AMS Newsletter 27 June 2024

In this edition

• Better care for women with heavy menstrual bleeding
• Kidney function is associated with tooth loss in postmenopausal women 
• New faces at AMS
• Menopausal Hormone Therapy (MHT) patch shortages May 2024
• IMS World Congress on Menopause in Melbourne 2024

Health Professionals - join AMS for Members-only content 

• Menopause Matters
• The Menopause Society Annual Meeting 2024: Details and dates.
• Sexual Dysfunctions, Update on Gynae Cancers and Management - IMS Webinar online now
• International Osteoporosis Foundation - The 206
• European Menopause and Andropause Society (EMAS) Online School 2024
• European Menopause and Andropause Society (EMAS) Newsletter

In this edition

Better care for women with heavy menstrual bleeding

Heavy menstrual bleeding affects one in four Australian women of reproductive age and can have a serious impact on women’s social, emotional and physical quality of life.

The Australian Commission on Safety and Quality in Health Care (the Commission) has published a new Women’s Health Focus Report showing a decrease in hysterectomy rates over eight years – and an increase in the less invasive option of endometrial ablation.

Hysterectomy is one option for treating heavy menstrual bleeding, but there are a number of associated risks. Less invasive treatments are available, including oral medicines, the hormonal IUD and procedures like endometrial ablation.

The Commission has also released the updated Heavy Menstrual Bleeding Clinical Care Standard (2024), which outlines best practice care and how healthcare practitioners can support women living with this condition.

The Standard highlights key aspects of quality care for women with heavy menstrual bleeding including comprehensive assessment, ensuring they are offered appropriate treatment options, and supporting women to make informed choices about their care.

This combined work aims to improve care for women with heavy menstrual bleeding. It will ensure they are offered the most appropriate and least invasive treatment for their individual situation, and can make informed choices from the range of treatments.

Health service organisations, PHNs and clinicians can use the data in the Women’s Health Focus Report to view hysterectomy and endometrial ablation rates in their local area and reflect on what it means for their practice and patients.

If there is substantial variation in the treatment of heavy menstrual bleeding, it is important to investigate if appropriate care is being delivered.

Women with heavy menstrual bleeding that is impacting their life should be offered treatment for symptom relief from first presentation, even when waiting for investigations or access to other treatments.

A trusted practitioner can help a woman understand the range of treatments. The best treatment option will differ for each woman. It is important for clinicians to ask women about their menstrual health, as some women may not recognise their heavy bleeding is unusual and can be treated, so many do not seek help.

Read more here

Kidney function is associated with tooth loss in postmenopausal women

Kidneys play a critical role in overall health by removing waste products from the blood. When they fail to sufficiently filter out foreign elements, several serious, lifethreatening, medical conditions can result. A new study suggests that chronic kidney disease may also be linked with tooth loss.

A woman’s glomerular filtration rate shows how well her kidneys are functioning. Kidney function decreases with time after menopause and is associated with declining reproductive hormone levels. These hormone changes during menopause also often lead to abdominal obesity, which is an independent risk factor for the development of chronic kidney disease and also linked with a higher risk of tooth loss.

The consequences of kidney disease are numerous, including an increased probability of experiencing problems with bone and cardiovascular health. Tooth loss, which reflects oral health status, is also associated with systemic diseases, such as diabetes, thyroid disease, and osteoporosis, and is independently associated with an increased risk of stroke. Excessive tooth loss can also impair chewing and speech.

Previous studies have identified an association between kidney function and tooth count. This newest study involving nearly 65,000 participants, however, is the first known to evaluate the association between chronic kidney disease and tooth loss in postmenopausal women across the ages. It concluded that the glomerular filtration rate, a measure of kidney function, is significantly associated with having at least 20 (of a total of 28) adult teeth, suggesting that chronic kidney disease and tooth loss are significantly associated, especially in postmenopausal women aged 66 to 79 years.

These findings suggest that preventing and managing mineral and bone metabolism disorders in postmenopausal women with chronic kidney disease are crucial to prevent tooth loss. It is also important to address kidney disease progression, as the consequences affect multiple body systems beyond just oral health. 

Reference online here

New faces at AMS

Naomi Sutton
Policy, Research and Education Officer

Originally from the UK, Naomi began her academic journey at Liverpool University, where she obtained a Law degree. Driven by a passion to address health disparities and social injustices, she went back to university to complete a master's in Humanitarian Studies at Liverpool School of Tropical Medicine.

Transitioning from academia to advocacy, Naomi joined one of Scotland’s leading children's rights organisations as a Policy Officer. Her role was instrumental in the passage of a law that provides greater protections for children and young people.

Seeking fresh challenges and a change of scenery, Naomi relocated to vibrant Melbourne, where she now serves as a dedicated Policy, Education, and Research Officer at AMS. She seeks to leverage her expertise to promote wider discussions and studies that support women’s transition through menopause.

Geoff Setty
Communications and Marketing Advisor

Geoff has been a communications professional for over 20 years. Geoff has a degree in Communications/Media and a Post-Graduate Diploma in Business Marketing, both from Edith Cowan University. He has spent the last decade specialising in not-for-profit communications. Geoff regards health, housing and welfare as highly valued in society.

Geoff has worked in a variety of health-based organisations including the Australian Institute of Health and Welfare, Medicines Australia and the Department of Health and Ageing.

Moving to Melbourne in the early 2010s Geoff worked for the National Growth Areas Alliance, ermha365 and most recently Nadrasca, Geoff looks forward to liaising with you all through surveys and other mechanisms to better AMS’s advocacy and communications.

Menopausal Hormone Therapy (MHT) patch shortages May 2024

Australia 

Patch Shortages

There are a number of MHTs that are currently unavailable. Please note that the TGA has approved some unregistered products under Section 19A and some substitute doses are currently in supply in Australia.

Pharmacists are encouraged to contact suppliers Medsurge Healthcare Pty Ltd on 1300 788 261 for orders of Estramon and Sandoz on 1800 726 369 for orders of Estradiol Transdermal System.

Oestradiol patches

	Expected supply due		Alternative supply under Section 19A
Dose	Estradot	Estraderm	Estramon	Estradiol Transdermal System
25 mcg	12 Jul 2024	Available	Available
37.5 mcg	20 Sep 2024		Available	Available
50 mcg	7 Sep 2024	1 Aug 2024	Available	Available
75 mcg	15 Jun 2024	1 Aug 2024	Available	Available
100 mcg	15 Jul 2024	1 Aug 2024	Available	Available

Combined patches

Dose	Estalis Sequi	Estalis Conti
50/140	17 June 2024	8 Jun 2024
50/250	15 Jul 2024	3 Aug 2024

All doses of Climara have been deleted from the market and there will be a reduction in supply until supply is exhausted.

The AMS Guide to MHT Doses (Australia only) provides a guideline to approximately equivalent doses of the different MHT/HRT products in Australia.

New Zealand

As at 15 May 2024, patch availability is provided below.

Dose	Estradot	Viatris	Estraderm MX
25mcg	Unavailable	Available	Available
50mcg	Low	Available
75mcg	Low	Available
100mcg	Low	Available

More information can be found  here 

The AMS Guide to MHT Doses (New Zealand only) provides a guideline to approximately equivalent doses of the different MHT/HRT products in New Zealand.

IMS World Congress on Menopause in Melbourne 2024

A reminder that registrations are still open for the IMS World Congress in Melbourne on 19-22 October.  So far there are over 800 attendees who are going to experience a stunning program.

Registration for Australian and New Zealand trainees is FREE until 23 September 2024. Simply go here to register. 

We look forward to welcoming you to the IMS World Congress on Menopause in Melbourne.

Health Professionals - join AMS for Members-only content 

Menopause Matters: Professor Athol Kent has reviewes and comments on recent journal articles.

The Menopause Society Annual Meeting 2024: Details and dates.

IMS Live 16 June 2024: The impact of overweight and obesity in postmenopausal women
Recently, Martínez-Vásquez et al. [1] reported the results of a cross-sectional study that aimed to investigate the association between overweight and obesity in postmenopausal women (n=395) and different health related aspects including quality of life, physical activity, and sleep quality, by filling out respectively, the 12-item quality of life short-form survey (SF-12), the International Physical Activity Questionnaire (IPAQ), and the Pittsburgh Sleep Quality Index (PSQI). It was found that a 64.6% were overweight or obese. Binary logistic regression analysis determined that obesity was associated with higher odds of having a lower quality of life, including alterations in physical role and function, pain and vitality. Those overweight/obese had higher odds of cardiovascular problems... 

Sexual Dysfunctions, Update on Gynae Cancers and Management - IMS Webinar online now
Moderator: Prof Johannes Bitzer

International Osteoporosis Foundation - The 206 - See latest copy.

European Menopause and Andropause Society (EMAS) Online School 2024: Details here.

European Menopause and Andropause Society (EMAS) Newsletter AMS is an affiliate of EMAS. See latest copy.