To provide effective patient-centred care for people experiencing menopause, it is important to understand the context and needs of their specific communities, including priority and vulnerable groups.
Consumer enablement is based on the principles of patient-centred care, and involves consumers in decision making and goal setting to manage their own healthcare.
Resources
Consumer enablement: a clinician's guide
Information, tools and resources for clinicians to help consumers, carers and communities manage their own health and wellbeing.
Source: Agency for Clinical Innovation
Culturally and linguistically diverse (CALD) communities within NSW include both long established communities and smaller emerging groups, such as refugees.
NSW Health is committed to ensuring culturally responsive care that recognises and respects linguistic and cultural needs. This includes access to care and supporting health literacy to enable shared decision making.
Staff working in menopause services should adapt their communication style and cultural knowledge to support consumers, families and carers.
Consumers, their families and carers who do not speak English as a first language or who are deaf have the right to free, confidential and professional interpreters when they use public health services. These can be accessed in-person, via telephone and videoconference.
Resources
NSW health care interpreting services
Contacts for each of the services (available 24 hours a day, 7 days per week) in local health districts, translation services and multilingual health information.
Source: NSW Health
CALD assist
Information on a free downloadable app to help clinicians communicate with people who have limited English proficiency. The app does not replace interpreters but can help to overcome basic language barriers when interpreters are unavailable.
Source: Multicultural Health Communication Service
Appointment translation tool
Translate appointment details into a patient’s language, save and print or send to an email or mobile number.
Source: Multicultural Health Communication Service
Auslan introduction to menopause
Video in Auslan for consumers – an introduction to menopause.
Source: Women’s Health Loddon Mallee
Women living with a disability experience particular disadvantage and can present with unique and complex health issues, which may be exacerbated by menopause. Services should be tailored to meet the needs of people with disability, including intellectual, physical and sensory disabilities, for best outcomes.
When working with people with a disability, ensure appropriate access, manual handling equipment, resources and training are in place to complete all assessments. Carers and case workers may attend the appointment for support, with patient consent.
Resources
Easy read information for perimenopause and menopause
Information on menopause for consumers with intellectual disability.
Source: NSW Government perimenopause and menopause toolkit.
Intersectionality refers to the ways in which different aspects of a person’s identity or social characteristics (e.g. gender, sexual orientation, ethnicity, class language, religion, age, ability, socioeconomic status) can expose them to overlapping forms of discrimination and marginalisation.
An intersectional approach means understanding that all people seeking care for severe and/or complex menopause should have equal access to a safe, inclusive, respectful and accountable health system.
Resources
The intersections project
Introductory video and resources to support intersectional healthcare.
Source: Health Consumers NSW
Lesbian, gay, bisexual, trans/transgender, intersex, queer and other sexuality, gender, and bodily diverse people require a health care experience that is inclusive and responsive. The menopause transition can be complex for people in this community.
Services should be inclusive and safe, using appropriate terminology including preferred pronouns and gender affirming language in all communication.
Resources
NSW LGBTIQ+ health strategy 2022 - 2027
Source: NSW Health
Inclusive language statement
Source: Agency for Clinical Innovation
Mood variations or fluctuations, including feelings of anxiety and depression, are very common throughout the perimenopausal period. Other symptoms include lack of motivation, low self-esteem, difficulties concentrating, increased irritability, fatigue, panic and disrupted sleep. Symptoms can have a significant impact on daily functioning and quality of life for patients and their families. See Mental health and mood disorders.
Resources
Menopause - managing psychological symptoms (PDF 176.0 KB)
Perimenopausal depression – an under-recognised entity
Short article regarding the identification and management of perimenopausal depression.
Source: Australian Prescriber
Menopause and mental health
Consumer fact sheet on mental health symptoms related to menopause and treatment options.
Source: Australasian Menopause Society
People from refugee backgrounds can face multiple barriers in accessing health services, including:
- language and cultural barriers
- unfamiliarity with the Australian healthcare system
- lack of trust in healthcare providers
- limited socio-economic resources
- competing settlement priorities, such as housing, education and employment.
Services should identify women who may need additional support on referral or early in their outpatient journey with menopause management. Best practice is to take a trauma-informed approach to care (see below).
Resources for health professionals
Refugee Health Service fact sheets
Fact sheets for health professionals on a range of health topics, including developing resources for people with refugee backgrounds.
Source: NSW Refugee Health Service
Developing health resources for people from refugee backgrounds: Best practice guide for NSW Health staff
Guidance on planning, development, production, post-production and distribution phases of multilingual health information for refugee communities.
Source: NSW Multicultural Health Communication Service
STARTTS: Training in the impact of trauma
Regular training opportunities on the impact of trauma on people from a refugee background.
Source: The NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS)
Delivering healthcare to refugee communities in regional NSW
A guide for healthcare workers and their community partners on how to establish trauma-informed and culturally-safe health services for refugee communities in regional NSW.
Source: Agency for Clinical Innovation
Resources for consumers
NSW health care system information booklet
A booklet for refugees and newly arrived migrants on all aspects of navigating healthcare, available in multiple languages.
Source: NSW Refugee Health Service
Information in other languages
Translated resources (e.g. fact sheets, videos) on a range of health topics.
Source: NSW Refugee Health Service
Trauma is defined as an event, series of events or set of circumstances that are experienced as physically or emotionally harmful or life threatening. These adverse experiences have a strong negative impact on health.
Trauma-informed care is an approach based on an understanding of the ways trauma affects people’s lives, their service needs and service usage.
Resources
Trauma-informed care and practice in mental health services
Information on the ways trauma affects people’s lives, and how those affected use health services.
Source: Agency for Clinical Innovation
The following education modules are available to NSW Health staff through the My Health Learning platform (login required).
How to use healthcare interpreters
- Risks in using family to interpret
- Assessing the need for an interpreter
- Face to face communication with interpreters
- Telephone interpreting
- Interpreting in family conferences
Understanding communities
- Health literacy and teach-back
- Introduction to LGBTIQ+ inclusive health care
- Respecting the difference: Know the difference
- Meeting the healthcare needs of refugees
- Culturally responsive healthcare
Working with people with intellectual disability
- Intellectual disability: Communication essentials
- Intellectual disability: Virtual care
- Intellectual disability: Reasonable adjustments
- Intellectual disability: Consent and decision making I
- Intellectual disability: Consent and decision making II
- Intellectual disability: Behaviour as communication I
- Intellectual disability: Behaviour as communication II
Trauma-informed care
Aboriginal women have unique experiences of menopause.
Many Aboriginal women do not have a word for menopause in their language. They refer to it as “the change of life”, which signifies the ageing process with an associated gain of respect in community. However menopause is becoming accepted by most Aboriginal women, except for elders.
A lack of awareness and understanding impacts many aspects of their lives.
The average age of menopause onset appears earlier in most Aboriginal groups.
An understanding of potential increased social and health risk factors for Aboriginal people will assist clinicians helping Aboriginal women to navigate midlife health assessments. It is important to consider their educational needs and support for improved general health and wellbeing.
Look for opportunities to partner with your local community. Consider how you can support women on country. This might include engagement activities such as menopause education, storytelling, awareness and empowerment activities. Consider partners such as Aboriginal health workers, Aboriginal community controlled health organisations, yarning circles and weaving groups, women's health practitioners, existing relationships with other services and local community champions.
Read more about Aboriginal women’s menopause experience
Resources
Finding your way
A shared decision-making model created with mob, for mob and so mob can feel safe and trusted to make informed decisions based on their values and beliefs.
Source: Agency for Clinical Innovation
WellMob
Social, emotional and cultural wellbeing online resources for Aboriginal and Torres Strait Islander people. There are also training resources to support your work in the community, and resources to help you look after yourselves.
Source: WellMob
AHMRC NSW health programs
Resources and health programs for physical and psychological health and wellbeing.
Source: Aboriginal Health & Medical Research Council of NSW
Jean Hailes first nations resources
Developed with Aboriginal and Torres Strait Islander women and their health professionals. Resources include booklets and educational animations about menopause and other health concerns.
Source: Jean Hailes for Women’s Health
National Aboriginal Community Controlled Health Organisation (NAACHO)
Find out more about the national peak body representing Aboriginal community controlled health organisations across the county on Aboriginal and Torres Strait Islander health and wellbeing issues.
Source: National Aboriginal Community Controlled Health Organisation
Menopause Aboriginal artwork
To support clinical engagement, education and culturally safe clinical environments, we have three Aboriginal artworks that can be used for the Menopause Initiative programs.
Source: Agency for Clinical Innovation
NSW Aboriginal health plan 2024-2034
Provides guidance on the redesign of health services, with a focus on Aboriginal expertise to drive shared decision making to achieve health equity for Aboriginal peoples in care delivery.
Source: NSW Ministry of Health
NSW Aboriginal health governance, shared decision making and accountability framework
Outlines four principles to guide and embed these concepts in NSW Health and improve outcomes for Aboriginal people in NSW.
Source: NSW Ministry of Health