The Australasian Menopause Society (AMS) provides education to health professionals to improve the healthcare of women at perimenopause and after menopause.

The AMS welcomes discussion of menopause and efforts to improve access to appropriate care. However, we have recently become aware of spurious claims being made about menopause and hormone therapy by some health professionals on social media and in opinion pieces. These claims are presented as mainstream expert opinion, but some of them do not accord with current evidence-based guidelines.

The concerning content includes:

• Promotion of menopausal hormone therapy (MHT) for treatment of a wide variety of symptoms that may not be related to menopause.

• Promotion of MHT for primary prevention of cardiovascular disease and dementia prevention for women at the usual age of menopause. This is not supported by evidence or current guidelines.

• Not using agreed definitions of the perimenopause, leading to patient treatment with MHT outside of accepted indications. Perimenopause is defined as beginning when menstrual cycle changes occur as per the STRAW +10 criteria.

• Promoting testosterone as a routine component of MHT and promoting testosterone for non-specific symptoms such as fatigue or ‘brain fog’, or to improve general wellbeing. The only evidence-based indication for testosterone currently is hypoactive sexual desire dysfunction in postmenopausal women. Evidence for testosterone to treat any other symptom or for disease prevention is lacking.

• Minimising risks of MHT and making overly simplified statements regarding the highly emotive area of MHT use and breast cancer risk. Much more research is needed before it can be said that any of the available forms of MHT are risk free with regards to breast cancer.

• Suggesting that breast cancer survivors can routinely be prescribed MHT. There are very occasional circumstances when women with breast cancer may be prescribed MHT but it should be a careful decision involving multidisciplinary discussion.

MHT is the most effective treatment for menopausal symptoms and has a role in preventing osteoporosis and fracture. It can be offered to women who are medically eligible, along with an individualised discussion of the benefits and risks. AMS promotes a balanced, evidence-based discussion of the benefits and risks of hormone therapy.

On 13 June 2024 the Australian Commission on Safety and Quality in Health Care released national trend data in a new report suggesting that women may be turning from hysterectomy to less invasive treatments for heavy menstrual bleeding, a condition that affects one in four Australian women.

It has also released an updated Heavy Menstrual Bleeding Clinical Care Standard (2024) to ensure that women with this condition can make an informed choice about the most appropriate treatment for their individual situation.

Together these resources aim to improve care for women with heavy menstrual bleeding, which can have a substantial impact on a woman's quality of life.

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. 

Key findings

The Women’s Health Focus Report found a 20% decrease nationally in the rate of hysterectomy between 2014-15 and 2021-22, and a 10% increase in the rate of the less invasive option of endometrial ablation (2013-16 and 2019-22).* 

However, the data indicate inconsistencies in care across the country. Rates for both procedures were consistently higher in regional areas than in major cities and remote areas. In 2021-22, the hysterectomy rate for First Nations women was 9% higher than for other Australian women.

Use the Report’s interactive maps and graphs to view hospitalisation rates and trends in your state or territory, PHN and local area. If substantial variation exists, investigate whether appropriate care is being delivered in line with the Standard. 

Download the Standard and implementation resources to learn more about best practice care and local improvement opportunities for women with heavy menstrual bleeding.