Objectives Clinical Assessments and Interventions Follow-up Actions 120 ● Discuss current research findings on hormone replacement therapy (HRT) and advise to discuss op- tions only with health care provider. ● Recommend support groups and current literature as appropriate. ● Provide educational materials. ● Counsel on methods to deal with the negative expectations of menopause. ● Refer employee to an EAP if appropriate. ● Analyze employee demographics to plan programs based on need, such as the appropriateness of im- plementing menopause seminars. ● Discuss herbal remedies the em- ployee is considering or currently taking. Emphasize the importance of consulting the personal health care provider regarding con- traindications. Although studies of herbal treatments have not sub- stantiated effectiveness, some of the current herbal remedies popu- lar with perimenopausal and menopausal women include black cohosh (used instead of estrogen to relieve menopausal symptoms) and soy (phytoestrogens in soy are similar to estrogen). Identify self-care measures to reduce any discomfort. ● Assist employee to develop and implement a regular exercise program, including weight-bearing exercises, such as brisk walking, to prevent osteoporosis. ● Discuss proper nutrition and adequate di- etary calcium intake (1,200–1,500 mg/day) to prevent osteoporosis. ● Discuss the use of water-based lubricants for relief from vaginal dryness or soreness with intercourse. ● Identify methods to reduce the discomfort, such as wearing lightweight clothes limit- ing or avoiding caffeine or alcohol avoid- ing rich, spicy foods eating light and frequent meals increasing cool fluid intake and avoiding hot drinks. Note: In July 2002, the Women’s Health Initiative study found that HRT increased the risk of coronary artery disease and breast cancer, out- weighing any protection against fractures and colon cancer. Although only a slight increased risk for individuals, HRT should only be considered based on advice from the health care provider.