The experience of a menopause clinic in Kuwait: Implication for primary health care

The aim of this study was to evaluate the sequelae of menopause and how this can be managed in a primary health care setting. Between June 1992 and June 1994, 261 postmenopausal females who attended the menopause clinic at the Kuwait Maternity Hospital were evaluated clinically and with laboratory investigations; mammography, bone density assessment with quantitative computed tomography (QCT) scan and colposcopy were done for some patients. Ninety percent of the patients attended the clinic because of distressing vasomotor symptoms of hot flushes, night sweats and palpitations, and others because of psychological and/or psychiatric problems and secondary amenorrhea and infertility. About 21.5% of the patients were hypertensive, while 13.8% were diabetic. Nonspecific inflammatory bacterial vaginal infection occurred in 18.4% of the patients. High total cholesterol was found in 26%, high LDL in 20% and low HDL in 17% of the patients. Thirty-one percent of females who had bone density measurement had low bone density, while in 7.7%, mammography was abnormal. The authors conclude that the evaluation of patients prior to beginning estrogen therapy, as well as the follow-up, can be done in the primary health care centers.