Keywords
Climacteric
Women’s Health
Interdisciplinary Studies
Patient-Centered Care
How to Cite
Abstract
The climacteric and menopause require a comprehensive approach because of their physical, psychological, and social repercussions. The United Kingdom and Canada have developed interdisciplinary strategies that improve healthcare and women’s quality of life. This study compared these strategies to identify practices that could be adapted to Costa Rica and to analyze the limitations of its regulatory framework. A descriptive and comparative study was conducted, including a literature review covering the period from 2019 to 2024. The search was conducted between 2024 and 2026 using PubMed and institutional databases (NICE, NHS, Canadian Menopause Society and CCSS). The information was organized using an extraction matrix and analyzed qualitatively and comparatively. The United Kingdom and Canada have models that integrate interdisciplinary teams, continuing education, and coordinated physical and mental healthcare. Costa Rica, in contrast, has fragmented care, limited coordination among services, and a lack of formal interdisciplinary teams. Its regulatory framework, which has been in force since 2009 without subsequent updates, has faced significant implementation limitations in practice: it lacks implementation, monitoring, and accountability mechanisms and therefore has not translated into meaningful changes in healthcare delivery. The strategies implemented in the United Kingdom and Canada constitute adaptable references for Costa Rica. Their incorporation requires, as a prerequisite, updating the national regulatory framework and providing it with concrete implementation and monitoring mechanisms.
References
Achío Tacsan, M. (2003). Salud de las mujeres de mediana edad: Retos para los servicios de salud. Revista de Ciencias Sociales, (101–102), 95–106. https://archivo.revistas.ucr.ac.cr/index.php/sociales/article/view/54688
Al Wattar, B. H., & Talaulikar, V. (2024). Non-oestrogen-based and complementary therapies for menopause. Best Practice & Research Clinical Endocrinology & Metabolism, 38(1), 101819. https://doi.org/10.1016/j.beem.2023.101819
Asamblea Legislativa de la República de Costa Rica. (2025). Proyecto de ley: Ley para la atención integral de la menopausia, la andropausia y los cambios hormonales de la mediana edad (Expediente N.° 25.347). https://d1qqtien6gys07.cloudfront.net/wp-content/uploads/2025/12/25347.pdf
Asociación Costarricense de Climaterio y Menopausia. (2009). Guías de manejo de la mujer adulta. Fármacos, Edición Especial, 62–65. https://www.binasss.sa.cr/revistas/farmacos/especial2009/art11.pdf
Bacon, J. L. (2017). The menopausal transition. Obstetrics and Gynecology Clinics of North America, 44(2), 285–296. https://doi.org/10.1016/j.ogc.2017.02.008
Canadian Menopause Society. (2023). Pocket guide menopause management: A practical tool for healthcare professionals (2nd ed.). https://www.canadianmenopausesociety.org/sites/default/files/pdf/publications/Final-Pocket%20Guide.pdf
Charlton Lewis, D. (2003). Climaterio y menopausia, una mirada de género. Revista de Ciencias Sociales, (101–102), 107–112. https://revistacienciassociales.ucr.ac.cr/images/revistas/RCS101_102/08CHARLTON.pdf
Currie, H., Abernethy, K., & Hamoda, H. (2021). Vision for menopause care in the UK. Post Reproductive Health, 27(1), 10–18. https://doi.org/10.1177/2053369121989230
Davis, S. R., Pinkerton, J., Santoro, N., & Simoncini, T. (2023). Menopause—Biology, consequences, supportive care, and therapeutic options. Cell, 186(19), 4038–4058. https://doi.org/10.1016/j.cell.2023.08.016
East Goenaga, M. S. (2023). Mujeres, climaterio, menopausia y su abordaje desde las políticas públicas en salud: Situación actual en la región de América Latina y el Caribe [Tesis de maestría, FLACSO, Sede Académica Argentina]. Repositorio FLACSO Andes. https://repositorio.flacsoandes.edu.ec/bitstream/10469/19187/2/TFLACSO-2023%20MSEG.pdf
Fatima, U., & Rasheed, R. (2024). The unmet needs of menopausal women in primary care. British Journal of General Practice, 74(Suppl. 1), bjgp24X737949. https://doi.org/10.3399/bjgp24X737949
Fondo de Población de las Naciones Unidas. (2024, 19 de octubre). Menopausia y derechos humanos: Preguntas frecuentes. https://www.unfpa.org/es/resources/menopausia-y-derechos-humanos-preguntas-frecuentes
García González, R. (2004). El sistema nacional de salud en Costa Rica: Generalidades. CENDEISSS. https://www.binasss.sa.cr/opac-ms/media/digitales/El%20Sistema%20nacional%20de%20salud%20en%20Costa%20Rica.%20Generalidades.pdf
Hobson, G., & Dennis, N. (2024). I can't be dealing with this brain fog: A workplace focus group study investigating factors underpinning the menopausal experience for NHS staff. Maturitas, 180, 107889. https://doi.org/10.1016/j.maturitas.2023.107889
Holloway, D. (2018). Menopause symptom management in the United Kingdom. Nursing Clinics of North America, 53(2), 263–277. https://doi.org/10.1016/j.cnur.2018.01.004
Koysombat, K., Mukherjee, A., Nyunt, S., Pedder, H., Vinogradova, Y., Burgin, J., Dave, H., Comninos, A. N., Talaulikar, V., Bailey, J. V., Dhillo, W. S., & Abbara, A. (2024). Factors affecting shared decision-making concerning menopausal hormone therapy. Annals of the New York Academy of Sciences, 1538(1), 34–44. https://doi.org/10.1111/nyas.15185
Lega, I. C., Fine, A., Lam Antoniades, M., & Jacobson, M. (2023). A pragmatic approach to the management of menopause. Canadian Medical Association Journal, 195(19), E677–E682. https://doi.org/10.1503/cmaj.221438
Mora Aguilar, Á. (1978). El climaterio en Costa Rica. Revista Médica de Costa Rica, 45(462), 3–6. https://www.binasss.sa.cr/revistas/rmcc/rmedica/%28462%29/art2.pdf
National Institute for Health and Care Excellence. (2015). Menopause: Identification and management (NICE guideline NG23). https://www.nice.org.uk/guidance/ng23
National Institute for Health and Care Excellence. (2019). 2019 surveillance of menopause: Diagnosis and management (NICE guideline NG23). https://www.nice.org.uk/guidance/NG23
Northeast and North Cumbria Integrated Care Board. (2024). Management of the menopause. Northern Treatment Advisory Group. https://ntag.nhs.uk/wp-content/uploads/2024/10/NENC-Menopause-guidance-FINAL-Sept-24-approved.pdf
Rees, M., Bitzer, J., Cano, A., Ceausu, I., Chedraui, P., Durmusoglu, F., Erkkola, R., Geukes, M., Godfrey, A., Goulis, D. G., Griffiths, A., Hardy, C., Hickey, M., Lindén Hirschberg, A., Hunter, M., Kiesel, L., Jack, G., Lopes, P., Mishra, G., … Lambrinoudaki, I. (2021). Global consensus recommendations on menopause in the workplace: A European Menopause and Andropause Society (EMAS) position statement. Maturitas, 151, 55–62. https://doi.org/10.1016/j.maturitas.2021.06.006
Reid, R., Abramson, B. L., Blake, J., Desindes, S., Dodin, S., Johnston, S., Rowe, T., Sodhi, N., Wilks, P., & Wolfman, W. (2014). Managing menopause. Journal of Obstetrics and Gynaecology Canada, 36(9), 830–833. https://doi.org/10.1016/S1701-2163(15)30487-4
Rosado Valenzuela, A. L., Sheffel, A., Lara Salinas, A. M., Mussini, M., & Di Giorgio, L. (2023). Ampliación de la cobertura del Expediente Digital Único en Salud (EDUS) en el sistema de APS en Costa Rica. Banco Mundial. https://documents1.worldbank.org/curated/en/099722410062329856/pdf/IDU029eec4230462e0478f0897a0b5e393a08372.pdf
Sydora, B. C., Yuksel, N., Veltri, N. L., Marillier, J., Sydora, C. P., Yaskina, M., Battochio, L., Shandro, T. M. L., & Ross, S. (2018). Patient characteristics, menopause symptoms, and care provided at an interdisciplinary menopause clinic: Retrospective chart review. Menopause, 25(1), 102–105. https://doi.org/10.1097/GME.0000000000000942
Tserotas, K., Hernandez, L., Morera, F., Pineda, R., & Chedraui, P. (2011). Treatment for the menopause in Central America: Use, knowledge, perceptions and attitudes among urban living middle-aged women. Gynecological Endocrinology, 27(7), 504–511. https://doi.org/10.3109/09513590.2010.495798
Wolfman, W., Krakowsky, Y., & Fortier, M. (2021). Guideline No. 422d: Menopause and sexuality. Journal of Obstetrics and Gynaecology Canada, 43(11), 1334–1341.e1. https://doi.org/10.1016/j.jogc.2021.09.005
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