Definition and Overview
Menopause marks the end of a woman’s menstrual cycles and her capability to conceive. It is preceded by a stage called perimenopause, where women begin to experience symptoms very similar to menopause that can manifest as early as during 30’s. Perimenopause ends when the woman has been without her monthly cycles for a year and this is the start of the menopause stage.
Both perimenopause and menopause stages can be difficult for some women. Thus, they are advised to consult an obstetric and gynaecologist (OB-GYN) or any medical professional who specialises in the management of this condition especially in the presence of the following symptoms:
- Hot flashes
- Night sweats
- Vaginal dryness and itching
- Painful sex
- Mood changes
Once the initial consultation has been completed, a menopause follow-up visit is usually scheduled. Its purpose is to monitor the progress or effectiveness of the treatment program that the doctor has previously prescribed to the patient. It will be considered effective if the discomfort and other symptoms were eliminated or at least reduced. Otherwise, the treatment plan will be adjusted accordingly or changed completely until the desired results are achieved.
Who Should Undergo and Expected Results
The main purpose of a follow-up consultation is to monitor the effectiveness of the treatment program that the patient is currently in. This is scheduled between two to four weeks after the treatment (which can include medications and hormone therapy) has been initiated. If, at this point, there are no discernible improvements, the doctor may change the treatment method or make an adjustment to the current one. Also, the doctor will determine if the treatment has resulted in any side effects.
Women who are currently undergoing hormone therapy are required to make follow-up visits. Hormone therapy or hormone replacement therapy (HRT) involves the use of estrogen and progesterone to control menopausal symptoms like hot flashes and vaginal dryness. However, the therapy is linked to breast cancer and heart attacks, so monitoring is essential.
A menopause follow-up consultation is also a must when women develop additional symptoms after their initial consultation. These too will have to be assessed and treated as soon as possible.
Over the course of the menopausal period, the patient may have a change of mind over the kind of treatment that she’s undergoing. It can be due to the side effects, further research that makes her fearful of the possible complications of the current therapy, or she just wants to try a new program out of curiosity. Such concerns must be brought up during a follow-up consultation and the attending physician will provide the patient with adequate information to help her make a well-informed decision.
How Does the Procedure Work
A menopausal follow-up visit is a rather simple process. Depending on the nature of the follow-up, it can extend from 30 minutes to an hour. It usually begins with the doctor reviewing the notes from previous consultation to get up to speed with the patient’s history. The patient’s current vitals will be taken for comparison, such as blood pressure and weight. The results of the tests that were conducted prior to the follow-up will also be evaluated.
If the purpose of the follow-up is to monitor the progress of treatment, the patient and the doctor will discuss whether the treatment is successful based on how well the symptoms are managed. This is the point where the patient will relay any changes brought on by the treatment, whether they are improvements or side effects. This will allow the doctor to modify the current plan, if needed.
However, if the follow-up was scheduled due to the presence of new symptoms, the doctor will perform a thorough physical examination and recommend further testing. Naturally, a succeeding follow-up will be required where the results of the tests will be discussed as well as the most appropriate treatment or management plan.
Possible Complications and Risks
In the process of conducting the menopause follow-up consultation, there is a potential for the discovery of diseases and other risk factors that may alarm the patient. It is essential that this discovery is discussed calmly and rationally.
Also, in cases wherein a series of treatment methods have been tried but nothing worked, this could lead to the patient being frustrated, who may then decide to abandon the treatment altogether.
Lobo R. Menopause and care of the mature woman. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Mosby Elsevier; 2012:chap 14.
American College of Obstetricians and Gynecologists Committee on Gynecologic Practice. ACOG Committee Opinion No. 420, November 2008: hormone therapy and heart disease. Obstet Gynecol. 2008;112:1189-1192.