Advanced Pharmacy Australia (AdPha) welcomes the Albanese Labor Government’s $573.3 million funding package to provide women with more choice, lower costs and better health care.

Announced on 9 February, the new package of measures incorporates key recommendations from AdPha, shaped by the expertise and insights of its members.

AdPha President Tom Simpson praised the government for listening to patients and health care stakeholders, including the valuable contributions of AdPha Women’s and Newborn Health Specialty Practice members, to take action on expanding care and access in women’s health.

“AdPha members welcome these long-awaited measures, which will help remove barriers that have prevented women from accessing affordable health care for too long,” Mr Simpson said.

“We have strongly advocated for a comprehensive approach to managing perimenopausal and menopausal symptoms – focusing on awareness, education, and access to affordable, evidence-based treatments.

“We are pleased to see many of our recommendations, put forward during the Senate Inquiry and through our submission, reflected in this new package of measures,” he said.

“A/Prof McGuire from our Women’s and Newborn Health Committee specifically mentioned in her evidence that it had been over 20 years since any new medicines for menopause had been listed on the PBS, and these new listings will ensure that menopause hormonal therapies remain both affordable and accessible,” Mr Simpson said.

“Currently, over 85% of women experiencing bothersome symptoms of menopause or perimenopause are not receiving evidence-based care, despite the availability of both hormonal and non-hormonal therapies. With treatment options declining in recent years, we hope these reforms will reverse that trend.

“It is also great to see new contraceptives listed on the PBS for the first time in over 30 years, reflecting and subsidising contemporary treatment options that are used by many Australian women,” he said.

“We thank the government for prioritising women’s health and recognising the invaluable role of pharmacists in advocating for and supporting women’s health care needs.

“As this expands to including the provision of contraceptives and anti-microbials for uncomplicated UTIs at PBS co-payment prices for concession card holders by pharmacists – in direct support of our first recommendation of our Federal Budget submission – we look forward to enhanced multidisciplinary collaboration between doctors and pharmacists as we achieve patient-centred care,” Mr Simpson said.

“As medicines experts across all stages of reproductive health – from pregnancy, labour, and lactation to menopause and beyond – pharmacists are well-positioned to support women through these changes. With these new measures, we can play an even greater role in ensuring women receive safe, appropriate, and efficient care.”

The post AdPha applauds long overdue investment in women’s health appeared first on Retail Pharmacy.

Published in Clinical Endocrinology, the review was led by UK consultant endocrinologist Professor Annice Mukherjee and Monash University clinician researcher Professor Susan Davis AO.

“This review recommends tailored use of MHT for well-defined indications, recognising its value for menopause symptom relief and skeletal benefits for many midlife women,” state the authors.

“MHT may be used as long as benefits outweigh the risks, through shared decision-making.

“There is insufficient clinical evidence to support the long-term use of MHT in some contemporary cohorts of women accessing MHT in clinical practice.”

Professor Davis, Director of the Women’s Health Research Program at Monash University, emphasises the review’s focus on evidence-based recommendations for prescribing.

“This paper reviews the evidence-based recommendations for menopausal hormone therapy and recommended prescribing,” she says.

“It also highlights that prescribing estrogen in doses higher than approved may increase the likelihood of vaginal bleeding, and that no studies have shown higher than regulator-approved doses of menopausal hormone therapy to be safe with regards to breast cancer and other disease risks.”

These findings contribute to the ongoing discussions around best practices for menopause management, particularly for healthcare professionals navigating treatment options for midlife women.

The post New review highlights need for individualised menopause hormone therapy appeared first on Retail Pharmacy.

Professor Susan Davis, who heads the Monash University Women’s Health Research Program in the School of Public Health and Preventive medicine, is leading the four studies.

“The testosterone changes across midlife and the menopause have never been documented with accuracy or precision,” Professor Davis said. “Despite menopause affecting 51 per cent of the population, these hormone changes at menopause remain uncertain.”

Professor Davis, who developed the Practitioner’s Toolkit for Managing the Menopause, said the world-first Menopause Matters: The Australian Women’s Midlife Years (AMY) Study will provide critical information for healthcare providers and policy makers.

The project surveyed more that 8000 women aged 40-69 about menopause, their mood and wellbeing, sexual function, and paid and unpaid work.

“The findings will have a major socioeconomic impact beyond women’s health,” Professor Davis said. “It will enable workplace policies or amendments pertaining to female workers to be formulated based on sound information, such that outdated perceptions and/or negative social attitudes about menopausal women are not reinforced.

“Ultimately, this study will improve the health and well-being of women before, during the menopause transition and beyond, and ensure that they are able to continue to contribute to the community with equity and confidence.”

The post Menopause relief in spotlight appeared first on Retail Pharmacy.

Published in Climacteric, the latest toolkit – the 2023 Practitioner’s Toolkit for Managing Menopause – has been updated and enhanced from the original 2014 toolkit with new advice and therapies based on a systematic review of the latest menopause research and best practice guidelines.

As well as outlining the latest general treatment guidelines, it offers bone health guidance as part of a menopause health assessment. The update also incorporates information on new medications related to managing menopausal symptoms.

Senior author Dr Rakib Islam, from the Monash University School of Public Health and Preventive Medicine Women’s Health Research Program, says the toolkit update will make a difference for many.

“The 2023 Practitioner’s Toolkit is the most up-to-date evidence-based practical guidance for health care providers to menopause care globally,” he says.

The latest toolkit has been designed to be used anywhere in the world and has been endorsed by the International, Australasian and British Menopause Societies, the Endocrine Society of Australia and Jean Hailes for Women’s Health.

For more information, visit: tandfonline.com/doi/full/10.1080/13697137.2023.2258783

The post Updated menopause toolkit released appeared first on Retail Pharmacy.

Menopause occurs naturally when a woman’s ovaries no longer have any eggs to release, and its symptoms are caused by a drop in hormone levels.

More than three million Australian women are currently in the 40–59 age bracket – the years that are most associated with menopause.

More than two million women aged over 60 years are affected by biological changes post-menopause that increase lifelong risks of cardiovascular disease, dementia, diabetes, osteoporosis and some cancers.

Despite this natural prevalence, perimenopause and menopause remain hidden conditions, with 85% of Australian women experiencing significant symptoms mostly undiagnosed, misdiagnosed, untreated, and/or mistreated.

Hot flushes, night sweats, brain fog, depression, anxiety and weight gain are just some of the many symptoms that women can suffer during their perimenopause and menopausal years.

More than 30% of Australian women will experience severe impacts on their general and psychological well-being, which can lead to breakdowns in relationships, mental health illnesses and decreased productivity both in work and home lives.

After unexpectedly experiencing the start of perimenopause, Associate Professor Erin Morton from Flinders University realised how little community awareness there was about this stage of life. She was concerned about the lack of knowledge and support available, and the impact of symptoms, costs and time commitments on daily tasks, employment and family budgets.

“Three years ago I realised I’d hit perimenopause and I was rather horrified at how little was known or seemed to be done about it,” says Associate Professor Morton.

“This is an area of health that is so neglected and is still really stigmatised. There seems to be a lack of knowledge across healthcare roles, poor access to services, negative attitudes and lagging research to support women through this important time of life.  There is very little information and support available, not to mention a lot of misinformation about hormone replacement therapy.”

Drawing on more than 20 years of clinical trial and health data expertise, Associate Professor Morton decided to take matters into her own hands and has created a registry that gathers information on Australians’ experience of perimenopause and menopause.

The new registry is called VITAL (Virtual Registry of Peri-/Menopause in Australia) – and has a particular focus on exploring community priorities and creating tangible improvements in healthcare outcomes.

“VITAL is designed to provide the perimenopause and menopausal community with greater opportunities for involvement in their own care, and critically to collect key data that can be used to identify trends and improve research and education for measurable improvements in women’s health.

“I decided to create this community-driven registry to give a voice to the perimenopause and menopausal population; to define what peri really means, what really matters to them and its true – and hidden – impacts across the country.

“I believe there should be more focus and funding on women’s lifelong health, and more attention made to improving their perimenopause and menopausal quality of life and subsequent health outcomes,” adds Associate Professor Morton.

The online registry is officially registered with the World Health Organisation (WHO) and the Australian Commission on Safety & Quality in Healthcare clinical trials and registry platforms.  It has received cross-party recommendations in both Federal Houses of Parliament during Women’s Health Week recently.

VITAL is open to everyone – perimenopause and menopausal participants, family, friends, colleagues, healthcare providers and policymakers – at: flinders.edu.au/research/vitalmeno

The post Australia’s first online registry for perimenopause and menopause appeared first on Retail Pharmacy.

The nationally representative findings indicate that the workplace impact of menopause symptoms may be overstated, while underscoring the importance of timely medical consultations during perimenopause.

The National Women’s Health Survey found that one-quarter of Australian women in mid-life (45-64) reported that symptoms (experienced in the last five years) that they attributed to menopause made it hard to do daily activities. However, another one-quarter reported these symptoms had no substantial impact on their daily lives.

Dr Sarah White, CEO of Jean Hailes for Women’s Health, emphasised the need for accurate data.

“There are people quoting shocking statistics, like ‘nearly one million’ women quitting their jobs in the UK because of menopause, when really this was a study that bundled together a variety of reasons, including pregnancy, for why women left the workforce.

“While we often hear alarming statistics about women quitting jobs due to menopause, our survey reveals that only 7% of mid-life Australian women have missed work due to menopause symptoms, however 17% reported taking an extended break in the last five years.

“We must address workplace flexibility for women with severe symptoms, but we also need to recognise that other health issues like pelvic pain and menstrual problems affect women similarly.”

“As more commercial organisations and health advocates venture into this global menopause market, there is a danger that they will create a ‘menopause problem’ in the minds of women and employers that can be ‘fixed’ by the purchase of goods and services,” said Dr White.

Professor Susan Davis AO, report co-author and head of the Monash University Women’s Health Research Program, said that the National Women’s Health Survey revealed women’s perceptions of menopause-related symptoms, but that public understanding about these symptoms and their management is limited.

“The menopause can cause debilitating symptoms for some women.” However,  unfortunately, a lot of women are being led to believe that everything that goes wrong in mid-life is due to menopause and that’s just not the case. Mid-life is a time when women are dealing with kids, with careers, with elderly parents, with changes in health. It’s not all about menopause.”

“Recognising menopause-related symptoms and differentiating them from mid-life stressors or medical issues, is crucial for effectively promoting women’s health and well-being. Women who attribute all mid-life challenges to menopause miss the chance to address underlying issues.”

“Increasing awareness of genuine menopause and perimenopause symptoms is vital to dispel myths and prevent commercial exploitation. While understanding women’s diverse experiences, we must safeguard against attempts to monetise this life stage,” said Professor Davis.

Study co-author, Dr Karen Magraith, immediate Past President of the Australasian Menopause Society said it was vital to approach women’s health with empathy and understanding.

“Valuing women’s experiences and highlighting that some women do not suffer menopausal symptoms is not about undermining the experiences of those who do but about acknowledging that menopause is unique for each woman.”

“Menopause should be a key check point for health, and all women, regardless of their experience should be equipped with accurate information, support, and knowledge to navigate this transition confidently.”

Recommendations from the report include:

• Improving public understanding of menopause symptoms and evidence-based treatments.
• Encouraging women under 45 to consult a doctor if they think they might be menopausal
• Equipping GPs to assess and manage menopausal symptoms and related health risks.
• Promoting informed discussions on menopause without catastrophising the transition.

The post New Research Reveals Impact of Menopause Symptoms on Australian Women appeared first on Retail Pharmacy.

Both men and women can gain weight as they age, but for women, it can be difficult to separate the effects of ageing from those of menopause. Between the ages of 45 and 55, women gain on average half a kilo a year.¹ Fortunately, making healthy lifestyle choices can help women to achieve and/or maintain a healthy weight and improve their future health.

According to researchers from the University of Sydney’s Charles Perkins Centre, minor adjustments to the balance of macronutrients in a woman’s daily diet during the transition to menopause could lessen or even prevent weight gain and lean tissue loss.

The researchers propose that such problems develop when no changes to food intake or levels of activity are made to counteract the natural biological changes that occur at menopause.²

Protein leverage effect 

The researchers suggest that the body’s appetite for protein increases during perimenopause due to hormonally induced tissue protein breakdown. But if protein requirements aren’t met, women overconsume other forms of energy.

This is due to the ‘protein leverage effect’³ previously discovered by Charles Perkins Centre professors David Raubenheimer and Stephen Simpson and applied here to the menopause transition for the first time. This essentially means that without increasing the proportion of protein in the diet, the body’s drive to reach its target protein intake will make us continue to eat unnecessary calories until the target is reached.

To make matters worse, levels of energy expenditure tend to fall during menopause, so the researchers hypothesise that women need to eat both less energy (in the form of carbohydrates and fats) and more protein to compensate for the biological changes at menopause.

“The evidence suggests that staying on the typical highly processed Western diet during the transition to menopause at around age 40 to 50 will result in excess energy intake, leading to weight gain and increased risk of obesity and cardiometabolic diseases,” said Professor  Simpson, lead author and Academic Director of the Charles Perkins Centre.

Professor Raubenheimer, co-author and head of the Nutrition Theme at the Charles Perkins Centre, added: “The good news is that it appears very small changes to the diet in terms of prioritising protein, reducing fats and carbohydrates and being physically active could make a big difference in the long-term.”

Increased awareness 

Professor Kirsten Black, co-author and academic gynaecologist from Central Clinical School in the university’s Faculty of Medicine and Health, noted the problem of weight gain in perimenopause was now more widely recognised in the community.

“Women are interested to learn more about the macronutrient compositions of foods and the impact these can have on their health,” said Professor Black, who is also Head of the Menopause Clinic at Concord Hospital. “Our discussions with consumers have also identified a gap in knowledge around what constitutes high or low protein foods, which needs targeted education.”

Senior author and endocrinologist Professor Emeritus Arthur Conigrave from the Charles Perkins Centre and Faculty of Science says a substantial prospective study of around 1000 women aged 40-45 is needed to formally test this hypothesis.

“If proven correct, this would allow us to develop new preventative strategies for the significant proportion of women who report weight gain and associated health problems during the transition to menopause despite no changes being made to their food intake or levels of physical activity,” he said.

Ideal diet 

So, if the hypothesis is proven correct, what would the ideal diet look like during the transition to menopause?

The researchers suggest that increasing the proportion of protein in the diet by around three per cent of daily energy intake and lowering total energy intake by five to 10 per cent a day may be the key.

“For many, cutting out a bag of crisps, a glass of sugar sweetened beverage, or the equivalent, and ensuring that high quality animal or plant protein is in the daily diet will do the trick,”  Professor Simpson said.

References 

1. org.au/health-info/fact-sheets/maintaining-your-weight-and-health
2. onlinelibrary.wiley.com/doi/10.1111/1471-0528.17290?af=R
3. wiley.com/doi/10.1111/j.1467-789X.2005.00178.x

The post Warding off weight gain in menopause  appeared first on Retail Pharmacy.

Between the ages of 45 and 55, women gain on average half a kilo a year.¹ Fortunately, making healthy lifestyle choices can help women to achieve and/or maintain a healthy weight and improve their future health.

According to researchers from the University of Sydney’s Charles Perkins Centre, minor adjustments to the balance of macronutrients in a woman’s daily diet during the transition to menopause could lessen or even prevent weight gain and lean tissue loss.

The researchers propose that such problems develop when no changes to food intake or levels of activity are made to counteract the natural biological changes that occur at menopause.²

Protein leverage effect 

The researchers suggest that the body’s appetite for protein increases during perimenopause due to hormonally induced tissue protein breakdown. But if protein requirements aren’t met, women overconsume other forms of energy.

This is due to the ‘protein leverage effect³ previously discovered by Charles Perkins Centre professors David Raubenheimer and Stephen Simpson and applied here to the menopause transition for the first time.

This essentially means that without increasing the proportion of protein in the diet, the body’s drive to reach its target protein intake will make us continue to eat unnecessary calories until the target is reached.

To make matters worse, levels of energy expenditure tend to fall during menopause, so the researchers hypothesise that women need to eat both less energy (in the form of carbohydrates and fats) and more protein to compensate for the biological changes at menopause.

“The evidence suggests that staying on the typical highly processed Western diet during the transition to menopause at around age 40 to 50 will result in excess energy intake, leading to weight gain and increased risk of obesity and cardiometabolic diseases,” said Professor Simpson, lead author and Academic Director of the Charles Perkins Centre.

Professor Raubenheimer, co-author and head of the Nutrition Theme at the Charles Perkins Centre, added: “The good news is that it appears very small changes to the diet in terms of prioritising protein, reducing fats and carbohydrates and being physically active could make a big difference in the long-term.”

Increased awareness 

Professor Kirsten Black, co-author and academic gynaecologist from Central Clinical School in the university’s Faculty of Medicine and Health noted the problem of weight gain in perimenopause was now more widely recognised in the community.

“Women are interested to learn more about the macronutrient compositions of foods and the impact these can have on their health,” said Professor Black, who is also Head of the Menopause Clinic at Concord Hospital.

“Our discussions with consumers have also identified a gap in knowledge around what constitutes high or low protein foods, which needs targeted education.”

Senior author and endocrinologist Professor Emeritus Arthur Conigrave from the Charles Perkins Centre and Faculty of Science says a substantial prospective study of around 1000 women aged 40-45 is needed to formally test this hypothesis.

“If proven correct, this would allow us to develop new preventative strategies for the significant proportion of women who report weight gain and associated health problems during the transition to menopause despite no changes being made to their food intake or levels of physical activity,” he said.

Ideal diet 

So, if the hypothesis is proven correct, what would the ideal diet look like during the transition to menopause?

The researchers suggest that increasing the proportion of protein in the diet by around three per cent of daily energy intake and lowering total energy intake by five to 10 per cent a day may be the key.

“For many, cutting out a bag of crisps, a glass of sugar-sweetened beverage, or the equivalent, and ensuring that high-quality animal or plant protein is in the daily diet will do the trick,”  Professor Simpson said

References 

1. menopause.org.au/health-info/fact-sheets/maintaining-your-weight-and-health
2. obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.17290?af=R
3. onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2005.00178.x

The post Warding off weight gain in menopause appeared first on Retail Pharmacy.

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. 

The post Helping women navigate ‘the change’ appeared first on Retail Pharmacy.

The meta-analysis, which pooled data from more than 300,000 women across 12 studies found that if the time between a woman’s first period and menopause was fewer than 30 years there was a 71 per cent increased risk of heart disease and stroke, compared to women with a reproductive life span of 36 to 38 years.

The researchers also found an association between age at menarche and reproductive life span, with women who have both a short reproductive life span (less than 33 years) and early menarche (age <11 years) having the highest risk of cardiovascular disease (CVD).

The authors of the study conclude: “Short reproductive life span [is] associated with an increased risk of nonfatal CVD events in midlife, and the risk [is] significantly higher for women with early age at menarche.”

These results suggest that it may be even more important for women who had their first period early, or who reached menopause earlier in life, to follow a heart healthy diet and lifestyle to help reduce their risk of heart disease.

To read the research, visit: jamanetwork.com/journals/jamacardiology/article-abstract/2770502

The post Link between length of reproductive life span and heart health appeared first on Retail Pharmacy.