Safety of vaginal oestrogens for genitourinary symptoms in women with breast cancer.

Background: Oestrogen deprivation is the mainstay of treatment for women with hormone receptor-positive breast cancer, but unfortunately it causes multiple side effects that can significantly impair quality of life. Genitourinary symptoms are very common and although these symptoms can be effectively managed with vaginal oestrogens, concerns about their safety in women with breast cancer limits their use.

Objective: The aim of this review is to provide a summary of the data on the safety of vaginal oestrogens in women with breast cancer to help general practitioners advise their patients in this situation.

Management of menopause.

During perimenopause and after menopause, women may experience diverse symptoms. All women require a comprehensive assessment of their current health and risks for future disease, appropriate screening, and promotion of a healthy lifestyle. Menopausal hormone therapy is the most effective treatment for menopausal symptoms.

The 2023 Practitioner's Toolkit for Managing Menopause.

Objective: The Practitioner's Toolkit for Managing the Menopause, developed in 2014, provided an accessible desk-top tool for health-care practitioners caring for women at midlife. To ensure the Toolkit algorithms and supporting information reflect current best practice, the Toolkit has been revised in accordance with the published literature.

Methods: A systematic search for guidelines, position and consensus statements pertaining to the menopause and published after 2014 was undertaken, and key recommendations extracted from the Clinical Practice Guidelines determined to be the most robust by formal evaluation.

Premature ovarian insufficiency and infertility.

Background: Premature ovarian insufficiency (POI) is the loss of ovarian function before the age of 40 years and can be spontaneous or iatrogenic. It is an important cause of infertility, and the diagnosis should be considered in any woman presenting with oligo/amenorrhoea, even in the absence of menopausal symptoms suchas hot flushes.

Objective: The aim of this article is to provide an overview of the diagnosis of POI and its management with respect to infertility.

Making choices at menopause.

Background: Menopause is a time of change in women's lives and an opportunity for health promotion. Women can present with a range of symptoms and concerns.

Objective: The aim of this article is to review the key components of the assessment of women who are perimenopausal or menopausal, and to discuss the benefits and risks of hormonal and non-hormonal treatments, thereby assisting clinicians to appropriately manage these women.

Compassion fatigue and burnout: the role of Balint groups.

General practitioners are often the 'first port of call' for patients with a range of mental health problems, many of whom have a history of trauma or loss. Exposure to emotionally difficult situations puts them at risk of burnout and compassion fatigue. Balint groups are groups of GPs, usually facilitated by a psychiatrist, who discuss the doctor-patient relationship and provide peer support.