Section of Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK.
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
Ann N Y Acad Sci. 2024 Aug;1538(1):34-44. doi: 10.1111/nyas.15185. Epub 2024 Jul 17.
Menopausal hormone therapy (MHT) is an effective treatment for menopause-related symptoms. Menopause management guidelines recommend a personalized approach to menopause care, including MHT use. Decision-making around menopause care is a complex, iterative process influenced by multiple factors framed by perspectives from both women and healthcare providers (HCPs). This narrative review aims to summarize evidence around factors affecting decision-making regarding menopause-related care. For HCPs, the provision of individualized risk estimates is challenging in practice given the number of potential benefits and risks to consider, and the complexity of the data available, especially within time-limited consultations. Women seeking menopause care have the difficult task of making sense of the benefit versus risk profiles to make choices in line with their decisional needs influenced by sociocultural/economic, educational, demographic, and personal characteristics. The press, social media, and influential celebrities also impact the perception of menopause and decision-making around it. Understanding these factors can lead to improved participation in shared decision-making, satisfaction with the decision and decision-making process, adherence to treatment, reduced decisional regret, efficient use of resources, and ultimately long-term satisfaction with care.
绝经激素治疗(MHT)是治疗绝经相关症状的有效方法。绝经管理指南建议采用个性化方法来管理绝经,包括使用 MHT。绝经护理决策是一个复杂的、迭代的过程,受到来自女性和医疗保健提供者(HCP)的多个因素的影响。本叙述性综述旨在总结影响与绝经相关护理决策的因素的证据。对于 HCP 而言,由于需要考虑的潜在益处和风险数量以及可用数据的复杂性,尤其是在有限的咨询时间内,提供个体化风险估计在实践中具有挑战性。寻求绝经护理的女性面临着一项艰巨的任务,即需要理解利弊状况,以便根据受社会文化/经济、教育、人口和个人特征影响的决策需求做出选择。媒体、社交媒体和有影响力的名人也会影响对绝经的看法和对其的决策。了解这些因素可以提高共同决策的参与度、对决策和决策过程的满意度、对治疗的依从性、减少决策后悔、提高资源利用效率,最终提高对护理的长期满意度。