In this episode of The Good GP, host Dr Maria Li continues her conversation with Dr Katherine Wyld, a Queensland-based endocrinologist, exploring the topic of menopause pseudoscience and its impact on patient care. This second part in the hormones series explores the growing prevalence of misinformation around menopause and hormone therapy, and practical guidance for general practitioners.

Dr Wyld discusses several areas of menopause care commonly affected by false or misleading information, including:

• The use of hormone monitoring during treatment. Dr Wyld clarifies that routine measurement of estrogen and progesterone levels is not recommended for guiding menopause treatment. Dosing should be based on symptoms.
• Testosterone therapy in menopause. Evidence supports its use only for hypoactive sexual desire disorder; benefits for other menopause symptoms are not proven. Common side effects include acne, excess hair growth, and skin oiliness.
• Bioidentical hormone therapy. The term is unregulated and used as a marketing tool. Standard, regulated formulations are safer and more effective.
• Use of high-dose estrogen. Prescribing above recommended limits increases risk and is not backed by safety data. Referral to a specialist is advised for complex cases.
• Strategies for GPs when encountering unfamiliar therapies or requests for non-evidence-based treatments.When unsure, consult guidelines or colleagues and use trusted resources for evidence-based answers.

They aim to support GPs in navigating menopause-related consultations, equipping them to communicate clearly, critically evaluate new trends, and provide safe, evidence-based care to their patients.

Links & Resources: 

• Australian Menopause Society - https://www.menopause.org.au/
• British Menopause Society - https://thebms.org.uk/
• International Menopause Society - https://www.imsociety.org/
• Bioidentical Hormone Therapy information sheet - https://menopause.org.au/health-info/fact-sheets/bioidentical-hormone-therapy?highlight=WyJiaW9pZGVudGljYWwiXQ==
• Menopause complementary therapy information sheet - https://menopause.org.au/hp/information-sheets/complementary-medicines-and-therapies-for-hot-flushes
• Prof Susan Davis Instagram - https://www.instagram.com/professorsusandavis/?hl=en

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