Dear Menopause
Are you experiencing changes to your physical, mental and emotional health you find hard to explain?
Have you tried talking to your doctor/partner/employer/best friend and been left feeling unsupported?
In this weekly show, host Sonya Lovell interviews a range of experts and shares the stories of everyday people to help you understand what the hell is going on, why and where you can find support, empowerment and most importantly, a like-minded community.
Dear Menopause
107: BONUS Hot Take | $573.3M Gov Investment in Women's Health
Could a $573.3 million investment revolutionise menopause health in Australia?
Tune in to discover how this historic commitment from the Albanese government is set to transform menopause and perimenopause care across the nation.
With bipartisan support ensuring the longevity of these initiatives, we explore the Senate Inquiries and Budget Submissions that paved the way for these groundbreaking developments and the profound impact they promise for countless women.
This episode sheds light on how accessibility to menopause care is being reimagined, with Medicare rebates incentivising GPs to gain new skills and the expansion of existing clinics to include menopause specialists.
With advocacy playing a crucial role in these advancements, hear about the collaborative efforts behind the scenes that have resulted in cost reductions for MHT like Prometrium and Estrogel.
We wrap up with exciting news of an upcoming Dear Menopause interview with Assistant Minister Ged Kearney, promising an in-depth look into the policy changes that are shaking up women's healthcare.
Don't miss your chance to submit questions for this insightful conversation, as we aim to bring you all the behind-the-scenes details and celebrate these significant strides in women's health.
Links:
Endometriosis and Pelvic Pain Clinics
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Welcome to the Dear Menopause podcast. I'm Sonya Lovell, your host Now. I've been bringing you conversations with amazing menopause experts for over two years now. If you have missed any of those conversations, now's the time to go back and listen, and you can always share them with anyone you think needs to hear them. This way, more people can find these amazing conversations, needs to hear them. This way, more people can find these amazing conversations. Okay, everybody, strap yourselves in. This is a bonus Newsflash episode of Hot Take. Joining me on the other side of my screen is Jo Wicks.
Sonya:Jo, welcome, hi, sonya Nice to see you Always nice to see you, like we haven't been talking to each other nonstop for the last 20. Exactly, I'm sorry, everyone. I just broke the third wall and the illusion that Joe and I really don't communicate outside of this podcast when we record it. No, we have literally been either WhatsAppping or on the phone nonstop for 24 hours, and why you may ask. All right, let's unwrap this incredible gift that was handed down to the Australian women, yesterday being Sunday, the 9th of February. So, jo, $573.3 million just slightly higher than half a billion dollars was announced yesterday as a gift. I promise, oh my gosh, there's so much to unwrap but it is a package that has been announced, all supporting women's health. So you and I are going to shine a spotlight specifically on the menopause and perimenopause aspects of that.
Sonya:We'll touch briefly at the end on some of the other inclusions, because they are also important, obviously, to our wonderful audience. There's a few things I want to unpack with you, and you and I have gone back and forth on this, but I think it would be really good to share. What does this actually mean? Like, let's get down to the nuts and bolts. It all looks great on paper, but what does it actually mean and what needs to happen next. One of the questions that I noticed was coming up a lot in the comments yesterday was oh, let's hope there's not an election and the opposition gets in, and then they undo all of this. So let's unpack what the likelihood of that is and obviously go line by line and look at what these inclusions are.
Jo:Well, basically, it's not just a lot of hot air and words. It's an actual, very tangible outline of commitments for women's health that the Albanese government has made. It's responding to two Senate inquiries that have been held over the last two years one on equity and access around reproductive health care and one on menopause and perimenopause. Both of those Senate inquiries were delivered to the parliament and have been waiting a formal response by the government, and so this announcement is, I guess, the government's way of responding formally to both of them and the recommendations, and what a response it is.
Sonya:Yeah, and I think actually I also happened to catch Katie Gallagher on the Insiders on Sunday morning. She did actually say in that interview that the government would be formally responding to both of those Senate inquiries this coming week.
Jo:Yes, in fact, now the Parliament's back again. So what they've done, their suite of announcements, covers off the majority of the recommendations in those reports and it's really, really exciting Now because it's half a billion dollars for women's health. There is a lot that's reproductive healthcare, but I thought we'd hone in on menopause, given that you know a big club that we both are passionate about. And, like you said, yes, not everything's going to happen at once. Some things are going to happen pretty much at once, but, um, the rest of the items have been put into the forward budget, is my understanding, over the next five years, so they are part of the budget process. So it's not it's not um a meaningless promise. It is actually grounded in the budget and the opposition I has come out and committed to all the announcements made. So, no matter what happens in the election in 2025, my understanding is that means that it now has bypassed.
Sonya:Yeah, yeah, and they did that really quickly yesterday morning, which off the back of the announcement, which I thought was really great. I thought we can't stick our heads in the sand and pretend there's not an election coming. You know, everybody knows that there is, and we also can't deny that. One of the things that I dislike the most about elections is that one party promises something and then the other one comes straight out and slams that and offers something else, and it's really really good to know that that hasn't happened with this.
Jo:Yeah, and I think that's because it's really really good to know that that hasn't happened with this. Yeah, and I think that's because it's been grounded in so much, um, public engagement. You know, I saw a few snippy comments on social media last night and, look, they were the minority, overwhelmingly. Hundreds of comments of just absolute excitement by australian women, um, and and some jealousy by, uh, international women. But you know there were a few saying, oh, this is just, you know, meaningless election promises and, as someone you know, like yourself, sonia, who's been in this space now for a couple of years, that's actually not true.
Jo:Both the Senate inquiries that this response has drawn from were incredibly detailed processes. You know. They heard hundreds and hundreds of hours of testimony, they read hundreds of submissions across both of them, and that is a lot to sift through and come up with good, solid policy that meets the recommendations, and that's not something that can be done overnight and I think what we see here is really careful policy decisions that the Albanese government has outlined. And so, yeah, do you want me to run through them? Yeah, let's do that, me to run through them. And yeah, let's, let's do that, let's run through them, yeah, okay, so the first one I'm going to talk about is, um, it's and I think you know, I think there'd be hundreds, if not hundreds of thousands of women that will be able to relate to this one and that this is going to be.
Jo:It's the first tbs listing for new menopause hormone therapies in over 20 years. And that is, I think we discussed in the last hot take how some of the modern menopause hormone therapy the body identical, estrogel, estrogel Pro and Prometrium had gone up to PBAC Pharmaceutical Benefits Advisory Committee for consideration for the PBS and we had been waiting on the outcome because PBAC had recommended that they be consideration for the PBS. And we had been waiting on the outcome because PBAC had recommended that they be considered for PBS listings and it had then gone to a negotiation between the pharmaceutical company and the government. And that negotiation has obviously gone extremely fast because these new therapies will be on the PBS on the 1st of March.
Sonya:I know it's huge. I pulled out my Prometrium to take it last night and I looked at the packet and I'm on a two pack per script kind of scenario and I looked at it. I went 90. It was costing me every two months for my Prometrium. And I said to my husband it's on the PBS. The next time I pick this up it'll be on the PBS. What we don't know, though, yet is what price point it will be on the PBS yet. So we know that it will be less than what we were paying, but we don't know yet what it actually will be.
Jo:Yeah, and look, if you're already buying Estrogel, by itself I can imagine there won't be much of a price difference because it's already around the $30 mark if you go to Chemist Warehouse. But where the real savings will be, the average Australian is for the Promethean, or if you're on Estrogel Pro, it could potentially be extremely cost effective. But the the thing that I think that I've seen from doctors the most is that they're most excited about and it's one of the things that we advocated for and which was in our budget submission last year. But it means that if you're on a health care card or a concession card, these, you know, safe, modern, re-identical drugs are now um $7.50, I think, which is just, you know, will make a huge difference and it means it's accessible for a lot of women that couldn't afford them and I think it makes it. It's that equity of access.
Sonya:Yeah, and that's just. That's huge, isn't it? Like you know, that's what we have been talking about and I know it's a drum that I bang over and over again is that we need to make healthcare and medicines accessible and equitable, and this really does do that.
Jo:Yeah, I've already seen so many comments by women going oh my goodness, I'm going to switch to Prometrium. I'm going back to the doctor from the 1st of March to get a new script because now this is going to be affordable.
Jo:I mean, and the 1st of March is super soon. Oh, it's around the corner. Secondly, the next piece that I was super excited about was there is going to be a national awareness campaign funded out of this announcement and again, this is something else that us and many other advocates have been calling for and this is around the fact that so many women you know, myself included, had no idea what perimenopause or menopause is, and a national awareness campaign will mean that this is rolled out across all parts of Australia in all different formats to help educate women and ABFAB people about what menopause means and how it will impact them.
Sonya:Yeah, and I think one of the things that I love about it as well is it's not just educating the women, it's actually educating the entire population. We're going to capture in that awareness campaign partners and sons and daughters and colleagues and leaders in the workplace. You know it is.
Jo:It is an absolute game changer to know that there is actually now going to be an awareness campaign that's funded and I think you know what I'm most excited about is my understanding it will be going out to tender, so I hope that lots of the creative agencies will team up with some patient advocacy groups and think about putting in for a tender to do some really kind of exciting, engaging ways of sharing this information.
Sonya:And we've because you know, I know I've seen some incredible awareness campaigns come out of particularly some of the European countries, and they are often campaigns that are collaborated on with either a pharmaceutical company or a more commercial kind of company. But yeah, the creative agencies can literally have a field day with this if they connect with the right people and they can be successful in the tender.
Jo:No, I know, and have you seen the I think is it NYX N-K-N-I-X one To me that really resonates as a Gen X woman.
Jo:And have you seen the I think is it NYX N-K-N-I-X one To me that really resonates as a Gen X woman. I'm like it's funky, it's strong, it's informative, you know, it's really engaging. So yeah, that's a bit of an excitement in that space. It is One of the other things that got mentioned, which will be that we'll have some national clinical guidelines on perimenopause and menopause. National clinical guidelines on perimenopause and menopause. I mean, what a gap. There are no national clinical guidelines on perimenopause and menopause in Australia. Just a small gap that's existed, mind-blowing.
Sonya:Yeah, that should have been a no-brainer to be included, I know.
Jo:So I don't think any information hasn't come out yet about how that's going to be organised, but usually what will happen is there will be an expert advisory committee, often created, which will bring clinicians from all different backgrounds so all different views get heard, and not necessarily just one side or the loudest voices, but it's an opportunity for everyone to come together and nod out yeah great.
Sonya:What's the?
Jo:best evidence, what's the best guidelines? And I think, sonia, thinking about your new role, I feel that this is something where you know there'll be potentially a massive seat at the table um to have that discussion about how clinical guidelines affect women affected by cancer.
Sonya:Yeah, yeah, yeah, I'll definitely be, uh, making a little bit of noise to get my voice heard in that aspect, and then the third thing that I got super excited about was the medicare rebate. So yeah, this one's fantastic and again, it's something that was a recommendation from the Senate inquiry and also our budget submission that we put in. I think this is one that perhaps not a lot of people would have even been aware was a possibility, so I think this is a really cool one to talk about.
Jo:Yeah, and I think so. This came up a lot by a lot of the medical professionals who presented at the Senate inquiry. So it's around doctors having enough time to talk to women and make an in-depth assessment of what's going on. I mean, we heard a lot about how a lot of women are just hopped onto antidepressants In a 15-minute consult or a six-minute consult. There's not very much that a GP can do in terms of, I guess, fleshing out what is going on in the person sitting in front of them's life, and that the rebates for long consults have just not been adequate. It doesn't incentivize either patients or GPs to do a long consult. So this will give more time to have those important conversations and go. If someone does talk about low mood, is it related to hormones or is it something else? I think that's going to be a really big, big difference and I think we'll see a lot of excitement from the medical community around this.
Sonya:Yeah, and what needs to go hand in hand with that? Obviously and I know that this is on our list of things to talk about as a result of this package but that is GP education, because you know, there is absolutely no point giving us this Medicare rebate and setting this precedent for these long health assessments related to perimenopause and menopause, but not having educated GPs and nurses within the clinics as well. That can then actually support the patient.
Jo:Yeah, and I think this is the one that was going off quite a lot on social media last night with a lot of people being like, oh my goodness, gp education is so needed. You know, can't wait to. You know, help upskill my GP. And you know a lot of GPs were calling for this in the Senate inquiry testimonials as well, you know, and sort of saying there hasn't been a lot of education in this space and they've had to upskill. So again, my understanding is that this will also be going out to tender.
Jo:Now, both the National Awareness Campaign and the GP Education Campaign aren't going to happen in the next few weeks. They will take a little while to get set up. The Department of Health will usually put together a tender, a procurement document, and I suspect, given the time of year, that may have to wait until after the election. Election. Yeah, because you know that's a time-consuming process and once the election's called, no new tenders can be entered into. So I think we'll probably have to wait till after April, may for that process to start. But again, I guess it's a heads up that if you are interested in potentially providing GP education, education and you think your you know organization or a consortium is going to be well well positioned to do this. Um start thinking about what it is. What is to be your unique value proposition yeah, absolutely.
Sonya:But and also a really good time for patients when they are having their appointments with gps and clinicians in these weeks and months leading up to those tenders being successful and the training programs created and rolled out, is to actually just start nudging them. So are you planning to upskill? We've had this amazing announcement. We know that we've got this Medicare rebated appointments. Now you know what are your plans to upskill into menopause?
Jo:Yeah, exactly. And the last one, I think, think and I'll see if anything else jumps out was the expansion of the medical clinics, expanding the network of the endometriosis and pelvic pain clinics. I think there's 22 across Australia at the moment, and so they're going to add 11. So that will make 33 clinics across Australia, and they will now also be staffed to provide specialist for perimenopause and menopause, which is so important, especially when we come back to that equity of access issue. Again, there have been quite a few amazing menopause clinics that exist. Now, you know, they've obviously got the original Wellfem, who provides telehealth across all of Australia, and then you've got HERA.
Sonya:You've got Myma here in Sydney.
Jo:And so there are more and more coming on. But you know, many of them still have a fairly decent out-of-pocket cost which isn't accessible for all. Pocket cost which isn't accessible for all. This does mean that you know, if you think your regular GP isn't upskilled and you're not getting the support you need, then you'll be able to make an appointment with one of these clinics and get yourself to one of them and they are distributed across Australia.
Jo:And I meant to add before, when we're talking about the medicare rebate for menopause health assessment that's going to be introduced from the 1st of july well, okay, so they did announce a date with that, so that's from the 1st of july, okay, great.
Sonya:Yeah, so there's a real incentive there for the gps to actually start really considering upskilling. Yeah, because there is going to be a significant demand come the first of july, so I know, and then um, I thought I'd just do a.
Jo:Do you want I do a quick run through of all the other things that would yeah, yeah, absolutely.
Jo:Let's touch on the other things, for sure because the other thing I was feeling a little bit excited about um, I've got a teenage daughter, uh, and was thinking around there's a whole big suite around contraceptive access as well, which is so needed was even, dare I say, more overdue than um menopause hormone therapy. There had been no new modern contraception added to the pbs for 30 years. Yeah, which is just like mind-blowing, especially when you think about how far contraceptive care has come in the last 30 years. Um, there's been real progress around um a lot of body far contraceptive care has come in the last 30 years. There's been real progress around a lot of body identical contraceptive, lower dose contraceptives. So I think it's Yaz and Yasmin again that we've just talked about on a previous talk tape are going to be going onto PBS on 1st of March as well.
Sonya:And Slinda, I think as well. Is that right? Well, I think Slinda has. Oh, okay, okay, um, is that right? Well, I think slinda has. Oh, okay, okay, I'll say that, yeah, that's so. That's one of the ones that's still being negotiated with the pharmaceutical company, from pricing and that sort of thing. Okay, cool, but definitely yaz and yasmin, yeah and yasmin, yeah, which is really, really.
Jo:I mean I can imagine there's going to be a huge uptake over those mom contraceptives.
Sonya:And I think, alongside that as well was also the treatment for uncomplicated UTIs being accessible direct from a pharmacy as well, which I think is just, you know, brilliant, the same way that hopefully one day we'll be on here talking about vaginal estrogen being available direct from a pharmacist as well. But you know, yeah, to be able to get that over-the-counter care for uncomplicated UTIs is, you know, a great addition and it will.
Jo:You know it makes it. It makes it cheaper for the consumer, but it also relieves pressure on you know the medical system, the GP, gp system.
Sonya:Yeah, exactly, um, okay, so what else have?
Jo:we got in there around oh, and the other one was around IUD. So reducing the cost of getting an IUD or Implanon, which could be a cost saving for up to $500, which is massive. I'm actually due to get a new IUD, so I'm like, oh, when does this one come in?
Sonya:Yeah, you know what? I am not someone that's ever had an IUD, so I was again educated on ABC Insiders yesterday morning when I was watching it because I think it was Samantha Maiden actually gave out the cost of all the different you know having an IUD, having an implant on and all of that sort of thing, and I had no idea it was so expensive.
Jo:It's really expensive and that is partially been because obviously you have to do quite specific training to be able to insert and remove an IUD or an implant on. But then the rebate that the provider gets for doing it is I can't remember what it is, but it's very, very low. It's really not worth their time. So they're both procedures that you certainly can't do in 15-minute care.
Sonya:Yeah, and you have to have the skills to be able to do it. Not every GP can do that.
Jo:Can do that. The amount the rebate was wasn't incentivising doctors to upskill. So again, it's that now I could be incentivised to provide these forms of contraception and do so, you know, to more women, especially rural and remote where it can often be quite hard to. I can imagine, and you know because the IED that for me in perimenopause I use that for my, the progestin of my MHT, and it's also amazing with the heavy bleeding which you know. I think that's something that Dr Talael and Women's Health Road you know they've created the Bleed Better campaign around that awareness raising around heavy menstrual bleeding, and the idea just was amazing for reducing that. So, so many women experience that in perimenopause.
Jo:So not only is it a great form of birth control, because you put it in and you don't think about it for five years, but then it can absolutely wipe out that heavy bleeding.
Sonya:Yeah, you don't think about it for five years, but then it can absolutely wipe out that heavy weighting. Yeah, fantastic. So, overall, some fantastic, fantastic recommendations or investments that have been documented in this, this package. You know I love that their tagline is more choice, lower costs and better health care for women, like it's it's. You know they're delivering what they're selling in the tagline.
Sonya:What we've touched on, other than the things that we know that we have dates for coming, which is the PBS for the Prometrium and the Eastergel and the Eastergel Pro and the 1st of July for the Medicare rebates everything else is pretty much not likely to get much movement until post-election and obviously tender processes are completed and that sort of thing. So, yeah, lots of excitement, lots of hope that you know we have really broken through. You know what really was feeling like a bit of a concrete wall there for a while, and you know one of the things that we were going to touch on and is around how this process has kind of evolved. You know A lot of people think that these things the government just goes and cherry, picks something off a tree and throws them into a report and puts some money against them. But let's talk just for a moment, so that people do have an understanding of what's gone into this actual outcome From my perspective.
Sonya:My involvement in this started back with our pre-budget submission, which I think, if I'm right, we started putting together in 2022. Oh, 2023.
Jo:Yeah, we did a small one in 2022. Okay, because it was quite rushed. And then we did a much bigger one. I think it probably started around August 2023.
Sonya:Yeah.
Jo:Built a collaboration of. You know. It was clinicians, patient advocates and academics who came together and nutted out, you know, if we wanted to see transformative menopausal action, what would be the pillars that the government would need to act on to really sort of change the landscape. And I think we came up with seven key things. It was our wish list of what we'd like to see the government do and I noticed that Kelly Teagle had done a beautiful little graphic on last night showing that five of the seven items on our budget submission got big green ticks.
Sonya:Big green ticks, yeah. So this has been a labor of love for many of us, a really big cohort. We're so driven by passion and a real desire to make change for the community. At the end of the day, this isn't about lining anyone's pockets and it's not about putting anybody on a pedestal as being the best. In Australia, this is very much been driven by, and the government has delivered on what is the biggest needs in the community right now how can we improve the quality of life for our women that are in their perimenopausal and menopausal years? And also the other things that we talked about that have been ticked off as well, outside of our remit. So, yeah, a huge cause for us for celebration.
Jo:Yesterday, you know there were many on and I think it is that sense of you know people are wondering. You know, I think in the last hot take we talked about the Menopause Advocacy Toolkit, but it's kind of everywhere and it's that reminder that sometimes it can feel like doing a budget submission. You know, I think if you go onto the Treasury website there's like 300 from this time last year, which is where the collaborative effort that we contributed to is. It can feel like it just goes nowhere and nobody reads it. But I think it's that reminder that you have to participate in the process to have your voice heard, and that was part of the advocacy that we all did. And then it was the conversations with politicians, it was the conversations with journalists, having people on the Dear Menopause podcast. You know that all then builds the story and the narrative and, yes, a glass of champagne for sure.
Jo:I just want to just add the other thing that struck me when I was reflecting on this last night is this is why representation matters, I think you know is this is why representation matters. I think you know this is partially come about because the Australian Parliament has more women parliamentarians than any other time in its history and we have a Minister for Finance, a Minister for Women who's a woman. We have an Assistant Minister for Health who's a woman. We have a Minister for Social Services and Aged Care who's a woman. The leader for women in the Greens, larissa Waters, is a woman. When you have women in these decision-making positions of power and influence, the issues that matter to women are more likely to be heard. And it's this perfect storm of advocacy and having, frankly, women in positions where they can act on the things that are important to other women's communities that's really excited me, yeah, yeah.
Sonya:And I think the other thing I'd add to that too that I think is really important to um to you know, acknowledge, and that is that we are also in this, you know, this new space of where people have access to information, where voices can be heard, and I think you know we now have these incredible tools, love them or hate them, but social media, you know, is where people go now to get their news to you know, so much of the traditional news now is behind a paywall. Yes, exactly.
Sonya:You know, people are listening to podcasts, people are on social media, you know that is where they are.
Jo:People have conversations with people.
Sonya:I listening to podcasts. People are on social media. You know that is where they are. People have never met, I know, isn't it awesome? I mean, there's some people on there that you really kind of don't want to meet as well. But you know, I really think this says a lot for the raising of the conversation and the profile of people that can be trusted and people that are really doing hard work out there aren't always found in your traditional. You know places that the world has changed and it's time everyone embraced that.
Jo:I know it's a really exciting time. Well, let's look forward to the 1st of March and filling our scripts.
Sonya:Sonia, I am going to finish off by sharing a little bit of exciting news that I got this afternoon, and that is that Assistant Minister for Health and Aged Care, jed oh, I must learn how to say that properly before I interview her Jed Carney will be joining me here on Dear Menopause and we're hoping to record in the next week or so, so I will be able to really deep dive with her into like everything that went on behind the scenes with this. I'll get all the juicy gossip for you we should list those.
Jo:You know, if they've got any burning questions, should they?
Sonya:send you some. Look, my DMs are always open. Absolutely Hit me up. What a great way to end Awesome.
Jo:Thanks Jo.
Sonya:All right, I'm going to hit end. Oh my gosh. Thank you, thank you, thank you.
