Menopause/Perimenopause Medicine
A North Brisbane Perimenopause & Menopause Clinic for Australian women, with a focus on up-to-date, evidence-based lifestyle & pharmacological management to preserve quality of life, and long-term health for women.
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Medicare-rebatable In-person & Telehealth consultations available.
What are Perimenopause & Menopause?
Perimenopause is the period of time prior to Menopause, during which menstrual irregularity occurs. This is the traditional definition, though we know that many women will experience physical and psychological symptoms of Perimenopause prior to cycle irregularity. This phase is driven by the ovaries becoming resistant to the brain signals for ovulation, leading to more chaotic estrogen fluctuations that drive many symptoms. Perimenopause can last anywhere from a few months, to over a decade, during which estrogen will gradually decline to almost zero at Menopause.
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Menopause is defined as a 24-hour period, prior to which there has been no ovulation, and therefore no menstruation, for 12 months. This can be a tricky definition for women who don't menstruate for medical reasons - such as those who have had an ovary-conserving hysterectomy, an endometrial ablation, or a Mirena.
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Why does this matter?
The ovaries produce the vast majority of the body's estrogen through the ovulatory process, so the 12 months prior to Menopause, and life after Menopause are characterised by a significant Estrogen-deficit that is life-long.
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Living without Estrogen for decades has a profound outcomes for a woman’s physical health - after Menopause, risks of heart disease, osteoporosis, dementia and diabetes start to climb. Heart disease is the leading cause of death in women worldwide, and 1 in 2 Australian women will have an osteoporotic fracture in their lifetime, a disease which contributes to death in 1 in 4 people who have a hip fracture over the age of 45. A woman's mental health may also deteriorate, as Estrogen (and probably Progesterone and Testosterone) are incredibly important in the brain - in Australia, the highest rates of recurrent depression in women are in those aged 45-55.
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Not only are there significant health conditions that arise directly as a consequence of Estrogen deficiency, a woman's quality of life can also suffer.
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Common symptoms of the Pauses include:
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Joint or muscles aches & pains
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Insomnia & other sleep disorders
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Changes to the menstrual cycle or character of menstruation
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Hot flushes, night sweats
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Lowered libido
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Painful sex
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Urinary frequency, recurrent UTIs or vaginal infections
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New or worsening PMS, PMDD
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New or worsening depressive or anxious symptoms
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Irritability
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The average duration of Pause symptoms is 7 years, though women may still experience symptoms into their 70s and 80s.
What does The Pause Clinic do?
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The Pause Clinic takes a holistic and individual approach to every woman’s Pause journey. We know that appropriate medical care through a woman's Pause journey can significantly reduce her risk of chronic disease, and that Estrogen deficiency lasts forever - so it's never too late to visit us!
There has been extensive misinformation about Hormone Replacement Therapy (HRT) in the media and online over the past 20 years. Dr Em is able to provide up-to-date, unbiased and evidence-based recommendations around systemic and local HRT. The HRT currently available in Australia is considered safe, and can be used for as long as the benefits outweigh the risks - for many women, this will be the rest of their life! HRT remains one component of management, and significant importance is placed on preventative health - sleep, nutrition, exercise, stress and alcohol.
At the Pause Clinic, Dr Em will take the time to get to know you as a person and a patient, before working with you to build an individualised treatment plan that will restore quality of life and reduce the burden of chronic disease now and in the future. Every woman’s Pause journey is unique, and so should be her medical care.
At the Pause Clinic, we will listen to you, and we will believe you.
We will work with you to create the healthspan that you want and deserve, walking beside you every step of the way.
We can't wait to meet you.