Why should GPs and healthcare professionals mention menopause to women during their NHS 40+ Health Check? Menopause Mandate founding director and health journalist Alice Smellie asks Menopause specialist Dr Clare Spencer from My Menopause Centre for the answers. 
 
 
Theramex has no control over the editorial or expert content in the films. Their involvement has been purely to fund production and publication, for which we are very grateful.
 
NOTES : The NICE guidelines (NG23) were under review at the time of recording. Some guidance may change once these are published later in 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, and none of the aforementioned parties accept any responsibility.
 
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, and none of the aforementioned parties take any responsibility. 





MM 40+ GP

# Understanding the Importance of Including Menopause in Over-40 Health Checks

Menopause is a significant transition in a woman's life, typically beginning in the mid-forties, but it can start earlier. The transition, known as perimenopause, leads to the menopause, which is marked by the cessation of menstrual periods for 12 months. Post-menopause follows, continuing for the rest of a woman's life. Recognising the onset of menopause is crucial due to its subtle symptoms, which can significantly impact quality of life and long-term health.

## The Over-40 Health Check: A Critical Assessment for Men and Women

The over-40 health check, available to individuals between the ages of 40 and 74, is a preventive measure provided by general practitioners or local authorities every five years. It is designed for those without pre-existing conditions or specific risk factors already under medical supervision. This comprehensive check includes assessments for major health issues such as heart disease, dementia, type 2 diabetes, and chronic kidney disease.

During the check, various measurements and tests are conducted:

*   Blood pressure, height, and weight are measured.
*   Lifestyle factors such as smoking, alcohol intake, diet, and exercise are evaluated.
*   Family medical history is reviewed.
*   Screening for depression and memory issues may be conducted.
*   Blood tests, which can vary regionally, typically include cholesterol levels, kidney function, and HbA1c for diabetes monitoring.

## Why Menopause Should Be Included in Health Checks

Incorporating menopause into the over-40 health check is vital for several reasons:

1.  **Early Symptom Recognition**: Many women do not realise that symptoms like anxiety, insomnia, or memory difficulties are related to menopause. Early recognition can alleviate unnecessary anxiety and provide a pathway to appropriate treatment.
2.  **Risk Management**: Menopause increases the risk of osteoporosis and heart disease. Early detection and management of these risks can lead to better long-term health outcomes.
3.  **Educational Benefits**: Understanding the normal age range for menopause (45-55 years, with an average age of 51) helps identify women who may be entering menopause earlier than usual, allowing for timely interventions.

## The Difference Between Perimenopause and Menopause

Perimenopause is the phase marking the onset of the menopause transition, characterised by irregular periods and fluctuating symptoms due to hormonal changes. Menopause itself is a specific point in time, identified after a woman has not had a period for 12 months. Understanding this distinction is crucial for appropriate symptom management and treatment.

## Addressing Surgical and Medical Menopause

Surgical menopause occurs when the ovaries are removed, often due to cancer prevention or treatment, causing a sudden drop in estrogen levels. Medical menopause can result from treatments like chemotherapy or radiotherapy. These conditions can lead to more severe symptoms and increased long-term health risks, making awareness and appropriate treatment essential.

## Comprehensive Symptom Overview

Menopause can cause a wide array of symptoms, affecting nearly every part of the body:

*   **Vasomotor Symptoms**: Hot flashes, night sweats.
*   **Physical Symptoms**: Joint aches, palpitations, headaches, skin dryness.
*   **Psychological Symptoms**: Anxiety, mood changes, depression.
*   **Cognitive Symptoms**: Memory issues and concentration difficulties.
*   **Sexual Function**: Loss of libido, vaginal dryness.

Recognising these symptoms early can prevent misdiagnosis and ensure that women receive the most effective treatment, such as hormone replacement therapy (HRT), rather than treatments for conditions with similar symptoms like depression or anxiety.

## Conclusion

The inclusion of menopause in the over-40 health check is not just a health measure but a necessary step towards empowering women with knowledge about their bodies. This awareness enables them to seek appropriate care and support, leading to healthier, more informed decisions about their health as they age.
