Menopause: Doctors criticize SNS responses and ask for “integrated vision”

As Portuguese societies of Gynecology and Endocrinology and the Order of Doctors criticize the responses of the National Health Service (SNS) to women in perimenopausal and menopause, asking for an “integrated vision” and “differentiated monitoring”.

Physicians also warn that hormonal therapy “is safe” and that women should be treated with symptoms and loss of quality of life due to sleep or mood disorders, irritability, mental confusion, difficulty concentrating, urinary or sexual complaints, among others.

“SNS does not respond to perimenopausal and menopause women. In the SNS, political power has not yet looked at this in order to have an integrated vision, from primary care to hospital care ", regrets Cláudio Rebelo, president of the Menopause Section of the Portuguese Society of Gynecology, in response to Lusa's questions on the subject.

The doctor points out that 52% of Portuguese women are over 45 years old, so political power should “note the pressure of numbers”.

“ It was important to have a standard of clinical guidance and invite those who are dedicated to treating menopause to understand how primary care can be motivated, even if it was the incentive program they already have for other pathologies ", specifies.

At the same time, it would be necessary to “give central hospitals a direct referral route”.

Currently, without “the specific hospital support of a menopause consultation”, primary care refers women to a general gynecology consultation, he explains.

“ These women are at the bottom of a list with other general gynecology consultations, such as myomas, menstrual irregularities, sometimes even infertility ", guarantees.

Rosa Maria Príncipe, of the Portuguese Society of Endocrinology, notes that one of the difficulties is “access to a differentiated follow-up”.

“There is still no guarantee, for the entire national territory, of uniform access to a consultation specialized in perimenopausal and menopause”, censorship.

In the SNS, “there is, or not always, an integrated route”, and the answers are “dispersed by different specialties: gynecology, endocrinology, general medicine and family”, observes.

The professional suggests “more training and more dedicated doctors”, something that “must be a government option”.

But women must also understand that “if something takes away their quality of life, they must seek help”.

“ They often accept this decrease as inevitable, because it has already happened with mothers. This is what we have to change”, he says.

The expert clarifies that perimenopausal women are concerned with “a phase of hormonal transition that cannot be reduced to menstrual irregularity”.

“ It is a phase in which hormonal changes, often not seen in the analyses, can already start to cause very relevant physical, emotional and cognitive symptoms, because they affect the woman in a phase of life in which she is at the peak of her career ", warns, referring to the safety of current therapies.

Amália Martins, a doctor at the College of Gynecology of the Order of Doctors, also states that the SNS has “little answers”.

“ In health centers, I think they are giving the worst response,” he says.

Disinterest in the area will be due, suggests, to the World Women’s Initiative study, which had hormone replacement therapy as one of the research strands and, in 2002, was interrupted because the results indicated an increased risk of breast cancer, stroke and cardiovascular diseases.

This therapy “has not been used in Portugal for many years”, he says, clarifying that there was, however, “a black phase of menopause” in which women had “to endure”.

Currently, “they should undergo hormonal therapies when they have complaints, or even without complaints, if they have low bone mass, for example”.

“ Women will live a third of their lives in menopause. We must reduce the symptoms to a good quality of life. I think that should be the bet of all doctors ", highlights.