Managing climacteric problems in the general practitioner's surgery

A review article on the current management options for climacteric problems in the general practitioner's surgery is presented. The climacteric is a natural period in the life of a woman in which there is a decline in oestrogen and progesterone production, which in some women may require medical attention. Climacteric problems are not completely natural, particularly when affecting a woman's everyday life, and should be paid attention to, diagnosed, and treated by health care providers. Hormonal therapy is not primarily intended for general practice. Nevertheless, a number of recommendations and alternative treatment options are available. In many cases, antidepressants have to be prescribed, particularly in patients presenting with an anxiety disorder, sleep disorder, or eating disorder. Lifestyle modification is of importance, vitamins and natural products containing phytoestrogens may be helpful, as may rehabilitation and physiotherapy, using physical methods. It is of major importance for the doctor to engage in an unhurried conversation with the patient, as well as to show empathy and understanding and an interest in hearing the patient out. It is behavioural changes, lack of communication, and poor understanding by her family and community that often worsen the patient's perception of climacteric problems.

Keywords: climacteric, women's health, menopause, hormone replacement therapy, phytoestrogens, hot flushes, climacteric syndrome, low oestrogen, psychotherapy.