Strategies for effectively addressing women's concerns about the menopause and HRT

HRT has many benefits for postmenopausal women yet acceptance and compliance with therapy is low. This paper sets out some of the main concerns women have regarding HRT and highlights ways that physicians can effectively deal with these concerns. Physicians dealing with women concerned about starting or continuing HRT should conduct patient-centered consultations employing good counseling skills. Dealing effectively with women's concerns means addressing their attitude to HRT, listening to the patients' fears in an understanding and non-dismissive way, and focusing on good communication. Common concerns relating to unwanted effects such as bleeding, fear of cancer, weight gain, thrombosis, general systemic effects, and the use of medical intervention generally, can be dealt with if the physician follows the principles for conducting a patient-centered interview. When it comes to decisions about starting and continuing on HRT, it is important that women are treated with understanding, their concerns are taken seriously, and they are given time to air their views and ask questions. Tailoring treatments to individual patients can overcome many of the problems women have with HRT, however it is important that the decision to start HRT, and the most suitable regimen and delivery system to use, be decided in partnership with the patient. This should result in the patient having a better understanding of HRT, and may improve compliance.