‘Sex education for grown-ups’: making menopause better

4 minute read

A new online portal gives clinicians the resources to transform this stage in their patients’ lives.

The healthcare landscape is ever evolving, and it’s imperative that we general practitioners stay ahead of the curve, particularly in areas that profoundly impact our patients’ lives.

One of these areas is menopause care. This week I spoke at the Senate inquiry into menopause to help highlight three key issues that I see as priorities: improved public awareness, better medical education, and affordable, accessible hormones.

I think of menopause education as sex education for grown-ups: essential knowledge to live happily and healthily in the next phase of life (and still have good sex). All doctors need to understand how biological sex affects disease, including how sex hormones impact every aspect of health. Ensuring all Australian women have access to safer contraceptive pills and body-identical hormone therapy is crucial. The appetite for change among the senators was palpable, but it’s up to us to deliver this transformation.

Menopause has long been misunderstood and underappreciated in its complexity. It is often reduced to merely the end of fertility or menstruation, overshadowing a myriad of symptoms that range from mild discomfort to debilitating distress.

For example, consider the well-established impact of menopause on mental health. Low mood, anxiety, and even suicidal ideation are recognised symptoms of falling hormone levels during menopause, and the rate of antidepressant use doubles during this transition. In fact, 20% of women aged 45-54 are on antidepressants, while less than 15% of all menopausal women receive hormone therapy.

There is also confusion regarding hormone types, with gold-standard body-identical options often overlooked. Women are frequently given older, synthetic forms of hormone therapy (which are on the PBS), especially where cost is an issue, or prescribed the contraceptive pill to treat perimenopause symptoms when they don’t need contraception.

Despite robust evidence, the connection between menopause and a range of chronic diseases is insufficiently addressed in medical training. Extensive research shows that the timely introduction of body-identical hormones significantly reduces the risk of various conditions and outperforms all other available preventative medications. This includes cardiovascular disease and dementia, which are the leading causes of death in women.

For doctors like me who are passionate about hormones, our learning has been largely serendipitous, self-sought, and self-directed – a model that is inadequate when caring for 51% of the population. Inspired by Dr Louise Newson, a tireless advocate for better menopause care, it became clear that better education and support for doctors is urgently needed here in Australia.

This realisation led to the development of Healthy Hormones, a new website launched this week aimed at transforming menopause care for Australian women. This user-friendly community offers free online education, support, and networking opportunities for healthcare providers.

Members gain access to a range of evidence-based resources, including handouts, prescriber guides, and a library of books, podcasts, and articles. A dynamic discussion forum is used by practitioners to share cases and seek advice, fostering a collaborative approach to menopause care. The platform will also host regular webinars and online events, to keep members up to date, and courses will be introduced in the near future.

Founded by myself and fellow GPs Dr Emma Harvey and Dr Jo Bruce, our mission is to demystify menopause and equip doctors and healthcare providers with the tools to deliver patient-centred, personalised care using the gold standards of treatment. By providing evidence-based information and support, we aim to empower our members to collectively improve the accessibility and quality of menopause care for all Australians.

Initially accessible to doctors and other AHPRA-registered health practitioners, we plan for Healthy Hormones to also include a public section, helping women and other individuals to learn more about menopause and access the support they need.

For more information, and to join this transformative community for free, visit healthyhormones.au, or follow us on instagram @healthyhormones_. Together, we can redefine menopause care in Australia and improve the lives of countless women.

Dr Ceri Cashell started her career in general practice in 2004 in Edinburgh but since 2012 she has been working in Avalon, Sydney, where she is a practice principal and owner. She is a passionate advocate for increased awareness of the effects of hormones on physical and mental health.

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