Menopause inquiry recommends GP education boost

The Parliamentary committee charged with investigating the impact of menopause and perimenopause in Australia has released its long-awaited full report, finding GPs are often perceived as having ‘limited knowledge’ and are unable to recognise perimenopausal symptoms.
 
Handing down its recommendations on Wednesday, the Senate Community Affairs References Committee called for specific modules on perimenopause and menopause to be added to all medical university curriculums.
 
It also recommends professional development ‘beyond the limited and varied undergraduate medical education’.
 
But GPs have argued that the system is set up to work against them, through the incentivisation of shorter consults through Medicare and structural factors that create barriers to improving care.
 
The committee’s conclusions follow public hearings across the country, where hundreds of women shared their stories alongside feedback from academics, clinicians, businesses, public health bodies and government departments.
 
It also recommended a comprehensive evidence base on the impacts of menopause and perimenopause be established, an awareness campaign be launched, and flexible working arrangements be made for women during menopause.
 
‘To date, menopause, despite being a natural transition for over 51% of the population, has remained an area in women’s health where women’s voices and pain have been ignored or poorly understood,’ the report reads.
 
‘Submitters contended that women’s health training and further education related to menopause for GPs must be prioritised to support a more highly skilled general practice workforce.’
 
The committee says women often discussed the ‘limited knowledge of their healthcare providers’.
 
One witness to the inquiry said her GP told her that ‘all I learnt at med school was that menopausal women were either mad or sad’.
 
Another common theme, the report says, is of healthcare providers failing to recognise the variety of perimenopausal symptoms ‘until a woman had a hot flush or night sweats’.
 
‘It was only when the night sweats and hot flushes kicked in that my GP said the word “perimenopause”,’ said one woman.
 
‘That was almost five years after my original symptoms presented themselves – five very frustrating years.’
 
Dr Karen Magraith, the former president of the Australasian Menopause Society, says GPs do excellent work in managing the majority of menopausal and perimenopausal care but there are gaps in their knowledge base.
 
‘I don’t want to engage in GP bashing, which is so prevalent and unhelpful, but at the same time I would like to see an improvement in access to appropriate care for women,’ she told newsGP.
 
‘It’s disappointing to hear so many stories about women feeling dismissed or not receiving the assistance they need.
 
‘However, it is true that there are some who are not up to date with menopause management or simply avoid dealing with it at all.’
 
She says ‘everyone would agree’ that medical students should learn about menopause.
 
‘But we receive reports of as little as an hour or less of menopause education over the duration of the course,’ Dr Magraith said.
 
‘I appreciate that medical school curricula are crowded, but it would be great to see menopause education integrated more where possible.’
 
The report did recognise the high burdens placed on GPs when accessing training and education to upskill or specialise in menopause and perimenopause.
 
‘The committee acknowledges that there are barriers to continuing professional development for GPs in Australia, including the costs of maintaining a practice and managing a patient load, which can mean that professional development is de-prioritised,’ it reads.
 
Dr Sara Whitburn, Chair of RACGP Specific Interests Sexual Health Medicine, told the Senate that if there are calls for further education for GPs, they must consider the costs involved.
 
‘General practice being a small business, any time GPs are trying to educate they are doing it at a time that might impact not only on their ability to provide patient care but also on income,’ she told newsGP.
 
‘Though it’s very important they do continuing education – it’s part of our registration, and we should certainly do it – it often has to be squeezed in around making sure they’re available for their community and the cost to take the time to do that education.’
 
Dr Whitburn said GPs need to be supported in furthering their education in this space and make use of the resources available, such as the Menopause Toolkit from Monash University.
 
‘More and more people are asking about menopause and perimenopause, and that’s really good,’ she said.
 
‘But … how do we support GPs around increasing their knowledge around the current guidelines for menopause?’
 
Dr Magraith also raised barriers that GPs have in upskilling, such as workforce issues and incentives for ‘short consultations for simple issues’.
 
‘GPs are busy and often overwhelmed with demands both during their workday and after hours,’ she said.
 
‘GPs frequently give up their precious personal time to engage in education for the benefits of their patients. It would be best if GPs are paid for their time, as public sector employees are.’
 
Log in below to join the conversation.

menopause perimenopause Senate Inquiry women’s health