Research has led to the development of a practical framework to help health professionals worldwide diagnose and manage early menopause. 

It comes as a Senate Inquiry currently examines issues around menopause and perimenopause for Australian women, including impact on their work. 

The diagnosis of early menopause is often not straightforward unless a clear medical cause, like surgery or cancer treatment, is identified. 

Early natural menopause affects around 12% of women globally and is defined as the cessation of periods between the ages of 40 and 44. 

Women who go through early menopause are often unable to access timely diagnosis and effective treatment and may be at higher risk of chronic disease, including osteoporosis and heart disease, according to University of Queensland research. 

As a result, UQ researchers recommend that instead of applying distinct age thresholds, early menopause should be viewed on a spectrum between premature ovarian insufficiency (menopause before 40) and menopause at the average age of 50 – 51. 

“We recommend a more holistic and individualised care approach to managing early menopause,” said study-lead Professor Gita Mishra from UQ’s Faculty of Medicine. 

“This approach could be part of a broader attitude to reproductive health that ideally engages with individuals, especially those at risk of early menopause, well before it occurs.” 

This approach would raise awareness of the short and long-term risks of early menopause, argues Professor Mishra. 

“It would also provide an opportunity for a broader discussion with patients about heart and bone health, and whether the use of hormonal and non-hormonal therapies are appropriate to treat vasomotor symptoms,” she said. 

The study also highlighted the need for more research in the areas of early menopause and premature ovarian insufficiency. 

University of Melbourne senior author Professor Martha Hickey said more information about the unmet needs of people going through early menopause was needed. 

“It would be valuable to know whether they experience more severe symptoms and for a longer duration, than those who go through menopause at the average age.” 

There were important evidence gaps, particularly in middle- and low-income countries, around the causes, associated health risks, and optimal management of early menopause, said Professor Mishra. “This is particularly important for Australia because we have a diverse population. 

“Governments should be encouraged to look beyond reproductive and child health programs and consider the health consequences of ageing and the management of menopause-associated conditions, including menopause support in the workplace.” 

The Australian Senate launched an Inquiry in November 2023 into menopause and perimenopause to address the significant impact these conditions have on women’s lives. Unions including the Australian Nursing and Midwifery Federation, along with nurses and midwives have given evidence at the Inquiry. 

Unions have collectively called for 10 days of paid reproductive leave to be included in the National Employment Standards to support workers managing reproductive health issues such as menopause and perimenopause. 

With an overwhelmingly female workforce and the average nurse aged 47, ANMF Federal Secretary Annie Butler told the Inquiry that nurses and midwives dealing with menopause or perimenopause face increased challenges due to working across health and aged care systems that require 24/7 presence and shift work. 

The Senate’s Community Affairs References Committee is due to report on 17 September 2024. 

The research paper, “Optimising health after early menopause” has been published as part of The Lancet 2024 Series on menopause