News Special: Training in Menopause

By Ellie Holden / 03 May 2022

Following the release of a new report on women’s health, Aesthetics explores the limitations on current menopause training and how the aesthetics industry can help patients

By 2025, the number of postmenopausal women is expected to rise to 1.1 billion worldwide.1 Despite this, it has been recently highlighted by the Government that many women feel isolated and unable to seek guidance from their doctor or nurse. In the Women’s Health Strategy report published in April, it was outlined that healthcare professionals (HCPs) in England need better and more standardised training on the menopause.2

The report detailed that gaps were found in clinician education, including a reluctance to prescribe HRT due to existing guidelines issued by the National Institute for Health and Care Excellence (NICE) which highlighted the risks rather than the benefits.2,3 In addition, menopause training is often not mandatory so some GP placements may not be trained by someone with sufficient knowledge. Another issue was that the symptoms associated with the menopause, such as mood swings, can overlap with other conditions, leading to HCPs prescribing antidepressants to treat symptoms, which might not help.2

Upon reading the report, aesthetic practitioner and former GP, Dr Shirin Lakhani, who has a special interest in women’s health and holds a diploma of the Royal College of Obstetricians and Gynaecologists, said, “Women regularly present to me saying they have given up work or turned down a promotion because of their menopausal symptoms. It astounds me that the menopause isn’t given the same consideration as other hormone deficiencies, such as diabetes or hypothyroidism, despite the lack of these hormones leading to considerable morbidity and mortality in women.”

Training in the menopause

Currently in the UK, menopause is included in the Royal College of General Practitioners curriculum, however, training programmes are short. Practitioners therefore have to invest in additional training courses to gain further knowledge. Dr Lakhani believes it’s causing a lack of understanding amongst medical professionals when it comes to patient care. “Gaps in training for professionals hinders effective menopause care. Further training around the menopause should be mandatory for HCPs as it has a myriad of symptoms and signs, not just the well-known flushes and sweats,” she says. The gap in practitioner training, Dr Lakhani notes, presents an opportunity for those working within aesthetics to help patients by providing a holistic approach to their consultations. Dr Lakhani says practitioners should complete a full examination of their patient and factor in the menopause as a possible cause. “Aesthetic professionals should seek additional training and be equipped to recognise the symptoms of the menopause and signpost women to the correct services, or be able to successfully treat and guide patients in your own clinic,” she says. For aesthetic practitioners interested in furthering their knowledge, Dr Lakhani recommends joining the British Menopause Society, and seeking out training with The Marion Gluck Clinic, American Academy of Anti-Ageing Medicine and the European College of Aesthetic Medicine and Surgery.

Understanding the treatment options

The NHS states that HRT is advised as the main option to help relieve symptoms such as hot flushes, mood swings and vaginal dryness. Other treatment approaches include cognitive behavioural therapy or clonidine.4 Dr Lakhani notes, “In my experience, HRT is still regularly feared by HCPs who can actively discourage their patients from taking it, rather than having a discussion, considering up-to-date evidence instead of older flawed studies.” Dr Lakhani refers to the results of two large studies which raised concerns in the early 2000s about the safety of HRT, particularly with regards to breast cancer and heart disease.5,6 However, she highlights that newer research has found that bioidentical HRT does not carry the same risks as traditional HRT, so this is something she actively recommends to her patients and believes should be more widely available.7

According to Dr Lakhani, the NHS does not promote the use of other well-known interventions commonly found in clinics which may also help patients. These include skin treatments to tackle pigmentation, sagging and dryness, hair treatments to improve hair loss, radiofrequency tightening treatments for vaginal dryness and laxity, or supplements to help calcium and vitamin D levels.

“A large proportion of our aesthetic patients fall into this demographic, and there has been an increase in clinics broadening their offering to meet the medical needs of post-reproductive women. In my clinic, we offer radiofrequency technology to help with vaginal laxity, platelet-rich plasma for menopausal atrophy, intimate fillers and hydrating skinboosters as well as the usual aesthetic treatments to tackle the face and body,” Dr Lakhani comments.

Taking the menopause seriously

To ensure that patients receive the correct diagnosis and optimal treatment options available, Dr Lakhani believes that extended education on the menopause should be implemented. Dr Lakhani concludes, “I hope the report will help to highlight the need for practitioners to understand the menopause and its symptoms. I believe that with thorough training, menopausal management is a holistic service that many clinics can add. Holistic care is what differentiates us from the number of non-medical clinics, so let’s start to take the menopause more seriously!”

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