Improving menopause diagnosis experiences

It is a condition which impacts half of all patients, but many GPs still do not feel comfortable or confident guiding patients through menopause.
 
And while an increase of studies and knowledge about menopause has been welcomed, many myths about it and its treatments persist, both within the medical world and the broader community.
 
Australasian Menopause Society (AMS) past president and GP Dr Karen Magraith said there are still a lot of women with significant menopausal symptoms who are not being offered appropriate treatment.
 
‘Menopausal hormone therapy (MHT) is the most effective treatment for menopausal symptoms, and there are still women in Australia who don’t get offered that treatment when they should,’ she told newsGP.
 
‘We are keen to help ensure more GPs are confident with menopause assessments and are able to offer hormone therapy when it’s indicated.
 
‘What we’re always wanting to do is make sure that clinical practice is in line with current evidence and guidelines.’
 
Dr Magraith encourages health professionals to seek information from guidelines backed by endorsed bodies, such as the 2023 Practitioner’s Toolkit for Managing Menopause.
 
Earlier this year, the RACGP told the Federal Parliament there is an ‘urgent need’ for improved support and access to care for people experiencing menopause and perimenopause.
 
According to the college’s submission, current Medicare subsidies do not adequately support people experiencing menopause and perimenopause, and greater education is needed.

‘Upskilling of clinicians providing care for patients at midlife, concerning the indications for and prescribing of MHT, urgently needs to be addressed,’ the submission said.
 
Dr Magraith agreed, adding that she has concerns with current differing definitions of perimenopause, which can lead to patients being treated with hormone therapy outside of accepted indications.
 
The AMS also raised concerns with a growing trend of testosterone becoming a routine component of MHT and promoting testosterone for non-specific symptoms such as fatigue, as well as minimising the risks of MHT and promoting it as treatment for a wide variety of symptoms that may not be related to menopause.
 
Dr Magraith said while hormone therapy remains an effective treatment, it is important that GPs do not promise women that it is a ‘panacea for all sorts of symptoms’.
 
‘We need to be cautious, because a lot of symptoms that women have are non-specific, so it might be fatigue, or it might be brain fog, and some of that might be related to menopause, but some of it might have other causes.
 
‘I do encourage GPs to have a look at the different resources that are available, and for someone seeking help, try and come back to the evidence-based guidelines, and encourage the patient to come back for a long appointment.’
 
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