Post Reproductive Health

To evaluate the impact of a short-term cognitive-behavioural therapy (CBT) protocol on menopausal symptoms and quality of life in women undergoing menopause.

A short-term individual CBT protocol was developed. Peri- and post-menopausal women with symptoms were enrolled and assigned to either the experimental group (CBT) or the waitlist (CTL group) by patient’s decision.

Three validated questionnaires were used to assess psychological well-being before (T1) and after (T2) the intervention: the Menopausal Rating Scale (MRS), Clinical Outcomes in Routine Evaluation - Outcome Measure (Core-OM), and the World Health Organization Quality of Life in the short version (WHOQOL-BREF).

Forty-eight women were included, 24 in each group. At T1, the CBT group had worse scores than the CTL group across all questionnaires. At T2, the CBT group showed significant improvement in all measures, while the CTL group experienced significant worsening in CORE-OM and WHOQOL-BREF scores, with stable MRS scores. In the MRS, at T2 the CBT group showed significant reduction in both the psychological and somatic sub-domains (<0.001), while the CTL group’s scores remained unchanged. In the CORE-OM, the CBT group showed significant improvement in the well-being (p = .002), problems (p = .005), and functioning (p = .001) sub-domains, while the CTL group had significant declines. In the WHOQOL-BREF, the CBT group demonstrated significant improvements in all domains (p < .001), while the CTL group declined.

A short-term tailored individual CBT protocol is effective in managing menopausal symptoms, helping women develop the resources and coping strategies needed to adjust to this complex period.

Lifestyle optimisation and education plays a crucial role in the holistic management of symptoms during the menopause transition as well as reducing the risk of chronic diseases in the post-menopausal period. Provision of lifestyle education tailored to the menopause transition is limited in primary care, largely due to time pressures on general practitioners.

To upskill HWB coaches in primary care to deliver lifestyle advice and support as part of holistic menopause care.

A CPD and networking event aimed at HWB coaches was organised following engagement with all relevant stakeholders and collation of baseline data. This event focused on areas of highest demand according to a patient survey of women between the ages of 45 and 55 in a local GP surgery.

Pre- and post-event feedback was sought. All attendees were asked to rate their confidence on each topic presented at the event.

An increase in confidence in the knowledge of each topic covered at the event was demonstrated by attendees.

This project demonstrated how a simple and focused education and networking event has promoted engagement and collaboration with local HWB coaches, and it has shown a clear increase in knowledge of key topics which can be transferred to their interactions with patients. It is hoped that this will serve as a foundation upon which further work can be done to expand the involvement of HWB coaches and the wider healthcare team to improve access to holistic menopause care in the community.

Primary headache associated with sexual activity (PHASA) is uncommon and can resemble serious secondary causes such as subarachnoid haemorrhage or reversible cerebral vasoconstriction syndrome. We report a 47-year-old woman with a history of migraine with aura who developed thunderclap headaches exclusively at orgasm after her transdermal oestradiol dose was increased from 50 µg to 75 µg twice weekly. Neuroimaging was normal. She also noticed a significant increase in libido during the higher dose period.

Both the headaches and libido changes resolved after reducing oestradiol to 50 µg. Clinicians should consider HRT as a potentially reversible trigger in PHASA.