More than 2 million women reach menopause each year in the United States. For most of them, that means having menopausal symptoms that vary dramatically.
Some women may have no symptoms at all, while others may experience a range of symptoms, including hot flashes, night-time sweats, sleep problems, difficulty concentrating, vaginal dryness or pain, that are usually related to the low estrogen levels and that could all severely affect the quality of life of women as they go through the menopause transition.
One of the most complex decisions that both women in menopause and their healthcare providers face is whether to use prescription medications for menopausal symptom management, mainly the hormonal treatments.
For example, not all women are good candidates for hormonal treatments, mostly due to their personal preferences or risk factors, so they should consider other, non-hormonal options. But, when deciding on the best options for their patients, healthcare providers face another problem. Most of the available information on how to manage and relieve menopause symptoms is not objectively presented or evidence based.
To address this issue, the North American Menopause Society (NAMS) developed MenoPro, a free mobile app for clinicians and women, with a goal to help them work together to find the optimal individual treatment for annoying menopause symptoms, based on personal preferences and risk factors.
The app is based on current NAMS Menopause algorithm which was published in the Journal of the North American Menopause Society in 2014. It is available for both iPhone and Android users, but only for women age 45 and up.
The app is easy to use with a clean and intuitive interface. Upon the launch, it will ask you if you are a provider or patient. The questions are constructed in more or less similar fashion, asking both patients and professionals to provide various demographic information, including age, prior behavioral/lifestyle modifications (at least 3 months), duration of menopause, health conditions, interest in hormonal treatment and non-hormonal medications along with indications, and so on.
Healthcare professionals are also asked some specific questions, for example regarding the severity of vasomotor symptoms, and they also get specific recommendations for management.
Based on the answers provided MenoPro app then determines whether the patient is menopausal, assesses symptom severity, calculates cardiovascular risk (for patients interested in HT), and evaluate risk for reproductive organ cancer.
For example, if a patient is interested in hormonal treatment, the app will calculate an AHA/ACC ASCVD score. If the risk is >10%, the app would recommend patients to consider non-hormonal options, because the risk makes them a not good candidate for HT.
Going through the questions is simple and doesn't take more than a couple of minutes. At each question, the app also provides recommendations with links, particularly for questions about medications, which include dosing information, potential side effects, drug interactions, and so on. The app also includes hand-outs on different topics that open within the app and that can be emailed to patients or printed.
As been said, MenoPro app uses a nearly identical user interface and information for patients, asking them about their symptoms and potential interest in hormonal and non-hormonal treatment.
This part of the app, in my opinion, isn't optimized for patients and may confuse them, because it provides quite technical information, particularly about various drugs that many patients may be unfamiliar with. But, since the developers stated that patients should use MenoPro app only while working together with their medical providers, this isn't a big objection.
Besides questionnaire/calculator part, the app also has an "About" section that includes some useful information for both providers and patients, including a PDF of the complete algorithm that the calculator section of the app is based on, and an overview document about how the app was developed and how to use it at the point of care. This section also includes two risk assessment tools, one for breast cancer and FRAX for fractures that both lead to outside sources that can be viewed inside the app (at least on iPhone).
It should be noted that currently, neither the American Congress of Obstetricians and Gynecologists (ACOG) or the United States Preventive Services Task Force (USPSTF) recommend the use of hormone therapy as a prevention measure for chronic conditions or coronary vascular disease. Despite this, MenoPro app still recommends hormone therapy for many young patients with significant symptoms and less than 10 years since menopause.
Another thing that should be noted for anyone looking for evidence-based medicine in this app is that while MenoPro app is based on evidence-based statements and guidelines, they have not been prospectively validated.
Nevertheless, MenoPro app is very useful tool for both clinicians and their patients, helping them make informed decisions regarding optimal treatment options for menopause symptoms, based on patient's preference, history, and risk factors.
Benefit: The app can be used by medical providers and their patients