March 20, 2025 • 41 mins
Updates on the rapidly changing landscape of menopause care in Australia and globally, focusing on revolutionary PBS changes making hormone therapy more affordable and the growing momentum around women's health initiatives.
• Pharmaceutical Benefits Scheme (PBS) now includes Estrogel, Prometrium, and Estrogel Pro (as of March 1st), with Slinder joining May 1st
• PBS prescriptions require specific coding - you may need a new prescription to access subsidised pricing
• FDA removed warnings from testosterone in the USA, highlighting the need for Australia to update outdated warnings on vaginal estrogen products
• The "So Hot Right Now" Medical Conference created an inclusive learning environment for healthcare providers to discuss menopause care
• Government funding for GP education ($1.5 million) lacks sufficient scope and evaluation mechanisms
• Dr. Lisa Mosconi leading a $50 million research program to reduce Alzheimer's in women by studying the relationship between protective hormones and brain health
• Jo launches Sheela Consulting - Unapologetic Advocacy, focusing on women's health policy and advocacy
If you've missed any of our expert conversations over the past two years, go back and listen, and please share them with anyone who needs this information.
To listen to my previous episode and interview with Assistant Minister Ged Kearney, please head to episode 110.
Links:
So Hot Right Now Medical Conference
Dr Lisa Mosconi - CARE funding
Australian Government $573M funding
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Sonya (00:01):
Welcome to the Dear Menopause podcast.
I'm Sonya Lovell, your host Now.
I've been bringing youconversations with amazing
menopause experts for over twoyears now.
If you have missed any of thoseconversations, now's the time
to go back and listen, and youcan always share them with
anyone you think needs to hearthem.
This way, more people can findthese amazing conversations,
(00:24):
needs to hear them.
This way, more people can findthese amazing conversations.
Welcome to this week's episodeof A Hot Take, with Johanna
Wicks and myself here to bringyou up to date on all of the hot
topics that are currentlyimpacting the menopause
conversation globally, but, mostimportantly, here in Australia.
Jo, welcome.
Jo (00:43):
Lovely to be back I think it's been just over a month and,
wow, a lot has happened in thatmonth.
Sonya (00:48):
It's been a huge month.
I'm going to mention upfrontthat I got COVID a couple of
weeks ago.
I lost my NOVID status.
I had never had COVID up untildodged it for five years.
I know I thought I was specialApparently not.
Jo (01:02):
Sonya, where did you get your COVID from?
Sonya (01:06):
Well, jo, not that I want to apportion blame on anybody,
and it isn't the takeaway that Iwas hoping for, but I did get
sick after the so Hot Right Nowweekend in Sydney.
Basically, I had a big day onthe Friday and the Saturday and
woke up very, very unwell on theMonday.
So, look, I hugged a lot ofpeople.
(01:28):
Thanks for all the hugs, but nothanks to the COVID.
But why I wanted to mentionthat was because my voice is
still doing strange and weirdand wonderful things.
So if I start to lose my voiceor my voice sounds a bit
scratchy or wobbly.
That's why and I'll just let Jodo all the talking if that's
what ends up happening Great, myfavorite.
Awesome, jo, we have got lotsto talk about.
(01:49):
What are we going to kick offwith today?
Jo (01:51):
Well, I think it would be very timely to yet again kick
off talking about the PBS, thePharmaceutical Benefit Scheme,
because since we last spoke, the1st of March has been, which
saw Estrogel, prometrium andEstrogel Pro hit the PBS and
Yasmin, and then on the weekendthere was another announcement
from the Albanese governmentwith more drugs for women's
(02:14):
health going onto the PBS.
It's just, I mean, it's sort ofan unprecedented deluge of
awesome medication.
Sonya (02:20):
It really is, isn't it so ?
Slinder was the announcement,the big announcement that's
going to impact most likely ourperimenopausal menopausal
listeners that is going to beavailable as of the 1st of may
as a pbs priced drug therapyfantastic and I think what is
super excited about this isafter, um, the 1st of march.
Jo (02:40):
You know I've done a bunch of posts and different platforms
around the fact that especiallyprometrium had gone onto the
pbs.
And but you, this is after the1st of March.
You know I've done a bunch ofposts and different platforms
around the fact that especiallyPrometrium had gone onto the PBS
and you know sort of saying,you know, obviously we know
there's some other amazing drugsout there and what would people
like to see also on the PBS.
And you know, out of all theresponses I got, Slinder came up
the most.
Sonya (03:00):
The most.
Jo (03:01):
So I think there'll be a lot of very happy women across
Australia, especially becauseSlinder is, so it really works
from basically kind of yourteenage years through to being
almost post-menopausal, becauseit's sort of safe across all age
cohorts.
So it's a very versatile drugand that a lot of people who are
progesterone sensitive cantolerate quite well.
Sonya (03:22):
Can tolerate.
Yeah, it's.
It's fantastic.
Now, whilst we are excited aboutall of these amazing um new
drugs turning up onto the pbsbeing cheaper, there has been
quite a bit of conversation,I've noticed around the need to
get a new prescription to beable to be eligible for the new
pbs pricing.
So obviously now, since sincewe're past the 1st of March for
(03:44):
your, as you said, prometrium,estrogel and Estrogel Pro, and
something to bear in mind withSlinder coming up on the 1st of
May so the correct procedurearound this is if you have a
prescription that is dated afterthe 1st of March, then you will
be getting that automaticallyat the PBS rates.
However, if your prescriptionwas dated prior to that, some
(04:09):
pharmacies and from what I cangather, most pharmacies are
requiring you to get a new,updated prescription so that
that can go through their systemat the PBS.
That the correct coding withthe correct pricing attached to
it.
I thought it'd be good for usto just kind of talk through
this a little bit, because I wassurprised at the amount of
conversation that came up aroundthis from women.
Jo (04:31):
Me too, and I think you know I've just made an appointment
for next week to go and get allmy scripts updated because I use
Estrogel and I think that it'sa little bit tricky because
obviously that it'd be lovely ifall pharmacists could just
honour your current script, andI believe a very small minority
are able to.
But it is very hard in thebureaucratic system that is, you
know Medicare, to make sureyou've got all your codes that
(04:56):
are lined up and it is mucheasier just to have a script
that has the correct codes on it.
And the other thing I wanted toadd to that, sonya, which is
something I only learned when Iwas at the so Hot Right Now
medical conference I hadn'trealized that you need to
specifically ask your doctor fora 60-day dispensing and then
you get two months worth of themedication for $31, which blew
(05:22):
my mind.
I was so excited about the factthat you know especially,
estrogel Pro is on PBS and isnow $31 for both medications in
their one pack.
Yeah, yeah, to get two months'worth for $31 was just like oh,
that is a huge cost saving.
Sonya (05:40):
I know I did a post and this was when I realised the
conversation that was coming uparound the prescriptions.
I did a post and this was whenI realized the conversation that
was coming up around theprescriptions.
I did a post because I happenedto.
Actually, I think I ran out ofmy progesterone, my prometrium,
about two days before the 1st ofMarch, so I literally didn't
get mine filled until after thatdate had ticked over.
And look, I have a fantasticpharmacist, small, local
(06:01):
pharmacy.
I've got a great relationshipwith him, he knows what I do.
So I was walking, I was likeJohn, we did it, we're on the
PBS and, um, you know, I didhave a relatively new
prescription, was probably datedmore like the start of February
, and he honored that for me andput it through at the new PBS
pricing which you know.
It was literally on the firstor the second of March that I
(06:23):
got down there to get that.
Now I was paying $97.60, Ithink, or something like that,
for my 60-day Prometrium and Igot it at $31.60.
And I was just beside myself.
I was so excited, which is whyI came up and photographed it
and popped it onto my Instagramto let everyone know, but yeah,
(06:43):
then the whole thing about theprescriptions came up.
So I thought what might be anice idea is if we just talk
through the different optionsthat you have available to you
to actually get a newprescription, because I did
notice that there was a lot ofpeople that felt that it wasn't
right that they would then haveto go and book a whole new
appointment with their GP andjust to go in to just get their
(07:05):
prescription updated.
Now you and I are lucky enoughto have a lot of friends that
are GPs a lot of colleagues andwe sit in different conversation
groups with them, and it wasinteresting seeing the
conversations going back andforth between them about how
different GPs and different GPclinics were managing the need
for updated prescriptions.
I think one of the things thatcame up regularly was that there
(07:26):
is an option for some clinicsthrough hot docs, so if you're
doing an online booking, you canput in that that you just
require an updated prescriptionand then it might be that your
GP just does a telehealth callwith you that's bulk billed and
just ticks the box that theyhave had a conversation with you
and they will send you throughvia text.
Often I get all my prescriptionsnow via text and updated
(07:48):
prescription, and that there wasalso other GPs that were
offering telehealth calls fortheir patients, rather than
thinking that you have to bookin to go in and sit in the
waiting room and have this biglong process of having a GP
appointment and the cost that'sassociated with it.
So I guess my takeaway fromthose conversations and being
able to sit on the fence alittle bit and hear both sides
(08:10):
of the stories is, if you dorequire a new prescription, just
reach out to your clinic andask them what your options are.
Don't assume that you're goingto have to go in and see someone
.
Maybe just give them a call andask them what your options are.
Jo (08:22):
Because the likelihood is that they've come up with a way
of dealing with it, becausethere's been a lot of women
talking about this.
But it is important to notethat if you are using like a
60-day prescribing for the firsttime, then you know that might
be not as easy as justreplenishing your script.
Sonya (08:39):
Yeah, that's a good point .
Jo (08:40):
And, as Sonya just said, you know, it is definitely worth
making sure that you get thetwo-month code, so that it is
$31 a month is great, $31 fortwo months is even better.
Sonya (08:52):
Yeah, and I suppose the only other thing I'd like to say
around that is don't get crankywith your pharmacist, don't get
cranky with your GP.
You know this is a procedureand protocol situation.
There is codes and ways thatthings have to go through
computer systems for them to beable to dispense or to provide
(09:12):
you with a prescription.
The system's not ideal, we allknow that.
So just be patient, find outwhat your options are that are
going to work best for you.
But yes, it is likely that youare going to need to get a new
prescription and then thinkabout adding up all the money
that you'll save from now untileternity.
Jo (09:30):
If you're going to take your MHT until death, like I am.
Sonya (09:33):
And me.
Jo (09:35):
And that's a huge saving.
And I think that's one of thethings I did want to acknowledge
.
You know, I wanted toacknowledge that these are big
changes and, you know, obviouslythere's a bit of political
fostering going on which I'vetried not to roll my eyes at,
but I have others in thepolitical space, sort of being
like we're equally committed,and I have felt a sense of
frustration because I was like,well, you were in government for
(09:57):
10 years and you didn't put anyof these drugs on the PBS and
you had plenty of opportunity inthat 10 years to do so.
So I do think that what thecurrent government has done in
getting so many new drugs on thePBS does matter.
It doesn't mean that we stopasking for more.
Like, when I did the littlesurvey, people had mentioned
(10:17):
Zoli as another contraceptive.
That's really really, reallyimpressive and really effective.
Androfem is the only femaletestosterone in the world.
A lot of chatter about intrarosa, um, which only came into
Australia last year, but is anew, incredible vaginal estrogen
, and DHEA, yeah, um and got totalk about a lot.
(10:39):
It's so hot right now.
So there are.
There are drugs that need to goon the PBS, but this is kind of
like an exciting start and itfeels like there's real
motivation behind it.
Sonya (10:48):
Yeah, absolutely 100%.
All right, so where does thatlead us?
What's next?
Should we talk about the FDAremoving, while we're talking
about drugs and hormones and youjust mentioned androfem and
testosterone, you know, as partof that conversation.
So if you have been a long-timelistener, first of all, thank
you very much.
Secondly, you'll probablyremember us talking about the
(11:12):
push in the US specifically toremove the warnings, the black
box warnings, from your vaginalestrogen, and we were talking
about the fact that testosteronealso falls into that kind of
category as well.
So the FDA have actually goneahead and removed the, or
they're going to remove I can'tquite remember the process
remove the warnings fromtestosterone in the US.
Jo (11:35):
Yeah, and there's quite a long story behind it, but there
was a worry that men usingtestosterone in the US was
contributing to theircardiovascular risk and bad or
adverse cardiovascular outcomes,and so what actually happened
is the FDA, which is theAmerican version of the TGA,
actually requested that there bea big randomized control trial
(11:59):
looking at testosterone in menwith a history of cardiovascular
disease or a high chance ofdeveloping cardiovascular
disease, and they actuallycompelled the four big companies
that provide testosterone inthe US to pay for it.
To my understanding, it was avery extensive study, but I
think it looked at over 5,000men, of which half had a placebo
(12:19):
and half were giventestosterone.
The results came back andshowed that there is no
increased cardiovascular risk ornegative outcomes for that
cohort, which was quite amazing,and I think that study
concluded maybe just over 12months ago, or the results were
presented 12 months ago, but nowa couple of I think it was even
(12:40):
on the 1st of March.
I feel like a lot happened onthe 1st of March.
Yeah, maybe it was yeah,because Kelly Casperson did a
post while she was in Australiaabout it, and so the FDA has
actually said right, we've takeninto consideration this study
and we now are going to take offthe warnings around
cardiovascular risk associatedwith testosterone for men in the
(13:03):
US.
But why this is, I think,important, samuel, which is what
you're alluding to is it showsthat things can change and that
the labelling on medication canbe updated or removed, in this
case, when evidence comes tolight.
And I think one of the thingsthat has been frustrating for
women in Australia and the USand the UK and around the world
(13:25):
is that there are I mean, whosaid it?
I think was it Kelly who saidthere's 500 studies of vaginal
estrogen in breast cancerpatients that show that vaginal
estrogen is safe to use andacross 25,000 women.
And yet we still have thesereally dire warnings on vaginal
(13:47):
estrogen in Australia.
And I think this is a call outto the government, to the TGA,
that you can choose to takethese non-factual risks out of
these products, and I mean Idon't think they don't have to
have anyone ask them to do that.
They could voluntarily decideto review the literature and do
this off their own bat, hint,hint TGA.
(14:09):
Or, you know, we could also lookat having a bit of a campaign
to Theramex, novonordic andAspen, who make the three
vaginal estrogen products inAustralia and look at the three
of those companies, could alsoapproach the tga and say, hey,
you know what, these warningsare outdated and we actually
(14:32):
have evidence to the contrary.
So can we please, can we pleasetake that out?
Um, so, yes, thinking about howwe could make australia you
know, we could lead the world inthis because the us, the fda,
has has not acted yet on vaginalestrogen.
I mean, try not to think aboutsexism.
Much testosterone for men ohyes, let's quickly fix that up.
Vaginal estrogen for women so,trying not to look at it with
(14:55):
that gender lens, they'refailing.
So yeah, jalia, wonderfulgovernment, get moving on
vaginal estrogen.
Another easy fix for you to do,yeah, another one that will make
lots of women happy and alsoprobably increase the uptake.
Because I mean, sonya, I thinkyou last time on the podcast we
spoke about this you know youtalked about how women have
(15:16):
opened it up, looked at thepamphlet and gone oh, it says
you're going to die ofeverything.
Sonya (15:19):
It's actually really dire it is, it's awful, all right.
So from there, I think, whilstwe're kind of talking about
government and, you know, thingsthat they can do to improve
outcomes for women, the umconversation that I had recently
with jed carney when she was aguest on my podcast and one of
(15:41):
the topics that we talked aboutwas the part of the 573 million
dollar pledge was to provideeducation to GPs, to upskill our
clinicians, because, as CeriCashell said so beautifully on
her Instagram the other day,it's great to make all of these
therapies and these drugs moreaccessible and more affordable,
(16:05):
but let's educate the peoplethat are going to prescribe them
.
Jo (16:08):
Yes, because there are so many GPs who won't prescribe.
Sonya (16:11):
Who still have reservations.
Let's put it that way.
Okay, so we wanted to talkabout two things.
We want to do a quick debrieffrom the medical conference that
was a part of the so Hot RightNow weekend.
I didn't attend, but you didWant to talk about what I want
to hear from you because weactually haven't spoken about
(16:31):
this yet what it was like to bein the room, what you felt the
energy and the vibe was from thedoctors that attended.
There was a huge online cohortas well and then perhaps feed
that into what the governmentcould consider doing when it
comes to apportioning thefunding for that GP education.
Jo (16:52):
Oh gosh, you're right.
A quick conversation.
I have a lot to say on this,sorry.
Okay, let's start with so HotRight Now.
So the reason I was at themedical conference because
obviously I'm not a medicalpractitioner is I was supporting
Healthy Hormones, who were theorganisers and the hosts of that
component of the so Hot RightNow extravaganza weekend.
(17:15):
So the medical conference washeld on the Sunday after the
event at the Opera House and itwas done in the Hyatt Regency.
So we had, I think, 250 peopleattend in real life and I can't
remember I think it was around500 online, but I can't actually
remember that off the top of myhead and it was like nothing I
(17:37):
have been to before.
So I've been lucky enough.
In my, when I was working in apharmaceutical company, I got to
go to an internationalmenopause society meeting in
Portugal.
Two and a half years ago I gotto go to an International
Menopause Society meeting inPortugal two and a half years
ago.
I've been to two AustralasianMenopause Society conferences
and you know I learned a lot atall of those conferences.
But I think what was so strikingabout the so Hot Right Now
(17:59):
medical conference was theenergy and it was just this
incredible buzz?
I mean, you were there at theOpera House.
You felt the buzz in theaudience.
Oh my gosh.
It was very similar to that.
It had been carefully thoughtout, all the speakers they had.
I sat at the back because I waslike you know, I've heard this
all before.
And then I was madly takingnotes because I was learning so
(18:20):
much more, even though I'velistened to the podcasts of most
of the presenters.
I've been to so many of thesetypes of conferences yeah, it
was.
And then they had an incrediblespace for sponsors to be able
to talk to the attendees andthat was just buzzing the whole
day.
Sonya (18:37):
Can I pause you there for a second and ask a question or
clarify something?
So for anybody that's listening, that's not familiar.
The presenters at the medicalconference on the Sunday were
the same presenters that were onstage at the Opera House, so
we're talking about Dr LouiseNewson, Dr Kelly Casperson, Dr
Vonda Wright, Dr Mary-ClaireHaver.
(18:57):
Was there anyone else thatpresented?
Did we have some localrepresentation as well?
Jo (19:02):
Yes, yes, so we had Dr Angela Kwong, we had Dr Odette
Best, we had Dr Talat Uppel, soyou can actually there is, the
website is still up and it sortof goes through what everybody
spoke about, and if you're amedical professional, it is
going to be available to watchas webinars as well.
There was a couple of thingsthat came up again and again
(19:23):
when I was talking to people inthe breaks and at the end of the
day was next year can we haveit over two days?
And the other main takeawaythat I felt was really different
from other medical conferencesthat I've been to was just the
feeling of it being a room fullof equals.
There was no hierarchy.
I had a number of GPs say thatthey didn't feel like they were
(19:44):
spoken down to, that they weretreated as lesser.
In fact, Vonda Wright did thisbeautiful speech because a
number of the speakers had twoslots and spoke about different
things, and when she came back Ithink it was after lunch or
afternoon break to do her secondslot, she actually stood up and
said I just want to raisesomething.
(20:05):
I've had so many lovelyconversations here today, but I
want to stop you now.
I want to stop everyone who hassaid to me, I'm just a mere GP
from using that kind ofterminology and framing yourself
in that way.
I'm paraphrasing here, but shewas basically like being a GP is
exceptionally important.
(20:26):
The fact that I'm an orthopedicsurgeon does not make me better
, you know, than you.
It was, it was just.
It was really nice, and I'venever really heard that
acknowledged before.
So I think a lot of people thatI spoke to were then sort of
going.
I just felt like I could askanything.
I felt like nothing was off thetable.
I didn't feel like I, you know,had to be anything other than
(20:47):
who I was, and I think for amedical conference, that says
quite a lot, and I think thatthe Healthy Hormones team are
going to be, you know,evaluating the event and I
really have my fingers crossedthat they decide to continue on
this path, because it gave anopportunity for so many
practitioners to ask questions,and I think that's really
(21:09):
important, you know, from alearning perspective, is that
everybody has a differentlearning style, regardless of
what your profession is and whoyou are, and whether you have a
professor or a doctor beforeyour name.
Sonya (21:20):
You know, and there are many upskilling courses that are
available online that are verysimplistic in many respects and
they are, you know, maybe kindof directed at the lowest common
denominator.
Yeah, yeah, and it doesn't giveyou the opportunity to ask
questions beyond what you'rebeing taught as you go through
(21:43):
that online syllabus.
You don't have contact with areal person that is actually
operating in this field, day in,day out, every day.
So, yeah, when you're able tolearn in an environment where
there is open conversationthat's inclusive, it just takes
learning to a whole other level,doesn't it?
Jo (22:00):
Yeah, I mean the excitement.
The doctor, like the people Ispoke to, were just like buzzing
, and I think you've raised somereally good points.
There is, I think, one of thethings that what healthy
hormones are trying to do isthey are trying to meet GPs
where they're at and come upwith ways of sharing information
that works in the 21st century.
(22:20):
So their platform healthyhormones is, you know, it's live
.
There's lots there are.
There are specific spaces forGPs and other allied healthcare
professionals to haveconversations with each other in
like real time about what'shappening with patients.
There's also fact sheets.
They're putting togetherwebinars which will be focused
on very like sort of niche areasas well as the big picture
(22:42):
areas.
But it's once you get beyondyour kind of average
perimenopausal or menopausalwoman where gps are often sort
of left floundering, whether itbe something like migraines or
how it interacts with adhd orinteracts with endometriosis or
you know, there there is, thereis endless.
So it is it's this constantlyinvolving space, and so then
(23:02):
when you've got practitionersthat are looking at all the
research and wanting to makethat available real time, and
that's the other thing, likeWellfem, which is Australia's
leading telehealth space formenopausal care, you know, I
know they've got some reallybrilliant ideas about
replicating the GP psychiatryline where, you know, gps could
actually call a telehealthhotline manned by menopause
(23:25):
experts to get real-timeinformation if they've got a
patient in front of them.
Sonya (23:30):
Yeah, which really should be able to then eliminate that
situation for a woman who goesin to see her GP and the GP
doesn't know the answer andlet's be honest, GPs don't have
all the answers all the time attheir fingertips, you know, and
maybe it is a more complicatedaspect of their perimenopause or
their menopause experience.
But if there is a serviceavailable, whether it's through
(23:51):
a platform like Healthy Hormones, where they can jump into a
chat with whoever's online andworkshop the situation with them
, or whether it's through, youknow, a welfare call with a
specialist, it just means thatthe patient, at the end of the
day, should be getting a muchbetter level of healthcare than
just being told I don't know.
(24:12):
Go Google it, sort yourself out.
Jo (24:13):
Go shop around, go try yeah.
Sonya (24:15):
Or us always saying just go get a second opinion, go find
another GP, which isn't as easyas it sounds for a lot of
people.
Jo (24:21):
No, my GP has just moved to another part of Victoria and I'm
like, oh, now I've got to startagain.
Really annoying.
But yeah, it's not like thosesort of appointments or those
sort of skilled GPs are readilyavailable.
So I think there's a lot ofexciting options for how the
government could look at the GPmedical training component.
But I guess this is where, forall the excitement and how much
(24:43):
love I feel like I have rightnow for Albanese government and
Ged and Marielle and Katie andMark Butler, I have got a little
bit of less love around the GPeducation component.
So you know, when we finallydug into the detail after that
incredible announcement on the9th of February, that is the
(25:05):
weak link.
So much of what we had hopedwould be addressed after two and
a half years of advocacy we'vebeen doing is addressed, but the
GP education is the weak link.
It is.
Sonya (25:18):
And that was something that I addressed with Jed, you
know, as best as I could on whenI sat down with her for an
interview for a podcast.
I'll link to the episode in theshow notes so that if anybody
didn't listen into that, theycan go back and listen to it,
because one of the things Ireally wanted to see if I could
get some clarity from her on,was where would they be seeking
providers of this GP education,and Ged made reference to a
(25:43):
couple of existing providersthat have received funding in
the past that would perhaps beused again this time.
The issue that I have with thatand I spoke to Ged about this
is, if we're using existingproviders, can we unpack if
that's actually been goodeducation?
Has it worked?
Because, from my perspective,if we're sitting in this
(26:04):
position now, where we know thatthere is a significant gap in
education for GPs, that ithasn't worked and don't just
hand out money to an existingprovider because they've done it
before, because we wouldn't bein this place if they'd done
their job well in the firstplace.
Jo (26:21):
I think that's a really good point because it's that are you
evaluating what currentlyexists and are you seeing what's
working and what isn't working?
And that's as someone who'sbeen so embedded in this space
for the last two and a halfyears and previously, from a
personal perspective.
My great frustration is how thehell did I get and I've spoken
about this before how the helldid I get to 45 and have never
(26:42):
heard the word perimenopause?
Like, as someone who's workedin reproductive healthcare,
whatever has been funded is notworking if your incredibly
health literate component of thepopulation doesn't know
anything about perimenopause andmenopause.
So you're going to have to trysomething new.
You're going to have to look atwhat are the options out there.
(27:02):
So the disappointing thingsabout that 1.5 million, which,
frankly, is simply not enough.
But when you dig into it, itturns out it isn't actually
really for GP education.
It's for advertising GPeducation courses.
It's not even developing newmeaningful GP education.
It's advertising courses.
Now I listened.
That podcast you did with Gedwas fantastic and I loved it and
(27:24):
I've shared it with lots offriends.
But there was something in itwhere she said that some of that
money would be going to tender,but then at Senate estimates.
I think it was back in February.
A question was asked atestimates about that money and
where it would be going, and theDepartment of Health replied
that it would be going to JeanHailes and the Australasian
Menopause Society, whichindicates that it is not going
(27:45):
to tender Jean Hailes and theAustralasian Menopause Society
which indicates that it is notgoing to tender.
Sonya (27:47):
Yeah, and they are.
Two previous existing providersthat have received funding in
the past are looking atreceiving funding again, but the
question needs to be asked, asyou said is there an evaluation
process in place?
Jo (28:00):
Yeah, I mean, if you actually look at the Jean Hailes
funding, they've actually had$38 million over the last 10
years.
Now, obviously that's forwomen's healthcare more broadly.
They do brand themselves asleaders in the menopause space.
So if they're the leaders inthis space, how is that money
being spent, how is it beingevaluated and what are they
delivering?
Because, according to what wesaw out of the Senate inquiry,
(28:24):
gp knowledge absolutely dire.
Community knowledge isabsolutely dire.
So maybe continuing to investin the same old same old is not
necessarily the best policy hereand there's different ways you
could do it.
You could open it, have atender, give it to 10 different
players and after two years,evaluate which one's working the
best.
You know there are differentways of utilising new
information and new modes ofinformation.
(28:46):
Like the world is changing sofast.
Sonya (28:49):
Absolutely, you know.
So we all got very excited.
You know.
$573 million is a lot of money.
Everybody was referring to itas half a billion dollars,
because that sounds even better.
But let's dig into the detail.
Let's get clear on what it allmeans and how it's going to be
delivered, because those of usthat have been working and
(29:12):
advocating and lobbying forthese things for so long need to
make sure that the governmentis then trusted to get it right.
Jo (29:20):
Yeah, exactly, and I think that that is, you know, where
the Department of Health said itwas sort of a little bit like,
well, who made that decision toA provide so little funding for
GP education and B around whereit was going to go.
But on the plus because I'malways an optimist, sonya I see
this as opening the door to agreater opportunity to design
(29:40):
some really awesome, a bit likethe community awareness campaign
which has 12.8 million.
So let's do something similarfor medical education and let's
look at a whole different youknow raft of ways of meeting
people where they're at.
They don't necessarily have totravel to something like SoHot
right now.
Some of them might just want tobe able to call a hotline and
have a conversation, or some ofthem might not want to talk to
another human and just do it allon a platform where people
(30:02):
learn.
So there are lots of optionsthere none of, actually, which
are that expensive.
Like you know, I've looked athow much some of these different
options cost and they're notgoing to break the bank.
Sonya (30:14):
There are corporate organisations that roll out
learning platforms.
You know on a regular basis.
Like the technology exists, youdon't have to start from
scratch.
Find a model that works reallywell in a different industry and
just translate that over intothis healthcare industry.
Jo (30:31):
Yeah, no, I think great, I think that's you know, got that
sorted there we go In the nextcouple of weeks.
Thanks, government.
Sonya (30:38):
You know where we are.
We're full of great ideas.
Reach out anytime.
So, yes, there's our very shortbut robust conversation around.
You know our concerns and ourdesires of how this GP education
gap is filled.
Jo (30:51):
Okay, what else do we have?
There's one other thing Iwanted to talk about.
Dr Lisa Mosconi has beenawarded an incredible grant, so
before we talk about that, Ijust want to say what's exciting
about this is.
I think it's really about howthe land what we're seeing
happen in Australia with the PBSis it's changing the landscape
of what drugs are affordable.
(31:13):
What it's going to mean forwomen to be able to access drugs
that can enable them to this isthe new frontier.
Like, if we're going to reallyaddress the black hole of
knowledge around some of theissues that impact the health of
women, you're just going tohave to come.
(31:35):
We're just going to need somebig, meaty grants.
So how much is she getting?
Sonya (31:40):
Sonia, my goodness, a couple of things I want to cover
off here.
So a non-profit Welcome Leaphave announced a new $50 million
research program to prevent54.5 million Alzheimer's cases
in women by 2050.
So huge amount of money, hugegoal, significant goal
(32:05):
significant reduction in thenumber of Alzheimer's cases in
women being prescribed each year, which is just amazing.
But I thought that, before wejump into too much of that
detail, it might be a good ideafor anyone that's listening that
doesn't know who Dr LisaMosconi is, to give them a
little bit of insight into that.
The fact that she's actuallyjoining this whole research
(32:31):
program as the program director.
You know she's going to beabsolutely involved at ground
level as well as be driving allthis research.
So that's very, very cool.
So Dr Lisa Mosconi is aneuroscientist.
She's European.
Am I right in saying she'sItalian?
Yeah, she's a neuroscientistwho has done extraordinary work
(32:53):
in, specifically, alzheimer'sand dementia risk and prevention
in women.
Specifically, she published herfirst book last year, I think.
Jo (33:02):
Called the Menopause Brain and because she's the founder of
the Alzheimer's PreventionProgram and the Women's Brain
Initiative at is it well,cornwall Medicine.
Yeah, that's it.
Yeah and um, she's.
If you, if you google her,she's got some amazing, like a
ted talk about the impacts, um,of estrogen on the brain, but in
(33:25):
particular, she really talksabout the intersection of oh god
, it's very technical languagelike neuro endocrine risks and
neuro generation and how that'sgoing to impact brain health.
But it's, it's really excitingand it's a really decent amount
of money.
Sonya (33:43):
Yeah, it's really exciting.
One of the things that reallyjumped out at me and I think
this is something that we reallyneed to start demanding more of
and pushing for more of fromour government and from our
healthcare system and from ourresearch funds is that they're
looking at the impact that thisresearch will have on from a
financial aspect, so theeconomic impacts, but also the
(34:04):
health outcomes.
So the thing that really jumpedout to me was that, beyond
improving health outcomes,cutting Alzheimer's risk in half
could save the US alone 4.56trillion US dollars.
Holy cow, like that is a number, I literally can't even wrap my
(34:24):
head around.
Jo (34:25):
And all for a mere 50 million.
Sonya (34:27):
Yeah, exactly, we get caught in this conversation all
the time and we've talked aboutit and vented about this before
where there's just not enoughresearch, not enough funding put
into research.
And we hear over and over againthe response that gets wheeled
out when we question why isthere so much argument about
using, let's say, testosteronetherapy for women?
(34:48):
And the answer is constantlybecause we don't have the
research to prove it, nobodywants to fund it.
We know that Professor JayashriKulkarni, who has done
groundbreaking work on themental health implications of
perimenopause and menopause, hasbeen trying so, so hard to get
funding because everybody keepssaying to her well, until you do
some research and you canactually prove this, we're not
(35:11):
really going to take youseriously.
There is just this bottleneckof getting these funds to the
research programs so that we canstop wheeling out the well, we
don't have the researchwheelbarrow.
So this just goes to show that$50 million investment is going
to have an economic impact ofpotentially four points.
Jo (35:32):
Now, that's a return on investment that anyone would say
is well worth doing.
Sonya (35:36):
Thank, you very much.
Jo (35:38):
I know that we're about to have an election coming up and
there's going to be a new term,but whoever wins the next
election, let's go back tolooking at a really big, decent,
fast budget, to do someresearch, to address some of
these big picture issues thatcould actually end up saving the
Australian economy and theglobal economy trillions of
(35:59):
dollars.
Sonya (35:59):
Hey, look, spending on women long-term is absolutely
beneficial for everyone, alwaysa good return on investment,
always a good return oninvestment.
So the link to this I guess whywe're talking about this is
that there is a lot of researchthat's been done that does
suggest that the loss of theneuroprotective sex hormones and
that is predominantly estrogenmay increase the risk of
(36:24):
Alzheimer's post-menopausal.
So that's where thisannouncement around this funding
is going to have huge globalimplications and really for our
perimenopausal and menopausalgenerations to start getting
excited about.
Jo (36:39):
Yeah, and because that's what I think blew my mind when I
first started reading about itwas that it is.
You know, alzheimer's doesn'tappear until decades down the
track, but basically it startswhere we are now.
It starts at midlife.
So if you can nip it in the budor reduce your chances now,
then you know that's hugelyimpactful.
And you know, one of thereasons I'm grateful I'm trying
(37:00):
estrogen because, even thoughI'm not part of a clinical trial
, I'll find out.
Sonya (37:04):
Our own little personal experiments.
Yeah, it's awesome and I thinkthat you know Alzheimer's in
particular and any of thosecognitive decline diseases are
so impactful on our communities.
Not even if we take intoaccount that economic impact,
the impact that it has onfamilies, on caregivers, on our
(37:27):
health system, on our nursesthis sector of the population
that do get impacted byAlzheimer's and dementia is
really significant.
So anything that we can do toprevent that just has such big
flow-on impacts.
Jo (37:40):
No, I agree.
I agree, but they were callingfor proposals from researchers
from around the world, so itclosed only a few days ago.
Sonya (37:49):
Oh, it did.
It closed on the 14th of Marchoh.
Jo (37:52):
I wonder if anyone from Australia has put in.
So I'll look forward to seeinghopefully they'll announce at
some point who have been awardedsome of the grants to work on
their free-made areas.
Sonya (38:02):
To work on it.
Jo (38:03):
Yeah.
Sonya (38:04):
Exciting time.
Exciting time, all right, and Ithink I want us to finish up on
a positive note.
So, jo, talking about excitingtimes and I love having you here
as my co-host on our Hot Takesyour episode that we did dare
menopause episode where Iinterviewed you about your
experience and what brought youinto this space hugely popular
(38:25):
people love it.
They love hearing your story.
Can you share with us whereyou're at right now from a um,
you know, a personal careerperspective?
Jo (38:35):
yes, okay, great.
So I haven't actually done aformal you know launch yet.
But yes, I've got my ownconsulting business now and it's
called Sheela UnapologeticAdvocacy and I am going to be
working with organisations,businesses, not-for-profits
around their advocacy goals andproviding support to help shape
(38:56):
how they want to put togethertheir arguments probably
predominantly to governmentaround what they'd like to see
on the policy agenda and, Iguess, continue making a lot of
loud noise about issues that arepassionate to me.
I think over the last few yearsthere might have been a few in
the sector who've tried to usethe word lobbyist in relation to
(39:17):
what I do, and I've had tograpple with that because you
know I do find the word lobbyistit does for some reason it has
really negative connotations ofwell people doing evil things
for money.
But if I am going to do this, Iam going to have to register on
the Australian um lobbyistregister with the government.
But I'm reframing it.
(39:37):
I'm still an advocate.
I still advocacy is what I doand advocacy to me is about
working on something that youpassionately believe in.
So you know, my partner's jokedand he's like, yeah, you could
go and get a job like workingfor an oil company, and then
he's giggled because he knowsthat's never going to happen.
I am going to be hopefullydoing some really cool things
(40:02):
with some really cool entitiesand organizations and people.
Sonya (40:06):
Amazing.
I'm so proud of you and I am soexcited for where this goes.
I'm very excited for you to beshaking up the lobbyist world.
Jo (40:14):
And you know, the other thing is I've had a few people
say, oh, sheila, that name.
It's like I'm not a fan.
Sonya (40:22):
But you know, for me it's all about being authentic and
very on brand for me, but you dohave a website that we can
share in the show notes.
Oh, linkedin, okay cool.
We'll share your LinkedInprofile and anybody that is
listening and that would like toknow more about what you're up
(40:43):
to and, perhaps, potentially,how they could work with you.
They can reach out to you onLinkedIn.
Awesome, jo.
Thank you so much.
As always, it's great to sithere and have these robust
conversations and start puttingout ideas for people to think
about and not just being supernegative, but not also being
super shiny.
Positive all the time, likethis is the reality of what's
(41:04):
going on.
Jo (41:05):
Yeah, I know, and it feels like we are in a very exciting
period, so hopefully we willchat again.
The election still hasn't beencalled, so there's time for more
amazing things andannouncements to happen.
It's like every morning you'rewaking up and it's Christmas
morning.
Sonya (41:21):
What's going to happen?
It's like every morning you'rewaking up and it's Christmas
morning.
What's going to happen?
What's going to be in the newstoday?
It does.
It is literally the gift thatkeeps on giving right now.
Long may it last.
Welcome to the Dear Menopause podcast.
I'm Sonya Lovell, your host Now.
I've been bringing youconversations with amazing
menopause experts for over twoyears now.
If you have missed any of thoseconversations, now's the time
to go back and listen, and youcan always share them with
anyone you think needs to hearthem.
This way, more people can findthese amazing conversations,
(00:24):
needs to hear them.
This way, more people can findthese amazing conversations.
Welcome to this week's episodeof A Hot Take, with Johanna
Wicks and myself here to bringyou up to date on all of the hot
topics that are currentlyimpacting the menopause
conversation globally, but, mostimportantly, here in Australia.
Jo, welcome.
Jo (00:43):
Lovely to be back I think it's been just over a month and,
wow, a lot has happened in thatmonth.
Sonya (00:48):
It's been a huge month.
I'm going to mention upfrontthat I got COVID a couple of
weeks ago.
I lost my NOVID status.
I had never had COVID up untildodged it for five years.
I know I thought I was specialApparently not.
Jo (01:02):
Sonya, where did you get your COVID from?
Sonya (01:06):
Well, jo, not that I want to apportion blame on anybody,
and it isn't the takeaway that Iwas hoping for, but I did get
sick after the so Hot Right Nowweekend in Sydney.
Basically, I had a big day onthe Friday and the Saturday and
woke up very, very unwell on theMonday.
So, look, I hugged a lot ofpeople.
(01:28):
Thanks for all the hugs, but nothanks to the COVID.
But why I wanted to mentionthat was because my voice is
still doing strange and weirdand wonderful things.
So if I start to lose my voiceor my voice sounds a bit
scratchy or wobbly.
That's why and I'll just let Jodo all the talking if that's
what ends up happening Great, myfavorite.
Awesome, jo, we have got lotsto talk about.
(01:49):
What are we going to kick offwith today?
Jo (01:51):
Well, I think it would be very timely to yet again kick
off talking about the PBS, thePharmaceutical Benefit Scheme,
because since we last spoke, the1st of March has been, which
saw Estrogel, prometrium andEstrogel Pro hit the PBS and
Yasmin, and then on the weekendthere was another announcement
from the Albanese governmentwith more drugs for women's
(02:14):
health going onto the PBS.
It's just, I mean, it's sort ofan unprecedented deluge of
awesome medication.
Sonya (02:20):
It really is, isn't it so ?
Slinder was the announcement,the big announcement that's
going to impact most likely ourperimenopausal menopausal
listeners that is going to beavailable as of the 1st of may
as a pbs priced drug therapyfantastic and I think what is
super excited about this isafter, um, the 1st of march.
Jo (02:40):
You know I've done a bunch of posts and different platforms
around the fact that especiallyprometrium had gone onto the
pbs.
And but you, this is after the1st of March.
You know I've done a bunch ofposts and different platforms
around the fact that especiallyPrometrium had gone onto the PBS
and you know sort of saying,you know, obviously we know
there's some other amazing drugsout there and what would people
like to see also on the PBS.
And you know, out of all theresponses I got, Slinder came up
the most.
Sonya (03:00):
The most.
Jo (03:01):
So I think there'll be a lot of very happy women across
Australia, especially becauseSlinder is, so it really works
from basically kind of yourteenage years through to being
almost post-menopausal, becauseit's sort of safe across all age
cohorts.
So it's a very versatile drugand that a lot of people who are
progesterone sensitive cantolerate quite well.
Sonya (03:22):
Can tolerate.
Yeah, it's.
It's fantastic.
Now, whilst we are excited aboutall of these amazing um new
drugs turning up onto the pbsbeing cheaper, there has been
quite a bit of conversation,I've noticed around the need to
get a new prescription to beable to be eligible for the new
pbs pricing.
So obviously now, since sincewe're past the 1st of March for
(03:44):
your, as you said, prometrium,estrogel and Estrogel Pro, and
something to bear in mind withSlinder coming up on the 1st of
May so the correct procedurearound this is if you have a
prescription that is dated afterthe 1st of March, then you will
be getting that automaticallyat the PBS rates.
However, if your prescriptionwas dated prior to that, some
(04:09):
pharmacies and from what I cangather, most pharmacies are
requiring you to get a new,updated prescription so that
that can go through their systemat the PBS.
That the correct coding withthe correct pricing attached to
it.
I thought it'd be good for usto just kind of talk through
this a little bit, because I wassurprised at the amount of
conversation that came up aroundthis from women.
Jo (04:31):
Me too, and I think you know I've just made an appointment
for next week to go and get allmy scripts updated because I use
Estrogel and I think that it'sa little bit tricky because
obviously that it'd be lovely ifall pharmacists could just
honour your current script, andI believe a very small minority
are able to.
But it is very hard in thebureaucratic system that is, you
know Medicare, to make sureyou've got all your codes that
(04:56):
are lined up and it is mucheasier just to have a script
that has the correct codes on it.
And the other thing I wanted toadd to that, sonya, which is
something I only learned when Iwas at the so Hot Right Now
medical conference I hadn'trealized that you need to
specifically ask your doctor fora 60-day dispensing and then
you get two months worth of themedication for $31, which blew
(05:22):
my mind.
I was so excited about the factthat you know especially,
estrogel Pro is on PBS and isnow $31 for both medications in
their one pack.
Yeah, yeah, to get two months'worth for $31 was just like oh,
that is a huge cost saving.
Sonya (05:40):
I know I did a post and this was when I realised the
conversation that was coming uparound the prescriptions.
I did a post and this was whenI realized the conversation that
was coming up around theprescriptions.
I did a post because I happenedto.
Actually, I think I ran out ofmy progesterone, my prometrium,
about two days before the 1st ofMarch, so I literally didn't
get mine filled until after thatdate had ticked over.
And look, I have a fantasticpharmacist, small, local
(06:01):
pharmacy.
I've got a great relationshipwith him, he knows what I do.
So I was walking, I was likeJohn, we did it, we're on the
PBS and, um, you know, I didhave a relatively new
prescription, was probably datedmore like the start of February
, and he honored that for me andput it through at the new PBS
pricing which you know.
It was literally on the firstor the second of March that I
(06:23):
got down there to get that.
Now I was paying $97.60, Ithink, or something like that,
for my 60-day Prometrium and Igot it at $31.60.
And I was just beside myself.
I was so excited, which is whyI came up and photographed it
and popped it onto my Instagramto let everyone know, but yeah,
(06:43):
then the whole thing about theprescriptions came up.
So I thought what might be anice idea is if we just talk
through the different optionsthat you have available to you
to actually get a newprescription, because I did
notice that there was a lot ofpeople that felt that it wasn't
right that they would then haveto go and book a whole new
appointment with their GP andjust to go in to just get their
(07:05):
prescription updated.
Now you and I are lucky enoughto have a lot of friends that
are GPs a lot of colleagues andwe sit in different conversation
groups with them, and it wasinteresting seeing the
conversations going back andforth between them about how
different GPs and different GPclinics were managing the need
for updated prescriptions.
I think one of the things thatcame up regularly was that there
(07:26):
is an option for some clinicsthrough hot docs, so if you're
doing an online booking, you canput in that that you just
require an updated prescriptionand then it might be that your
GP just does a telehealth callwith you that's bulk billed and
just ticks the box that theyhave had a conversation with you
and they will send you throughvia text.
Often I get all my prescriptionsnow via text and updated
(07:48):
prescription, and that there wasalso other GPs that were
offering telehealth calls fortheir patients, rather than
thinking that you have to bookin to go in and sit in the
waiting room and have this biglong process of having a GP
appointment and the cost that'sassociated with it.
So I guess my takeaway fromthose conversations and being
able to sit on the fence alittle bit and hear both sides
(08:10):
of the stories is, if you dorequire a new prescription, just
reach out to your clinic andask them what your options are.
Don't assume that you're goingto have to go in and see someone
.
Maybe just give them a call andask them what your options are.
Jo (08:22):
Because the likelihood is that they've come up with a way
of dealing with it, becausethere's been a lot of women
talking about this.
But it is important to notethat if you are using like a
60-day prescribing for the firsttime, then you know that might
be not as easy as justreplenishing your script.
Sonya (08:39):
Yeah, that's a good point .
Jo (08:40):
And, as Sonya just said, you know, it is definitely worth
making sure that you get thetwo-month code, so that it is
$31 a month is great, $31 fortwo months is even better.
Sonya (08:52):
Yeah, and I suppose the only other thing I'd like to say
around that is don't get crankywith your pharmacist, don't get
cranky with your GP.
You know this is a procedureand protocol situation.
There is codes and ways thatthings have to go through
computer systems for them to beable to dispense or to provide
(09:12):
you with a prescription.
The system's not ideal, we allknow that.
So just be patient, find outwhat your options are that are
going to work best for you.
But yes, it is likely that youare going to need to get a new
prescription and then thinkabout adding up all the money
that you'll save from now untileternity.
Jo (09:30):
If you're going to take your MHT until death, like I am.
Sonya (09:33):
And me.
Jo (09:35):
And that's a huge saving.
And I think that's one of thethings I did want to acknowledge
.
You know, I wanted toacknowledge that these are big
changes and, you know, obviouslythere's a bit of political
fostering going on which I'vetried not to roll my eyes at,
but I have others in thepolitical space, sort of being
like we're equally committed,and I have felt a sense of
frustration because I was like,well, you were in government for
(09:57):
10 years and you didn't put anyof these drugs on the PBS and
you had plenty of opportunity inthat 10 years to do so.
So I do think that what thecurrent government has done in
getting so many new drugs on thePBS does matter.
It doesn't mean that we stopasking for more.
Like, when I did the littlesurvey, people had mentioned
(10:17):
Zoli as another contraceptive.
That's really really, reallyimpressive and really effective.
Androfem is the only femaletestosterone in the world.
A lot of chatter about intrarosa, um, which only came into
Australia last year, but is anew, incredible vaginal estrogen
, and DHEA, yeah, um and got totalk about a lot.
(10:39):
It's so hot right now.
So there are.
There are drugs that need to goon the PBS, but this is kind of
like an exciting start and itfeels like there's real
motivation behind it.
Sonya (10:48):
Yeah, absolutely 100%.
All right, so where does thatlead us?
What's next?
Should we talk about the FDAremoving, while we're talking
about drugs and hormones and youjust mentioned androfem and
testosterone, you know, as partof that conversation.
So if you have been a long-timelistener, first of all, thank
you very much.
Secondly, you'll probablyremember us talking about the
(11:12):
push in the US specifically toremove the warnings, the black
box warnings, from your vaginalestrogen, and we were talking
about the fact that testosteronealso falls into that kind of
category as well.
So the FDA have actually goneahead and removed the, or
they're going to remove I can'tquite remember the process
remove the warnings fromtestosterone in the US.
Jo (11:35):
Yeah, and there's quite a long story behind it, but there
was a worry that men usingtestosterone in the US was
contributing to theircardiovascular risk and bad or
adverse cardiovascular outcomes,and so what actually happened
is the FDA, which is theAmerican version of the TGA,
actually requested that there bea big randomized control trial
(11:59):
looking at testosterone in menwith a history of cardiovascular
disease or a high chance ofdeveloping cardiovascular
disease, and they actuallycompelled the four big companies
that provide testosterone inthe US to pay for it.
To my understanding, it was avery extensive study, but I
think it looked at over 5,000men, of which half had a placebo
(12:19):
and half were giventestosterone.
The results came back andshowed that there is no
increased cardiovascular risk ornegative outcomes for that
cohort, which was quite amazing,and I think that study
concluded maybe just over 12months ago, or the results were
presented 12 months ago, but nowa couple of I think it was even
(12:40):
on the 1st of March.
I feel like a lot happened onthe 1st of March.
Yeah, maybe it was yeah,because Kelly Casperson did a
post while she was in Australiaabout it, and so the FDA has
actually said right, we've takeninto consideration this study
and we now are going to take offthe warnings around
cardiovascular risk associatedwith testosterone for men in the
(13:03):
US.
But why this is, I think,important, samuel, which is what
you're alluding to is it showsthat things can change and that
the labelling on medication canbe updated or removed, in this
case, when evidence comes tolight.
And I think one of the thingsthat has been frustrating for
women in Australia and the USand the UK and around the world
(13:25):
is that there are I mean, whosaid it?
I think was it Kelly who saidthere's 500 studies of vaginal
estrogen in breast cancerpatients that show that vaginal
estrogen is safe to use andacross 25,000 women.
And yet we still have thesereally dire warnings on vaginal
(13:47):
estrogen in Australia.
And I think this is a call outto the government, to the TGA,
that you can choose to takethese non-factual risks out of
these products, and I mean Idon't think they don't have to
have anyone ask them to do that.
They could voluntarily decideto review the literature and do
this off their own bat, hint,hint TGA.
(14:09):
Or, you know, we could also lookat having a bit of a campaign
to Theramex, novonordic andAspen, who make the three
vaginal estrogen products inAustralia and look at the three
of those companies, could alsoapproach the tga and say, hey,
you know what, these warningsare outdated and we actually
(14:32):
have evidence to the contrary.
So can we please, can we pleasetake that out?
Um, so, yes, thinking about howwe could make australia you
know, we could lead the world inthis because the us, the fda,
has has not acted yet on vaginalestrogen.
I mean, try not to think aboutsexism.
Much testosterone for men ohyes, let's quickly fix that up.
Vaginal estrogen for women so,trying not to look at it with
(14:55):
that gender lens, they'refailing.
So yeah, jalia, wonderfulgovernment, get moving on
vaginal estrogen.
Another easy fix for you to do,yeah, another one that will make
lots of women happy and alsoprobably increase the uptake.
Because I mean, sonya, I thinkyou last time on the podcast we
spoke about this you know youtalked about how women have
(15:16):
opened it up, looked at thepamphlet and gone oh, it says
you're going to die ofeverything.
Sonya (15:19):
It's actually really dire it is, it's awful, all right.
So from there, I think, whilstwe're kind of talking about
government and, you know, thingsthat they can do to improve
outcomes for women, the umconversation that I had recently
with jed carney when she was aguest on my podcast and one of
(15:41):
the topics that we talked aboutwas the part of the 573 million
dollar pledge was to provideeducation to GPs, to upskill our
clinicians, because, as CeriCashell said so beautifully on
her Instagram the other day,it's great to make all of these
therapies and these drugs moreaccessible and more affordable,
(16:05):
but let's educate the peoplethat are going to prescribe them
.
Jo (16:08):
Yes, because there are so many GPs who won't prescribe.
Sonya (16:11):
Who still have reservations.
Let's put it that way.
Okay, so we wanted to talkabout two things.
We want to do a quick debrieffrom the medical conference that
was a part of the so Hot RightNow weekend.
I didn't attend, but you didWant to talk about what I want
to hear from you because weactually haven't spoken about
(16:31):
this yet what it was like to bein the room, what you felt the
energy and the vibe was from thedoctors that attended.
There was a huge online cohortas well and then perhaps feed
that into what the governmentcould consider doing when it
comes to apportioning thefunding for that GP education.
Jo (16:52):
Oh gosh, you're right.
A quick conversation.
I have a lot to say on this,sorry.
Okay, let's start with so HotRight Now.
So the reason I was at themedical conference because
obviously I'm not a medicalpractitioner is I was supporting
Healthy Hormones, who were theorganisers and the hosts of that
component of the so Hot RightNow extravaganza weekend.
(17:15):
So the medical conference washeld on the Sunday after the
event at the Opera House and itwas done in the Hyatt Regency.
So we had, I think, 250 peopleattend in real life and I can't
remember I think it was around500 online, but I can't actually
remember that off the top of myhead and it was like nothing I
(17:37):
have been to before.
So I've been lucky enough.
In my, when I was working in apharmaceutical company, I got to
go to an internationalmenopause society meeting in
Portugal.
Two and a half years ago I gotto go to an International
Menopause Society meeting inPortugal two and a half years
ago.
I've been to two AustralasianMenopause Society conferences
and you know I learned a lot atall of those conferences.
But I think what was so strikingabout the so Hot Right Now
(17:59):
medical conference was theenergy and it was just this
incredible buzz?
I mean, you were there at theOpera House.
You felt the buzz in theaudience.
Oh my gosh.
It was very similar to that.
It had been carefully thoughtout, all the speakers they had.
I sat at the back because I waslike you know, I've heard this
all before.
And then I was madly takingnotes because I was learning so
(18:20):
much more, even though I'velistened to the podcasts of most
of the presenters.
I've been to so many of thesetypes of conferences yeah, it
was.
And then they had an incrediblespace for sponsors to be able
to talk to the attendees andthat was just buzzing the whole
day.
Sonya (18:37):
Can I pause you there for a second and ask a question or
clarify something?
So for anybody that's listening, that's not familiar.
The presenters at the medicalconference on the Sunday were
the same presenters that were onstage at the Opera House, so
we're talking about Dr LouiseNewson, Dr Kelly Casperson, Dr
Vonda Wright, Dr Mary-ClaireHaver.
(18:57):
Was there anyone else thatpresented?
Did we have some localrepresentation as well?
Jo (19:02):
Yes, yes, so we had Dr Angela Kwong, we had Dr Odette
Best, we had Dr Talat Uppel, soyou can actually there is, the
website is still up and it sortof goes through what everybody
spoke about, and if you're amedical professional, it is
going to be available to watchas webinars as well.
There was a couple of thingsthat came up again and again
(19:23):
when I was talking to people inthe breaks and at the end of the
day was next year can we haveit over two days?
And the other main takeawaythat I felt was really different
from other medical conferencesthat I've been to was just the
feeling of it being a room fullof equals.
There was no hierarchy.
I had a number of GPs say thatthey didn't feel like they were
(19:44):
spoken down to, that they weretreated as lesser.
In fact, Vonda Wright did thisbeautiful speech because a
number of the speakers had twoslots and spoke about different
things, and when she came back Ithink it was after lunch or
afternoon break to do her secondslot, she actually stood up and
said I just want to raisesomething.
(20:05):
I've had so many lovelyconversations here today, but I
want to stop you now.
I want to stop everyone who hassaid to me, I'm just a mere GP
from using that kind ofterminology and framing yourself
in that way.
I'm paraphrasing here, but shewas basically like being a GP is
exceptionally important.
(20:26):
The fact that I'm an orthopedicsurgeon does not make me better
, you know, than you.
It was, it was just.
It was really nice, and I'venever really heard that
acknowledged before.
So I think a lot of people thatI spoke to were then sort of
going.
I just felt like I could askanything.
I felt like nothing was off thetable.
I didn't feel like I, you know,had to be anything other than
(20:47):
who I was, and I think for amedical conference, that says
quite a lot, and I think thatthe Healthy Hormones team are
going to be, you know,evaluating the event and I
really have my fingers crossedthat they decide to continue on
this path, because it gave anopportunity for so many
practitioners to ask questions,and I think that's really
(21:09):
important, you know, from alearning perspective, is that
everybody has a differentlearning style, regardless of
what your profession is and whoyou are, and whether you have a
professor or a doctor beforeyour name.
Sonya (21:20):
You know, and there are many upskilling courses that are
available online that are verysimplistic in many respects and
they are, you know, maybe kindof directed at the lowest common
denominator.
Yeah, yeah, and it doesn't giveyou the opportunity to ask
questions beyond what you'rebeing taught as you go through
(21:43):
that online syllabus.
You don't have contact with areal person that is actually
operating in this field, day in,day out, every day.
So, yeah, when you're able tolearn in an environment where
there is open conversationthat's inclusive, it just takes
learning to a whole other level,doesn't it?
Jo (22:00):
Yeah, I mean the excitement.
The doctor, like the people Ispoke to, were just like buzzing
, and I think you've raised somereally good points.
There is, I think, one of thethings that what healthy
hormones are trying to do isthey are trying to meet GPs
where they're at and come upwith ways of sharing information
that works in the 21st century.
(22:20):
So their platform healthyhormones is, you know, it's live
.
There's lots there are.
There are specific spaces forGPs and other allied healthcare
professionals to haveconversations with each other in
like real time about what'shappening with patients.
There's also fact sheets.
They're putting togetherwebinars which will be focused
on very like sort of niche areasas well as the big picture
(22:42):
areas.
But it's once you get beyondyour kind of average
perimenopausal or menopausalwoman where gps are often sort
of left floundering, whether itbe something like migraines or
how it interacts with adhd orinteracts with endometriosis or
you know, there there is, thereis endless.
So it is it's this constantlyinvolving space, and so then
(23:02):
when you've got practitionersthat are looking at all the
research and wanting to makethat available real time, and
that's the other thing, likeWellfem, which is Australia's
leading telehealth space formenopausal care, you know, I
know they've got some reallybrilliant ideas about
replicating the GP psychiatryline where, you know, gps could
actually call a telehealthhotline manned by menopause
(23:25):
experts to get real-timeinformation if they've got a
patient in front of them.
Sonya (23:30):
Yeah, which really should be able to then eliminate that
situation for a woman who goesin to see her GP and the GP
doesn't know the answer andlet's be honest, GPs don't have
all the answers all the time attheir fingertips, you know, and
maybe it is a more complicatedaspect of their perimenopause or
their menopause experience.
But if there is a serviceavailable, whether it's through
(23:51):
a platform like Healthy Hormones, where they can jump into a
chat with whoever's online andworkshop the situation with them
, or whether it's through, youknow, a welfare call with a
specialist, it just means thatthe patient, at the end of the
day, should be getting a muchbetter level of healthcare than
just being told I don't know.
(24:12):
Go Google it, sort yourself out.
Jo (24:13):
Go shop around, go try yeah.
Sonya (24:15):
Or us always saying just go get a second opinion, go find
another GP, which isn't as easyas it sounds for a lot of
people.
Jo (24:21):
No, my GP has just moved to another part of Victoria and I'm
like, oh, now I've got to startagain.
Really annoying.
But yeah, it's not like thosesort of appointments or those
sort of skilled GPs are readilyavailable.
So I think there's a lot ofexciting options for how the
government could look at the GPmedical training component.
But I guess this is where, forall the excitement and how much
(24:43):
love I feel like I have rightnow for Albanese government and
Ged and Marielle and Katie andMark Butler, I have got a little
bit of less love around the GPeducation component.
So you know, when we finallydug into the detail after that
incredible announcement on the9th of February, that is the
(25:05):
weak link.
So much of what we had hopedwould be addressed after two and
a half years of advocacy we'vebeen doing is addressed, but the
GP education is the weak link.
It is.
Sonya (25:18):
And that was something that I addressed with Jed, you
know, as best as I could on whenI sat down with her for an
interview for a podcast.
I'll link to the episode in theshow notes so that if anybody
didn't listen into that, theycan go back and listen to it,
because one of the things Ireally wanted to see if I could
get some clarity from her on,was where would they be seeking
providers of this GP education,and Ged made reference to a
(25:43):
couple of existing providersthat have received funding in
the past that would perhaps beused again this time.
The issue that I have with thatand I spoke to Ged about this
is, if we're using existingproviders, can we unpack if
that's actually been goodeducation?
Has it worked?
Because, from my perspective,if we're sitting in this
(26:04):
position now, where we know thatthere is a significant gap in
education for GPs, that ithasn't worked and don't just
hand out money to an existingprovider because they've done it
before, because we wouldn't bein this place if they'd done
their job well in the firstplace.
Jo (26:21):
I think that's a really good point because it's that are you
evaluating what currentlyexists and are you seeing what's
working and what isn't working?
And that's as someone who'sbeen so embedded in this space
for the last two and a halfyears and previously, from a
personal perspective.
My great frustration is how thehell did I get and I've spoken
about this before how the helldid I get to 45 and have never
(26:42):
heard the word perimenopause?
Like, as someone who's workedin reproductive healthcare,
whatever has been funded is notworking if your incredibly
health literate component of thepopulation doesn't know
anything about perimenopause andmenopause.
So you're going to have to trysomething new.
You're going to have to look atwhat are the options out there.
(27:02):
So the disappointing thingsabout that 1.5 million, which,
frankly, is simply not enough.
But when you dig into it, itturns out it isn't actually
really for GP education.
It's for advertising GPeducation courses.
It's not even developing newmeaningful GP education.
It's advertising courses.
Now I listened.
That podcast you did with Gedwas fantastic and I loved it and
(27:24):
I've shared it with lots offriends.
But there was something in itwhere she said that some of that
money would be going to tender,but then at Senate estimates.
I think it was back in February.
A question was asked atestimates about that money and
where it would be going, and theDepartment of Health replied
that it would be going to JeanHailes and the Australasian
Menopause Society, whichindicates that it is not going
(27:45):
to tender Jean Hailes and theAustralasian Menopause Society
which indicates that it is notgoing to tender.
Sonya (27:47):
Yeah, and they are.
Two previous existing providersthat have received funding in
the past are looking atreceiving funding again, but the
question needs to be asked, asyou said is there an evaluation
process in place?
Jo (28:00):
Yeah, I mean, if you actually look at the Jean Hailes
funding, they've actually had$38 million over the last 10
years.
Now, obviously that's forwomen's healthcare more broadly.
They do brand themselves asleaders in the menopause space.
So if they're the leaders inthis space, how is that money
being spent, how is it beingevaluated and what are they
delivering?
Because, according to what wesaw out of the Senate inquiry,
(28:24):
gp knowledge absolutely dire.
Community knowledge isabsolutely dire.
So maybe continuing to investin the same old same old is not
necessarily the best policy hereand there's different ways you
could do it.
You could open it, have atender, give it to 10 different
players and after two years,evaluate which one's working the
best.
You know there are differentways of utilising new
information and new modes ofinformation.
(28:46):
Like the world is changing sofast.
Sonya (28:49):
Absolutely, you know.
So we all got very excited.
You know.
$573 million is a lot of money.
Everybody was referring to itas half a billion dollars,
because that sounds even better.
But let's dig into the detail.
Let's get clear on what it allmeans and how it's going to be
delivered, because those of usthat have been working and
(29:12):
advocating and lobbying forthese things for so long need to
make sure that the governmentis then trusted to get it right.
Jo (29:20):
Yeah, exactly, and I think that that is, you know, where
the Department of Health said itwas sort of a little bit like,
well, who made that decision toA provide so little funding for
GP education and B around whereit was going to go.
But on the plus because I'malways an optimist, sonya I see
this as opening the door to agreater opportunity to design
(29:40):
some really awesome, a bit likethe community awareness campaign
which has 12.8 million.
So let's do something similarfor medical education and let's
look at a whole different youknow raft of ways of meeting
people where they're at.
They don't necessarily have totravel to something like SoHot
right now.
Some of them might just want tobe able to call a hotline and
have a conversation, or some ofthem might not want to talk to
another human and just do it allon a platform where people
(30:02):
learn.
So there are lots of optionsthere none of, actually, which
are that expensive.
Like you know, I've looked athow much some of these different
options cost and they're notgoing to break the bank.
Sonya (30:14):
There are corporate organisations that roll out
learning platforms.
You know on a regular basis.
Like the technology exists, youdon't have to start from
scratch.
Find a model that works reallywell in a different industry and
just translate that over intothis healthcare industry.
Jo (30:31):
Yeah, no, I think great, I think that's you know, got that
sorted there we go In the nextcouple of weeks.
Thanks, government.
Sonya (30:38):
You know where we are.
We're full of great ideas.
Reach out anytime.
So, yes, there's our very shortbut robust conversation around.
You know our concerns and ourdesires of how this GP education
gap is filled.
Jo (30:51):
Okay, what else do we have?
There's one other thing Iwanted to talk about.
Dr Lisa Mosconi has beenawarded an incredible grant, so
before we talk about that, Ijust want to say what's exciting
about this is.
I think it's really about howthe land what we're seeing
happen in Australia with the PBSis it's changing the landscape
of what drugs are affordable.
(31:13):
What it's going to mean forwomen to be able to access drugs
that can enable them to this isthe new frontier.
Like, if we're going to reallyaddress the black hole of
knowledge around some of theissues that impact the health of
women, you're just going tohave to come.
(31:35):
We're just going to need somebig, meaty grants.
So how much is she getting?
Sonya (31:40):
Sonia, my goodness, a couple of things I want to cover
off here.
So a non-profit Welcome Leaphave announced a new $50 million
research program to prevent54.5 million Alzheimer's cases
in women by 2050.
So huge amount of money, hugegoal, significant goal
(32:05):
significant reduction in thenumber of Alzheimer's cases in
women being prescribed each year, which is just amazing.
But I thought that, before wejump into too much of that
detail, it might be a good ideafor anyone that's listening that
doesn't know who Dr LisaMosconi is, to give them a
little bit of insight into that.
The fact that she's actuallyjoining this whole research
(32:31):
program as the program director.
You know she's going to beabsolutely involved at ground
level as well as be driving allthis research.
So that's very, very cool.
So Dr Lisa Mosconi is aneuroscientist.
She's European.
Am I right in saying she'sItalian?
Yeah, she's a neuroscientistwho has done extraordinary work
(32:53):
in, specifically, alzheimer'sand dementia risk and prevention
in women.
Specifically, she published herfirst book last year, I think.
Jo (33:02):
Called the Menopause Brain and because she's the founder of
the Alzheimer's PreventionProgram and the Women's Brain
Initiative at is it well,cornwall Medicine.
Yeah, that's it.
Yeah and um, she's.
If you, if you google her,she's got some amazing, like a
ted talk about the impacts, um,of estrogen on the brain, but in
(33:25):
particular, she really talksabout the intersection of oh god
, it's very technical languagelike neuro endocrine risks and
neuro generation and how that'sgoing to impact brain health.
But it's, it's really excitingand it's a really decent amount
of money.
Sonya (33:43):
Yeah, it's really exciting.
One of the things that reallyjumped out at me and I think
this is something that we reallyneed to start demanding more of
and pushing for more of fromour government and from our
healthcare system and from ourresearch funds is that they're
looking at the impact that thisresearch will have on from a
financial aspect, so theeconomic impacts, but also the
(34:04):
health outcomes.
So the thing that really jumpedout to me was that, beyond
improving health outcomes,cutting Alzheimer's risk in half
could save the US alone 4.56trillion US dollars.
Holy cow, like that is a number, I literally can't even wrap my
(34:24):
head around.
Jo (34:25):
And all for a mere 50 million.
Sonya (34:27):
Yeah, exactly, we get caught in this conversation all
the time and we've talked aboutit and vented about this before
where there's just not enoughresearch, not enough funding put
into research.
And we hear over and over againthe response that gets wheeled
out when we question why isthere so much argument about
using, let's say, testosteronetherapy for women?
(34:48):
And the answer is constantlybecause we don't have the
research to prove it, nobodywants to fund it.
We know that Professor JayashriKulkarni, who has done
groundbreaking work on themental health implications of
perimenopause and menopause, hasbeen trying so, so hard to get
funding because everybody keepssaying to her well, until you do
some research and you canactually prove this, we're not
(35:11):
really going to take youseriously.
There is just this bottleneckof getting these funds to the
research programs so that we canstop wheeling out the well, we
don't have the researchwheelbarrow.
So this just goes to show that$50 million investment is going
to have an economic impact ofpotentially four points.
Jo (35:32):
Now, that's a return on investment that anyone would say
is well worth doing.
Sonya (35:36):
Thank, you very much.
Jo (35:38):
I know that we're about to have an election coming up and
there's going to be a new term,but whoever wins the next
election, let's go back tolooking at a really big, decent,
fast budget, to do someresearch, to address some of
these big picture issues thatcould actually end up saving the
Australian economy and theglobal economy trillions of
(35:59):
dollars.
Sonya (35:59):
Hey, look, spending on women long-term is absolutely
beneficial for everyone, alwaysa good return on investment,
always a good return oninvestment.
So the link to this I guess whywe're talking about this is
that there is a lot of researchthat's been done that does
suggest that the loss of theneuroprotective sex hormones and
that is predominantly estrogenmay increase the risk of
(36:24):
Alzheimer's post-menopausal.
So that's where thisannouncement around this funding
is going to have huge globalimplications and really for our
perimenopausal and menopausalgenerations to start getting
excited about.
Jo (36:39):
Yeah, and because that's what I think blew my mind when I
first started reading about itwas that it is.
You know, alzheimer's doesn'tappear until decades down the
track, but basically it startswhere we are now.
It starts at midlife.
So if you can nip it in the budor reduce your chances now,
then you know that's hugelyimpactful.
And you know, one of thereasons I'm grateful I'm trying
(37:00):
estrogen because, even thoughI'm not part of a clinical trial
, I'll find out.
Sonya (37:04):
Our own little personal experiments.
Yeah, it's awesome and I thinkthat you know Alzheimer's in
particular and any of thosecognitive decline diseases are
so impactful on our communities.
Not even if we take intoaccount that economic impact,
the impact that it has onfamilies, on caregivers, on our
(37:27):
health system, on our nursesthis sector of the population
that do get impacted byAlzheimer's and dementia is
really significant.
So anything that we can do toprevent that just has such big
flow-on impacts.
Jo (37:40):
No, I agree.
I agree, but they were callingfor proposals from researchers
from around the world, so itclosed only a few days ago.
Sonya (37:49):
Oh, it did.
It closed on the 14th of Marchoh.
Jo (37:52):
I wonder if anyone from Australia has put in.
So I'll look forward to seeinghopefully they'll announce at
some point who have been awardedsome of the grants to work on
their free-made areas.
Sonya (38:02):
To work on it.
Jo (38:03):
Yeah.
Sonya (38:04):
Exciting time.
Exciting time, all right, and Ithink I want us to finish up on
a positive note.
So, jo, talking about excitingtimes and I love having you here
as my co-host on our Hot Takesyour episode that we did dare
menopause episode where Iinterviewed you about your
experience and what brought youinto this space hugely popular
(38:25):
people love it.
They love hearing your story.
Can you share with us whereyou're at right now from a um,
you know, a personal careerperspective?
Jo (38:35):
yes, okay, great.
So I haven't actually done aformal you know launch yet.
But yes, I've got my ownconsulting business now and it's
called Sheela UnapologeticAdvocacy and I am going to be
working with organisations,businesses, not-for-profits
around their advocacy goals andproviding support to help shape
(38:56):
how they want to put togethertheir arguments probably
predominantly to governmentaround what they'd like to see
on the policy agenda and, Iguess, continue making a lot of
loud noise about issues that arepassionate to me.
I think over the last few yearsthere might have been a few in
the sector who've tried to usethe word lobbyist in relation to
(39:17):
what I do, and I've had tograpple with that because you
know I do find the word lobbyistit does for some reason it has
really negative connotations ofwell people doing evil things
for money.
But if I am going to do this, Iam going to have to register on
the Australian um lobbyistregister with the government.
But I'm reframing it.
(39:37):
I'm still an advocate.
I still advocacy is what I doand advocacy to me is about
working on something that youpassionately believe in.
So you know, my partner's jokedand he's like, yeah, you could
go and get a job like workingfor an oil company, and then
he's giggled because he knowsthat's never going to happen.
I am going to be hopefullydoing some really cool things
(40:02):
with some really cool entitiesand organizations and people.
Sonya (40:06):
Amazing.
I'm so proud of you and I am soexcited for where this goes.
I'm very excited for you to beshaking up the lobbyist world.
Jo (40:14):
And you know, the other thing is I've had a few people
say, oh, sheila, that name.
It's like I'm not a fan.
Sonya (40:22):
But you know, for me it's all about being authentic and
very on brand for me, but you dohave a website that we can
share in the show notes.
Oh, linkedin, okay cool.
We'll share your LinkedInprofile and anybody that is
listening and that would like toknow more about what you're up
(40:43):
to and, perhaps, potentially,how they could work with you.
They can reach out to you onLinkedIn.
Awesome, jo.
Thank you so much.
As always, it's great to sithere and have these robust
conversations and start puttingout ideas for people to think
about and not just being supernegative, but not also being
super shiny.
Positive all the time, likethis is the reality of what's
(41:04):
going on.
Jo (41:05):
Yeah, I know, and it feels like we are in a very exciting
period, so hopefully we willchat again.
The election still hasn't beencalled, so there's time for more
amazing things andannouncements to happen.
It's like every morning you'rewaking up and it's Christmas
morning.
Sonya (41:21):
What's going to happen?
It's like every morning you'rewaking up and it's Christmas
morning.
What's going to happen?
What's going to be in the newstoday?
It does.
It is literally the gift thatkeeps on giving right now.
Long may it last.
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