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A Method to Study the Impact of Chemically-induced Ovarian Failure on Exercise Capacity and Cardiac Adaptation in Mice
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Competency in menopause management: whither goest the internist?

Richard J Santen1, Cynthia A Stuenkel, Henry G Burger

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|March 15, 2014
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Internists should re-engage in menopause management, as new data show hormone therapy (HT) benefits outweigh risks for many women. Developing core competencies is crucial for comprehensive care.

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Area of Science:

  • Internal Medicine
  • Women's Health
  • Endocrinology

Background:

  • Menopausal hormone therapy (HT) use declined significantly after 2002.
  • Internists' role in menopause management has diminished.
  • Recent research has expanded understanding of HT's effects and mechanisms.

Purpose of the Study:

  • To evaluate the current role of internists in menopause management.
  • To advocate for internists to resume a central role in menopause care.
  • To identify necessary steps for internists to effectively manage menopause.

Main Methods:

  • Review of existing scientific literature on menopause and hormone therapy.

Main Results:

  • Consensus indicates HT benefits outweigh risks for symptom relief in select menopausal women.
  • Non-hormonal agents, SERMs, and tibolone are alternative management options.
  • Menopause management decisions are complex, involving multiple systems and disease risks, highlighting the need for internist expertise.
  • Most internists lack current expertise in menopause management, leading to fragmented care.

Conclusions:

  • Internists' comprehensive approach is ideal for complex menopause management.
  • New educational programs are needed for medical students, residents, and practicing physicians to build core competencies in menopause care.