For the first time, eligible patients will be able to obtain medicines for UTIs and hormonal contraceptives at Pharmaceutical Benefits Scheme (PBS) pricing, improving affordability and accessibility.

‘Breaking down healthcare barriers’

PSA National President Associate Professor Fei Sim FPS, who has co-chaired the Access, Care and Outcome Subcommittee under the federal government’s Women’s Health Advisory Council since 2023, describes the announcement as a significant step forward in breaking down healthcare barriers, particularly in rural and regional areas.

“Women deserve to receive timely, high-quality care, and pharmacists are trained and ready to support them in managing their health,” says Associate Professor Sim.

‘Announcement takes pharmacy programs further’

Associate Professor Sim emphasises the critical role pharmacists already play in enabling women to access treatment for UTIs and repeat prescriptions for hormonal contraceptives.

“This announcement will take these programs one step further, allowing pharmacists to initiate hormonal contraceptives and supply medications under the PBS for the first time,” she says.

With bipartisan support, cements pharmacists’ role as trust, accessible healthcare providers, reinforcing their ability to deliver essential women’s health services.

“Community pharmacists are trusted, accessible healthcare professionals.

“These policy changes are a game changer for women around the country,” says Associate Professor Sim.

PSA committed to pharmacy education and training

PSA is committed to equipping pharmacists with high-quality education and training to ensure safe and effective care under the new policies.

“PSA is proud to support these initiatives with high-quality education and training for pharmacists, building the capacity and expertise of our profession as we scale up our health care services for women across Australia.

“PSA looks forward to working closely with governments and healthcare stakeholders to ensure the success of these trials and to continue strengthening pharmacists’ role in women’s healthcare across Australia,” says Associate Professor Sim.

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Developed by the Centre for Research Excellence in Women’s Health in Reproductive Life (CRE-WHiRL) at Monash University in collaboration with key international health organisations, the guidelines involve both global health experts and women with lived experience.

Simultaneously published in Climacteric and two other leading journals, the guidelines aim to address critical gaps in POI care, including delayed diagnosis, inconsistent management and patient dissatisfaction.

Key updates in the 2024 guidelines 

The updated guidelines, developed in partnership with the European Society of Human Reproduction and Embryology (ESHRE), the International Menopause Society and the American Society for Reproductive Medicine, include 145 evidence-based recommendations.

Key highlights include:

• Faster diagnosis: A single elevated follicle-stimulating hormone (FSH) level combined with irregular or absent periods for four months is now sufficient for diagnosis. Repeated FSH tests are now only needed when the diagnosis remains unclear.
• Comprehensive care: Healthcare professionals are encouraged to evaluate patient sexual wellbeing, fertility needs, psychological health and risk of osteoporosis and cardiovascular disease.
• Personalised hormone therapy: Hormone therapy remains the cornerstone for symptom relief and chronic disease prevention should be initiated promptly and continued until the typical age of menopause unless contraindicated.
• New insights: The updated guidelines introduce new evidence on genetic causes, muscle health impacts, non-hormonal therapies, lifestyle interventions and complementary therapies.

“The new guidelines mean faster diagnosis of POI, conveyed in a sensitive manner and involving shared decision-making between healthcare professionals and women experiencing POI,” Associate Professor Amanda Vincent, Co-Chair of the guideline development group said.

“This provides healthcare professionals with the clear advice on best practice in POI care, based on the best evidence currently available.”

Additional tools and resources

The guidelines come with updated consumer resources, including the Ask Early Menopause App, which provides evidenced-based tools, a personal dashboard and a discussion forum.

Used by more than 9000 women worldwide, the app empowers women to better manage early menopause and engage in informed discussions with healthcare providers.

For healthcare professionals, a comprehensive toolkit is available that offers practical support to deliver best-practice care based on the latest evidence.

What is POI?

Affecting approximately 4% of women globally, POI is characterised by the loss of ovarian function before the age of 40 — occurring at an average age of 48-51 years in women globally.

POI can lead to infertility, psychological distress and increased risks of chronic conditions such as osteoporosis, cardiovascular disease, dementia and cognitive decline.

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Tasmanians who want to find a pharmacy near them that is offering the UTI service, or other pharmacy services, can visit www.findapharmacy.com.au.

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Amcal’s new brand signature is ‘Amcal. For You. For Life’. This new brand identity recognises that Amcal services all generations of customers with its trusted care and professional help, from babies to the elderly.

“The new campaign highlights Amcal’s strong heritage in Australia, supporting communities with trusted pharmacists’ advice through more than 85 years. Amcal has been consistently seen as one of the most trusted Australian pharmacy brands and was recently awarded Canstar Blue’s Most Satisfied Customers Award for 2024. We are proud to highlight Amcal’s consumer strengths and how it will continue to help every generation in communities across Australia,’’ said Sigma Healthcare CEO Vikesh Ramsunder.

“Amcal will always service all its valued customers, but it will have a particular focus on assisting with women’s health. The brand has launched a Women’s Health Magazine, which will not only feature great product offers but helpful and practical women’s health advice from our skilled pharmacists and other healthcare professionals,’’ he said.

Amcal’s also announced RizeUp Australia as it new charity partner, which supports families impacted by domestic and family violence. RizeUp is an independent not-for-profit dedicated to breaking the cycle of violence by mobilising communities to support people in crisis. Through our collective action, we will support RizeUp as they continue to deliver their much-needed practical support and resources to rebuild lives.

“RizeUp Australia thanks Amcal for its support and we are delighted by this new sponsorship. The awareness this will bring to our organisation and the importance of recognising domestic and family violence in our community will be enormous. RizeUp relies heavily upon the generosity and partnership of corporate Australia to provide our critical, life-changing work. This partnership will be instrumental in driving our impact further.’’ said Nicolle Edwards, Founder and CEO of RizeUp.

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The survey showed that half of all women are impacted by issues related to periods, pregnancy, birth, postnatal care, or other conditions such as endometriosis. 60 per cent of participants reported positive healthcare interactions, but one in three said that they had experienced disrespectful practitioners who left them feeling dismissed and unheard.

The Inquiry will examine systematic issues and solutions and hear directly from women across Victoria. The panel will be led by Women’s Health Advisory Council, submissions are set to open on 30 January.

Victorian Premier Jacinta Allan said, “This won’t be a mic drop moment for the majority of Victoria’s population, because every woman has either experienced it for herself or knows someone who has. But now we have the evidence to prove it.”

“It’s time we stopped treating women’s health like some kind of niche issue. We deserve to have our pain believed and relieved.”

The Pharmacy Guild of Australia welcomed the Inquiry. Victorian Branch Vice President, Grace Chong, said: “This inquiry is an important opportunity to improve the care and treatment of pain conditions for girls and women across Victoria.

“By listening to the pain and pain management experiences of girls and women, this inquiry will identify the issues and opportunities to improve the care, treatment and services of pain conditions.

“Pain is an issue that many Victorian women suffer from every day. In fact, a recent Victorian Government survey found that four in 10 women in this state live with chronic pain.

“Whether this is pain associated with periods, pregnancy and birth related pain, or for the management of conditions like endometriosis, or the symptoms of perimenopause or menopause, it is vital that girls and women are confident they can access treatment and care from a trusted health practitioner, which can, of course, include their community pharmacist.

“The Guild also encourages community pharmacists to make a submission to this inquiry. Sharing your experiences of the current care, treatment and services for pain conditions as part of this inquiry will help to identify opportunities for future improvement.”

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In the report, ‘the 2022 period perspective’ commissioned by Bayer, almost a third (32%) of women surveyed in Australia said menstruation bears a heavy load on their lives, affecting their ability to work, participate in social events, or simply maintain a normal daily routine due to feeling too fatigued.

As part of the campaign, Bayer is offering general information on heavy menstrual bleeding and a one-minute period survey to help Australians learn about their period flow and what to discuss with their doctor if they believe they have heavy menstrual bleeding.

Dr Talat Uppal is an obstetrician and gynaecologist who has experienced stigma associated with heavy bleeding firsthand with her patients: “Heavy menstrual bleeding is underdiagnosed, due in some degree to the stigma relating to women’s health issues in general.

“Women do not always volunteer the issues they are battling, especially when there is a societal view that it’s a fact of life for females.

“This could explain why the number of women seeking help for heavy menstrual bleeding is much lower than what it should be,” she says.

Due to feeling uncomfortable (19%), ashamed (7%) or embarrassed (16%) when it came time to speak to their doctor about their symptoms, almost half of women surveyed (44%) would like Health Care Professionals to proactively discuss period management systems with them proactively.

Jane English, Business Unit Head for Women’s Health and Established Products at Bayer, says: “Periods vary between individuals and without open conversations with doctors, family and friends, it’s hard to know what’s normal. What we don’t want is people suffering in silence when support is out there.

“Bayer is committed to helping women take control over their reproductive health by providing education and tools like the one-minute period survey to help Australians learn about their period flow and what to discuss with their doctor if they believe they have heavy menstrual bleeding.”

For more, visit:

• mybodymyway.com.au
• mybodymyway.com.au/period-survey

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What is the mission/vision of the organisation? 

The founders who set up the organisation were all incredibly passionate about women’s health. There are gynaecologists, endocrinologists and medical researchers … Their dedication and commitment to women’s health is extraordinary. It’s that wealth of knowledge, that commitment, which underpins the foundations of the organisation, which really is extraordinary.

In terms of its vision and mission, this hasn’t changed. It’s about keeping women and gender-diverse people well throughout their lives. It’s a focus on prevention and early detection. It’s a focus on giving women the confidence to manage their health and the knowledge to do so. To be confident, you must have the knowledge and you also must have the confidence to talk to your health professional in a way that you know how to get the best out of your medical consult or your health consult. And we knew that the best way to do this was to make sure we had a clinical service, comprehensive education programs [and that] we underpinned everything with rigorous research. 

Why did the organisation choose to specifically focus on women’s health? Why is it important to consider women’s health as separate from men’s health?  

I think this is because Mum was an expert in women’s health and because she was a leader and a pioneer in the field. The organisation really was set up to continue her work. Her expertise, her knowledge, and those of her colleagues were in women’s health. Having said that, we work very closely with men’s health organisations, too, because I have a view that, actually, it’s about everybody’s health. We just happen to be the experts, and we happen to have specialist knowledge in women’s health. But Men’s Health Australia is a close collaborator, and we can cross, we can collaborate. We can share knowledge and information.

According to the website, in 2016, the federal government formally announced Jean Hailes as the national digital gateway for women’s health and wellbeing. Can you tell us more about this? What was involved in the process? 

It came about after numerous discussions with the government at the time, and that was about having a central spot for [information]. We’re not the experts in everything, but there are key areas that we have specialist knowledge in. And then for those areas we don’t specialise in, we have referral pathways – for instance, the Continence Foundation, the National Heart Foundation, Diabetes Australia. However, saying that, we do sections on our website with some starting information about those other areas that we’re not specialists in, along with detailing where women should go for more detailed information. It’s about providing women with a roadmap of where to find information.

Interestingly, about 1700 external organisations link to our website, and our website material is used on government websites. So, it works as a sort of central hub for the community. We have an aspiration or a goal that Australians when they think of women’s health, they think of Jean Hailes. It’s a work in progress but it’s about providing people with the comfort that there’s this spot that they can [come to for information] to start the [healthcare] process.

Why is it important for women to be reminded that it’s OK to put themselves first in terms of healthcare and well-being?  

Because women tend to think they’re not as important as other members of their community, their families, etc. And I’m a prime example of that. Taking time out to look after yourself is not selfish. It does take time to have check-ups and [health] screening done, but it’s worth it. That’s what our big message is: taking time for yourself.

How can pharmacies best raise awareness for women’s health and support their female customers? How can pharmacies best utilise Jean Hailes for Women’s Health and its resources when supporting women’s health? 

One of the first things is [when women] come in with a [script] for some medication for another member of the family, ask about how that woman is going herself. She might have a sick child at home but it’s also important to tap into how she herself is feeling. Women tend not to be very good at looking after themselves or taking the time out for themselves.

The other way is if women are coming in for a prescription, particularly one related to hormones, or bleeding, or some very specific women’s health condition, the pharmacist could point them to the Jean Hailes website for more information. It’s understanding the resources that are available for women that the pharmacist can refer them to.

One of the things that’s invaluable on our website is access to a whole lot of factsheets in  10 or 12 community languages. They don’t provide all the information, but they give people a [basic] understanding, and a quick look at what [their condition] is all about.

Knowing that those resources are there is really important.

There’s an ability for pharmacists to use our website themselves. We have a variety of learning opportunities on the site. We’ve got podcasts and videos. We’ve got ‘Ask the Expert’, so pharmacists can get some very good information very quickly about things that they can use as their own professional development. But similarly, being able to refer women to the Jean Hailes website, or in fact promote Women’s Health Week, is gold in terms of supporting women.

It’s important for pharmacists to actively show their support for women in their communities by seizing every chance to open a conversation about women’s health and add extra value to the interaction with the client by providing them with information and resources.

This interview was originally published in the September issue of Retail Pharmacy magazine. To read the feature in full as it appears in the magazine, visit: retailpharmacymagazine.com.au/magazine/retail-pharmacy-september-2022

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Every woman’s experience with this transition is highly personalised and symptoms can vary from mild interruptions to more severe impacts in their day-to-day life. It is worth noting, however, that only 20 per cent of women report no menopausal symptoms whatsoever.¹

A 2021 multinational study found that less than half of women reported feeling “very well supported” during the menopause transition and that women who do not feel supported report more symptoms and a greater negative impact on their experience.²

Pharmacists can play an important role in helping the significant majority of women that do face symptoms to navigate through perimenopause and ensure they can confidently make informed health choices to stay in control of their symptoms. 

More than hot flushes

Vasomotor symptoms (hot flushes and sweats) are the hallmarks of menopause, occurring in approximately 75 per cent of postmenopausal women, with 25 per cent of these being severely affected.¹

While notable, hot flushes are not the sole issue that menopausal women must contend with. According to global, natural healthcare company SFI Health – Home of Flordis, menopausal women have a lot to think about, including changes to the vaginal microbiome, UTIs, insomnia, brain fog and memory loss, and elevated depressive symptoms.

“There are a multitude of potential symptoms,” said Simone Barrance, Science & Education Manager at SFI Health – Home of Flordis, “and while some women will not experience symptoms, many will. The pharmacist is in a unique position to help menopausal women understand their symptoms and the different treatment options available to help relieve them.”

Changing perceptions

While every woman’s experience with menopause is different, there has been a notable shift in perceptions and expectations of the experience. The next generation of women approaching menopausal transition is more likely to reject stigma and have higher expectations around healthcare and support than previous generations.

“In previous generations, women were expected to deal with it quietly, but today’s women expect information and treatment options,” said Dr Karen Magraith, President of the Australasian Menopause Society.

“Many of them are busy working and raising adolescent kids and caring for ageing parents and are expected to function at a very high level, despite debilitating symptoms.”

In the UK, research by the Menopause Experts Group found that employment tribunals involving menopause have increased by 44 per cent year on year³, highlighting women are expecting accommodations in the workplace.

Women are also seeking products that are high quality, sustainable and ‘stylish’ – just like themselves.

“Menopausal women are no longer treating their own health and natural processes as something to hide or be ashamed of,” Ms Barrance said.

“Ultimately, this next generation expects more and better service from health care professionals. However, we still need to do more to continue to change the conversation around menopause and help women understand the different treatment options that are available to them.” 

Integrative support for menopausal women

A key role that pharmacists can play in supporting women through the menopausal transition is education around treatment options.

Actaea racemosa, also known as black cohosh, has been used for the relief of menopause symptoms for many years, providing an evidence-based option derived from nature for women going through this natural life stage.

Given the variance of quality and efficacy of black cohosh products available, it is important for pharmacists to seek standardised, clinically proven extracts produced with a careful focus on quality.

Ze 450 is a specific extract of black cohosh first authorised in Germany in 1998. It is also one of only three black cohosh extract types approved by the European Medicines Agency for review by the Committee on Herbal Medicine Products (HMPC).

Ze 450’s proposed mechanism of action is the modulation of serotonin, dopamine, GABA & Q-opioid brain receptor activity and signalling pathways in the brain. It’s also proposed to counteract inflammation and oxidation caused by oestrogen fluctuations.

SFI Health – Home of Flordis utilises the well-researched extract in two products to provide relief from multiple menopausal symptoms: Femular (Actaea racemosa [Ze 450] extract dry concentrate 6.5 mg equivalent to dry root and rhizome 42.25 mg) and Femular Forte (Actaea racemosa [Ze 450] extract dry concentrate 13 mg equivalent to dry root and rhizome 84.5 mg).

Being available in two doses means support for varying degrees of menopausal symptoms, from perimenopause through to post-menopause and both have undergone dose-dependent studies showing statistically significant improvements in menopausal symptoms.

Research has demonstrated that Femular can provide relief of multiple menopausal symptoms within weeks, and ongoing benefits increasing with use, especially at the three and nine-month marks.⁵

Role of pharmacists

Community pharmacies are increasingly becoming the first port of call for a myriad of health care needs and those that provide satisfactory support are likely to see customers return.

With most women experiencing menopause symptoms for five to 10 years⁶, pharmacists that ensure they can provide quality menopause education, support and suitable treatment options will be in a much stronger position to support them.

References

1 menopause.org.au/hp/information-sheets/what-is-menopause

2 gremjournal.com/journal/03-2021/womens-perception-of-the-menopause-transition-a-multinational-prospective-community-based-survey

3 menopauseexperts.com/tribunals-triple-in-less-than-2-years

4 nccih.nih.gov/health/black-cohosh

5 Drewe J, et al. The effect of a Cimicifuga racemosa extract Ze 450 in the treatment of climacteric complaints – an observational study. Phytomedicine. 2013;15 (20):659– 666.

6 menopause.org.au/images/factsheets/Menopause_What_are_the_symptoms.pdf

This article was originally published in the September issue of Retail Pharmacy magazine. 

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The Pharmacy Guild of Australia, Queensland Branch welcomes the announcement, with Branch President Chris Owen saying it is “unequivocal recognition of community pharmacy’s integral role in delivering valuable primary healthcare services to patients”.

“To date, over 820 Queensland community pharmacies have participated in the Program and will be pleased to continue to provide this primary healthcare service and advance women’s healthcare,” Mr Owen said.

Mr Owen says that “nearly 9000 women have accessed the UTI service since its inception”, which is evidence that this service is needed and provides positive health outcomes, particularly for women who are unable to access a GP appointment or who need urgent treatment due to the sudden onset of symptoms.

Mr Owen says that these women will now be able to “access safe, effective and convenient care” for uncomplicated UTIs at their local pharmacy.

“We know from experience, that the quicker a case of UTI is diagnosed and treated, the less likely the patient is to experience further complications that may result in hospitalisation,” he said.

Mr Owen also welcomes the release of the independent clinical review of the Pilot’s effectiveness commissioned by Queensland Health and undertaken by independent experts at the Queensland University of Technology (QUT).

“This review, now made public, has found that the service was of significant value because of improved accessibility and convenience. Patients were happy with the service, would use it again and recommend it to others,” Mr Owen said.

“The independent review also concluded that pharmacists have delivered safe and appropriate care that aligns with clinical protocols and that pharmacists have the appropriate skills, competencies and training to manage the empiric treatment of uncomplicated UTIs in the community pharmacy.

“I hope other Australian states and territories follow Queensland’s lead in recognising the scope of community pharmacists and providing the same UTI service for women,” he said.

Queensland women can visit findapharmacy.com.au/UTI to find their local community pharmacy providing the UTI service.

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“The Hologic Global Women’s Health Index provides a starting point for Australia and the rest of the world to benchmark and address the health issues facing women and girls today,” Hologic Vice President and General Manager, ANZ Paul Braico, said.

The Index shows that Australia ranks in the top 10 countries globally regarding the health of women and girls, scoring 64 out of 100.

It also highlights gaps in women’s screening and preventive care while taking a deeper dive into perspectives on mental health and health and safety.

“We understand firsthand the importance of early detection, diagnosis and treatment in tackling the issues affecting women and girls’ health but without access to data, you can’t measure this,” Mr Braico said.

The Index also raised concerns about domestic violence, with women in Australia more likely than men to see domestic violence as a widespread problem (87% vs. 72%).

“Nine in 10 women see domestic violence as a widespread problem and women are far less likely to feel safe walking alone at night in their communities compared to men,” Mr Braico said.

“Australian women are also more likely than men to say they experienced stress and sadness for much of the previous day.

“Encouragingly, we are seeing attitudes shift over the last few years and with greater collaboration we can help address these problems,” he said.

Reported cancer screenings have fallen short of the 50% that would be expected if all Australian women complied with guidelines for 45- to 74-year-olds to have biannual breast cancer screenings.

Slightly more than one in three women (35%) aged 45 to 75 years old report being screened for any type of cancer in the past year.

However, 83% of Australians say they are satisfied with the availability of quality healthcare in their area.

“Gender-specific data collection is vital, not only to understand the health needs of women, girls and gender-diverse people living in Australia but also to identify any gaps and outliers,” Janet Michelmore AO, CEO of leading not for profit Jean Hailes for Women’s Health said.

“As an industry, we need to be constantly listening, learning and responding to be able to support, educate and ensure accessible health for all,” she said.

Hologic is calling for greater collaboration on global healthcare, leveraging the Index’s data and insights to guide the development of actionable and measurable plans and investments that prioritise women’s health effectively both in Australia and around the world.

The Index provides an actionable, science-backed data roadmap for improving life expectancy and quality of life for women and girls worldwide and was developed in partnership with analytics and advice firm Gallup.

It’s an unprecedented in-depth examination of critical markers for women’s health, by country and territory, and over time.

“This report provides a metric to guide policy decisions and initiatives to improve women’s health on both a national and global level. These data are timely and critical as the world recalibrates from the assault of a global pandemic,” a global leader in nursing, health care, and advocacy Professor Patricia Davidson, University of Wollongong Vice-Chancellor, said.

The Index findings are based on the experiences of more than 120,000 people from 116 countries and territories in 40 languages.

Hologic is committed to ongoing surveying to benchmark results in the long term and conducting the Index on a regular basis, delivering the data to world leaders to take action. A second Index will be delivered later this year.

For more information about the Hologic Global Women’s Health Index and year one findings, please visit hologic.womenshealthindex.com.

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