title: 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.
  
  
  METHODS
  An electronic cross-sectional questionnaire survey.
  
  
  METHODS
  Members of the British Menopause Society.
  
  
  METHODS
  All members of the British Menopause Society with a valid email address.
  
  
  METHODS
  Completion of an electronic survey.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: King's College Hospital NHS Foundation Trust, Assisted Conception Unit, London, UK monica.mittal@nhs.net.
authors: Monica
authors: M
authors: Mittal
authors: King's College Hospital NHS Foundation Trust, Assisted Conception Unit, London, UK.
authors: Michael
authors: M
authors: Savvas
authors: King's College Hospital NHS Foundation Trust, Assisted Conception Unit, London, UK.
authors: Nitish
authors: N
authors: Narvekar
authors: Queen Charlotte's and Chelsea & Westminster Hospitals, London, UK.
authors: Nick
authors: N
authors: Panay
authors: King's College Hospital NHS Foundation Trust, Assisted Conception Unit, London, UK.
authors: Haitham
authors: H
authors: Hamoda
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy; D005260:Female; D006062:Gonadotropins / Q000627:therapeutic use; D006176:Gynecology / Q000592:standards; D006801:Humans; D008594:Menopause, Premature; D011159:Population Surveillance; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D016649:Primary Ovarian Insufficiency / Q000188:drug therapy* / Q000517:prevention & control; D011795:Surveys and Questionnaires; D006113:United Kingdom; D016387:Women's Health
chemical_list: D006062:Gonadotropins
keywords: Estrogen; hormone replacement therapy; menopause; osteoporosis; vasomotor symptoms