The federal government has officially set the ball rolling on national clinical guidelines for menopause and perimenopause.
The latest version of the AMA’s position statement on women’s health includes new advice on managing menopause and perimenopause, just as the Department of Health, Disability and Ageing opens the tender for national clinical guidelines.
Released on Saturday, the AMA’s updated statement contains a new section covering menopause and perimenopause and calls for a national framework with goals and timelines for changes to treatment.
It specifically supported GP-led care for integrated treatment and prevention strategies, but acknowledged that patients with contraindications to menopausal hormone therapy or who were recovering from cancer may benefit from referrals to gynaecology and endocrine specialist services when needed.
“All women should have access to evidence-based support to determine the best course of action to manage symptoms and improve their health and lifestyle,” the updated statement said.
“Importantly – and often under-prioritised – is that the transition to menopause and perimenopause is an optimal time to identify women at greatest risk of diabetes, heart disease, osteoporosis, and some cancers, which are well documented long-term risks.”
Other additions to the AMA statement covered sexual health and gendered violence.
Broadly, the AMA maintains that access to the full suite of sexual and reproductive health services and information is “critical to safeguarding and promoting the health of women”.
This includes supporting the availability of short-term, long-term and emergency contraception, as well as accessible, safe and legal termination of pregnancy services.
It also recognises gendered violence as going beyond physical violence to women or children, and including sexual abuse, stalking, financial abuse and cruelty to pets.
Also on Saturday, assistant minister for women and health Rebecca White officially announced the opening of the tender process to develop Australia’s first national clinical guidelines for menopause and perimenopause.
The tender has technically been live since 30 September and closes on 27 October.
It does not specify the budget for the project, which will include a comprehensive needs analysis, extensive literature searches and systematic reviews of the existing evidence, managing consultation processes and disseminating and promoting the final product.
GP and women’s health expert Associate Professor Magdalena Simonis said a national guideline would put menopause and perimenopause “back on the health agenda” and would enable the sector to treat it as “a stage of life in which some women may well have some sequelae or consequences that interfere with … quality of life”.
“It provides an opportunity for us to think in terms of, one, [the patient’s] current status and what their psychosocial situation is, and in relation to their hormone status and their life and life phase,” she told The Medical Republic.
“But it also gives us the opportunity to think about how the decisions we make at this point, at this juncture, might impact them all the way down the track in track into ageing.
“That includes prevention of things like osteoporosis and heart disease, and also talking about things such as dementia.”
A nationally consistent clinical guideline, Professor Simonis said, would also give doctors the chance to debunk the stigma, misconceptions and misinformation that surrounded menopause.
Findings from the Women’s Health Initiative of 2002 in relation to menopausal hormone replacement therapy and ischaemic heart disease, breast cancer and cerebrovascular disease, for example, have since been walked back.
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In recent years, there has also been an uptick in social media wellness influencers building brands as self-styled menopause experts.
“There’s a huge industry out there that’s capturing a vulnerable population who are seeking assistance and help and who may not have found it through their usual medical relationships,” Professor Simonis said.
“And they’re seeking this online, and unfortunately online promoters of wellness are spruiking treatments that are not evidence-based.
“We need to warn women against these ‘bio identical’ hormones that are made in compounding [pharmacies] that are not considered safe by the Australasian Menopause Society, nor by the AMA, nor by the RACGP.”
“… [These guidelines are an opportunity to help doctors address these conversations with women with confidence, especially given that it’s not been part of our training for most of our professional lives unless we’ve sought it out ourselves.”
