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NICE Guidelines- NO ADs for peri meno please GPs!

(6 Posts)
PollyPerky Sat 25-Feb-17 09:04:43

It's clear from posts here that there are still some out of date GPs who are offering ADs for peri meno. This is wrong. NICE says it's wrong. ADs are potentially addictive drugs with many side effects that are not for women suffering from loss of oestrogen only.

1.4 Managing short-term menopausal symptoms

The recommendations in this section are not intended for women with premature ovarian insufficiency (see recommendations 1.6.6 to 1.6.8 for management of premature ovarian insufficiency).

1.4.1 Adapt a woman's treatment as needed, based on her changing symptoms.

Vasomotor symptoms

1.4.2 Offer women HRT for vasomotor symptoms after discussing with them the short-term (up to 5 years) and longer-term benefits and risks. Offer a choice of preparations as follows:

oestrogen and progestogen to women with a uterus

oestrogen alone to women without a uterus.

1.4.3 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.

1.4.4 Explain to women that there is some evidence that isoflavones or black cohosh may relieve vasomotor symptoms. However, explain that:

multiple preparations are available and their safety is uncertain

different preparations may vary

interactions with other medicines have been reported.

Psychological symptoms

1.4.5 Consider HRT to alleviate low mood that arises as a result of the menopause.

1.4.6 Consider CBT to alleviate low mood or anxiety that arise as a result of the menopause.

1.4.7 Ensure that menopausal women and healthcare professionals involved in their care understand that there is no clear evidence for SSRIs or SNRIs to ease low mood in menopausal women who have not been diagnosed with depression (see the NICE guideline on depression in adults).

chickensaresafehere Sat 25-Feb-17 16:07:57

Just want to say thank you Polly for pointing this out to me when I posted about SSRI's & the menopause.
I went back to a different GP,armed with all the facts (after reading up on Menopause Matters & NICE guidelines re.menopause)& had a much better consultation.She seemed much more clued up about HRT & was happy to prescribe it for me.
I have been taking Femoston 2/10mg for a week now & I am definitely starting to feel better.

PollyPerky Sat 25-Feb-17 21:16:22

Glad you had some success!

And a thank you Polly from me too.

I went to my GP appointment armed with the NICE info and having joined Menopause Matters. She listened to me, appreciated 'my' research and will be happy for me to have HRT when my BP is normal when taken at home
(I seem to have white coat syndrome)

Bunnycup Sat 25-Feb-17 22:00:44

Im a bit hmm about this particular guideline. Call me cynical but it looks like a neat way to keep SSRI prescribing costs down. And SSRIs arent addictive.

PollyPerky Sun 26-Feb-17 08:38:45

I think that is being cynical smile
If you look at the contributors to the report, I don't think any of them have an axe to grind about cost of drugs. They were more concerned about thousands of women being treated as if they had mental health issues. The options they suggest apart from HRT include CBT (for mood and anxiety issues) which is probably far more £££ than cheaper SSRis.

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