Louise Pratt (WA, Australian Labor Party) Share this | Hansard source

Thank you, Acting Deputy President Allman-Payne, for your own contribution to this inquiry. It is good to see you sitting in the chair presiding over this discussion. Women in Australia are demanding a better understanding from workplaces, medical practitioners, research bodies, governments and our society more broadly about their experience of perimenopause and menopause. But I guess the same could be said for our reproductive lives as a whole.

There's a growing movement in our nation where women are determined to no longer live with preventable and too often debilitating symptoms of perimenopause. Equally, as this inquiry showed, women are concerned about their long-term health, and there are a whole range of health risks that change with menopause, such as heart disease, stroke and more. And, I have to say, I know personally what a difference it makes to have a GP who listens and responds to your needs at this time of life, and I give my thanks to Dr Belinda Wozencroft. However, as the evidence for this inquiry shows, too few women have access to the supports they need. So our report from the Community Affairs References Committee on issues related to menopause and perimenopause is timely.

I thank Senator Waters and Senator Marielle Smith for bringing it forward. I also deeply thank my colleagues who were there, asking questions and participating together. I think it was good that, as women, we were able to engage with other women, medical practitioners and everyone around the nation to discuss these issues. I do wish at times there had been some engagement from male senators—but perhaps it might not have been so much fun!

The inquiry sat a little too close to home for me in its relevance at times, so I stand here tonight very much part of the movement of women asking for change and recognition of these issues. Women's poor experiences when seeking health care for symptoms of perimenopause and menopause were deeply reflected in the evidence put forward to the inquiry, with more than 300 submissions, seven days of public hearings, a hundred people or more giving evidence. I thank all of those people, and I want to give particular thanks to the women who shared with us their personal stories and experiences, some very traumatic. On that note, I have to say that at times, as they were speaking about their own experiences, I felt like they were portraying my own experience back at me. We heard stories of delayed diagnosis, over- or underprescribing medication, the effect of out-of-date medical knowledge on MHT, misdiagnosis or total dismissal of their pain and symptoms. There were harrowing stories from women facing significant barriers accessing appropriate health care.

Our inquiry showed that we have a health system that, in its foundation, has been built by men and largely based on men's biology. I guess at the time, as it evolved, it was a baseline for normal, because their hormonal profile did not have the fluctuations, perhaps, that women have and, perhaps, that is why our medical system did this. However, that is not normal. It is normal in our lives that our hormonal profiles fluctuate and change. We saw, in the course of the inquiry, a representation of the fact that women have been historically underrepresented in clinical trials and medical research, resulting in a gender data gap. We even saw old tropes about women being overly emotional and hysterical, and this their recent and current experiences with medical practitioners—current experiences, frankly, of medical misogyny. Stigma, shame and self-doubt make it difficult for women to discuss their needs with their general practitioner, let alone in their workplace, with their partners, families and other healthcare providers.

We saw examples of limited or no access to health professionals who are trained with even a basic medical knowledge about menopause. This was exacerbated by the experience of living in a rural or remote area. We saw limited or no access to evidence based information so that women could understand an absolute myriad of symptoms and treatment options—symptoms that go far beyond what you might expect in terms of a hot flush. We saw inadequate training for our normally very dedicated health professionals—health professionals who are still captured by an outdated understanding of menopause hormone therapy.

I want to highlight some of our recommendations: the need for a national response and a perimenopause awareness campaign and that menopause and perimenopause modules are included in all medical university curriculums and the need to mandate this education for all physicians practising in the public health system across Australia. When you look at the fact that the largest group drawing down dollars in the Medicare billing system are women reaching perimenopause or in menopause, there are in fact savings to be made by doing this properly; we can't show up, time and time again, undiagnosed or misdiagnosed, for our symptoms. We also recommended that workplace laws should ensure women can access flexible working arrangements.

As our inquiry saw, midlife can be a tough time for some women. We balance a lot of things: the busy lives of our children, demanding jobs, financial stress and, perhaps, ailing parents. When you add to this your own perimenopausal and menopausal health issues, it is little wonder that we did see the evidence of some women cutting their hours or dropping their income at a time of their life when we would hope that they would be growing their careers.

I was particularly moved by the experiences of women experiencing early menopause—women whose medical practitioners threw them into early menopause with cancer treatment or a hysterectomy and yet whose medical support did not include addressing the immediate issues that would arise from going into early menopause. This was really distressing to listen to: the lost education and career opportunities for women who, because of these kinds of symptoms, were unable to continue working because they didn't have access to the help or support they needed.

In finalising these remarks tonight, I want to say that the very best part of this inquiry—and I'm really quite moved by it—is seeing firsthand the incredible difference that the right support and care makes; the wonderful movement of practitioners; women getting together to talk about their experiences; successful campaigns for adjustments in workplace entitlements and flexibility; but, more than anything, a reduction in stigma by having an ability to talk about the symptoms and issues as they arise. Women are engaging and talking to each other. There's an incredible community of practice that is growing. There are a number of physicians who are ethically treating women with MHT. And there are the global trends where we see these treatments improving all the time. British Columbia saw, for example, free menopausal hormone therapy recently announced in their jurisdiction.

So I'm very pleased and proud to be part of this movement, and I very much commend the report to the Senate.