Strategies for effectively addressing women's concerns about the menopauseand HRT

HRT has many benefits for postmenopausal women yet acceptance and complianc e with therapy is low. This paper sets out some of the main concerns women have regarding HRT and highlights ways that physicians can effectively deal with these concerns. Physicians dealing with women concerned about startin g or continuing HRT should conduct patient-centered consultations employing good counseling skills. Dealing effectively with women's concerns means ad dressing their attitude to HRT, listening to the patients' fears in an unde rstanding and non-dismissive way, and focusing on good communication. Commo n concerns relating to unwanted effects such as bleeding, fear of cancer, w eight gain, thrombosis, general systemic effects, and the use of medical in tervention generally, can be dealt with if the physician follows the princi ples for conducting a patient-centered interview. When it comes to decision s about starting and continuing on HRT, it is important that women are trea ted with understanding, their concerns are taken seriously, and they are gi ven time to air their views and ask questions. Tailoring treatments to indi vidual patients can overcome many of the problems women have with HRT, howe ver it is important that the decision to start HRT, and the most suitable r egimen and delivery system to use, be decided in partnership with the patie nt. This should result in the patient having a better understanding of HRT, and may improve compliance. (C) 1999 Elsevier Science ireland Ltd. All rig hts reserved.