Menopause

You are a pharmacist working in a community pharmacy. A 49-year-old female patient has come to the pharmacy seeking advice about managing menopausal symptoms at home. She is considering taking supplements but would like to know more about her options. Currently, she does not wish to take HRT but would like evidence-based guidance on alternative approaches.

To do

1. Explore the patient’s current symptoms.

2. You are expected to provide counselling information to this patient and answer any questions appropriately. You must provide relevant advice.

You have 10 minutes.

You are Liling Zhang (LEE-ling JAHNG)

Opening Statement: “I have a few questions about supplements that I can use to help me deal with my symptoms of menopause.”

Patient Information:

Name: Liling Zhang

Age: 49

• Symptoms: 

• “I started going through menopause about two years ago. I’m not eager to take HRT and don’t really want to talk about it.”

• “I feel like I’ve been more irritable and moody lately—it’s just not like me.”

• “I get really bad hot flushes during the day, and at night I wake up drenched in sweat.”

• If asked: “I haven’t noticed any particular triggers and I haven’t tried anything to help.”

• If asked: “I get the occasional period - they’ve been a lot less often recently. Maybe every 2-3 months”

• If asked: “I sleep fine otherwise”.

• If asked: “I’m not anxious or low in mood.”

• If asked: “I’ve not noticed any issues with my concentration.”

• No other symptoms

• Medical history: 

• “I am quite healthy - I don’t have any medical conditions”

• Medication History: 

• “I am not on any medication.”

• Allergies:

•  “I don’t have any allergies.”

• Lifestyle factors: 

• “My diet is very balanced - I met with a nutritionist a year ago who made me a fantastic diet plan which is why I’m in such good shape!”

• “I drink alcohol occasionally, and only small amounts.”

• “I have never smoked.”

• “I go for walks every other evening with my husband and our dog.”

• “I don’t work - I’m a housewife.”

Questions to ask (use to prompt the student if they miss these areas):

1. What is the difference between menopause and perimenopause?

2. Are there any supplements I can take while I’m going through menopause to help with any of my symptoms?

3. Are there any lifestyle changes I can make that would help with these hot flushes? 

4. What other symptoms might affect me?

1. DR.VEGAN. (2024) PeriMenoFriend®. Available at: https://drvegan.com/products/perimenofriend?_pos=1&_psq=perim&_ss=e&_v=1.0 [Accessed 27 Jan. 2025].
2. DR.VEGAN. (2024) MenoFriend®. Available at: https://drvegan.com/products/perimenofriend?_pos=1&_psq=perim&_ss=e&_v=1.0 [Accessed 27 Jan. 2025].
3. Hodgkinson, K. (2024a) Get menopause ready in your 30S: Women’s Health, DR.VEGAN. Available at: https://drvegan.com/blogs/articles/get-menopause-ready-in-your-30s (Accessed: 01 February 2025).
4. Hodgkinson, K. (2024b) A survey into the effectiveness of HRT, DR.VEGAN. Available at: https://drvegan.com/blogs/articles/a-survey-into-the-effectiveness-of-hrt (Accessed: 01 February 2025).
5. National Institute for Health and Care Excellence (NICE). (2024). Menopause: What is it? [online] Available at: https://cks.nice.org.uk/topics/menopause/background-information/definition/ [Accessed 01 Feb. 2025].
6. National Institute for Health and Care Excellence (NICE). (2024). Menopause: Scenario: Managing women with menopause, perimenopause, or premature ovarian insufficiency [online] Available at: https://cks.nice.org.uk/topics/menopause/management/management-of-menopause-perimenopause-or-premature-ovarian-insufficiency/ [Accessed 27 Jan. 2025].