Table 2.

GP Barriers to Diagnosis and Offering HRT

Barriers to Diagnosis	Barriers to Offering Treatment with HRT
Beliefs/perceptions of the menopause as not an illness but a natural process; deprioritised compared with other “real” illnesses	Belief that the menopause does not require treatment
Clinical restrictions; limited consultation time	Lack of knowledge about HRT and other treatment options
Lack of knowledge/recognition of symptoms other than vasomotor	Lack of confidence in prescribing HRT
Misattribution of symptoms to another cause eg depression	Misunderstandings/misperceptions about HRT in terms of breast cancer risk and a lack of knowledge of health outcome benefits
Avoiding embarrassing/difficult conversations so women are not proactively asked about specific menopausal symptoms such as sexual dysfunction and vaginal issues	Not knowing when to refer for specialist help