Asking the right questions and getting the right answers can help women navigate menopause and the years surrounding it. But where do you start? Who better to ask than the experts…
Menopause can be a time of transformation – and frustration. As a clinician in women’s health at Jean Hailes, GP Dr Fiona Jane has seen countless women in their midlife recall feeling “unheard”, “untreated” or “partially treated” when trying to seek menopausal health care.
The reality is that when it comes to menopause there are big knowledge gaps among health professionals and the general public, says Dr Elizabeth Farrell AM, gynaecologist and Medical Director of Jean Hailes.
So what should you do? Here both doctors share some of the questions that women should be asking their GP about menopause, plus the answers and reasoning behind them.
Do you specialise in menopause care?
Dr Jane: Seeking advice about menopause is one thing, but getting good, evidence-based, current information and management are another. Try to find a GP who takes an active interest in women’s health, is across the latest research and has time to talk. If your doctor is not confident in this area, ask for a referral to one who is.
How will I know I’m nearing menopause?
Dr Farrell: The lead-up to a woman’s final menstrual period is called perimenopause and it affects every woman differently. Usually, it starts in your mid-40s and lasts four to six years on average. There is no test for perimenopause but if you're experiencing irregular periods and other menopausal symptoms, you might be going through it.
What treatment options are there for my menopausal symptoms?
Dr Jane: Every woman has a different experience of menopause and I have always found that addressing her key concerns is the most important part of the consultation. There are different treatments for different symptoms and your personal and family medical history will form part of the discussion.
I’ve heard mixed things about menopausal hormone therapy (MHT) – should I consider it?
Dr Farrell: Twenty years ago, the publication of a study led many women to avoid MHT over fears it caused breast cancer. We’ve come a long way since then. Considering MHT involves weighing up its risks and benefits.
If you have symptoms that are bothersome, heart health issues or a family history of osteoporosis, this is a conversation worth having. That’s because MHT has been shown to lower the risk of osteoporosis, bone fracture and heart disease, in addition to providing relief from menopausal symptoms.
Can MHT help with my hot flushes?
Dr Farrell: Yes, if menopause is causing them. Hot flushes can have other causes – think anxiety, uncontrolled high blood pressure, some medications. Prescribing MHT involves doing a full assessment.
How long should treatment with MHT last?
Dr Farrell: There is no set figure. Treatment duration depends on the duration of bothersome symptoms. (Menopausal symptoms last on average about eight years.) Dosages and even the prescribed product may change over time. What’s important is that we assess the woman and weigh up the risks and benefits regularly.
How can I manage vaginal dryness?
Dr Farrell: Many women are too embarrassed to ask this question, but if you’re suffering, try to seek help because there are treatments. Lubricants, vaginal moisturiser and vaginal oestrogens can help, as can regular intercourse.
How can changes at midlife affect me long term and what should I do?
Dr Jane: Research shows that while most women recognise the immediate consequences of menopause, they don’t know the long-term ones.
The hormonal changes that occur at menopause can have an ongoing effect on your heart, bones, brain and body fat. So, it’s important to talk with your doctor about a healthy bodyweight, nutrition, physical activity, sleep, mental and emotional wellbeing, and all the relevant health checks, plus other issues such as vaginal health and libido.
Midlife offers a wonderful opportunity to assess your health and set yourself up for that next phase of life.
Interviews by Kate Cross. Illustrations by Tam Bower.
Published September 2022
This article is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your medical practitioner.
Jean Hailes for Women’s Health gratefully acknowledges the support of the Australian Government.
© Jean Hailes for Women’s Health 2022