When I was a new mum in my early 40’s I definitely couldn’t relate to the “grey ladies” I’d always associated with menopause. Sure, I was older than most new mums but I was still in the prime of my active, productive years. Menopause is something that happens when you get old, right?

I reflect uncomfortably now on my naïve attitude. How could I have gotten it so wrong? Mum and I talked about everything: periods, sex, having babies… why didn’t we talk about menopause too? Even worse, I’m a doctor who specialises in women’s health; how did I not know better? I was so unprepared.

Life became complicated for my husband and I in our mid-30’s, as it does for many people. We’d prioritised career over kids for too long and then struggled to fall pregnant. Eventually, we were blessed with two beautiful babies but years of gruelling IVF treatment had gradually eroded our relationship. Finally, at the age of 42 with two kids under four, our marriage imploded and I had to face the future as a single mum.

Our separation occurred just as I was leaving my safe, secure government job of 20 years. The financial security I’d always taken for granted was gone along with the social support of my peer group. My life was in turmoil. Under the circumstances it seemed understandable that I was irritable, anxious, sleeping poorly and feeling… well frankly, like crap. When I confessed to my GP that I was unravelling she- quite appropriately- prescribed antidepressants and counselling,

It was after weeks of drenching night sweats that I finally began to wonder if other forces were at work. My periods were already long gone since the insertion of a Mirena IUD; this masked the irregular periods which often signal perimenopause. Luckily I worked with some wonderful gynaecologists who were generous with their advice and sent me for some tests. Mystery solved: I was in menopause.

The news rocked me to say the least, but knowing the reason for my symptoms was also a huge relief. It was a start-point on the map to where I wanted to be. I now know that about 5% of women reach menopause before age 45, and 1% under 40. I was very fortunate to have my babies just in time but my heart aches for those who don’t. I was also very fortunate to know some great doctors and get the right treatment, so before long I was starting to feel like myself again.

Fast-forward eight years to my life today. I’m a 50-year old mum of tweens with a career as a women’s health practitioner, and mostly flush-free. My “baptism of fire” into menopause prompted me to learn a whole lot more about it, so now I devote a large proportion of my practice to helping other women with their perimenopausal symptoms. When these women meet me they often say “I just want to feel like myself again”, as I once did. In hindsight I can see that my pre-menopausal and post-menopausal selves are very different women, but not in a bad way. Menopause is just the beginning of a “new normal”.

So what is menopause exactly?

The official definition is when you’ve been without a period for twelve months. A blood test is not usually needed to diagnose it, although in cases where a woman is unexpectedly young or has a Mirena IUD it can be helpful. The average age of menopause for Australian women is 51 but perimenopausal symptoms can actually start many years beforehand and go on for years- maybe even decades- afterwards. The point when a woman goes from being perimenopausal to menopausal is not really that important unless it influences her treatment, for example whether or not to continue contraception.

The symptoms of perimenopause may include:

Hot flushes or night sweats, mood changes, sleep disturbance, muscle aches and pains, vaginal dryness and sexual or urinary issues. About 80% of women will have symptoms, 20% of them quite severely, yet only one in five women with severe symptoms finds effective treatment; why is that?

I’ve worked with hundreds of midlife women over the years and become increasingly concerned about the misconceptions surrounding menopause. Fear and misinformation prevent women from discussing it or seeking treatment. This deprives them of opportunities for symptom relief, better quality of life and ongoing health benefits. For example, hormonal therapy is now proven to be a safe, effective treatment for hot flushes. It can also improve bone density and reduce the risk of heart disease and some cancers. Yet many women and doctors alike still avoid using it because of misleading statements made in the press almost 20 years ago that made people believe it was unsafe.

Well-informed care

Added to this legacy of fear is the problem of access to well-informed care. We GP’s see a vast range of medical problems and struggle to keep up with the latest treatments for everything. We just can’t know it all, so even excellent GP’s will sometimes lack expertise in treating menopausal symptoms, particularly in more complex situations.

It’s frustrating that so many women endure debilitating symptoms unnecessarily, particularly those with limited access to medical services in rural and remote communities. When I started thinking about ways to help them I soon realised that menopause care could be delivered easily and inexpensively by Telehealth (phone or videoconference). Internet and phone coverage is improving all the time; Australians should be able to access medical services by Telehealth regardless of where they live. This thinking led me to develop WellFemme, Australia’s first dedicated Telehealth menopause clinic.

Australia’s first dedicated Telehealth menopause clinic

I’ve designed WellFemme to be as simple and straightforward as possible. Women can book online from the website, or by phone if they don’t have a computer. If they have reasonable internet or smartphone coverage they simply click on the link that’s emailed to them to start their video session. The fall-back option is to conduct the consultation by phone. Sessions are 45 minutes long to allow a really thorough assessment and provide women with holistic, personalised advice.

The journey to develop WellFemme has been slow but steady. There are still many barriers to Telehealth in Australia, including the one thing that should support it the most- Medicare. I can provide the exact same menopause service by Telehealth as I do in person, yet my patients can only claim a rebate if they visit in person. If I were a gynaecologist my clients could claim Telehealth rebates. Medicare discriminates against GP’s like myself who provide specialised services and it discriminates against patients who need them, like those in rural areas. I’ve actually started a petition to show Government that people want services like this to be rebated.

What women really need to know is that menopause is not the top of a long downhill slide. It’s a normal transitionary life-stage, not something to be dreaded or ashamed of. Celebrate the wisdom, confidence and insight you’ve gained. Become an inspirational leader of women and educate our daughters about menopause. Reassess what’s worked for you before and make new choices that will serve you better moving forward. Embrace your new normal! And don’t endure dreadful menopause symptoms; get evidence-based advice from a doctor who is knowledgeable about the treatment options.

Dr Kelly Teagle is a GP in Canberra specialising in women’s health and is the Founder and Principal of WellFemme Women’s Health Services. She runs free menopause seminars in regional towns and can provide small-group webinars Australia-wide on request. WellFemme consultations can be booked via the website www.wellfemme.com.au or by phoning (02) 6179 8724.

Please show Government that you care about rural and remote women’s health by signing Kelly’s Telehealth petition.