A Free Reference on Menopause for Primary Care

Since the 2002 publication of the Women’s Health Initiative (WHI) study which demonstrated reduced fractures but increased incidence of coronary artery disease, breast cancer, and thrombosis with use of combination estrogen/progesterone replacement, the use of hormone replacement therapy (HRT) dropped dramatically.

In the years since, several studies have validated the original findings of the WHI, while other subgroup analyses have suggested that there are lower risks with younger patients, short duration of HRT, etc. Currently, neither the United States Preventive Services Task Force (USPSTF) or the American College of Obstetricians and Gynecologists (ACOG) recommend the use of hormone therapy to prevent chronic conditions or coronary vascular disease. The USPSTF published their most recent statement on the topic in 2017, and ACOG reaffirmed their position statement in 2018. However, many experts including ACOG and the North American Menopause Society (NAMS) advocate for short-term use of HRT for symptoms. Previously with reviewed the NAMS app, Menopro, with some reservations due to their advocacy of HRT to a somewhat broader audience, but loved the interactive aspects of the app. 

Now Johns Hopkins has released a reference app called the Hopkins Menopause Guide via Unbound Medicine. Here at iMedicalApps we have been big fans of many of the Hopkins apps especially their outstanding ABX Guide — the infectious disease app of choice in our opinion — and also enjoyed their Osler Medicine Survival Guide


Evidence-based medicine
The app’s stated aim is to improve the health of women during and after menopause. It is written by expert physicians associated with Johns Hopkins and is extensively referenced. The app would serve as an excellent reference on the topic and includes well-written reviews of key research studies on HRT for example.

What providers would benefit from this App?
Residents, mid-levels and Family Medicine, Internal Medicine and Ob/Gyn physicians. Any provider that cares for patients going through menopause.

Price

  • Free

Likes

  • Comprehensive information in an easy-to-follow table of contents
  • Detailed section on key research literature on menopause regarding HRT
  • Available for Android

Dislikes

  • Potential over emphasis recommendations from ACOG vs. USPSTF
  • No section discussing diagnosis/differential
  • Unclear of authors’ intent for proper use of the app

Overall
A comprehensive mobile textbook on menopause and associated women’s health issues. I most appreciated the detailed discussion of related research studies on HRT. The authors are authoritative, well-referenced, but ACOG-heavy in recommendations. The app does not “walk” providers through medical decision as the popular Menopro app does.

Overall Score
o 4.0 stars

User Interface
o 4.0 stars
Textbook-like in its layout. Seems to overlook section on diagnosis/work-up.


Multimedia Usage
o 4.0 stars
Well-referenced with PMID’s, some tables and charts.

Price
o 5.0 stars
A helpful resource for free.

Real-World Applicability

A comprehensive resource for anyone who treats patients with menopause symptoms. However, the app lacks some context on how best to apply it to patients at the point of care and most of the women’s health recommendations are from ACOG not USPSTF.

Device Used For Review
iPhone 8 running iOS 12.3.1

Available for Download for iPhone, iPad, and Android

Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.