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Senate told that menopause care requires overhaul


Morgan Liotta


27/02/2024 3:11:41 PM

There is an urgent need for improved support and access to care for people experiencing menopause and perimenopause, the RACGP says.

Female GP with female patient
Despite menopause being a normal stage of life, the RACGP says too many women are missing out on essential care.

Current Medicare subsidies do not adequately support people experiencing menopause and perimenopause, according to a new RACGP submission to the Senate Community Affairs References Committee.
 
The Committee is hosting an inquiry into issues related to menopause and perimenopause, which  the college has used as an opportunity to advocate for better support for longer appointments, underling their importance for providing high-quality care. 
 
The RACGP has said these patients need access to longer consultations to discuss treatment options and GPs also need to be better supported to upskill in training on the recent changes in menopause care.
 
Menopausal symptoms can lead to a range of physical and mental health impacts, and the RACGP outlines that longer appointments are ‘essential to provide a comprehensive assessment and discussion of treatment options’ for the complex condition.
 
President Dr Nicole Higgins said because menopause and perimenopause are normal stages of life, everyone experiencing them deserves access to high-quality care and support.
 
‘But too many women are missing out on the care they need,’ she said.
 
‘One of the barriers to quality menopause care is patients having enough time to spend with their GP – current Medicare subsidies don’t adequately support people who need longer appointments.
 
‘This care is complex, menopausal symptoms can have numerous physical and mental health impacts.’
 
For GPs providing holistic care, one of the barriers to assisting in quality menopause management is having adequate time to support longer appointments to assess the ‘multiple’ related health impacts, but also to consider preventive care and risk screening, the submission states.
 
The RACGP highlights that menopause occurs during a mid-life period that can include increased risk of metabolic diseases such as diabetes, cardiovascular disease, breast and bowel cancer, and osteoporosis.
 
The Senate Inquiry has particular reference to:

  • economic consequences
  • physical health impacts and associated medical conditions
  • mental and emotional wellbeing, including mental health, self-esteem, and social support
  • cultural and societal factors influencing perceptions and attitudes toward menopause and perimenopause, including specifically considering culturally and linguistically diverse communities and women’s business in Aboriginal and Torres Strait Islander communities.
‘There needs to be more research into culturally appropriate best practice menopausal care for Aboriginal and Torres Strait Islander [people], the LGBTQIA+ community, and culturally and linguistically diverse people,’ Dr Higgins said.
 
It is estimated around 80% of Australian women and people with ovaries experience symptoms of menopause, and while these generally do not require treatment, around 20–25% have severe and/or prolonged symptoms requiring medical intervention.
 
However, other research suggests that many are not receiving effective menopause treatment.
 
The cost of treatments for menopause is a significant barrier, a situation Dr Higgins says must be addressed.
 
‘Many menopausal hormone therapy [MHT] products are not available on the PBS, making them too expensive for some patients,’ she said.
 
‘And Medicare subsidies for IUD insertion are still too low.’
 
While the 52 mg levonorgestrel IUD – which can be a useful part of MHT by providing contraception, perimenopausal menstrual control and endometrial protection – is listed on the PBS as a ‘restricted benefit’, it still has a low Medicare rebate for insertion in primary care. The RACGP believes this presents potential barriers for GPs wanting ‘to learn and provide insertion services’.
 
Awareness among medical professionals and patients with symptoms of menopause and perimenopause and available treatments, including affordability and availability, is another key term of reference in the Senate Inquiry.
 
In its submission, the RACGP points to research that demonstrates while Australian healthcare providers ‘appear knowledgeable’ about menopause, many remain uncertain about its management.
 
‘MHT prescription appears limited to those with severe symptoms,’ the submission states.
 
‘Upskilling of clinicians providing care for patients at midlife, concerning the indications for and prescribing of MHT, urgently needs to be addressed. Further education in recognising symptoms and signs but also a systematic evidence-based approach to management including non-drug therapy, MHT, and other management options is required.’
 
Dr Higgins says research into best practice menopause clinical education and funding for education activities for health professionals would help to address these gaps.
 
‘GPs could be better supported to undertake refresher training in menopause care,’ she said.
 
‘While more women are becoming GPs than men, and with this comes personal understanding of the issue, funding to support and encourage participation in training would be valuable for all GPs Australia-wide,’ she said.
 
‘This will help ensure high-quality, evidence-based care is accessible for everyone who needs it.’
 
The RACGP’s submission to the Senate Inquiry joins other healthcare organisations, including the Australian Psychological Society, Australian and New Zealand College of Anaesthetists and Women’s Wellbeing Association.
 
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Medicare rebate menopause perimenopause Senate Inquiry women’s health


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