A cross-sectional national questionnaire survey assessing the clinical attitudes of members of the British Menopause Society to the management of women with premature ovarian insufficiency

Abstract

Objective: To explore the current clinical attitudes of members of the British Menopause Society to the management of premature ovarian insufficiency.

Design: An electronic cross-sectional questionnaire survey.

Setting: Members of the British Menopause Society.

Population: All members of the British Menopause Society with a valid email address.

Method: Completion of an electronic survey.

Main outcome measures: Investigations and treatment options and preferences for the management of women with premature ovarian insufficiency.

Results: A total of 130 questionnaires were returned and analysed. The majority of responses were from Hospital Consultants (n = 55/130; 42.3%). A total of 53/124 (42.7%) clinicians routinely performed a bone density scan. A total of 73/130 (56.2%) clinicians would prescribe hormone replacement therapy in preference to combined ethinyl estradiol and progesterone (COC; 27/130, 20.8%). A total of 44/108 (40.7%) routinely prescribed oral estradiol in preference to transdermal administration (62/108, 57.4%). A total of 26/128 (20.3%) prescribed oral micronised progesterone, 31/128 (24.2%) oral progestogens, while 42/128 (32.8%) preferred the intra-uterine system. Fertility concerns remain an important aspect of care, with 33.9% (n = 39/115) of clinicians indicating that more than 50% of their patients had a concern regarding their fertility.

Conclusion: The majority of clinicians indicated a preference for hormone replacement therapy instead of the COC as their choice of hormone replacement in women with premature ovarian insufficiency. However, there was a significant variation in practices. This information can be useful in counselling women and in guiding clinical practitioners. The results highlight the need for further research to determine the optimal regimens for the management of women with premature ovarian insufficiency.

Keywords: Estrogen; hormone replacement therapy; menopause; osteoporosis; vasomotor symptoms.