Introduction by Croakey: A Senate inquiry has identified an extensive list of gaps in knowledge about menopause and made recommendations for improving research, community understanding and workplace support, as well as healthcare.
Sarah White, CEO of Jean Hailes for Women’s Health, has reviewed the inquiry’s report, and says that while it may not present groundbreaking revelations, its very existence highlights a critical point: the gaps in our knowledge and approach to women’s health are not insurmountable challenges, but rather a reflection of longstanding neglect.
“Underlying many of the barriers to women routinely being able to access quality menopause care is a systemic failure to prioritise women’s health issues,” she says.
Sarah White writes:
The Senate Inquiry report on issues related to menopause and perimenopause, handed down this week, offers wide-ranging recommendations that primarily highlight the historical lack of focus on women’s health.
While the report contained very little in the way of surprises, it underscores the gaps in our understanding and approach to this aspect of women’s lives.
The Senate Inquiry’s 25 recommendations can be categorised into five main areas – the need for more research and more public education on menopause, better access to trained healthcare professionals and evidence-based medications, and improved workplace flexibility.
As a brief overview to help explain the Senate Inquiry recommendations, menopause marks the permanent end of menstruation, occurring naturally on average at 51 years of age – some people experience menopause earlier due to various factors.
The term ‘perimenopause’ is increasingly being adopted in online conversations, which begins with persistent changes in the menstrual cycle and concludes one year after the final menstrual period.
About one in four people will experience menopausal symptoms that impact their ability to do daily activities, another quarter will have very few, if any, symptoms, and the remaining half will have mild to moderate symptoms.
Common menopausal symptoms include hot flushes, sleep disturbances, mood changes, and musculoskeletal pain.
Key recommendations
1. More research
A growing list of symptoms is attributed to menopause, but it’s unclear how many are due to hormonal changes versus midlife pressures like work, finances, and caregiving responsibilities. Some symptoms may be incorrectly attributed to menopause due to increased awareness and marketing.
More research is needed on the impact of menopause on mental and emotional health.
Menopause is influenced by biopsychosocial factors and we lack knowledge about the experiences of women from diverse backgrounds, including multicultural, First Nations, disabled, and LGBTQIA+ populations.
While recent Australian Bureau of Statistics data don’t show a mass exodus of women from the workforce due to menopause, some with severe symptoms struggle with full participation. The extent of this issue remains unknown.
2. More education
Many women who submitted to the Inquiry reported feeling uninformed and unprepared for menopause; however, this may reflect selection bias as women who feel informed and prepared might be less likely to participate in the Inquiry.
The Inquiry recommended a public awareness campaign to provide information and resources. The challenge lies in determining how, where, and when women seek menopause information, considering information-seeking and media consumption changes over time.
The Inquiry also recommended incorporating menopause education into core training for healthcare professionals, addressing the surprising lack of knowledge about a condition affecting half their patients.
3. Better access to trained healthcare professionals
Education of healthcare professionals is a start but it’s not enough to ensure all women routinely receive good menopause care.
The recommendations include changing Medicare Benefit Scheme rebates to reflect the complexity of consultations, utilising existing women’s health facilities, and expanding nurse practitioners’ scope in rural areas.
4. Improved access to proven medicines
International shortages of menopausal hormone therapy and the out-of-pocket costs involved are hurting women who need these medications to manage severe symptoms.
It will be challenging to implement the recommendations addressing these issues when nearly all manufacturing is offshore, and Australia has well-established processes around subsidisation of products on the Pharmaceutical Benefits Scheme. Of course, these are issues not limited to medicines for menopause.
5. Increased workplace flexibility
The Inquiry made several recommendations to enhance workplace flexibility for menopausal women. These include potential amendments to the Fair Work Act to specifically address menopause, encouraging the development of supportive workplace policies, and enabling the Workplace Gender Equality Agency (WGEA) to gather data on employer support.
Notably, the Inquiry wisely refrained from recommending specific menopause leave. This decision acknowledges concerns raised by numerous groups about potential unintended consequences, such as ‘othering’ midlife women and increasing the risk of stigma and discrimination in the workplace.
Longstanding neglect
Underlying many of the barriers to women routinely being able to access quality menopause care is a systemic failure to prioritise women’s health issues.
Despite the availability of accredited continuing professional development for menopause for decades, relatively few healthcare professionals have engaged in further education.
Similarly, information and education resources have long been available from organisations like Jean Hailes, the Australasian Menopause Society, and women’s hospital websites. However, there are still many women not knowing where to look for information.
The Senate Inquiry report lays bare the extensive list of unknowns surrounding menopause and suggests mechanisms to address them.
While it may not present groundbreaking revelations, its very existence highlights a critical point: the gaps in our knowledge and approach to women’s health are not insurmountable challenges, but rather a reflection of long-standing neglect.
The path forward is clear. It requires a fundamental shift in how we prioritise, research, and address women’s health issues.
The recommendations provide a roadmap, but their success hinges on genuine commitment from healthcare systems, policymakers, and society at large.
See Croakey’s archive of articles on women’s health