INTERNATIONAL experts have warned of a sharp increase in direct-to-consumer (DTC) menopause services offered by wellness practitioners and online suppliers, many of which are unnecessary and do not improve care.
In an article published in The BMJ, Canadian women's health experts raised questions around the reliability of these services and the potential commercial bias of the information on offer.
Symptoms are best assessed by a thorough clinical history with treatment decisions guided by clinical response and patient preferences, they said.
The promotion of routine hormone panel testing by wellness providers for the evaluation of menopausal symptoms is one of the most concerning trends.
The tests can cost hundreds of dollars and are marketed to patients and clinicians as necessary for "individualising" hormone therapy.
But in reality, they are of limited clinical use as there is no clearly defined therapeutic window for menopausal hormone therapy, and they often do not offer accurate assessment of hormone levels.
Hormone testing offers no reliable way to determine who will benefit from treatment, when the final menstrual period will occur, or whether it is safe to discontinue contraception, they explained.
In women over age 45 presenting with validated symptoms of menopause, including menstrual irregularity, menopause is a clinical diagnosis, and hormone testing is unnecessary, they said.
"For midlife women, effective treatment begins not with numbers, but with listening," the experts concluded.
The DTC testing trends have also been observed in Australia, with pharmacist Bo Youn Kim, who works with women to manage menopause (PD 28 Jul), pointing to panel tests costing around $600.
She told Pharmacy Daily there is no point because everyone has a different response to oestrogen and progesterone levels, "so there is no reason to chase the numbers".
"The hormone level that makes one person better might not work for another person, so why would we put women through unnecessary - and invasive and expensive - testing?"
Read the paper HERE. KB
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