GP and women's health professionals study day

GP and women's health professionals study day Medical education

There has been a lot recently in the medical literature about impact of different types of exogenous hormones on Meningi...
22/06/2026

There has been a lot recently in the medical literature about impact of different types of exogenous hormones on Meningiomas.
Here is a useful narrative review by Nicola Pluchino and colleagues on the topic.

The authors recommend that women’s health specialists should systematically assess a history of meningioma before prescribing progestins.

In patients with incidental meningiomas, discontinuation of high-risk progestins should be considered, followed by MRI reassessment within 3–6 months.
When hormonal treatment remains necessary, the lowest effective dose and regular neuro-oncologic monitoring are recommended.

Increased awareness and individualised counseling are essential to optimise hormonal management in women at risk of meningioma.
https://pubmed.ncbi.nlm.nih.gov/42323841/

Most of the evidence of risk for meningiomas comes from the use of progestins (synthetic progestogens) used for contraception such as cyproterone acetate or depo Provera and the absolute risks remain low. Little or no evidence is available with use of levonorgestrel intrauterine coil or micronised natural progesterone and some women certainly can cautiously make a choice to use hormones with regular tumour surveillance after a thorough individualised discussion of benefits and risks depending on the site, size and nature of the tumour they have had.

We discuss this more in details at one of our Menopause Research Education Fund videos.
https://www.youtube.com/live/zAie2vyR5is?is=gSJQEtOj5VUJyjK3

Haematology and female hormone health intersect at multiple levels. As the authors of this review point out - Haematolog...
21/06/2026

Haematology and female hormone health intersect at multiple levels. As the authors of this review point out - Haematologists have a unique privilege of providing lifetime care, often in multidisciplinary clinics such as sickle cell disease or haemophilia treatment centres.
This is a useful and comprehensive review that covers discussions on hormone changes of menarche, pregnancy, menopause and how these life transitions impact people with underlying haematological disorders, including an increased risk of iron deficiency with or without anaemia.

The review focusses specifically on the impacts of anticoagulation on menstrual bleeding, thrombosis risk on gender-affirming care, and pregnancy on those with sickle cell disease and inherited bleeding disorders.

The authors note that most haematologists have little or no exposure to training on haematology-related, women's health-specific outcomes. However, many outcomes are impacted by, or are even early signs of, haematological diseases. The review provides a basis for overlap between hormones and haematology conditions and aims to support haematologists in the care of their patients.
https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(26)00110-9/abstract

Friday 19 June was World Sickle Cell Day, a United Nations-recognised day to raise awareness of sickle cell disorder across the world.
https://www.sicklecellsociety.org

Hormone health, fertility problems and menopause transition remain under-researched in sickle cell and thalassaemia patients. This can cause delays in diagnosis, treatment and missed opportunities for optimal fertility and long-term health outcomes. We need to continue working hard to spread more awareness and deliver better outcomes.

It was wonderful to talk to everyone at the ‘National Highways’ staff event in Birmingham today. We covered Menopause, H...
18/06/2026

It was wonderful to talk to everyone at the ‘National Highways’ staff event in Birmingham today. We covered Menopause, HRT and what is new in this field.
Thank you all who shared your personal stories and experiences.
A big thank you to Clare Ball and her menopause warriors team who are providing an exceptional support to colleagues and making the workplace/organisation menopause friendly. Amazing work!
Together, we can keep making progress.

From the pioneering research work of German virologist Dr. Harald zur Hausen who first detected and proved that the Huma...
18/06/2026

From the pioneering research work of German virologist Dr. Harald zur Hausen who first detected and proved that the Human Papillomavirus (HPV) causes cervical cancer in the early 1980s to the US Food and Drug Administration (FDA) approval for Gardasil, the first quadrivalent HPV vaccine to today’s research headlines - what a journey this has been and what a scientific achievement! Forever grateful to the research teams who made this possible 🙏🏻

https://www.bbc.co.uk/news/articles/c621z28z138o

Here is a recent useful study from Simko et al. using the TriNetX database which was used to identify women 18 and older...
17/06/2026

Here is a recent useful study from Simko et al. using the TriNetX database which was used to identify women 18 and older with surgically diagnosed endometriosis. The study showed that patients with endometriosis had a 3.7x the risk of primary ovarian insufficiency and 12.4x the risk of surgical menopause (p < 0.0001), with an overall risk of 1.4% and 0.7%, respectively. Rates of menopause in patients with endometriosis aged 18–39 were 4.7x that of the general population. Reported prevalence proportions of premature and surgical menopause among patients with a diagnosis of endometriosis increased over the past decade, alongside rates of oophorectomy and hysterectomy.

Rates of premature and surgical menopause are higher among patients with endometriosis. With higher rates of oophorectomy and hysterectomy at younger ages, adequate counseling on the risks of premature menopause are essential. Further studies are required to guide management of hormone replacement therapy for patients with premature menopause while minimising endometriosis recurrence. A focus on early diagnosis and preventative strategies (especially peri-operative planning about the use of hormones) is essential to improve the long-term health outcomes for these patients.

https://www.sciencedirect.com/science/article/pii/S2468784726001157

Here is a useful paper from Javier Mejia-Gomez and colleagues on borderline ovarian tumours (BOTs) and use of hormone re...
16/06/2026

Here is a useful paper from Javier Mejia-Gomez and colleagues on borderline ovarian tumours (BOTs) and use of hormone replacement therapy (HRT).
These tumours account for approximately 15% of primary ovarian neoplasms.
This systematic review evaluated the association between HRT use and BOT outcomes and 11 studies met the inclusion criteria (four cohort, seven case–control). Six reported a statistically significant association between HRT and increased odds of BOTs; five did not. Combined oestrogen–progestogen therapy showed a stronger, more consistent positive association (odds ratio 1.426, 95% confidence interval 1.083–1.877), whereas oestrogen-only therapy showed a nonsignificant association. The findings possibly hint at differential actions of two hormones on the ovarian epithelium. No study addressed BOT recurrence, and only one observational study evaluated BOT survival, finding no adverse association.

The authors concluded that evidence on HRT–BOT association is heterogeneous and inconsistent. Although a statistical association was observed between combined HRT use and increased odds of BOTs, postsurgical safety data are limited and overall certainty of evidence is very low so findings warrant considerable caution. Current literature is insufficient to confirm or exclude an association between HRT and BOT recurrence or survival. Indications for HRT after BOT surgery require individualised, multidisciplinary discussion involving oncology and menopause specialists, balancing quality-of-life benefits against unquantified theoretical risks.

There are significant limitations of the study -
studies included were heterogenous, there was inability to assess any impact of HRT on recurrence and survival by formulation type, dosage or differences in route of administration, possibility of publication bias and there were limited number of studies contributing to subgroups. There was heterogeneity in MHT exposure definitions across studies and potential confounding by indication cannot be excluded.

The BGCS BMS menopause and cancer guidelines currently support use of HRT after BOT depending on the nature and extent of disease.

https://www.bgcs.org.uk/wp-content/uploads/2024/08/BGCS-BMS-Guidelines-on-Management-of-Menopausal-Symptoms-after-Gynaecological-Cancer.pdf

This paper again demonstrates some of the uncertainties that may be associated with decision making about HRT following some forms of tumours or cancers. Individualisation is key and informed patient choice should be respected. More research is the need of the hour……..
Future prospective research, ideally randomised controlled trials, are required to establish the evidence base for the safe management of surgical menopause in this population.

https://www.tandfonline.com/doi/full/10.1080/13697137.2026.2675561

Last week was the ‘Diabetes Week’ (8th to 14th June 2026 - to raise public awareness, promote early diagnosis, improve d...
15/06/2026

Last week was the ‘Diabetes Week’ (8th to 14th June 2026 - to raise public awareness, promote early diagnosis, improve daily management, and eradicate the stigma faced by people living with it). On 3rd June on Harley street at Home, we talked about how diabetes, PMOS and other endocrine conditions intersect with menopause, and how this impacts everyday clinical decision-making. To catch up -
https://www.harleystathome.com/ -premium
A useful resource from Diabetes UK -
https://www.diabetes.org.uk/living-with-diabetes/life-with-diabetes/menopause

The day after on Midlife Matters webinar we discussed Surgical menopause and why it’s different from natural menopause. Still a long way to go to achieve ideal peri-operative care for all but awareness is improving and healthcare professionals are increasingly discussing hormones after surgical menopause now. We need to keep going!
Catch up here if you are interested -
https://rdp-int.com/index.php?&pgid=20011
A useful resource from Menopause Support -
https://menopausesupport.co.uk/?page_id=18181

What is the impact of clinic waiting times on patient’s symptoms and quality of life?An interesting study from Alexa Gru...
14/06/2026

What is the impact of clinic waiting times on patient’s symptoms and quality of life?

An interesting study from Alexa Gruber and team from Canada assessed the impact of clinic wait times (6 months) on quality of life (QOL) among patients awaiting consultation for menopause or vulvar dermatologic concerns in a tertiary academic hospital.

Of 363 participants who completed their survey, 285 were included in the analysis. The median wait from referral to survey completion was 246 days for menopause patients (n=149) and 161 days for vulvar dermatology patients (n=135). The median overall wait from referral to appointment was 390 days for menopause patients and 450 days for vulvar dermatology patients. The most represented age group was 45-54 years (33%).

Study findings suggested that prolonged waits for specialised gynecology care were associated with increased symptom burden and impaired QOL, particularly among patients awaiting menopause care and that generic QOL instruments may fail to capture wait-time dependent symptoms.
Patients frustrated with their wait time, and those experiencing highly disabling symptoms were also less interested in participating.
The authors recommended improved resource allocation and healthcare provider education as essential steps to improving care for these patients.

As demands for menopause care increase and more complex patients such as cancer survivors and women with medical co-morbidities seek treatment options for menopause management, we certainly need more resources and investment in provision of clinical care not just for the initial consultation but also ongoing support and follow-up care for patients across primary, secondary and tertiary settings.

https://pubmed.ncbi.nlm.nih.gov/42285504/

The publication of National Institute for Health and Care Excellence (NICE) guidance on Menopause Management in November...
08/06/2026

The publication of National Institute for Health and Care Excellence (NICE) guidance on Menopause Management in November 2015 in the UK was a pivotal moment that changed the menopause management landscape and transformed the way we prescribe hormone replacement therapy (HRT).

After years of myths, misconceptions and scaremongering about the negative impact of HRT on long-term health, the NICE guidance provided a clear and evidence-based summary of benefits versus risks of HRT for menopause symptoms and advised that for majority of women benefits of HRT outweighed the risks.

More and more women visited their healthcare professionals to discuss their symptoms and consider HRT and other treatments for their menopause symptoms and quality of life.

But it was not all about HRT. The balanced document also summarised the evidence for various lifestyle and non-hormonal interventions for women who wished not to take HRT or had medical contraindications to or side effects from HRT.

No guidelines are perfect but they do serve as instruments that change healthcare practices and bring into focus the gaps in clinical research and research recommendations.

NICE guidance was one of the first to recommend against the routine use of SSRIs (antidepressants) and consideration of HRT for mood changes related to hormone changes of menopause transition. The guidance was updated in 2024 and now also covers the use of novel NK3 receptors antagonists as a non-hormonal treatment of menopause symptoms which is a very valuable addition to the existing limited options. We are eagerly awaiting the formulary approval of Fezolinetant across the NHS so that this option can be offered to NHS patients too and not just in the private sector.

Here are some key NICE recommendations for symptom management:
Vasomotor symptoms -
Offer HRT to people with vasomotor symptoms associated with menopause.

Consider menopause-specific cognitive behavioural therapy (CBT) as an option for vasomotor symptoms associated with menopause:
* in addition to HRT or
* for people for whom HRT is contraindicated or
* for those who prefer not to take HRT.

Fezolinetant is recommended as an option for treating moderate to severe vasomotor symptoms associated with menopause when HRT is unsuitable.

Do not routinely offer selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) or clonidine as first-line treatment for vasomotor symptoms alone.

Mood changes -
Consider HRT to alleviate depressive symptoms (not meeting the criteria for a diagnosis of depression) with onset around the same time as other symptoms associated with menopause.

Consider CBT as an option for people who have depressive symptoms (not meeting the criteria for a diagnosis of depression) in association with vasomotor symptoms:
* in addition to other management options or
* for people for whom other options are contraindicated or
* for those who prefer not to try other options.

For details of basis for recommendations and practical prescribing/monitoring -
https://www.nice.org.uk/guidance/ng23/chapter/Recommendations -symptoms-associated-with-menopause-in-people-aged-40-or-over

It was wonderful to join the teams away day for inpatient women’s health nurses at University College London Hospital to...
04/06/2026

It was wonderful to join the teams away day for inpatient women’s health nurses at University College London Hospital today. We discussed so much about menopause and HRT. Thank you Uma Bhatta for the opportunity.

Nurses have a vital role to play in delivering menopause healthcare. They are usually the first point of call for many women who seek help and support for menopause in primary care or specialist services. The next teaching session will be in 2 weeks time!

Later in the day, we discussed surgical menopause at the Menopause Matters meeting and how pre-operative planning for menopause management and support post-operatively (including HRT as needed) is crucial right from the time before surgery happens to the time recovery begins on the ward and much beyond.

Surgical menopause is an acute event and there is profound shift in hormones for many women when functional ovaries are removed. Many participants across the country shared their challenges of disjointed care and difficulty in obtaining the right support after surgery. Although some guidelines and recommendations exist on the topic, they fall short on many grounds. We must continue to strive for better clinical care pathways for women who experience surgical menopause.

Address

UCLH
London
NW12BU

Website

Alerts

Be the first to know and let us send you an email when GP and women's health professionals study day posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Contact The Business

Send a message to GP and women's health professionals study day:

Shortcuts

Share

Category