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ALISON: Hello, my name is Alison McMillan. I’m the Commonwealth Chief Nursing and Midwifery Officer and I’m joined here today by Karen Cook,

from the Nursing Taskforce. Can I first acknowledge the Traditional Owners on the lands on which we meet today? We’re here on the land of the Ngunnawal people and pay my respects to Elders past, present, and emerging.

KAREN: Thanks Alison. It’s great to be with you.

ALISON: Thank you.

KAREN: We’re filming a second video on menopause today. Our first video can be found on our social media channels. In that video, we explained what menopause is, what the common symptoms are, and options for managing those symptoms. Today, we’re going to talk a little bit more about perimenopause, menopause, and some other treatments that you can use to manage menopause. So, Alison, what is the difference between perimenopause and menopause?

ALISON: Thanks Karen. So, perimenopause is that stage leading up to menopause, as the words tend to explain. Menopause for most women tends to occur between the ages of 45 and 55. For some, it’s earlier, and for some, as we know, it’s later. Perimenopause is that stage where the ovaries begin to reduce releasing eggs and sometimes there is development of some of the early symptoms. Perimenopause can be, on average, probably two to four years, but for some it can be a much longer one to ten years, for some. Menopause, then, is, we understand, of course, is where there’s the actual cessation of this, where you no longer have menstrual periods. And menopause is considered that when you have not had a period for more than 12 months, it hasn’t been caused by pregnancy, contraception, or some other cause.

KAREN: OK, yeah. So, can we talk a little bit more about what the symptoms are of perimenopause?

ALISON: The symptoms are the similar of those often leading up to menopause. So, it can be a change in period, in the menstrual period, they could be more frequent, less frequent, lighter, heavier or general changes. No one single person is the same. And so it can have different changes for different people. But certainly, some sort of change in the regularity of the menstrual periods is an often the some of the early signs of perimenopause.

KAREN: So very similar, in fact, to the symptoms of menopause in terms of mood swings, irritability, hot flashes and things, but possibly not to the same extent.

ALISON: That’s right and they may progress over time. So, you may first see changes in menstrual periods and then changes in mood swings. Many of the things we discussed in the first video, you know, interruptions in sleep, often inability to concentrate, and those things that we all know that are very common for all women, the hot flushes, the sweating, particularly the night sweats, which can be really difficult, changes in mood, as we’ve talked about, a whole range of symptoms. And as I say, each woman is unique, but as you know, Karen, we often talk to each other and compare symptoms. And it is a good way…

KAREN: We’ve done that Alison, yes.

ALISON: ..to, you know, to talk to other women about your experiences, because it is often reassuring just to talk to somebody else who’s gone through the same sort of thing.

KAREN: It is, it’s I think it’s one of the best things that you can do, in fact. One of the other things that you can do, of course, is menopausal hormone replacement. So, I’d like to ask you and to talk a little bit about menopause hormone replacement and whether that’s a safe option for management of those symptoms.

ALISON: So, for some women, if the sort of lifestyle changes we’ve already talked about in the first video, those healthy living things that we all know we need to do if that’s not managing the symptoms, then it may be that talk to a health professional, your GP, about options of the menopause hormone therapy or because it may be suitable for you as a help to alleviate some of the symptoms that we do experience during menopause. So, it’s an important conversation to have.

KAREN: And Alison, I’m just thinking about menopause hormone replacement therapy in terms of managing symptoms, but I think there’s many ways you can take that hormone therapy, isn’t there? There’s patches and pills, and creams, and tablets and…

ALISON: Yeah, there’s a whole range.

KAREN: A whole range of things that you can do.

ALISON: But the your GP or the person prescribing a therapy will talk to you about what is the best option.

KAREN: OK, alright, and that’s great, and it’s nice to know that you’ve got all those options.

ALISON: Yes, it’s.

KAREN: OK, Alison. So, the obvious question to ask then, of course, is, are there any risks in taking menopause hormone? It’s a difficult transition and it’s a difficult word sometimes. Are there any risks in MHT?

ALISON: Thanks Karen and, as we know, all medications and therapies available in Australia do go through rigorous testing. So, you can have confidence that these have gone through the appropriate testing and are known and understood to be safe. But with any treatment, of course, there are consequences and risks. So, when taking MHT, as we’re gonna call it, because it’s easier to say, can lead to increased risk of blood clots, stroke, or breast cancer. And therefore, for those starting these therapies, it’s very important that you talk to your health professional about the risks associated with this, and they will consider those in relation to your family history when making a decision about which is the best therapy for you.

KAREN: Great, excellent. So, then I’ve got one more question and this question is about those women who may have had a hysterectomy or had their ovaries removed. How are those women going to know that they’re going through menopause?

ALISON: It’s a really important question, Karen, and I think sometimes a difficult question for women who’ve had a hysterectomy with or without the removal of their ovaries to ask. So, just so we’re clear, a hysterectomy is the surgical removal of the uterus. Depending on the reason for that hysterectomy, it may be necessary for the surgeon to also remove the ovaries. So, as we know, women who’ve had a hysterectomy don’t have menstrual periods. So, that means that that’s not the indicator they can use to understand whether they’re going through perimenopause or menopause. However, many of the symptoms we’ve described that are associated with menopause, the night sweats, the flushing, the hot flushes, the changes in mood, and all of those things are still often present for women who are either perimenopausal or going through menopause who have had a hysterectomy.

KAREN: OK.

ALISON: So, it’s important if you had a hysterectomy and you’re having some of these symptoms, do again talk to your health professional about this because they may choose, for a range of purposes, to do a blood test that can help confirm that this is the stage in your life that you’re now at.

KAREN: OK. Well, thanks for that Alison. I think that’s clarified a few questions that, certainly, I know a lot of my friends have had and certainly questions that you and I have had as we’ve gone through menopause. And I think it’s important that we understand the differences between perimenopause, menopause, the safety of menopause hormone replacement treatment and I think that’s a very important conversation, and then, understanding and knowing the signs of menopause, if you’ve had a hysterectomy with or without your ovaries being removed, or indeed, if you’ve had your ovaries removed. Everyone deserves a healthy transition to menopause. So, please make use of the resources available and consult a health care professional if you have any concerns at all.

ALISON: So, thank you Karen. I think that we both feel and confirm that the transition through perimenopause and menopause is sometimes a bumpy road, but talking to friends and colleagues, and health professionals is always the most important thing. We never do this alone and… so do share and talk to your friends and family because all women go through this and we can go through it together.

KAREN: And there is light at the end of the tunnel Alison…

ALISON: Absolutely, yes.

KAREN: We can confirm that.

ALISON: So, thank you for being with us today and we hope you’ve enjoyed our video.