Virtual care improves outcomes for menopausal women

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Published: March 2026. Next review: 2031.

Digital tools help women manage perimenopause and menopause by giving them easy access to multidisciplinary specialist support.

Up to one in 4 women experience severe and debilitating symptoms during perimenopause or menopause. This can reduce quality of life, impair their ability to work and increase healthcare use.

The South Western Sydney Specialist Menopause Service (SMS) uses digital tools to support women who struggle with symptoms, such as:

  • hot flushes
  • significant sleep disturbance
  • brain fog
  • arthralgia
  • weight gain
  • heart disease
  • severe vaginal dryness
  • reduced libido
  • bowel and bladder incontinence
  • mood and mental health-related disorders.

After menopause, women face higher risks of cardiovascular disease and bone density loss, increasing osteoporosis and fractures. As women live longer and receive better healthcare, many will spend up to a third of their lives in menopause, making it essential there is symptom support to improve their quality of life.

Improving access

Under the Statewide Initiative for Better Care, the NSW Government is investing funding over 4 years from 2023 to improve women’s health and establish a statewide menopause service. The service includes 12 referral sites supported by 4 specialist hubs in the following local health districts (LHDs):

General practitioners (GPs) remain the first point of care, while the hubs provide timely multidisciplinary support for women with severe or complex symptoms.

The South Western Sydney hub also supports women in Murrumbidgee, Western NSW and Nepean Blue Mountains LHDs, Aboriginal Medical Services and NSW Women’s Health Centres through the SMS. The service began as a fully virtual service and later added in-person appointments in 2026, creating a hybrid model that improves access, particularly for vulnerable groups.

Advantages of providing care virtually

  • Meets women’s needs by supporting those with work or care responsibilities
  • Improves access across 4 major LHDs covering nearly half of NSW
  • Efficient use of staff by allowing fractional clinical positions to manage consultations online
  • Reduces environmental impact by cutting travel emissions and using workflows
  • Delivers timely education to a broad clinical audience

Supporting priority populations

Aboriginal women often reach menopause about 5 years earlier than non‑Aboriginal women. They may not report symptoms due to cultural norms or because they attribute symptoms to other health issues. Earlier menopause combined with higher rates of chronic conditions, increases health risks and complicates symptoms.

Cultural, historical and systemic factors also shape experiences. Because menopause is considered 'women’s business', open discussion can be limited. Mistrust of mainstream healthcare, communication barriers and a lack of culturally appropriate information − especially in rural and remote areas – further restrict access to care and understanding.

The SMS has led focus groups with Aboriginal women and major culturally and linguistically diverse (CALD) groups in South Western Sydney, including Vietnamese, Arabic, Assyrian, Cantonese, Mandarin and Hindi speakers, as well as women from Pacific communities. Co-design has strengthened understanding of women’s experiences and needs. Consumer feedback continues to refine the hybrid model, including in-person care options, targeted education and preferred outreach approaches.

Patient quotes

“I'm incredibly happy. The specialist took the time to listen, explain everything clearly, and made me feel genuinely cared for. I appreciate how convenient the whole experience was.”

“Being able to access this expertise and specialist care from my regional shire of 4,000 people, and be bulk billed, has been absolutely invaluable.”

“I was sceptical of a virtual consult but it exceeded my expectations. I felt heard by the doctors, which I hadn’t felt for a long time. This is the service menopausal women need!”

Workflow

  1. Criteria

    • Younger than 40 and have onset of menopause
    • Aged 40 or older and have severe or complex symptoms, plus:
      • history of cardiovascular disease or stroke
      • increased risk of blood clots
      • cancer
      • high risk of fracture or past fragility fracture
      • early menopause due to medical treatments
      • acute liver disease
      • severe depression, anxiety or stress.
    • Women with severe or complex perimenopausal or menopausal symptoms that don’t improve with treatment
    • Women with socioeconomic vulnerablilities preventing access to specialist care

  2. Referral

    • GP, specialists, Aboriginal Medical Services and land councils, mental health clinicians, BreastScreen NSW and Family Planning NSW clinicians within Hunter New England, Northern Sydney, South Eastern Sydney and South Western Sydney LHDs
    • Referral available online via SWSLHD, HealthPathways or public health network websites and emailed to SMS

  3. Triage

    • Clinical nurse consultant reviews for eligibility and priority
    • Nurse conducts triage to confirm patient’s needs and goals

  4. Care

    • Urgent referrals are booked within 8 to 12 weeks; standard referrals are scheduled for 3 to 6 months
    • Patients emailed appointment details, appointment link and user guides (written and video) to help them use videoconferencing

Team

  • Medical: endocrinology, gynaecology, haematology, psychiatry
  • Allied health: physiotherapy, dietetics, clinical psychology
  • Other: nursing, administration support

The SMS works with Aboriginal health workers to improve service planning, delivery and patient care, and offers Aboriginal women additional support and engagement through these workers.

Patient education

The SMS delivers an online education series, Thrive through Menopause – Lifestyle Changes for Good,  to support women managing perimenopause and menopause. The series includes:

  • weekly 30-minute sessions over 6 weeks
  • 15-minute clinician-led education, plus 15-minute interactive Q&A
  • groups of up to 30 participants
  • topics covering understanding menopause, and managing risks and symptoms
  • participant evaluation to support continuous improvement.

Technology

Digital and clinical support tools

  • NSW Health-approved videoconferencing platforms for consults and education; and to support internal communication and operational processes
  • Hub with multiple, enlarged screens and pods
  • Noise-cancelling headphones
  • Laptops
  • Health Outcomes and Patient Experience (HOPE) platform for patient-reported measures (PRMs)

Patient feedback tools

The HOPE platform includes 3 validated PRMs tools:

  • Menopause-Specific Quality of Life (MENQOL)
  • Menopause Depression Rating (MENO D)
  • Depression, Anxiety, Stress Scale – 21 Items (DASS-21)

Clinicians collect these PRMs at the first assessment, end of care, and as needed.

The tools provide timely feedback from patients and highlight their priorities. They also guide care planning, track treatment effectiveness and support person-centred care.

Key enablers

Need: improves women’s health and quality of life, and reduces healthcare use.
Funding: the NSW Menopause Services Initiative receives priority government funding for 2023–2027.
Planning: includes extensive consultation across district partner groups, working groups, steering committees and targeted CALD focus groups.
Relationships: GPs remain the first contact with a clear escalation path and case conferences support GP education.
Processes: clear roles and responsibilities supported by digital documentation and structured templates.
Collaboration: fortnightly clinical case reviews and multidisciplinary meetings held across the LHD cluster, with patients central to all discussions.
Governance: embedded in existing structures and supported by the Steering Committee and Menopause Working Group, established in 2023.
Monitoring: Ministry of Health’s Economic and Analysis Unit leads statewide monitoring and evaluation, with the Agency for Clinical Innovation providing clinical leadership and project management alongside hubs.

    Impacts and outcomes

    Patient benefits

    • Improved health outcomes for women
    • More convenient and equitable access to specialised care, including for regional and rural areas
    • Women are empowered to engage in their care
    • Patients shape service design and improvement through co-design principles
    • Lower costs by avoiding parking and transport
    • Aboriginal women can receive culturally safe care on Country

    Clinician benefits

    • Strengthen capability and build networks with menopause care leaders across NSW and Australia
    • Build community and primary care skills through multidisciplinary video case-conferencing
    • Improve understanding of symptom impact and workplace advocacy
    • Reduce infection risk
    • Increase opportunities to attend or present at menopause-related forums, conferences and education or research showcases

    Service benefits

    • Better integration with primary health providers
    • Improved care coordination
    • Efficient care management and service planning, with appointments delivered to schedule

    System benefits

    • Model recognised as an exemplar virtual multidisciplinary service
    • Hub model that can be replicated across clinical specialities
    • Environmental benefits through no travel emissions and minimal paper use
    • Uses existing infrastructure

    Lessons learnt

    • Choose technology that supports clinical workflow; avoid systems that create extra administration
    • Trial new approaches; but stop, evaluate and redesign when they don’t work
    • Stay flexible and ready to pivot
    • Build strong relationships with IT and digital health teams
    • Share lessons widely

    Contact

    For more information, contact:

    Acknowledgement

    Thank you to Loretta Andersen, Operations Manager, South Western Sydney Local Health District, for the support and information provided for this Spotlight.

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