Sara, the practice nurse, expected the smear visit to be straightforward and quick. Her patient Jenni, aged 53 years, had always attended for screening, and there were no documented previous problems with the procedure. However, on the couch, Jenni admitted that she was 'a bit dry' and the procedure was uncomfortable for her.
After the procedure was complete and Jenni was comfortable, Sara took the opportunity to discuss the issue further and Jenni mentioned that, in addition to vaginal dryness, she had experienced hot flushes every day for more than a year. Her sleep was disturbed and she was finding it increasingly difficult to carry out her work as a personal assistant.
Sara briefly mentioned the option of hormone replacement therapy (HRT) and suggested that Jenni made an appointment to discuss this option further. It was at this point that Jenni sheepishly admitted she was carrying a prescription for HRT in her handbag and was having second thoughts about whether or not use it.
The menopause is a natural event, but can cause women anxiety. At 53 years of age, Jenni is experiencing menopause at around the average age for women in the UK, which is between the ages of 45 and 56 years.