Menopause – a new beginning

‘Menopause – a new beginning’… this is not only the theme of the next World Congress on the Menopause to be held in Melbourne, Australia 2020, but a phrase that is resonating across the globe. Women think less and less about becoming old and increasingly about remaining young through their second life phase. Midlife is their new beginning.

As health-care providers focused on midlife women’s health, we are witnessing a ‘new beginning’ in the rebirth of menopausal hormone therapy (MHT). Women have had enough of putting up with tough menopausal symptoms. They want effective treatment to alleviate symptoms and to prevent the long-term consequences of hormone insufficiency.

They want to know about MHT options and are expecting, and often wanting, their doctors to prescribe MHT. This is a dramatic shift in public receptivity to MHT. When I read Time Magazine headlines ‘Why Hormone Replacement Therapy May Be Safer Than You Think’¹, I feel as though I have crawled out of a dark hole and am shading my eyes from the bright light.

The question now is whether health-care providers are prepared for this ‘new beginning’? Broad dissemination of the early findings from the Women’s Health Initiative hormone therapy studies² resulted in ‘de-medicalization’ of menopausal care and a virtual tsunami of conflicting information about menopause and MHT, in both the medical literature and the public domain. Sixteen years later, there is widespread uncertainty amongst health-care providers as to how to advise their menopausal patients, and when and how to prescribe MHT. Indeed, there is an entire generation of young health-care providers who were indoctrinated on the dangers of MHT, and who may have never initiated treatment in a patient.

The International Menopause Society has taken, and will continue to take, solid steps to fill the knowledge gap at a global level. The annual White Papers for World Menopause Day have consistently provided guidance to health-care providers in a specific area of midlife women’s health, and community education through accompanying public awareness campaigns. This year’s White Paper on Sexual Well-being after Menopause will provide a pragmatic framework to assist clinicians in addressing their patients’ sexual health concerns.

I congratulate the 2016–2018 IMS Board on the development of the International Menopause Society Professional Activity for Refresher Training (IMPART) program, launched at the World Congress on the Menopause in Vancouver this year. This comprehensive, evidence-based program covers every aspect of midlife women’s health care and is internationally accessible online. The seven modules in Level 1 provide a solid foundation in the physiology and impact of the menopause transition, and thorough guidance to all available treatment options. Level 2 provides in-depth modules on the impact of menopause on specific aspects of health such as cardiovascular, cognitive and sexual health. IMPART will facilitate the upskilling of primary health-care providers, specialists, allied health practitioners and postgraduate and undergraduate trainees. I encourage you to access and use the IMPART program, and consider how it can be utilized further in your region.

The next 2 years offer exciting opportunities for the IMS. The Society’s Board is made up of members from diverse backgrounds and, for the first time, intentional representation of all regions of the world. We will work as a team to support the dissemination of knowledge and optimizing health care for women at midlife and beyond. As President of the IMS, I am committed to close engagement with regional societies, including the APMF, EMAS, FLASCYM and NAMS, and the Council of Affiliated Menopause Societies. I am also keen to strengthen IMS relationships with other leading professional societies and organizations, with the objectives of achieving consensus in clinical practice recommendations and a global road map for health aging.

The IMS is a living organization and every member of the Society is part of the life blood of the organization. I encourage you to be active members of the IMS by using our educational resources, submitting your research to Climacteric and commentaries to Menopause Live, participating in the next World Congress, being an ambassador of the Society in interactions with colleagues and patients and helping women experience ‘menopause as a new beginning’.

Conflict of interest

S.R.D. has received honoraria from Besins Healthcare, Pfizer Australia and Lawley Pharmaceuticals Australia and has been an investigator for Lawley Pharmaceuticals Australia.

Source of funding

S.R.D. holds an NHMRC Senior Principal Research Fellowship [Grant no 1135843].