Twelve WellFemme clinicians recently attended Australia’s Premier menopause conference in Fremantle. Here are their key take-ways…
The Australasian Menopause Society’s (AMS) annual Congress is always a blur of familiar faces, quick catch-ups, and the inevitable scramble to find your bearings before three days of intense learning (and, of course, a few photo ops!). For many of our team it was also their first in-person meeting with WellFemme colleagues, so there were plenty of warm hugs and excited chatter.
Most of the other WellFemme doctors also attended the lectures online. With a jam-packed schedule of presentations and social events, the energy was infectious and the pace relentless. But the insights and connections made every moment worthwhile. Here are a few of our top takeaways from this year’s Congress: inspiring, surprising, and downright fascinating.
Dr Kath Turner, NSW
On resistance training: My take-home was the importance of resistance training in retaining lean muscle mass and enhancing strength when on GLP1 weight loss medications like Mounjaro.
Dr Kelly Teagle, ACT
On weight loss: Losing weight from injectable drugs without strength training can lead to loss of lean body mass equivalent to 10 years of ageing! You don’t want to be a skinny jellyfish, so make sure you’re working with a dietician and exercise specialist to optimise nutrition and retain lean muscle and bone.
Dr Elise Turner, QLD
On the dangers of medicine to cats: Transdermal estrogen contact and ingestion causes aplastic anaemia and marrow failure in cats, so ask and inform patients with feline friends! (and don’t let your cat lick your arm after applying your estrogen gel!) On breast cancer survivors: We should consider testing BMD in breast cancer survivors. Especially those on aromatase inhibitors plus GNRH analogues in treatment of breast cancer will have worse bone density loss.
Dr Alice Webb, WA
On cardiovascular disease: Menopause itself is an individual risk factor for cardiovascular disease (heart attacks and strokes). And menopause under age 40- DOUBLES your cardiovascular risk if untreated. On testosterone: Change in sexual function do not appear to correlate with low testosterone. The only evidence for testosterone use is for women with hypoactive sexual desire disorder. Also, transdermal testosterone does not have negative effects on lipid or glucose.
On eating disorders: Eating disorders in menopause- 73% of midlife women dissatisfied with their weight. Binge eating and body dissatisfaction increase in midluteal phase (about a week after ovulation/ before period). Hypersensitivity to estrogen fluctuations increases a woman’s risk of eating disorders. This is a great resource for patients: Menopause and Eating Disorders
Dr Cecilia Akinloye, VIC
On heart health: Heart health is brain health! On osteoperosis: HRT remains the treatment of choice for prevention of osteoporosis in postmenopausal women. On fat accumulation: Menopausal abdominal fat accumulation may be offset by estrogen therapy, with a reduction in overall fat mass, improved insulin sensitivity and lower rates of type 2 diabetes.
Dr Sonia van Gessel, NSW
On body fat: Hormonal treatment doesn’t increase body fat – instead it decreases android fat, which is responsible for increasing metabolic and CVD risk. On Nocturia (excessive night-time urination): This is often a sign of Obstructive Sleep Apnoea (OSA), particularly if the woman has no daytime issues, and does not markedly improve with vaginal estrogen. Treat the OSA, cure the nocturia. Also with frontal headaches that go away within an hour of waking – think OSA. Who knew?!
Dr Rebecca Jarvis, SA
On brain health: the brain changes associated with Alzheimer’s disease start in your 50s, decades before you start to notice the cognitive changes.
Dr Celine Goh, SA
On breast screening: women who have MRI for breast screening should also have a mammogram too, as MRIs do not pick up calcifications, which could indicate early or pre-cancer like DCIS. Mammogram is better in detecting calcifications. On bone loss: Bone loss is around 1% per year after menopause. However, MHT (Menopausal Hormonal Treatment) use (when appropriate) can provide long term bone protection, even long after it’s ceased.
Dr Nicola Shankey, QLD
On medication: Duloxetine (antidepressant/ antianxiety medication sometimes used for pain) has proven benefit for symptomatic reduction of menopause related joint pain in women who use aromatase inhibitor after breast cancer.
Dr Brada Shimmin, SA
On the reason why you shouldn’t use MHT even after hormone-receptor negative breast cancer: 20% of metatases from hormone receptor negative breast cancer are hormone receptor positive. Tumour variability means the tumour sample tested may not be fully representative. Therefore, try to avoid MHT even in these patients.
Dr Rebecca Goodman, SA
On Testosterone: Testosterone declines in 40- 60 year olds but then increases after 60. Testosterone treatment is also associated with weight gain and can take 4-6 weeks to get any benefit. On sleep: Always ask about sleep as it affects everything. Women may have low scores for obstructive sleep apnoea (testing geared for men) but significant symptoms; they should consider having a sleep study and treatment.
Dr Gemma McQuillan, NSW
On genito-urinary symptoms: Systemic MHT may not treat genitourinary symptoms, so offer local topical therapies (eg. vaginal estrogen or moisturisers, intrarosa).
Dr Geraldine Young, QLD
On blood tests: Estradiol metabolises into other forms like estrone, but blood tests only capture Estradiol so they don’t capture all the different Estrogen types. Another reason not to do unnecessary blood tests!
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