Menopause and Cocktails: Good for Patient/Good for Practice

September 20, 2006
Loretta Nevarez-Kells, RN, MS, OGNP

Hot flashes, itchy skin, mood swings, and memory lapses – when the symptoms of menopause and perimenopause appear, they create a barrage of questions in women's minds struggling to prepare for this life milestone. When will my periods completely disappear?

Hot flashes, itchy skin, mood swings, and memory lapses – when the symptoms of menopause and perimenopause appear, they create a barrage of questions in women's minds struggling to prepare for this life milestone.  When will my periods completely disappear?  Should I investigate hormone replacement therapy?  Do I need to have my FSH (follicle stimulating hormone) level tested?  Will my sex life change?    Patients can feel overwhelmed and panicked by uncertainty while health care providers may feel challenged to address these concerns.

Taking the questions into a relaxed and less intimidating environment by offering a happy hour discussion is a new, innovative success at Scottsdale OB/GYN Women's Care, according to Loretta Nevarez-Kells RN and nurse practitioner with a background in women's health.  Nevarez-Kells offers informative, yet casual and open happy hour meetings held in a comfortable setting outside the clinic, where patients can gather to discuss questions on life changes, options for managing symptoms, products and more. 

The idea began with Nevarez-Kells getting together with her own friends and seeing how easily questions and information flowed within the group of women over a glass of wine and hors d'oeuvres.  She thought that if her friends were asking questions about women's health, other women could definitely benefit from the same kind of forum. 

Nevarez-Kells immediately saw the opportunity to help women learn more about the symptoms and challenges of perimenopause and menopause, knowing that this part of a woman's life is often clouded with uncertainty, and panic.  Just as the day a woman begins her period is a life altering moment, the days she realizes that she is no longer menstruating is similarly significant.

Nevarez-Kells found that pharmaceutical and medical products companies were more than happy to sponsor the meetings in order to have the opportunity to have products and solutions presented.  It was a win for her patients and a win for her practice at the same time. 

It became a very cost effective way for the practice to be able to hold the meetings and defray some of the costs through the pharmaceutical and other medical supply company sponsorships.  Women responded, often asking friends or family members along for the meetings.  The opportunity to educate current patients and reach out to new ones was immediately opened.

Nevarez-Kells, a labor delivery nurse for 12 years before getting her masters degree and teaching for three years at Arizona State University, joined Scottsdale OB/GYN Women’s Care three years ago.  She credits her teaching at ASU as the foundation for her in looking at overall health and not just obstetrics and gynecology in terms of pregnancy and birth only.

Women's healthcare has evolved rapidly in the past several years and the changes mean spending more time with patients, explaining the details behind test results and working together to achieve overall health, according to Nevarez-Kells.

"When I first came into the practice, we were doing bone density tests as part of our exam routine," she says.  "Then, we began looking at cholesterol levels and helping patients understand what it means to be heart healthy."

Nevarez-Kells found the more time she spent with her patients, the better their health.  She could extrapolate information from medical conferences and provide it to her patients.  Instead of just saying that a patient's lab work was normal, she began helping her patients understand what that exactly means to them now and later in terms of health.  She found that meetings outside of the schedule of the office allowed for time to discuss the importance of bone density testing, taking calcium, exercising and helping patients understand that it is possible to make a new, healthy plan for every year no matter where they are in their lives.

Meeting together in groups empower the women to discuss topics that might be uncomfortable in a clinical environment and also give them the opportunity to learn the answers to other questions they might not have even considered.  The approach to addressing and maintaining women's health overall and not just looking at lab results or handing over prescription refills has been very empowering for patients as well as for the practice, according to Nevarez-Kells.

"There are changes for every decade," Nevarez-Kells says.  "Besides addressing her reproductive system, we're looking at maintaining quality of life from her psychosocial well being to taking care of her heart, her bones, her weight - looking at the patient as a whole."

And meeting together in groups outside of the office gives this nurse practitioner the opportunity to better address questions that can impact a woman's overall health. 

Topics like being comfortable in your own body, learning about masturbation and orgasm and having a fulfilling sex life even as your body goes through the stages of menopause are all up for discussion in the non-threatening forums.  Patients are often better able to talk together and ask questions without being intimidated by the subject matter according to Nevarez-Kells.  And Nevarez-Kells helps patients understand products and what they do, while trying to match a patient's specific needs and wants to a particular product.    "I always try to talk a little about the sexuality part because sometimes, as women who are married, we forget," Nevarez-Kells says.  "We get complacent with our partners too. You have to go back to thinking about your partner on a regular basis."

An offsite, relaxing environment is also more conducive to patients interacting with each other about personal relationship challenges, the difficulties of balancing romance and the daily stresses of bills, childrearing, grocery shopping, household budgets and everything else that can complicate a relationship.  Today’s women often find themselves with many responsibilities and demands on their time.  Women with busy lives can forget that multi-tasking takes a big chunk out of their time for relationships, according to Nevarez-Kells.  Women worry about their relationships, taking care of children, how their lives may change once they are past the childbearing years, how their relationships may change and more.  Getting together with other women to talk about these topics help patients realize they are not alone and gives them a wonderful sense of belonging.

Another bonus is that taking time away from the office to thoroughly discuss patients' concerns also allows for more detailed information to be shared about new diseases and information, such as the human papillomavirus (HPV) vaccine, approved by the Centers for Disease Control and Prevention (CDC) in June.  Although the vaccine is now only available for the age group of 9 to 26, it has potential for older women as well.  More women are curious about the disease and the vaccine, as information becomes more widely disseminated in advertisements on television and the Internet.

Nevarez-Kells is able to open each meeting up for many topics important to patients and provide further details that help women understand their health and options for improving it or maintaining it.  And, the informal gatherings are a good way not only to meet the needs of her own patients but to introduce her practice to new patients as well – a “win-win” situation for everyone.   In the happy hour meetings and other social gatherings held by Scottsdale OB/GYN Women’s Care, Nevarez-Kells has truly found a creative way to reach out to established and prospective patients with minimal cost and maximum exposure.