to post, including symptoms, whether or not blood tests are necessary, and the importance of diagnosing early menopause and POI. 

**RESOURCES**

**BMS Guidelines**

<https://thebms.org.uk/wp-content/uploads/2022/12/09-BMS-TfC-NICE-Menopause-Diagnosis-and-Management-from-Guideline-to-Practice-Guideline-Summary-NOV2022-A.pdf> 

**CPD QR Code**

Register to download your CPD certificate and collect your CPD credits for this session with the QR code below:

\*\*﻿\*\*![](https://chart.googleapis.com/chart?chs=200x200\&cht=qr\&chl=https://thecpd.group/webinar/portal/9fa81737-3849-4c77-9338-72ee7aa568ee)


DIAGNOSIS OF PERIMENOPAUSE & MENOPAUSE -> FOR RESOURCES + CPD SCROLL BELOW 

Covering the complex subject of HRT. Looking at current indications and contraindications, how to advise about the benefits and risks, and the length of time on which women can stay on HRT.

**CPD QR Code**

Register to download your CPD certificate and collect your CPD credits for this session with the QR code below:

![](https://chart.googleapis.com/chart?chs=200x200\&cht=qr\&chl=https://thecpd.group/webinar/portal/dbc3cbcd-833e-408c-af10-d56b514b024a)

**Useful Resources:**

NOGG guidelines and BMS consensus summary

*   [Section 6: Pharmacological treatment options | NOGG](https://www.nogg.org.uk/full-guideline/section-6-pharmacological-treatment-options#hrt)
*   [Prevention and treatment of osteoporosis in post menopausal women - British Menopause Society](https://thebms.org.uk/publications/consensus-statements/prevention-and-treatment-of-osteoporosis-in-women/)

BMS consensus statement

*   <https://journals.sagepub.com/doi/pdf/10.1177/2053369120957514>

WHC infographic 

*   <https://www.womens-health-concern.org/wp-content/uploads/2019/10/WHC-UnderstandingRisksofBreastCancer-MARCH2017.pdf>


 HRT - INDICATIONS AND CONTRAINDICATIONS -> FOR RESOURCES + CPD SCROLL BELOW 

Here, Dr Balfour explains the options for prescribing oestrogen and when a progestogen or progesterone is needed. In addition, she looks at when to change a patient from sequential combined HRT to continuous combined, common side effects of HRT and when to review patients. 

**CPD QR Code**

Register to download your CPD certificate and collect your CPD credits for this session with the QR code below:

![](https://chart.googleapis.com/chart?chs=200x200\&cht=qr\&chl=https://thecpd.group/webinar/portal/c1b4ad85-ff9f-456f-b777-9758fefe272d)

**Useful Resources**

BMS Practical prescribing

BMS consensus summary - reviewed 2022’

*   <https://thebms.org.uk/wp-content/uploads/2022/12/03-BMS-TfC-HRT-Practical-Prescribing-NOV2022-A.pdf>
*   <https://thebms.org.uk/wp-content/uploads/2022/12/14-BMS-TfC-Progestogens-and-endometrial-protection-NOV2022-A.pdf>

FSRH document

*   [FSRH Clinical Guideline: Contraception for Women Aged over 40 Years (August 2017, amended September 2019) - Faculty of Sexual and Reproductive Healthcare](https://www.fsrh.org/standards-and-guidance/documents/fsrh-guidance-contraception-for-women-aged-over-40-years-2017/)


PRESCRIBING HRT -> FOR RESOURCES + CPD SCROLL BELOW 

###### Statistics vary as to how many women suffer from this, it’s thought that up to 80% of women will suffer from GSM at some point in their lives.

###### This episode explains what GSM is, who gets it and when, and then diagnosis and treatment options, including the safety of vaginal oestrogen. 

**Resources**

**WHC Urogenital problems**

*   <https://www.womens-health-concern.org/wp-content/uploads/2022/12/25-WHC-FACTSHEET-VaginalDryness-NOV2022-B.pdf>

**WHC Urogenital problems**

*   <https://www.womens-health-concern.org/wp-content/uploads/2022/12/23-WHC-FACTSHEET-UrogenitalProblems-NOV2022-B.pdf>

**CPD QR Code**

Register to download your CPD certificate and collect your CPD credits for this session with the QR code below:

![](https://chart.googleapis.com/chart?chs=200x200\&cht=qr\&chl=https://thecpd.group/webinar/portal/81c3fdc5-3b3e-4c32-bc2b-f7ed2f78c8ca)


GENITOURINARY SYNDROME (GSM) -> FOR RESOURCES + CPD SCROLL BELOW  

Testosterone is in huge demand, but it's a highly complex subject. Dr Balfour talks about the current UK guidelines for prescribing it, as well as the products available. Also looking at how testosterone drops in women, other causes of low libido, and possible benefits and side effects of using testosterone.  

\*\*CPD QR Code - \*\*

Register to download your CPD certificate and collect your CPD credits for this session with the QR code below:

![](https://chart.googleapis.com/chart?chs=200x200\&cht=qr\&chl=https://thecpd.group/webinar/portal/c252be66-e47b-468e-baaf-c1d3c6100aab)

***RESOURCES***

NICE NG23

*   [Overview | Menopause: diagnosis and management | Guidance | NICE](https://www.nice.org.uk/guidance/ng23)

BMS Testosterone replacement in menopause

*   <https://thebms.org.uk/wp-content/uploads/2022/12/08-BMS-TfC-Testosterone-replacement-in-menopause-DEC2022-A.pdf>

WHC Testosterone for women

*   <https://www.womens-health-concern.org/wp-content/uploads/2022/12/22-WHC-FACTSHEET-Testosterone-for-women-NOV2022-B.pdf>


MENOPAUSE & TESTOSTERONE -> FOR RESOURCES + CPD SCROLL BELOW

Speakers

Juliet Balfour

Dr

Alice Smellie

Ms

Replays

DIAGNOSIS OF PERIMENOPAUSE & MENOPAUSE -> FOR RESOURCES + CPD SCROLL BELOW

HRT - INDICATIONS AND CONTRAINDICATIONS -> FOR RESOURCES + CPD SCROLL BELOW