Opinion

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Opening the conversation: How to support women through menopause

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GPs need to take a greater lead in starting perimenopause and menopause conversations, including using specific checklists, which are readily accessible to GPs. That is according to GP Dr Elina Safro, Australasian Menopause Society NSW/ACT Director and Chair of its Board’s Education Subcommittee.
 
The current public attention on Women’s Health means it is an opportune time for GPs to focus on courageous conversations about menopause, including management of vasomotor symptoms (VMS) which can significantly impact a woman’s quality of life.
 
‘Menopause is not a medical episode that comes and goes,’ Dr Safro said.
 
‘As GPs, we need to remember that it is an ongoing physical, mental and emotional state of being, and for most women, they can expect to be in that phase for about a third of their lives.
‘It’s important for GPs to consider the bigger picture.’
 
Understanding the reluctance
Despite the impact of VMS and increasing public noise around menopause, many women do not seek medical advice. A combination of factors, including stigma, misinformation, and perception it is a natural process a woman must ‘just go through’, can create barriers to opening a conversation.
 
A recent survey conducted among more than 2200 GPs across Australia, showed half (51%) of GPs surveyed said a patient’s belief that menopause is a normal part of ageing and not worth discussing is the primary barrier to raising the topic.
 
Dr Safro urges GPs to recognise and address these barriers ensuring women feel seen and heard and receive the support they need.
 
Starting the conversation
Discussing menopause and VMS can feel daunting for many women.
 
Fifty-four-year-old EJ (not her real name) has been in menopause for three years and emphasises the importance of GPs initiating conversations earlier, so that women are not shellshocked when symptoms start.
 
‘Healthcare providers need to understand that this is a very real experience women go through, impacting every facet of our lives,’ EJ said.
 
‘I am fortunate to have a strong and open relationship with my GP who initiated the conversation, but I wish it had started earlier.’ 
 
GPs can ease this discomfort by creating a safe, non-judgemental space for these conversations. Here are strategies to help open conversations:

• Normalise the experience: Acknowledge that menopause is a natural life stage, and that VMS is common. Assure individuals that their symptoms are valid and treatable. If you’re not comfortable discussing menopause, refer them to a colleague.
• Ask open-ended questions: Encourage women to share their experiences with questions like, ‘Have you noticed any changes in your life recently?’ or ‘How are you feeling about the menopause transition?’ These questions can help women raise symptoms they might otherwise dismiss.
• Provide clear information: Many women may be unaware that their symptoms are due to menopause – GPs play a crucial role in helping them connect the dots. Provide clear, concise information about VMS and other symptoms, as well as the range of treatment options available, from lifestyle changes to menopause hormone treatment (MHT) and non-hormonal treatments.
• Address misinformation: Be prepared to debunk common myths about menopause and its treatment. Providing accurate, evidence-based information and directing patients to reputable resources like the Australasian Menopause Society can help alleviate concerns.
• Encourage ‘courageous conversations’: Empower patients to discuss how menopause effects their daily lives, including work, relationships and mental health with you and other in their personal life.

Supporting women through treatment choices
Once the conversation is open, it is essential to discuss treatment options to help manage symptoms that are impacting quality of life, such as VMS.
 
This includes lifestyle modifications, hormonal and non-hormonal treatment options.

‘Menopause can be a long and varying journey for women, it is important we individualise management,’ Dr Safro said. 
 
‘The recent introduction of non-hormonal medical treatments means our toolkit is expanded now, helping us to offer as many different options as possible to help meet the unique needs, medical history and personal choice of individual patients.’
 
Empowering women through awareness and support
GPs have a critical role in supporting women through menopause by initiating these conversations.

By normalising the topic, providing clear and compassionate guidance, and encouraging ‘courageous conversations,’ GPs can make a significant difference in their health and well-being.
 
For those seeking more information, visit the Australasian Menopause Society.
 
This article was commissioned by Astellas and independently reviewed by newsGP.
 
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menopause women’s health Women’s Health Week

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