It started out as an observation and turned into a quest to meet the needs of menopausal women seeking help shifting into the second half of life. On March 20, 2003 that quest will turn into the Integrative Menopause Health Program at UCSD’s Perlman Ambulatory Care Center.
Kathryn Pruzinsky, M.D., Assistant Clinical Professor of Reproductive Medicine recognized a departmental need. “We felt that a special clinic that focuses on menopause issues exclusively would be a positive contribution to the community.”
Pruzinsky says “A clinic that focuses specifically on the menopause will be an excellent opportunity to assess an individual woman’s breast cancer risk, risk of osteoporosis, need for hormone replacement therapy, do psychiatric screening, sexual function screening, and other related issues.”
Pruzinsky has worked closely with nurse practitioner, Betty Garbutt to implement a twice a month, half-day clinic, and a system to screen specific issues prior to patient appointments. When a patient calls the clinic at 858-657-8550 to make an appointment, Garbutt sends her a comprehensive questionnaire to fill out and mail back prior to the appointment. The questionnaire examines numerous health issues such as osteoporosis, breast cancer, heart disease, colon cancer screening, depression, uro-genital health, urinary incontinence and sexual function.
“We’re trying to offer a comprehensive whole person approach to menopause. It’s not that we’re necessarily going to treat this whole host of problems,” she stresses, “but we can identify problems where our colleagues in other specialties such as cardiology, psychiatry, orthopedics and uro-gynocology can help.”
Prior to the appointment, Pruzinsky and Garbutt will use the questionnaire to devise a preliminary care plan. At the appointment, Pruzinsky will interview the patient, discuss personal issues, assess five-year and lifetime breast cancer risk, examine weight, BMI, and nutrition. Osteoporosis screening will identify risk factors for who should receive the DEXA scan or if the woman has already been scanned, Pruzinsky will review it in advance and discuss the result’s ramifications. For cardiac screening she will utilize diagnostic tools to determine the patient’s individual risk for heart and coronary artery disease. Because hormone replace therapy is such a hot topic, she says a lot of her time will go into HRT counseling, troubleshooting HRT issues and examining alternative therapies for menopausal symptom relief.
“This is a good opportunity for a woman to improve her health in the second half of life by taking the time to identify what is really her risk of disease in the next 20 years and how we can help prevent that. Education should really start earlier,” she says.