Chapter 5Policy directions and governmental approaches

5.1This chapter discusses Australia’s current policy directions and approaches to addressing issues related to menopause and perimenopause across various facets of society.

5.2Firstly, this chapter examines the current policy initiatives at the federal level, led by the Department of Health and Aged Care (the Department). These include the National Women’s Health Strategy 2020–2030 (the Strategy) and the work of the National Women’s Health Advisory Council (the Council).

5.3This chapter then proceeds to review the approaches taken by state governments, looking specifically at New South Wales, Victoria and Tasmania.

5.4Lastly, this chapter illuminates approaches adopted by different international jurisdictions, drawing on examples from the United Kingdom and Spain, amongst other countries.

5.5It then concludes with the committee’s view and recommendations for the government to promote better outcomes for women experiencing perimenopause and menopause.

Australian Government initiatives

National Women’s Health Strategy 2020–2030

5.6The National Women’s Health Strategy 2020–2030 (the Strategy) outlines Australia’s approach to improving health outcomes for all women and girls in Australia.[1] The Strategy aims to inform targeted and coordinated action at federal and state levels.[2] The guiding purpose of the Strategy is to:

Improve the health and wellbeing of all women and girls in Australia, [by] providing appropriate, equitable and accessible prevention and care, especially for those at greatest risk of poor health.[3]

5.7The Strategy examines key health risks and issues for women and girls in Australia and outlines a number of factors that affect health outcomes. These are:

biomedical factors – relating to the condition, state or function of the body, such as medically significant obesity;

behavioural factors – relating to physical activity and healthy eating habits, including other risk factors such as smoking, tobacco, alcohol and/or illicit drug misuse;

social factors – non-modifiable risk factors which can be genetic, such as hereditary breast cancers relating to an inherited genetic mutation;

economic factors; and

environmental factors – natural and built.[4]

5.8The Strategy explores how the above factors can influence health inequities, such as access to services, health literacy, stigma and gender inequality.[5] The Department also emphasises that the Strategy recognises the unique needs of different demographics and identifies targeted interventions to improve health outcomes for priority populations.[6]

5.9The Department uses a ‘life course approach’ in the Strategy to recognise the different health needs, risks and influences experienced by women at different stages in their lives, with a particular focus on the importance of investing in awareness and education, health interventions, service delivery and research to maximise physical, mental and social health.[7]

5.10The Strategy contains specific principles and objectives to provide a framework for both the development and subsequent implementation of priorities and actions outlined in the Strategy. There are five distinct key priorities referenced in the Strategy:

maternal, sexual and reproductive health – increase access to information, diagnosis, treatment and services for sexual and reproductive health; enhance and support health promotion and service delivery for preconception, perinatal and maternal health;

healthy ageing – adopt a life course approach to healthy ageing; address key risk factors that reduce quality of life and better manage the varied needs of women as they age;

chronic conditions and preventive health – increase awareness and prevention of chronic conditions, symptoms and risk factors; invest in targeted prevention, early detection and intervention; tailor health services for women and girls;

mental health – enhance gender-specific mental health awareness, education and prevention; focus on early-intervention; invest in service delivery and multi-faceted care; and

health impacts of violence against women and girls – raise awareness about and address the health and related impacts of violence against women and girls; co-design and deliver safe and accessible services.[8]

Menopause in the Strategy

5.11Menopause is mentioned in priority areas one, two and four of the Strategy. Within priority area one, ‘maternal, sexual and reproductive health’, there are a total of 16 actions, and two of these reference menopause. These are:

raise community and health care provider awareness to improve visibility and diagnosis of under-recognised sexual and reproductive health conditions and reproductive risk factors; and

strengthen access pathways to sexual and reproductive health services across the country, particularly in rural and remote areas’.[9]

5.12Within priority area two, ‘healthy ageing’, there are a total of 14 actions, and one references menopause:

support women and their health care providers to manage the effects of menopause.[10]

5.13Within priority area four, ‘mental health’, there are a total of 19 actions; however, whilst the Department acknowledges that menopause is a critical life point, there is no explicit mention of menopause in these actions.[11]

Perspectives on the inclusion of menopause in the Strategy

5.14In its submission, Besins Healthcare argued the importance of implementing a ‘condition-specific national policy for menopause as it addresses the unique healthcare needs and challenges faced by women during this life stage’.[12] Besins Healthcare recommended the implementation of a national policy for menopause, given that it will assist ‘awareness, research, and education and enhance the overall wellbeing of women navigating this life-stage and promoting gender-sensitive healthcare practices’.[13]

5.15However, Besins Healthcare stated that is has been ‘four years into the Strategy and there has been little tangible action taken to improving menopausal awareness and care’, adding that:

Women are accessing well-respected, non-government websites such as the Australasian Menopause Society, Jean Hailes for Women’s Health and Wellfemme for information about menopause but many are getting their menopause information and advice from social media, which is obviously uncontrolled and not always accurate.[14]

5.16Some submitters argued that whilst the Strategy seeks to prioritise investment into research, there is not a clear connection between how the funding will support the implementation of the Strategy. For instance, Research Australia asserted that:

[Although] the Strategy emphasised the importance of ongoing research, highlighting some past funding initiatives that aligned with parts of the Strategy. … it lacked any means of directing research funding to support the Strategy’s goals and implementation.[15]

5.17They expanded on this statement by saying that the ‘research required to support these strategies has not progressed as intended, hampering Australia’s ability to respond effectively to these critical health issues’.[16]

5.18Some submitters suggested that the Strategy does not reach far enough so as to examine the interaction between menopause and voluntary or involuntary childlessness.[17] In its submission, The Empty Cradle contended that women who are involuntarily childless have unique and specific physical health needs at menopause and perimenopause.[18] A submitter with lived experience added that:

The National Women’s Health Strategy 2020–2030 makes no mention of childlessness. There is no question that we are an invisible demographic. … Hence the health outcomes and impact of menopause in this demographic cannot be understood without acknowledgement and research.[19]

National Women’s Health Advisory Council

5.19Established in February 2023, the role of the Council is to ‘provide advice to the government on priority health issues for women and girls in Australia… including recommendations on the implementation of the Strategy’.[20] The Council aims to ‘provide a better, more targeted healthcare system for Australian women and girls, ensuring it is culturally safe and appropriate’.[21]

5.20The Council has also established sub-committees to investigate gender bias within the healthcare system across five focus areas:

access;

care and outcomes;

empowerment;

research; and

safety.[22]

5.21The Council stated that there is growing evidence that shows systemic issues within healthcare delivery and medical research, resulting in women experiencing poorer health outcomes.[23] The Council mentioned that women ‘disproportionately experience delayed diagnosis, overprescribing, and a failure to properly investigate symptoms’.[24]

5.22However, the publicly available communiques of the Council do not currently have explicit references to dedicated work on issues related to menopause.[25]

5.23Research Australia discussed the importance of having a strategic approach to menopause research, with its primary objective of improving the evidence to guide the ‘prevention, diagnosis and effective treatment of the symptoms of menopause and perimenopause and provide appropriate support’.[26] As such, their submission advised that:

The Minister should charge the Council with identifying research priorities required to achieve this objective, as part of its remit to provide advice on priority issues and progress the implementation of the Strategy.[27]

National strategies on preventing and managing chronic conditions

5.24In its submission, the Department stated that the government’s national strategies focus on the prevention and management of chronic conditions, which evidence shows can be worsened by menopause.[28] These national strategies are embodied in the following plans:

The National Strategic Action Plan for Heart Disease and Stoke;[29] and

The National Strategic Action Plan for Osteoporosis.[30]

Health care services

5.25The Department noted that the government supports access to general and specific healthcare and services which may be suitable for sexual and reproductive health concerns, including menopause.[31] These include:

reforms to the Medicare Benefits Schedule (MBS) rebates, such as time-tiered items for complex conditions and referred services to consultant physicians specialising in sexual health medicine;[32]

providing longer general practitioner (GP) consultations (up to 60 minutes) to respond to complex conditions or reproductive health matters;[33]

expanding funding for Aboriginal Community Controlled Health Organisations to deliver culturally appropriate comprehensive primary care health services for First Nations people;[34]

expanding access to mental health care services, which can be accessed by women experiencing menopause and perimenopause symptoms;[35]

expanding access to translation and interpreting services;[36]

developing the Clinical Care Standard for Heavy Menstrual Bleeding;[37] and

expanding the remit of GP referrals to various allied health professionals including psychologists, physiotherapists and dieticians to support the management and treatment of menopausal symptoms.[38]

Health information

5.26The Department made clear that the government supports the provision of information and advice on sexual and reproductive health, including menopause and perimenopause, through the following programs:

Healthdirect – a consumer health information website, app and telephone line. Healthdirect provides a range of free, trusted online resources related to menopause, including information on perimenopause, early menopause, HRT and post-menopause;[39]

$23.5 million (GST exclusive) in funding provided to support Jean Hailes for Women’s Health implement the Strategy;[40] and

Health in My Language – providing $13.3 million in funding over three years for the delivery of the national bicultural health educator program, which provides people from CALD communities, including migrants and refugees, with opportunities to converse with trained professionals about COVID-19 and other health and wellbeing matters, such as menopause.[41]

My Health Record

5.27The inquiry heard about the use of the My Health Record platform as a mechanism for data collection related to menopause and perimenopause, including prescribing practices related to menopause hormonal therapy.[42]

5.28In a response to a question on notice, the Department provided the following update on the utility of My Health Record for these purposes:

My Health Record has medication information, which can be used by individuals and their healthcare providers for healthcare services. Health information held in My Health Record is not currently available for research or public health purposes, including the use of individuals’ prescription and dispense records to investigate prescribing of Hormone Replacement Therapy. My Health Record data will only be made available for these purposes when the required legislative, governance, security, privacy and technical arrangements are in place.

The Department of Health and Aged Care is currently working to develop a roadmap to guide a multi-year, staged implementation of research and public health use of My Health Record data.[43]

Health and medical research

5.29The Department outlined that the government provides support for health and medical research through the Medical Research Future Fund (MRFF) and the National Health and Medical Research Council (NHMRC).[44] The MRFF funds priority driven research focusing on research translation whereas the NHMRC focuses on investigator-led research.[45] The Department stated that while no funding has been allocated specifically for research addressing menopause, from its inception in 2015 to 31 October 2023, the MRFF has invested $205.71 million (GST exclusive) in 101 grants with a focus on women’s health research.[46]

5.30Between 2020 and 2023, the NHMRC has expended:

$23.3 million (GST exclusive) towards 41 active research projects relevant to menopause and perimenopause (of the $23.3 million, $620946 was expended for research relating to perimenopause). Issues investigated have included a randomised controlled trial of acupuncture for post-menopausal hot flushes, thermal instability at menopause, bone loss during and after menopause, vasoactive nutrients to promote healthy ageing in postmenopausal women, and evidence and new tools to improve health after surgical menopause.[47]

5.31The Department highlighted that the government’s research into menopause and perimenopause supports a key priority of the Strategy: ‘a strong and emerging evidence base’.[48] This key priority includes the objective of aligning Australian health research investment with the priority health issues affecting Australian women and girls.[49]

Approaches taken across different jurisdictions

5.32The committee received some evidence on the state jurisdictional/level approaches. Noting that other jurisdictions may also have work underway in this domain; however, it was not brought to the committee’s attention.

New South Wales

Menopause Services Initiative

5.33The New South Wales (NSW) Government has invested $37.35 million over four years between 2023–24 to 2026–27 for the delivery of a network of menopause services, which includes four menopause hubs and 12 referral sites across NSW.[50] The NSW Government stated that these new services will be an ‘escalation pathway to specialist care for women experiencing severe or complex symptoms of menopause’:

This will complement existing services and does not replace the need for existing women’s health services and the role of the general practitioner. Investment in menopause also supports a clinical group to lead the implementation of these new services and a state-wide education and awareness campaign.[51]

Menopause hubs and referral sites

5.34The NSW Government underscored that its NSW Menopause Services will build on NSW’s successful model of bone health services (called Osteoporotic Refracture Prevention services) to provide women with access to a broader range of support services, including access to allied health professionals for urinary continence management, exercise advice, nutrition and weight management advice.[52]

Menopause services model of care

5.35The NSW Government spoke of its model of care to enable improved access to care for severe and/or complex menopause symptoms and management.[53] The new services will provide expert advice and assistance for women about:

managing severe and complex symptoms of menopause;

bone health for the management of osteoporosis and to prevent fractures;

lowering the risk of cardiovascular disease and stroke;

supporting mental health and wellbeing;

management of weight and lifestyle; and

managing urinary problems which may cause problems for women following menopause.[54]

5.36The NSW Government advised it has established a number of bodies to oversee the implementation of the model of care. These include:

A clinician reference group with 77 members which provides broad clinical subject matter expertise to inform the taskforce;

A consumer reference group of seven members which provides the consumer lived experience to inform the model of care development; and

An Aboriginal Menopause Working Group which was established in 2023, with 27 members to understand the experience for Aboriginal communities and how the menopause initiative could improve menopause care within Aboriginal Health.[55]

MenoECHO

5.37Launched in September 2023, MenoECHO is an online education tool facilitated by the Menopause hubs to provide case-based learning for GPs, other medical specialists, allied health, and nursing professionals.[56] The NSW Government stated that more than 500 clinicians have registered for the sessions to date and bi-monthly engagements will continue throughout 2024.[57] Moreover, the Agency for Clinical Innovation has also delivered six clinical engagement and capability development sessions in the last year from December 2023, which discussed the following topics:

common questions;

the consumer and primary care perspectives;

the multidisciplinary team;

genitourinary syndrome;

continence; and

the workplace.[58]

Menopause Awareness Campaign

5.38In its submission, NSW Government highlighted that Women NSW is responsible for the development and delivery of the NSW Government’s Menopause Awareness Campaign.[59] In October 2022, Women NSW commissioned focus group research to understand perceptions and awareness of perimenopause and menopause among women from diverse backgrounds and their partners.[60]

5.39On 18 October 2022, on World Menopause Day, the NSW Government launched the Menopause Awareness Campaign to ‘destigmatise experiences of perimenopause and menopause’:

The Campaign was designed to raise awareness and encourage conversations about perimenopause and menopause, focused on three key stakeholders: communities, General Practitioners, and employers. The menopause awareness campaign is part of the NSW Government’s continuing commitment to supporting women’s health and wellbeing.[61]

Community campaign

5.40To support the launch of this campaign, the NSW Government also developed tailored resources and campaigns, including:

a Menopause Toolkit with free, reliable information which seeks to increase understanding of the symptoms of perimenopause and menopause;

a professionally accredited GP case study-based webinar; and

an employer campaign to assist employees and managers navigate menopause conversations in the workplace.[62]

Victoria

Women’s Sexual and Reproductive Health Plan 2022–2030

5.41According to the Department of Health Victoria, the Victorian Women’s Sexual and Reproductive Health Plan 2022–2030 was developed to strengthen the sexual and reproductive health of Victorian women, girls and gender diverse people:

The Victorian Government committed $153 million to improve health outcomes for girls and women as part of 2023/24 State Budget. We have established the first Victorian Women’s Health Advisory Council that is led by women, for women, to guide reforms that will support an integrated and equitable Victorian health system.[63]

Response to the physical impacts of menopause and perimenopause

5.42In its submission, the Department of Health Victoria pointed out that its Women’s Sexual and Reproductive Health Plan 2022–2030 includes initiatives to promote positive sexual health and related screening and testing services.[64]

5.43Cardiovascular health and cancer screening for perimenopausal and menopausal women was also identified as a health priority for the Department of Health Victoria, via the Victorian Heart Hospital.[65]

5.44The Royal Women’s Hospital and Monash Health-run menopause clinics also provide information, services and referrals for women, including those experiencing menopausal symptoms after cancer.[66] Further, the Department of Health Victoria fund the National Ageing Research Institute to continue to support older women with improved health and wellbeing outcomes.[67]

Response to cultural and societal factors influencing perceptions and attitudes toward menopause and perimenopause

5.45The Department of Health Victoria claimed that it has been a leader in destigmatising menopause and identified it as a priority in the first Victorian Women’s Sexual and Reproductive Health Plan released in 2017 and again in 2022:

The 2022–30 plan has a priority action to reduce stigma associated with perimenopause, premature menopause, and post-menopause. Our equal state, Victoria’s gender equality strategy released in 2023, has a strong focus on the need for cultural change in progressing gender equality.[68]

Response to level of awareness amongst medical professionals and patients

5.46The Department of Health Victoria has raised awareness of menopause through various channels, such as:

Via the Royal Australian and New Zealand College of Obstetrics and Gynaecology’s ‘A practitioner’s toolkit for managing the menopause’;

The Better Health Channel, via the Jean Hailes for Women’s Health website provides information on menopause for consumers and clinicians; and

Sustainability Victoria’s Menstruation and Menopause Policy which provides support and relief to staff members who are experiencing symptoms of menstruation or menopause, including additional paid leave provisions and flexible work measures.[69]

Tasmania

5.47The Tasmanian Government recognised that most menopause-related care is delivered in the community by GPs or by special-interest primary care services.[70]

5.48The Tasmanian Government acknowledged that access to specialists can be variable depending on geographical location, in which there are known workforce challenges for these specialities within the state.[71] In addressing these challenges, the Tasmanian Government is, under its Equal means Equal Tasmanian Women’s Health Strategy, developing a Gender Impact Assessment process to apply a gender lens to the design and implementation of budgets, policies, programs and services:

It is our vision that through this toolkit the needs of all women at every stage of life will be considered throughout the policy and budget cycle. The findings of the Inquiry will be valuable for enhancing the utility of the toolkit and providing guidance to agencies about the diverse impacts of menopause and perimenopause.[72]

International approaches

5.49After a discussion of the various approaches to menopause and perimenopause care adopted by the federal government and states and territories, it is now necessary to outline international models that contrast Australia’s policy landscape.

United Kingdom

5.50Some submissions have referred to the United Kingdom (UK) Government’s 2022 Parliamentary Inquiry into Menopause in the Workplace, conducted by the Women and Equalities Committee, as a model of best practice for Australia to look to.[73]

5.51The Menopause in the Workplace final report contained 12 recommendations aimed at facilitating change and increasing support for women experiencing menopause across various facets of society: government policy, employer practices and wider societal and financial change.[74] In 2022, the UK Government published a response to the recommendations of the inquiry and accepted in principle, or in part, most of the recommendations that were made.[75]

Menopause Ambassador

5.52One of the cornerstone recommendations that was recently implemented was the appointment of a Menopause Ambassador in 2023 (also referred to as the Menopause Employment Champion) to work on behalf of government to:

… work with stakeholders from business (including small to medium enterprises), unions, and advisory groups to encourage and disseminate awareness, good practice and guidance to employers.[76]

5.53According to the UK Government, the purpose of appointing a Menopause Ambassador is to drive forward work with employers and menopause workplace issues and to spearhead the proposed collaborative employer-led campaign.[77] The UK Government elaborated further on the role of the Menopause Ambassador:

Key to the role will be to give a voice to menopausal women, promoting their economic contribution, and working with employers to keep people experiencing menopause symptoms in work and progressing.[78]

5.54The Menopause Ambassador is also required to provide a six-monthly report on progress made by business, including examples of good practice.[79] In tandem with the Menopause Taskforce, measures have been put in place to ensure that employers facilitate training, processes and information so that colleagues have a better understanding of menopause and to also ensure that any policy or guidance documents be visible and well publicised.[80]

Prescription payment certification

5.55Cost was identified as one of the main barriers to accessing hormone replacement therapy (HRT). The UK Department of Health and Social Care implemented the prescription payment certificate (PPC) amid calls from women to widen HRT’s access.[81] As such, women need not pay for monthly prescriptions, but can now access their HRT via a one-off charge (equivalent of two prescriptions).[82] There are no limitations on the frequency of use of the PPC, nor the amount of HRT items it can be used for during the 12 months it is valid.[83] Since the certificate’s implementation, Newson Health Group outlined that:

Half a million women have signed up to the scheme since it was launched, with an estimated £11 million (AUD $21 million) saved by women utilising the PPC between April 2023 and January 2024.[84]

5.56In its submission, Besins Healthcare pointed out that the UK Government noted the importance of having a suitable methodology to quantify the cost of menopause to individuals, businesses, health services and wider society:

In three out of four countries within the UK (Scotland, Wales and Northern Ireland), prescribed menopause treatments are available to all citizens free of charge. In England, following a high-profile campaign, the Government introduced a new hormone replacement therapy prescription prepayment certificate on 1 April 2023. This reduces prescription costs for hormone replacement therapy medication in England to a total of £19.30 per year effectively reducing the cost for many women by up to 91 per cent.[85]

5.57Dr Lucy Caratti echoed Besins Healthcare’s remarks about the accessibility of HRT via the PPC in the UK, which gives patients a year’s worth of HRT for under 20 pounds.[86]

UK’s Equality Act 2010

5.58The UK’s Equality Act 2010 (Equality Act) provides:

Protection to individuals from prohibited conduct (including direct discrimination or failure to make reasonable adjustments for disabled persons), because of a protected characteristic (such as sex, disability or age) and in certain prescribed contexts (such as work, education and premises).[87]

5.59The Equality Act does not specifically include menopause as a protected characteristic; however, employees can bring a claim of menopause-related workplace discrimination to the UK Employment Tribunal on the basis of sex, age and disability.[88]

5.60Recommendation 12 of the Women and Equalities Committee’s inquiry report recommended that:

The Government should launch a consultation on how to amend the Equality Act to introduce a new protected characteristic of menopause, including a duty to provide reasonable adjustments for menopausal employees. This consultation should commence within six months of publication of this report. The Government’s consultation response should include a review of whether the newly commenced s14 (above) has mitigated concerns about the current law.[89]

5.61The UK Government did not accept this recommendation to amend the Equality Act on the basis that the Act itself already provides protections against unfair or unjust treatment of employees going through menopause via the umbrella of sex, age and disability.[90] The then UK Government provided an alternative approach, in that:

A new, separate protected characteristic might include an expansion of the reasonable adjustments’ duty in section 20 and schedule 21 through an expansion of the definition of disability; or expansion of age discrimination provisions as they apply to employment.[91]

5.62Further, the UK Government added that:

Given the importance of this legislation it is important to ensure that the policy is considered in the round to avoid unintended consequences which may inadvertently create new forms of discrimination, for example, discrimination risks towards men suffering from long-term medical conditions, or eroding existing protections. The more substantial the necessary changes to the 2010 Act are, the more likely it is that they would require a full-scale review of the Act. This could only be made as part of a wider reform of the Act. This is a major undertaking which would necessarily be some years away.[92]

5.63In the UK, there are several examples of claims that have been made for menopause-related discrimination under the disability characteristic. For instance, in its submission, Anti-Discrimination NSW provided a detailed case study of Lynskey v Direct Line Insurance Service Ltd: 1802204/2022 and 1802386/2022:

5.64In the Australian context, Maurice Blackburn Lawyers argued that the above recommendation would not be appropriate, given that it came as a response to:

High levels of unfair dismissal cases where women of menopause age were dismissed from their employment, and where they had cited symptoms as affecting their employment. We are unaware of a similar concentration of cases in Australia.[95]

Menstrual and menopause leave

5.65Internationally, there are several different countries that currently adopt a form of menstrual or menopause leave. For instance, Spain was the first European country to introduce laws permitting three to five days of paid menstrual leave for women with secondary disabling or incapacitating menstruations (referring to medical conditions that cause painful periods).[96]

5.66For employees to access menstrual leave, a doctor’s certificate is required and the costs to employers are met via Spain’s public social security system.[97] Spain’s laws were created to ensure that employees do not have to rely on personal or sick leave entitlements when unable to work.[98]

5.67Menstrual leave entitlements, in various forms, are also available in the following countries:

Japan;

Indonesia;

South Korea;

Zambia;

China – across five provinces; and

Taiwan.[99]

Committee view

5.68The evidence received throughout this inquiry has demonstrated that there is a glaring need for a range of actions to ensure that all women can continue to lead healthy and productive lives during the menopause transition. This includes raising community and health care awareness, improving access to appropriate health services and preventive care. To achieve this, the Australian Government needs to take a leadership role and ensure menopause care is recognised and prioritised.

National coordination

5.69The committee notes that menopause and perimenopause were mentioned in three of the total five priorities of Australia’s National Women’s Health Strategy 2020–2030. However, of the three priorities, there were a total of 49 definitive actions, with menopause only mentioned in three of these actions. The committee is of the view that further actions are required. Further, the committee noted the evidence that there have only been minimal tangible actions taken to improve menopausal awareness and care, four years into the Strategy’s implementation.

5.70The committee notes that the Department of Health and Aged Care’s submission stated that, since its inception in 2015 to 31 October 2023, the Medical Research Future Fund has invested $205.71 million (GST exclusive) in 101 grants with a focus on women’s health research. However, it is disappointing that, to date, nil funding has been allocated specifically for research into menopause.

5.71The committee recognises that the National Women’s Health Advisory Council has an important role to play to ensure that the implementation of the National Women’s Health Strategy 2020–2030 produces tangible health outcomes for women experiencing menopause and perimenopause across all spheres of their life.

5.72The committee acknowledges the different approaches adopted by some of the states and territories to support women during the menopause transition. The committee sees value in building on existing states and territory initiatives. A coordinated national menopause action plan would ensure a cohesive approach to menopause care in Australia. The committee is of the view that a national plan should encompass raising awareness in the community, addressing stigma, improving access to diagnosis and treatment and encouraging initiatives to create menopause friendly workplaces.

5.73The committee recommends that organisations tasked with improving menopause care utilise learnings from international best practice.

5.74The committee recommends that the Australian Government investigate improvements to the collection and use of data to assist with research into the experience of menopause and perimenopause, and surveillance of the outcomes of the use of MHT.

Recommendation 24

5.75The committee recommends that the Australian Government task the National Women’s Health Advisory Council to assist state and territory governments to deliver a National Menopause Action Plan which considers best practices in menopause care.

International approaches

5.76The committee notes that there are a number of international models of menopause care, including initiatives in the workplace, that Australia can learn from, particularly in the UK. The committee believes some of these policy approaches should be considered within the Australian context.

Recommendation 25

5.77The committee recommends that the Australian Government task the Department of Health and Aged Care and the Department of Employment and Workplace Relations to monitor international best practices to ensure Australia is at the forefront of menopause and perimenopause care.

Senator Penny Allman-Payne

Chair

Footnotes

[1]Department of Health and Aged Care, National Women’s Health Strategy 2020–2030, p. 6.

[2]Department of Health and Aged Care, National Women’s Health Strategy 2020–2030, p. 6.

[3]Department of Health and Aged Care, National Women’s Health Strategy 2020–2030, p. 7.

[4]Department of Health and Aged Care, National Women’s Health Strategy 2020–2030, p. 6 and 10.

[5]Department of Health and Aged Care, National Women’s Health Strategy 2020–2030, p. 6.

[6]Department of Health and Aged Care, National Women’s Health Strategy 2020–2030, p. 6.

[7]Department of Health and Aged Care, National Women’s Health Strategy 2020–2030, p. 6.

[8]Department of Health and Aged Care, National Women’s Health Strategy 2020–2030, p. 6.

[9]Department of Health and Aged Care, National Women’s Health Strategy 2020–2030, p. 24.

[10]Department of Health and Aged Care, National Women’s Health Strategy 2020–2030, p. 28.

[11]Department of Health and Aged Care, National Women’s Health Strategy 2020–2030, p. 35.

[12]Besins Healthcare, Submission 146, [p. 5].

[13]Besins Healthcare, Submission 146, [p. 5].

[14]Besins Healthcare, Submission 146, [p. 5].

[15]Research Australia, Submission 98, p. 10.

[16]Research Australia, Submission 98, p. 10.

[17]See, for example, The Empty Cradle, Submission 121, [pp. 6–7]; Name Withheld, Submission 130, [p. 5]; Name Withheld, Submission 231, [p. 1]; Name Withheld, Submission 235, [p. 1].

[18]The Empty Cradle, Submission 121, [p. 6].

[19]Name Withheld, Submission 130, [p. 7].

[20]Department of Health and Aged Care, National Women’s Health Advisory Council, www.health.gov.au/committees-and-groups/national-womens-health-advisory-council#communiques (accessed 14 August 2024).

[21]Department of Health and Aged Care, National Women’s Health Advisory Council, www.health.gov.au/womens-health-advisory-council (accessed 14 August 2024).

[22]Department of Health and Aged Care, National Women’s Health Advisory Council, www.health.gov.au/womens-health-advisory-council (accessed 14 August 2024).

[23]Department of Health and Aged Care, National Women’s Health Advisory Council, www.health.gov.au/womens-health-advisory-council (accessed 14 August 2024).

[24]Department of Health and Aged Care, National Women’s Health Advisory Council, www.health.gov.au/womens-health-advisory-council (accessed 14 August 2024).

[25]Department of Health and Aged Care, National Women’s Health Advisory Council – Communiques, www.health.gov.au/resources/collections/national-womens-health-advisory-council-communiques?language=en (accessed 25 August 2024).

[26]Maurice Blackburn Lawyers, Submission 20, p. 4.

[27]Research Australia, Submission 3, p. 3.

[28]Department of Health and Aged Care, Submission 15, p. 6.

[29]Department of Health and Aged Care, Submission 15, p. 6.

[30]Department of Health and Aged Care, Submission 15, p. 7.

[31]Department of Health and Aged Care, Submission 15, p. 7.

[32]Department of Health and Aged Care, Submission 15, p. 7.

[33]Department of Health and Aged Care, Submission 15, p. 7.

[34]Department of Health and Aged Care, Submission 15, p. 8.

[35]Department of Health and Aged Care, Submission 15, p. 8.

[36]Department of Health and Aged Care, Submission 15, p. 9.

[37]Department of Health and Aged Care, Submission 15, p. 10.

[38]Department of Health and Aged Care, Submission 15, p. 8.

[39]Department of Health and Aged Care, Submission 15, p. 14.

[40]Department of Health and Aged Care, Submission 15, pp. 14–15.

[41]Department of Health and Aged Care, Submission 15, p. 15.

[42]See, for example, Professor Gita Mishra, Private capacity, Committee Hansard, 29 July 2024, pp. 58–59; Professor Steve Robson, President, Australian Medical Association, Committee Hansard, 30 July 2024, pp. 25–26; Ms Alison Weatherstone, Chief Midwife, Australian College of Midwives, Committee Hansard, 30 July 2024, p. 50; Ms Francine Eades, Area Director, Aboriginal Health, East Metropolitan Health Service, Committee Hansard, 6 August 2024, p. 5; Dr Michelle Cotellessa, Private capacity, Committee Hansard, 6 August 2024, p. 29; Dr Sunita Chelvanayagam, Private capacity, Committee Hansard, 6 August 2024, p. 29; Dr Purity Carr, Founder, Purity Health Menopause and Wellbeing Centre, Committee Hansard, 6 August 2024, p. 41; Ms Louise Riley, Assistant Secretary, Medicare Benefits Schedule Policy and Reviews Branch, Department of Health and Aged Care, Committee Hansard, 13 August 2024, pp. 28–30.

[43]Department of Health and Aged Care, answer to question on notice IQ24-000106, 13 August 2024 (received 30 August 2024).

[44]Department of Health and Aged Care, Submission 15, p. 15.

[45]Department of Health and Aged Care, Submission 15, p. 15.

[46]Department of Health and Aged Care, Submission 15, p. 15.

[47]Department of Health and Aged Care, Submission 15, p. 15.

[48]Department of Health and Aged Care, Submission 15, p. 15.

[49]Department of Health and Aged Care, Submission 15, p. 15.

[50]NSW Government, Submission 53, p. 4.

[51]NSW Government, Submission 53, p. 4.

[52]NSW Government, Submission 53, p. 4.

[53]NSW Government, Submission 53, p. 5.

[54]NSW Government, Submission 53, p. 5.

[55]NSW Government, Submission 53, p. 5.

[56]NSW Government, Submission 53, p. 5.

[57]NSW Government, Submission 53, p. 5.

[58]NSW Government, Submission 53, p. 5.

[59]NSW Government, Submission 53, p. 6.

[60]NSW Government, Submission 53, p. 6.

[61]NSW Government, Submission 53, p. 6.

[62]NSW Government, Submission 53, pp. 6–7.

[63]Department of Health Victoria, Submission 14, p. 3.

[64]Department of Health Victoria, Submission 14, p. 5.

[65]Department of Health Victoria, Submission 14, p. 5.

[66]Department of Health Victoria, Submission 14, p. 5.

[67]Department of Health Victoria, Submission 14, p. 5.

[68]Department of Health Victoria, Submission 14, p. 8.

[69]Department of Health Victoria, Submission 14, pp. 4–9.

[70]Tasmanian Government, Submission 7, [p. 2].

[71]Tasmanian Government, Submission 7, [p. 2].

[72]Tasmanian Government, Submission 7, [p. 3].

[73]See, for example, The Royal Women’s Hospital Melbourne, Submission 33, pp. 10–11; University of Melbourne, Submission 105, pp. 15–16; The Office for Women, Submission 135, p. 8–9; Professor Martha Hickey, Submission 138, p. 14; The Australian Services Union, Submission 173, [p. 1].

[74]House of Commons Women and Equalities Committee, Menopause and the workplace: First Report of Session 2022–23; 28 July 2022, https://committees.parliament.uk/work/1416/menopause-and-the-workplace/publications/ (accessed 26 August 2024).

[75]House of Commons Women and Equalities Committee, Menopause and the workplace: Government Response to the Committee’s First Report of Session 2022–2023, 18 January 2023, pp. 2–19.

[76]House of Commons Women and Equalities Committee, Menopause and the workplace: Government Response to the Committee’s First Report of Session 2022–2023, 18 January 2023, p. 12.

[77]House of Commons Women and Equalities Committee, Menopause and the workplace: Government Response to the Committee’s First Report of Session 2022–2023, 18 January 2023, p. 12.

[78]House of Commons Women and Equalities Committee, Menopause and the workplace: Government Response to the Committee’s First Report of Session 2022–2023, 18 January 2023, p. 12.

[79]House of Commons Women and Equalities Committee, Menopause and the workplace: Government Response to the Committee’s First Report of Session 2022–2023, 18 January 2023, p. 12.

[80]Professor Martha Hickey, Submission 138, p. 14.

[81]Newson Health Group, Submission 19, p. 14.

[82]Newson Health Group, Submission 19, p. 14.

[83]Newson Health Group, Submission 19, p. 14.

[84]Newson Health Group, Submission 19, p. 14.

[85]Besins Healthcare, Submission 146, [p. 15].

[86]Dr Lucy Caratti, Private Capacity, Committee Hansard, 6 August 2024, p. 14.

[87]Anti-Discrimination NSW, Submission 28, p. 5.

[88]Anti-Discrimination NSW, Submission 28, p. 5.

[89]House of Commons Women and Equalities Committee, Menopause and the workplace: Government Response to the Committee’s First Report of Session 2022–2023, 18 January 2023, p. 18.

[90]House of Commons Women and Equalities Committee, Menopause and the workplace: Government Response to the Committee’s First Report of Session 2022–2023, 18 January 2023, p. 18.

[91]House of Commons Women and Equalities Committee, Menopause and the workplace: Government Response to the Committee’s First Report of Session 2022–2023, 18 January 2023, p. 18.

[92]House of Commons Women and Equalities Committee, Menopause and the workplace: Government Response to the Committee’s First Report of Session 2022–2023, 18 January 2023, p. 18.

[93]Anti-Discrimination NSW, Submission 28, pp. 5–6.

[94]Anti-Discrimination NSW, Submission 28, pp. 5–6.

[95]Maurice Blackburn Lawyers, Submission 20, pp. 4–5.

[96]Maurice Blackburn Lawyers, Submission 20, p. 4; National Tertiary Education Union, Submission 153, p. 5.

[97]Maurice Blackburn Lawyers, Submission 20, p. 4.

[98]Maurice Blackburn Lawyers, Submission 20, p. 4.

[99]National Tertiary Education Union, Submission 153, p. 5.