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The menopause care gap

Menopause symptoms are real, but far too many women find themselves toughing it out without proper medical care. The Yale review found that while 60% of women with significant menopausal symptoms seek medical attention, 75% leave their appointments untreated¹.

This is not an isolated problem. Biolae's State of Menopause Survey found a similar picture in Australia and New Zealand: 60% of women felt dismissed or invisible when discussing perimenopausal or menopausal symptoms with their healthcare providers, and only 32% felt heard and respected².

The reality is that many GPs don't receive enough menopause-specific training. "Even with the best intentions, many healthcare providers may not have the complete understanding of menopause to catch its full range of symptoms," says Dr Middleton. "With nearly 50 recognised symptoms, it's not unusual for women to be referred to multiple specialists or go through extensive tests before finding the right diagnosis. Often, perimenopause is overlooked."

To get the care you need, you have to advocate for yourself. Knowledge and preparation are the levers. Here are the five steps Dr Middleton recommends to every patient.

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Tip 1: Find a menopause-trained GP

Not all GPs are equipped with the latest information on menopause. If yours isn't, it's reasonable to look for one who is.

"I always tell women, if your GP isn't up to date on menopause treatments, it's okay to seek out a specialist," says Dr Middleton. "There are doctors who are trained to address menopause holistically — they'll look at both your symptoms and your long-term health risks, like heart disease and osteoporosis."

The Australasian Menopause Society publishes a directory of certified menopause practitioners who specialise in treating perimenopausal and menopausal women³. These doctors are more likely to be current on the latest research and treatment options. If you live in Australia, the Medicare Menopause Health Check is another structured starting point — a dedicated 45-minute Medicare-rebatable appointment for women aged 40–65.

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Tip 2: Match your doctor to your values

Your preferences matter, and it's important to find a doctor who respects them.

"It's critical that women feel heard and supported in their treatment decisions, whether they prefer natural remedies, hormone therapy, or a combination," says Dr Middleton. "I work closely with my patients to ensure their treatment aligns with their values and lifestyle. No one solution fits every woman."

If you're interested in incorporating natural remedies, consider seeking out an integrative GP. Either way, the goal is the same: a treatment plan suited to your individual needs, not a generic protocol.

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Tip 3: Bring your family history

Your close female relatives' menopause experiences can give your GP valuable context for your own care.

"Family history is incredibly important," Dr Middleton explains. "If your mother or other close relatives experienced early menopause or had hormone-related health issues, that can give us critical information for your care."

Beyond menopause timing, gather details on diseases that run in your family — heart disease, Alzheimer's, osteoporosis, breast and ovarian cancer. "Sharing this with your doctor helps tailor the right preventative measures," adds Dr Middleton.

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Tip 4: Know your treatment options

Before the appointment, think about what you're open to. Would you consider hormone therapy, and is your doctor willing to prescribe HRT (MHT)? Would you prefer non-hormonal options? Are you open to lifestyle and dietary changes? Are you considering evidence-based menopause supplements?

"There are many ways to manage menopause symptoms — from lifestyle changes to hormone therapy and supplements," says Dr Middleton. "Knowing what you're open to helps your doctor create a treatment plan that feels right for you."

Having a sense of your desired outcome makes the consultation faster and the plan more likely to stick.

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Tip 5: Track your symptoms

A symptom diary is one of the highest-leverage things you can bring to an appointment. Note fluctuations in mental health, hot flushes, stress, sleep, aches and pains, fatigue, weight, and memory. If you also have vaginal dryness or libido changes, note those too.

"I encourage all my patients to track their symptoms," says Dr Middleton. "When we can see patterns in how they're feeling day to day, it makes it easier to pinpoint effective treatments and understand the full scope of their experience."

The Greene Climacteric Scale is a validated tool that helps clinicians prioritise treatment for symptoms like anxiety, night sweats, and vaginal dryness. "Bringing a completed symptom scorecard to your appointment ensures your doctor has a clear understanding of what's most affecting your quality of life," Dr Middleton adds.

How to fill out the Greene Scale

Rate each symptom: 0 = none, 1 = mild, 2 = moderate, 3 = severe.

Symptom	Severity (0–3)
Anxiety (feeling tense/nervous)
Difficulty sleeping
Feeling excitable
Attacks of panic
Difficulty concentrating
Feeling tired or lacking energy
Loss of interest in sex
Feeling unhappy or depressed
Crying spells
Irritability
Feeling dizzy
Headaches
Muscular aches and pains
Hot flushes
Night sweats

Print it, fill it out the week before, and bring it with you. If a standard 10-minute appointment isn't enough, request a double appointment, or book a follow-up to cover what didn't fit.

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Why preparation pays off

Menopause affects every woman differently, and no single set of symptoms defines the experience. Preparation is the lever you have control over.

"Unfortunately, the healthcare system doesn't always provide the nuanced support women need during this transition," says Dr Middleton. "But by preparing yourself with the right information, you can make sure your voice is heard and get the care you deserve."

The five tips above — finding the right GP, matching them to your values, bringing your family history, knowing your treatment preferences, and tracking your symptoms — are how you turn a 10-minute consult into a treatment plan you can act on. It's about more than managing symptoms: it's about owning the next chapter of your health.