title: The need to do better - Are we still letting our patients down and at what cost?
abstract: OBJECTIVE
  To survey women's views on HRT and alternative therapies and make comparisons with 2007 data.
  
  
  METHODS
  A questionnaire on a UK patient-tailored independent clinician-led website with anonymous responses analysed using descriptive statistics.
  
  
  METHODS
  Answers to survey questions in 2007 and 2014.
  
  
  RESULTS
  A total of 1476 responses from 33 countries were obtained. Almost 70% of respondents had used/would consider using HRT. Over the last 5 years, 27.7% felt that their views had changed for the better. Most obtained information from health professionals or the Internet. About 51.1% felt that their family doctor did not recognise the importance of the menopause with one-third feeling resistance to being offered HRT. Compared to 2007, significantly more women were aware of the different risks associated with different types of HRT. More women were able to respond positively to the question asking whether or not they felt able to make an informed choice regarding HRT/alternative therapies.
  
  
  CONCLUSIONS
  There has been negativity and confusion regarding HRT management since the beginning of the millennium. Our findings suggest that we, as health professionals, continue to let our patients down with poor provision of information, inaccurate or wrong information, or access to the right care. The cost of this is women living with preventable sequelae associated with the menopausal transition with a consequent adverse impact on health and the health economy. The importance of the menopause consultation as part of a life course approach is highlighted as well as the emerging discipline of Health Web Science.
authors.affiliation: NHS, Dr Grays Hospital, Elgin, Elgin UK grant.cumming@nhs.net.
authors.forename: Grant Philip
authors.initials: GP
authors.lastname: Cumming
authors.affiliation: Dumfries and Galloway, Dumfries, UK.
authors.forename: Heather
authors.initials: H
authors.lastname: Currie
authors.affiliation: Norfolk & Norwich University Hospital, Norwich, UK.
authors.forename: Edward
authors.initials: E
authors.lastname: Morris
authors.affiliation: The Internet Design Shop, Dumfries, UK.
authors.forename: Rik
authors.initials: R
authors.lastname: Moncur
authors.affiliation: Medical Statistics Team, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Lee
mesh_terms: D000368:Aged; D000529:Complementary Therapies / Q000379:methods*; D015914:Estrogen Replacement Therapy / Q000379:methods*; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D008593:Menopause / Q000187:drug effects*; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011788:Quality of Life; D011795:Surveys and Questionnaires; D006113:United Kingdom; D016387:Women's Health
keywords: HRT; Menopause; alternative therapies; health web science; online questionnaires