Columnist Dr Copperfield questions whether a ‘menopause check’ is clinically appropriate and effective
Flushing hell! Look, I realise I’ll probably get slaughtered by at least half the population for saying this. And so, for the avoidance of doubt, I want to make it absolutely clear: no, I’m not a misogynist; yes, I do believe the menopause exists; no, I’m not anti-HRT; and yes, I feel almost as euphoric as my menopausal patients when the oestrogens I’ve managed to prise from the pharmacy kick in.
But FFS. We’ve tolerated a fairly lengthy period of ‘raising awareness’ of the menopause and all its implications, this raising awareness occurring at a time when we seemed to be talking, and hearing, about little else, and therefore wondering what awareness there was left to raise.
Yet, a couple of weeks ago, we had the All Party Parliamentary Group on Menopause suggest that menopause ‘discussion’ should be incorporated into health checks and incentivised within QOF. And now we have a health minister neatly demonstrating how politicised, unscientific and pre-determined the ‘debate’ has become by, on the one hand, saying the DHSC has asked the NHS health check advisory group to ‘review the case’ for including the menopause, and on the other stating it is ‘crucial’ that menopause is incorporated into the health check. So that’s the review done, then.
Reminder: I know the menopause exists, it can be bad and it can be treated. But I really resent unscientific drum-banging smothering perspective and rationality. Even if we accept that health checks are worthwhile at all – and that isn’t a given – where is the evidence that a ‘menopause check’ (whatever that is) is clinically appropriate and effective?
And why should GP action and payment through QOF dance to the tune of a single issue pressure group? If them, why not patients suffering arthritis, or Parkinson’s, or LUTs, or sinusitis, or Peyronie’s, or Plummer-Vinson-Patterson-Kelly-Brown syndrome, or work-related stress caused by mob behaviour dictating educational needs and terms of employment?
Because, with general practice, the clue’s in the title: generalism. We deal with everything and have that perspective that tells us that any one illness is pretty much as important as any other, especially to the individual suffering it. As soon as one assumes priority, it distorts everything and undermines the genuine entitlement of others.
Plus, there comes a point where raising awareness becomes alienation of the very group you’re trying to onboard, and that point is now. In better news, I hear that HRT shortages are over. So can we move on?
Dr Copperfield is a GP in Essex. Read more of his blogs here