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)

**Useful 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 

An episode focusing on what cancers might be oestrogen sensitive and how GPs can best support these patients. Whether HRT is ever an option for those who have had hormone-sensitive breast cancer, and advice for those with a BRCA 1 or 2 gene mutation after a risk-reducing bilateral salpingo-oophorectomy. Includes how to access more information and advice on managing more complex 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/c3e8c68f-b420-4c26-ae7e-da542634e7f1)

**Useful Resources**

BMS CBT

*   <https://thebms.org.uk/wp-content/uploads/2022/12/01-BMS-TfC-CBT-NOV2022-A.pdf>

1CKS guidance on family history referrals

*   [Breast cancer - managing FH | Health topics A to Z | CKS | NICE](https://cks.nice.org.uk/topics/breast-cancer-managing-fh/)

BMS Prescribable alternatives

*   <https://thebms.org.uk/wp-content/uploads/2022/12/02-BMS-TfC-Prescribable-alternatives-to-HRT-NOV2022-A.pdf>

WHC Alternatives to HRT

*   <https://www.womens-health-concern.org/wp-content/uploads/2022/12/03-WHC-FACTSHEET-Complementary-And-Alternative-Therapies-NOV2022-B.pdf>


OPTIONS FOR WOMEN WHO HAVE HAD BREAST CANCER  - > FOR RESOURCES + CPD SCROLL BELOW 

## There have been many HRT shortages over the last few years, leading to frustration for both healthcare providers and patients. This episode focuses on Serious Shortage Protocols, or SSPs, and specifically those for HRT; what they are, how how to implement SSPs and what information to give the patient and the GP. 

**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/4832b998-90a1-4ee5-92e9-05e4f44fc7ed)

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HRT SERIOUS SHORTAGE PROTOCOLS - > FOR RESOURCES + CPD SCROLL BELOW 

Everyone is trying to save money, and it's no exaggeration to say that some women can't afford HRT. Here, Thorrun explains ways in which pharmacists can support patients; suggesting who is eligible for free prescriptions, general advice about the HRT PPC and such tips as buying generic rather than branded over-the-counter products. 

**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/b8255ff6-3d90-4685-915c-070163403dc4)


PRESCRIPTION COSTS AND COST OF LIVING -> FOR RESOURCES + CPD SCROLL BELOW 

Pharmacists are about far more than dispensing medicine, and we know that menopause needs to be treated holistically. Topics on which pharmacists can offer advice, such as smoking cessation and weight management, and whether pharmacists can give guidance for other conditions that might need treatment in midlife, such as osteoporosis. 

**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/2ce116aa-d647-40ce-9b52-5ca8c2ff0669)

##  


MORE THAN MEDICATION -> FOR RESOURCES + CPD SCROLL BELOW 

There is still a great deal of confusion about HRT amongst the general population. We look at the role of the pharmacist in dispensing, understanding and explaining HRT - types and safety, as well as steering on testosterone and other medications used to alleviate menopause symptoms such as antidepressants. 

**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/ca168029-2555-42b2-b04c-91515336ce64)


MENOPAUSE 101 -> FOR RESOURCES + CPD SCROLL BELOW 

An incredibly sensitive subject, and one that many women are understandably embarrassed to address. Vaginal atrophy causes a great deal of discomfort and pain. What it is, how pharmacists are equipped to support women, and what advice to offer about local oestrogen. 

**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/29459115-b9d5-4d49-bf9e-c820ccadab4f)

. 


VAGINAL ATROPHY  -> FOR RESOURCES + CPD SCROLL BELOW 

Pharmacists have been rather caught in the crossfire of the HRT PPC launch on the 1st of April. What the HRT PPC is, to what HRT it refers (and doesn't), how much money women are able to save, and how pharmacists can implement it. 

**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/b6b63cda-54ea-4f8c-93e1-1941949e3f29)


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

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

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

PRESCRIBING HRT -> FOR RESOURCES + CPD SCROLL BELOW

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

MENOPAUSE & TESTOSTERONE -> FOR RESOURCES + CPD SCROLL BELOW

OPTIONS FOR WOMEN WHO HAVE HAD BREAST CANCER - > FOR RESOURCES + CPD SCROLL BELOW

HRT SERIOUS SHORTAGE PROTOCOLS - > FOR RESOURCES + CPD SCROLL BELOW

PRESCRIPTION COSTS AND COST OF LIVING -> FOR RESOURCES + CPD SCROLL BELOW

MORE THAN MEDICATION -> FOR RESOURCES + CPD SCROLL BELOW

MENOPAUSE 101 -> FOR RESOURCES + CPD SCROLL BELOW

VAGINAL ATROPHY -> FOR RESOURCES + CPD SCROLL BELOW

HRT PREPAYMENT -> FOR RESOURCES + CPD SCROLL BELOW