“I remember a patient once said to me that her fertility and having children was never important to her. She never really even thought she’d become a mother, but having the threat of that option taken away from her was actually quite distressing,” says A/Prof Michelle Peate, the Program Leader for the Psychosocial Health and Wellbeing Research (emPoWeR) Unit, University of Melbourne. 

Around 4000 women in Australia and 440 women in New Zealand are diagnosed with breast cancer each year who are under the age of 45. Some treatments for breast cancer, such as chemotherapy and hormone therapy, may induce premature menopause and can reduce a woman’s chance of having children in the future.

While treatments can affect each person differently, it’s important to discuss fertility options with a breast cancer or fertility specialist as soon as possible. 

Dr Peate says that once breast cancer treatment begins, there can be irreversible damage to fertility, so “it’s really important to have those discussions early and give people all the options so they can make an informed choice.”

“My perspective is a lot about giving everyone the information they need to make the right choice for themselves, which may be to preserve and freeze embryos or eggs, or it may be about making sure they all know that there’s a risk and know that there are options available to them,” she says.  

Whether or not you’ve had children, are single or in a relationship or haven’t thought much about family planning, Dr Peate recommends talking to your doctors about your fertility options. 

“And if the doctor is not able to provide that information, find another doctor who will,” she says. “Just make sure you have an informed decision.”

Values-driven options

One resource that might be useful for breast cancer patients is a ‘decision aid’, such as booklets or websites that contain information to help inform on fertility preservation options and the impact of cancer on fertility. 

An advocate for value-driven decisions, Dr Peate was one of the first people in the world to incorporate this aspect into a fertility decision aid.

“What’s the right thing to do really comes down to what’s important to the individual’s values,” she says. “So our decision aid always has at the end this thing called a ‘values clarification exercise’.”

Some examples of values-driven options that a fertility decision aid might give include whether it’s important for the patient that their children are biologically related to them. If so, then Dr Peate says looking into fertility preservation options may be right for that patient, to preserve that genetic link. Whereas, if adoption appeals to the patient, then it might be less important to consider those fertility preservation options. 

Through her research, Dr Peate says she and her team proved that decision aids with values-driven options “resulted in improved decision outcomes.”

“Women were more satisfied with their decision,” she says. “They did have less regret, as they were making choices consistent with their values.” 

POEMS Trial

Research into fertility options for breast cancer patients has been quickly evolving. One innovative, new treatment option for young women with breast cancer has emerged from the POEMS clinical trial, to better preserve fertility during chemotherapy. 

POEMS, which stands for Prevention of Early Menopause Study, was conducted in Australia and New Zealand by Breast Cancer Trials and globally by the SouthWest Oncology Group (USA).  

One of Australia’s most prominent research-orientated cancer surgeons, Professor Christobel Saunders says she’s excited about the POEMS trials results as it showed “it was safe to interrupt hormone therapy after about 18 months to try to become pregnant.”

“This is very important for women with ER positive breast cancer who may be looking at 10 years of treatment and very diminished fertility at the end of this,” says Professor Saunders. 

“This trial looked at how Zoladex may protect ovaries during chemo. Thanks to the trial and the women who participated, this is now standard of care and has allowed many women to maintain their ovarian function after chemo.”

Clinical trials such as POEMS can offer the best possible treatment and care to patients, says Professor Saunders, who encourages women with breast cancer to consider joining one to further their knowledge and help the next generation of patients. 

“We know those in trials–and even those managed in centres that run trials– have better outcomes,” she says.

Join Breast Cancer Trials’ next free and online Q&A, happening Tuesday 20 February from 5-6:30pm (AEDT). The session will be moderated by author and journalist Annabel Crabb on the topic of breast cancer and fertility. To register click here.

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To address this, the government has established a National Women’s Health Advisory Council, which has been actively working over the course of 2023 to advise the government on key policy areas of women’s health.

The Council’s role is in guiding how the Government delivers on the National Women’s Health Strategy 2020-2030. This strategy outlines Australia’s national approach to improving the health of women and girls – particularly those at greatest risk of poor health – and to reducing inequities between different groups.

Assistant Minister for Health Ged Kearney, a fromer nurse, has spoken to many women who’ve experienced medical misogyny. Earlier this year, she shared insights she’s heard with Women’s Agenda.

“Women and girls deserve tailored and targeted healthcare that recognises and reflects their experiences and concerns,” said Kearney.

Despite the fact that endometriosis affects 1 in 9 women and those assigned female at birth, or 190 million people globally, research has shown that medical professionals are still touting outdated pseudoscience that having a baby cures the disease (there is currrenlty no cure). And many don’t officially get diagnosed until their early thirties as it takes an average of eight years to be diagnosed with the common condition. 

When it comes to infertility, even though the condition affects about 1 in 6 Australian couples of reproductive age, gaps in knowledge among Australian women still persist, particularly in relation to what they can do to improve the chance of having children. 

Women also experience nearly twice as much depression as men, four times as much anxiety and 12 times the rate of eating disorders, according to Women’s Health Victoria. 

These unique challenges are leading women and girls to poorer health outcomes than men and boys.

Thankfully, this past year has brought about some exciting news in many areas of women’s health research. Here’s a look back at some of the biggest developments in 2023, and what they could mean for the future. 

New research proves that PCOS won’t hinder conception with fertility treatments

Women who have been diagnosed with polycystic ovary syndrome (PCOS) and wish to conceive have the same likelihood of falling pregnant as women without the condition when they undergo fertility treatments, a study from The University of Queensland has found this year.

Researchers from UQ’s School of Public Health studied 1109 women who were using fertility treatments and found no difference in births between the women with PCOS and those without PCOS. There was also no difference found between those on different treatment paths. 

In Australia, roughly one in 10 women are diagnosed with PCOS. The condition, which sees increased levels of two hormones in the body, causes women to ovulate irregularly, or not ovulate at all, making conception difficult. 

Dr Katrina Moss, a Research Fellow at the university specialising in reproductive health and assisted reproductive technology said that the latest research should provide some reassurance for women with PCOS who are anxious about their fertility.

New drugs show promising signs of slowing Alzheimer’s disease

Nearly two-thirds of Australians with dementia are women, and the numbers are only rising– the Australian Institute of Health and Welfare predicts the number of Australians with dementia to more than double by 2058 (533,800 women and 315,500 men). 

Dementia is also the leading cause of death for women, according to statistics from Dementia Australia. 

This year, pharmaceutical company Eli Lilly came out with the second drug in under a year to have been shown to slow Alzheimer’s- a form of dementia. It followed on the heels of lecanemab, sold under the brand name Leqembi.

Eli Lilly’s drug, donanemab, has been shown to slow the pace of the disease by about a third – a feat experts previously thought impossible.

In the company’s trial, there were 1,182 participants with early-stage disease whose brains had deposits of two key Alzheimer;s proteins, beta amyloid as well as intermediate levels of tau, a protein linked with the disease progression and brain cell death.

Overall, the pace of the disease was slowed by about 29 per cent with donanemab. And in a set of patients researchers thought more likely to respond, the clinical decline of the disease was at 35 per cent compared to a placebo. 

Australia welcomes its first uterine transplant baby 

Australia’s first uterine transplant baby, Henry Bryant, was born this week at a Sydney hospital.

“It’s been a whirlwind year and to have Henry here safely is beyond anything I thought possible,” said the baby’s mother, Kirsty Bryant.

She is the first woman in Australia to undergo a uterus transplant as part of a groundbreaking research trial led by Associate Professor Rebecca Deans, Gynaecology Specialist at the Royal Hospital for Women and clinical academic at UNSW Medicine & Health. 

“After my hysterectomy, I desperately wanted another child and I felt like there weren’t many options for somebody in my situation,” Bryant said.

“To hold this baby in my arms is a dream come true.”

First baby born in Australia from a cheaper alternative to IVF

Australia’s first ever baby conceived via a new clinical procedure to treat infertility was born this year.

Leanna and Theo Loutas celebrated the birth of their first-born, Bonnie, in October at Sydney’s Royal Hospital for Women in Randwick. 

Earlier this year, the couple were offered a new fertility procedure called CAPA IVM (Capacitation in-vitro maturation) — a treatment which involves retrieving eggs at an immature stage and bringing them to maturity in cell culture. It results in higher pregnancy rates per cycle.

It eliminates the need for two weeks of hormone treatment and costs about half the price of traditional IVF. 

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A world-first endometriosis discovery was made by researchers in Sydney

Researchers at the Royal Hospital for Women in Sydney made a world-first discovery into the diagnosis and treatment of endometriosis this year. 

The team successfully grew tissue from all known types of endometriosis in a laboratory. This has allowed researchers to observe cell changes and compare how different tissue responds to different treatments.

An increased understanding will allow doctors to better diagnose varying types of endometriosis to ensure patients receive the most effective treatment. 

The new development will also help determine whether a woman with endometriosis is likely to need fertility treatment in the future. 

Largest ever genetic study of endometriosis reveals links to other chronic pain

The largest ever genetic study of endometriosis has found that genetic risk factors are also associated with other chronic pain types such as migraine, back pain and multi-site pain. 

Researchers from the University of Queensland’s Institute for Molecular Bioscience, Dr. Sally Mortlock and Professor Grant Montgomery, collaborated with University of Oxford researchers and 24 teams across the world to compare the DNA code of more than 60,000 women with endometriosis and 700,000 women without the disease. 

The shared genetic basis for endometriosis and other types of seemingly unrelated pain may be indicative of ‘sensitisation’ of the central nervous system, according to Dr. Morlock, who says “This makes people suffering from chronic pain more prone to other types of pain”.

Before the study, researchers knew of 17 genetic regions associated with endometriosis compared to the 42 regions now known. They can now work to better understand what genes in these regions do and find new drug targets, leading to new treatments.

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Researchers from UQ’s School of Public Health studied 1109 women who were using fertility treatments and found no difference in births between the women with PCOS and those without PCOS. There was also no difference found between those on different treatment paths. 

Women with PCOS responded well to fertility treatments and had the same birth rate as women without the condition.  

Dr Katrina Moss, a Research Fellow at the university specialising in reproductive health and assisted reproductive technology said that the latest research indicates that women with PCOS were not disadvantaged when they underwent fertility treatments. 

“More women with PCOS used fertility treatment – 38 per cent compared to 13 per cent of women without PCOS, but the birth rate was equivalent,” Dr Moss said. 

She believes that the findings should provide some reassurance for women with PCOS who are anxious about their fertility.

In Australia, roughly one in 10 women are diagnosed with PCOS. The condition, which sees increased levels of two hormones in the body, causes women to ovulate irregularly, or not ovulate at all, making conception difficult. 

Those with PCOS who wish to conceive are usually taken through a series of steps based on clinical practice guidelines. They are given the option to try ovulation induction (OI) first, before being recommended to undergo intrauterine insemination (IUI) before finally trying IVF.

“According to our analysis, most women with PCOS are following the recommended treatment pathways,” Dr Moss said.

“71 per cent are starting OI compared to 36 per cent of women without PCOS, and fewer women with PCOS progress to IVF.” 

“It’s positive that non-invasive treatments like OI are highly effective, and there was no disadvantage to starting with that and progressing to other treatments if needed – suggesting the clinical practice guidelines work well for most women.”

Professor Jenny Doust, a Clinical Prof Research Fellow from UQ said the research should give GPs the green light to assure their female patients who have PCOS that their chances of falling pregnant are just as good as anyone else’s.

“However, it’s possible that this is because women with PCOS are more likely to start fertility treatments earlier, around age 31 compared to age 34 for women without PCOS, and age is a key factor for success,” Professor Doust said.

“We also found that women who need to go on to more invasive treatments such as IUI and IVF were more likely to have other reproductive disadvantages such as endometriosis, obesity or a higher age.” 

“These factors should be considered by clinicians and patients when choosing treatment pathways as it’s important to get women into the most effective treatment as early as possible.”

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Infertility affects about 1 in 6 Australian couples in reproductive age and is just as likely to impact females or males. 

There are many causes of infertility, such as low sperm count for males and blocked fallopian tubes in females or underlying causes including endometriosis for females and testicular problems in males.

Women’s healthcare company, Organon, has today released the Australian Fertility Report, revealing gaps in fertility knowledge among Australian women, particularly in relation to what they can do to improve the chance of having children. 

The report notes that although women are aware of a variety of fertility treatments, there’s still a lack of fertility awareness in relation to their own bodies. 

Drawing on findings from a new national survey commissioned by Organon of 2,044 women aged between 18-45 years in Australia, the report found that only 16 per cent of these women accessed fertility treatment despite one quarter of them currently having trouble conceiving. 

And only 11 per cent of all women surveyed have accessed fertility treatment, while most (71 per cent) surveyed are aware of different types of treatment, including IVF and egg freezing.

Women who have had trouble conceiving but have not accessed fertility treatments state that the reasons are concerns over the potential personal and emotional toll of the procedure (73 per cent), and concerns about the success rate of treatments (70 per cent).

Another key factor affecting women accessing fertility treatment is affordability (81 per cent), despite some treatments being subsidised through Medicare or covered by private health insurance. 

Experts have also suggested there’s a lack of understanding of how and when to start exploring fertility treatments. 

“People often don’t think about fertility until it becomes an issue. That is why there is a need for education through a more holistic life course approach to reproductive health, including family building, to reduce difficulty conceiving and to help Australians achieve their desired family-building intentions,” said the Head and Professor of the Discipline of Obstetrics & Gynecology in the School of Women’s & Children’s Health, Professor Bill Ledger.

The report also showed that most women understand endometriosis (90 per cent) and polycystic ovary syndrome (PCOS) (88 per cent) are major health issues women should talk to their doctors about before trying to fall pregnant.

Sydney-based woman Teniele Spicer, who is expecting her first child, said she had always planned to have children, but a diagnosis of Polycystic ovarian syndrome (PCOS) meant she started her fertility journey earlier than planned. 

“If it wasn’t for the conversations I had with my GP at 18-years-old that led to my diagnosis of PCOS, I doubt I would have started thinking about my fertility options until much later, which would have left me scrambling to start my fertility journey when I should have already started,” said Spicer. 

“Conversations between Australians that want to have children and their GPs need to begin early. As in my case, with knowledge comes power, and with a largely supportive public system, we actually do have the power to act early on fertility.”

Managing Director of Organon ANZ, Nirelle Tolstoshev said the Australian Fertility Report findings “demonstrate the need for fertility-awareness education to be at the top of the agenda to enable Australians to have children if and when they want to”.

Listen to Women’s Agenda’s own fertility podcast, Fertility Unfiltered here.

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The average age of both mothers and fathers has been steadily increasing since the mid-1970s. 

Less than 20 per cent of births were to mothers aged between 30 and 39 years old in 1975. 

Now, as Emily Walter, ABS head of demography says, “Nearly 60 per cent of births are to mothers in this age group.”

Women are also having fewer children, with the total fertility rate slowly dropping since the mid-70s. Last year, the rate was 1.63 births per woman — lower than the 2021 rate of 1.70 births per woman. 

“Although total fertility remains low, the fertility rate for women in their late 30s and early 40s has significantly increased,” Walter added. 

Between 1991 to 2022, the fertility rate of mothers aged 35-39 years almost doubled from 36.0 to 69.3 births per 1,000 women.

For women aged 40-44 years, the rate has nearly tripled from 5.5 to 15.8 births per 1,000 women. The fertility rate of teenage mothers though has reached an all-time low of 6.8 births per 1,000 women. In 1991, the rate was 22.1 births per 1,000 women. 

Last year, a total of 300,684 births were recorded in Australia — 9,000 less than the previous year, though higher than 2020 numbers. 

The highest fertility rate cohort were women in the 30-34 years age bracket, while women in the 45-49 years cohort continue to have the lowest fertility rate. 

The Northern Territory had the highest total fertility rate (1.73 babies per woman), while the ACT had the lowest total fertility rate (1.41 babies per woman).

The latest data is consistent with studies that have shown women having their first and subsequent births later in life, as well as the general trend of delayed parenthood due to other contributing factors, such as leaving the home, gaining economic stability, and marrying or forming long-term de facto relationships later than was seen in the past. 

Similar trends have been noted in the US, where the proportion of women giving birth at ages 40 to 44 has been on a steady rise. 

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Caines says she first looked into this fertility treatment after interviewing a woman who shared a heartbreaking experience of being unable to have her own biological child.

“She wasn’t with a partner, she was getting a sperm donor using her eggs and nothing was working, and she got to the age of 44 and her doctor told her that: ‘I’m sorry but your eggs have expired and you won’t be able to have your own biological child’,” Caines tells Tarla Lambert on our podcast series, ‘Fertility Unfiltered’, in partnership with Genea Fertility.

“And that just broke my heart just to think that this lady who wanted a baby so bad just couldn’t have a baby,” said Caines.

The woman explained what the concept of egg freezing was to Caines, who had never heard of it before but began to think seriously about it.

“I knew that children and a relationship wasn’t on the horizon for quite some time because I was so career-focused. So, I contacted a fertility provider, Genea, who were wonderful and talked me through the steps,” she says.

“Unfortunately egg quality does decline with age but the fortunate thing is your frozen eggs don’t. So, basically freezing my eggs at 28 years old – I have 28 year old eggs there now that are waiting for me to use them if I ever need to go through that.”

For those who are in a similar situation to Caines– not ready to have a family yet but wanting to keep their options open– egg freezing is something to think about. 

Genea fertility specialist Dr Danielle Robson says the best age to freeze eggs is before 35-years-old.

“The reason for that is that women over 35 years achieve poorer pregnancy outcomes from frozen eggs relating to oocyte quality deterioration with advanced maternal age,” says Dr Robson, adding the caveat that this doesn’t mean anyone over 35 years old can never freeze their eggs.

“It just means that your chance of success is slightly lower just as we know with natural ageing, we have decreases in the quantity and quality of our eggs.”

“So there’s no exact cutoffs or thresholds, it’s just about having informed conversations with women about when is the best time,” she says.

When it came to the actual process of egg freezing, Dr Robson says it’s “very similar to running an IVF cycle for a couple with infertility.”

There’s an initial consultation with a gynaecologist and then a treatment plan is developed, which includes receiving hormone injections to grow follicles on your ovaries. Following that, medication is given to stop ovulation, and then the patient undergoes egg collection.

For Caines, she didn’t tell many people about her egg freezing process while she was taking the injections but wishes she’d been more open about it.

“I sort of kick myself for keeping it such a secret and not really leaning on – even my work colleagues to say, ‘hey I’m going through this thing at the moment – I need a bit of time – bit of timeout or my emotions all over the place’,” she says. 

“I feel so empowered now that I went through that experience, and I’m really happy to share my story with as many women as I can because I just want people to be educated on how great this experience and this opportunity is.” 

To learn about more reproductive health topics from health experts, check out the rest of the podcast series, “Fertility Unfiltered”, as new episodes are released each week. We’re creating a safe space for conversations around fertility, ranging from the possibility of parenthood, seeking guidance on reproductive health and even the science behind conception. 

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“We booked an appointment with Genea and went in and – sat down with the doctor and talked to them about – our process of trying and just a little medical of like medical history and I told them that I have quite small testicles,” says Matt, adding that this was a red flag to the doctor.  

Speaking with Tarla Lambert on our podcast series, ‘Fertility Unfiltered’, in partnership with Genea Fertility, Matt says he had shown GPs in the past and concerns were never raised. This doctor, however, had him take a sperm sample.

“Turns out I had zero sperm,” said Matt, noting that this was “a big pill to swallow”. 

After more tests, Matt was diagnosed with a genetic condition called Klinefelter syndrome, which occurs when a male is born with one or more additional X chromosomes. 

Government health stats show it’s relatively common, affecting one in every 500 to 1000 males born in Australia each year. 

Like many men out there, Matt didn’t have any reason to believe that something was wrong with his fertility. This was especially true considering he’d been to many GP’s before Genea and nothing was ever mentioned. 

Professor Steve Robson at Genea is a specialist in general and unexplained infertility, and he says men can be apprehensive about sperm testing because they may believe it impinges on their masculinity in some way. 

“I think there are a number of common misconceptions that we see around male fertility,” says Professor Robson. “The first is that your fertility in some way reflects your masculinity and I see this all the time.”

“It’s really important to put that aside [as] there’s often no connection whatsoever between masculinity and fertility.” 

There are a number of factors that can impact male fertility, and Professor Robson says male infertility problems are more common than we may think. That’s why he says it’s important for hopeful dads and men to have open conversations when they’re trying to have a baby. 

With more women opening up about fertility, Dr Robson hopes we can encourage this among men as well so that they aren’t walking the journey alone. 

For Matt and his partner Miley, having a supportive circle of loved ones, trusted health practitioners, and each other, to lean on was crucial.

The pair decided to give IVF a chance and fortunately it worked. They’re now raising their son Jasper, and are happy to share their story with others in the hopes that it might help someone feel less isolated with their own fertility issues. 

“There’s plenty of people going through the same thing and it doesn’t change who you are and it doesn’t – make you any less of a man or less of a human being,” says Matt. 

“Don’t be scared to speak up.”

To learn about more reproductive health topics from health experts, check out the rest of the podcast series, “Fertility Unfiltered”, as new episodes are released each week. We’re creating a safe space for conversations around fertility, ranging from the possibility of parenthood, seeking guidance on reproductive health and even the science behind conception. 

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Online companies are now also selling the test directly to consumers to do at home, promoting the test as a way for women to decide when to have a baby, even if they aren’t thinking of having one any time soon.

But it can’t reliably predict the likelihood of pregnancy or how long it would take to get pregnant.

Despite this, egg timer testing is promoted to women not undergoing IVF as a way to assess their current and future fertility.

Our analysis of Australian and New Zealand fertility clinic websites found some claimed the test could predict a woman’s chance of conceiving or identify women at risk of early menopause.

What can and can’t the test do?

The test measures the level of anti-Mullerian hormone (AMH) in the blood and is known clinically as an AMH test.

AMH is produced by follicles in the ovaries (little fluid-filled sacs that contain immature eggs) and helps follicles and eggs grow during the menstrual cycle. Because the number of follicles in the ovaries drops with increasing age, the level of AMH also falls.

The AMH level indicates the number of eggs in the ovaries, or ovarian reserve.

It is often used in IVF treatment, as it can suggest how many eggs a woman may get when her ovaries are stimulated with fertility drugs.

But it can’t tell you anything about egg quality. Women with low AMH levels have the same chance of conceiving as women with normal AMH levels.

It also can’t reliably predict menopause timing for individual women.

Because of this, the American College of Obstetricians and Gynaecologists strongly discourages AMH testing in women who are not seeking fertility treatment. It states the test:

No similar guidance has been published by the relevant colleges in Australia.

should not be ordered or used to counsel women who are not infertile about their reproductive status and future fertility potential.

Who gets AMH tests and why?

The test isn’t Medicare-subsidised. Most AMH tests are paid for privately by consumers, costing around A$80-$120. Because of this, data on current test usage is not publicly available.

To find out how many women in Australia are accessing AMH testing and why, we conducted the first investigation into its use in Australia.

We surveyed a representative sample of 1,773 women aged 18 to 55, recruited through the Life in Australia national study.

We asked them if and how they had heard about AMH testing, whether they had ever had an AMH test, their main reason for testing and how they accessed the test.

Our results, published today, show 13% of the women had heard about AMH testing and 7% had had an AMH test.

The majority had the test for medically indicated reasons, such as during infertility investigations (51%), or to find out if a medical condition had affected their fertility (11%). This included having had chemotherapy or radiotherapy, endometriosis, thyroid issues, and others.

Concerningly, one-third reported having had the test for other reasons. This included gaining insights into their fertility or inform their reproductive life planning (30%).

Most women who had an AMH test first heard about it from their GP or fertility specialist, suggesting doctors are currently the main drivers of test uptake.

However this may change with the recent emergence of direct-to-consumer AMH testing in Australia, as online companies increase their marketing.

What are the downsides of having an AMH test?

Getting the test to inform you about your fertility may lead you to make choices based on a false premise.

If you get a normal or high AMH result, it may give a false sense of security about delaying pregnancy, when age is the most important factor of female fertility.

If you receive a low result, it may cause unwarranted anxiety about not being able to conceive. This may cause pressure to conceive earlier than desired, or create a sense of urgency and haste towards fertility treatment, such as egg freezing.

To make informed decisions about AMH testing, women need clear, evidence-based information. We have developed and are currently testing an evidence-based information guide to assist with this.

Can other tests tell me about my fertility?

Unfortunately, there is no reliable test of a woman’s fertility.

But it’s important to know a woman’s age is the greatest predictor of her chance of pregnancy. The only real way to know your fertility is by trying to get pregnant when you are ready.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Issued every two years, the report has uncovered a range of statistics showing life expectancy rates are continuing to rise, though rates of intimate partner violence is increasing.

Health and Aged Care Minister Mark Butler released a statement earlier this morning, commenting on the report.

“The Albanese Government has the policy agenda to tackle the health challenges and underlying social determinants as highlighted in the AIHW report,” he said.

“We are tackling inequities across our community that ultimately affect our health by addressing low wages, improving education, particularly early childhood education through our childcare reforms, and getting more women into the workforce.”

“We will build a stronger, fairer and more sustainable Australia for all Australians.” 

“In highlighting the pandemic as the standout health issue over the past two years, the AIHW reminds us still face very real challenges this winter.”

Here’s a quick snap shot of the main topics relating to women’s health. 

Physical and sexual violence 

In Australia, 1 in 6 women have experienced physical and/or sexual violence by a partner. 

In the first year of the pandemic, 9.6 per cent of women reported experiencing physical violence, while 7.6 per cent reported sexual violence.

During the pandemic, 42 per cent of women said physical violence had increased in frequency or severity. Forty-three per cent of women said sexual violence had increased in frequency or severity.

More than a quarter of women who experienced physical or sexual violence claimed they were unable to seek assistance on at least one occasion due to concerns over their own safety.

Compared with previous years, the number of hospitalisations for assault injuries related to family and domestic violence was lower in April 2020 compared to the same time the previous year.

However, between 2019–20, the total number of assault hospitalisations caused by assault injuries was higher than that for the years between 2018–19 and 2017–18.
 

The report claims that these changes in hospitalisation rates may reflect the increase in disclosure and/or identification of family violence in hospitals, or it could be an increase in family and domestic violence events that need hospitalisation. 

Fertility Rates 

The total fertility rate continues to decline, from 1.66 babies per woman in 2021–22 to 1.62 babies per woman by 2030–31. 

Women are now having children later in life, and fewer. The rate of women giving birth has dropped from 65 per 1,000 women of reproductive age (15–44) in 2009 to 58 per 1,000 women in 2019.

Almost three quarters of mothers lived in major cities while more than a third were born overseas.

Data from the Indigenous HPF showed that improvements in the health system for Indigenous Australians, including the increase in Indigenous women’s access of antenatal care in their first trimester of pregnancy. In total, 6 per cent of babies born in the country were Indigenous babies.

COVID-related impacts

The ABS National Study of Mental Health and Wellbeing 2020–21 showed that 19 per cent of women were classified as having high or very high levels of psychological distress. 

Telehealth claims were most popular among Indigenous people living in inner regional areas, Indigenous women, and Indigenous people aged 25 and older. 

Individuals living in the lowest socio-economic areas were nearly three more likely to die from COVID-19, while those born overseas were 2.5 times likelier to die. 

The rate of severe disease from the virus was seven times higher for Aboriginal and Torres Strait Islander people compared with the general Australian population. 

The median age of death among Indigenous people increased over the past decade, though their life expectancy rates remain significantly lower than non-Indigenous people.

Breast Cancer

The total number of screening mammograms conducted through BreastScreen Australia in 2020 fell due to pandemic restrictions. 

From January to June 2020, 145,000 fewer screening mammograms were conducted compared to the same period in 2018. 

During the earliest part of the pandemic, screening services were suspended, resulting in the number of mammograms for women aged 50–74 dropping from over 70,000 in March 2020 to roughly 1,100 in April 2020. 

As restrictions slowly eased, the number of screening mammograms increased. Between July to September 2020, 12,000 more mammograms were performed than in the same period in 2018. 

The groups which accessed screening mammograms latest after restrictions eased were younger women and women who spoke a language other than English at home. 

You can read the full report here. 

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The rebate is the first of its kind in Australia and is part of an $80 million package from the state government that also includes an extension of the rebate for pre-IVF fertility testing, efforts to boost the number of fertility preservation services for cancer patients, and five days of paid fertility treatment leave for public servants in NSW.

The NSW government says about 12,000 IVF patients who are using private fertility clinics will benefit from the rebate, and another 6,180 will be given access to publicly supported IVF treatment.

“We know that the costs of these treatments can be prohibitively expensive,” Mr Kean said.

“No-one should have to face the impossible choice between looking after their household budget and starting a family. I’m so proud NSW continues to lead the nation, helping thousands of families fulfil their dream of having a baby.”

Those eligible for the rebate will be able to receive up to $2000, depending on the cost of their treatment. It will only be available for treatments offered by accredited clinics. The rebate will open on 1 January 2023, with those who have undergone an eligible procedure from 1 October 2022 able to submit a claim.

The government’s affordable IVF initiative includes better publicly supported IVF services at the Royal Prince Alfred Hospital, Westmead Hospital and Royal Hospital for Women. It will also establish a publicly-funded fertility preservation service for cancer patients.

NSW Minister for Health Brad Hazzard said the government wants to ensure costs don’t stop families from accessing fertility services if they need them.

“This investment builds on the NSW Government’s $42 million election commitment for affordable IVF, which was successfully achieved during the past two years despite the impact of the COVID-19 pandemic,” Hazzard said.

NSW Minister for Women Bronnie Taylor pointed out that fertility challenges are very common, with one in every six couples experiencing a fertility issue.

“Fertility challenges can be stressful and heartbreaking. I hope that by lowering the cost of treatments, we can help more women on their journey to start a family,” Taylor said.

Michael Knaap, Monash IVF Managing Director and CEO, praised the government’s rebate scheme and said he hopes other state governments follow.

“Monash IVF commends the NSW Government for its decision to provide extra support to IVF patients and hope this will allow more people to achieve their dream of starting or building their families,” Knapp said.

“Introducing IVF leave is a welcome move that will help women to undertake treatment and further ease the emotional and financial burden of IVF. It’s important to note that not all patients having fertility treatment will necessarily need IVF and we therefore need to ensure that others, including single women and same sex couples, are also supported.

“We also hope that other state governments will follow NSW’s lead and introduce a similar rebate and leave provisions.”

The rebate will initially be open to 12,000 women, with a full evaluation to be completed after this to ensure private fees have remained low and competitive.

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The women who never got to have the baby they really wanted.

These women aren’t “childless by choice”, rather they never had the choice.

So where do you fit in, if this is you?   

You haven’t joined the mother’s group, the playgroup, the school drop-off group, or the soccer mums group.  And you can’t join the “childless by choice” group, because this wasn’t your choice.

You know what it feels like to hit rock bottom after month after month of no happy baby news, or seeing years go by that you didn’t get the opportunity to try and have a child. You know that feeling of helplessness, because infertility has taken over your entire life, from invading your personal life, career, money, diet, exercise, holidays, and even to what car you can buy or where you can live. Every waking moment it’s all you think about — so often an empty feeling in your heart when you see another pregnant bellies or agorgeous newborn baby.

So what group can you join? What term can you use to describe your experiences? Where do you fit in?

Now, I’m using the term Otherhood and I want others to join me. By embracing “otherhood” you know that despite really wanting a baby and doing all the things you could, it just never happened.  

By embracing otherhood, you can open your mind and heart to see all the other possibilities that life can offer. You release the shame around infertility and trauma from the rollercoaster ride of failed treatment cycles. 

Once the trauma has been released, clarity comes. Going through fertility struggles has given you an inner strength where you now know you can handle any of what life may throw at you going forward. This life experience will give you clarity on the things that do matter and you can work towards designing your life from a state of love and not from a state of fear or lack.

This newfound empowerment fuels your ambition to think outside the status quo of motherhood, and to focus and enjoy the children already in your life that you may help with their growth into adults. It’s the empowerment that may help support you in community centres that you can get involved with. 

By raising awareness for otherhood, I believe women will feel more empowered to fully express themselves to share their fertility journey, instead of suffering in silence. There are so many women going through these challenges and hiding out of shame. Feely guilty about what they’re currently experiences or guilt about what they did experence and the endpoint being that they were never able to have the children they wanted. By raising awareness for otherhood, these women will know that they aren’t alone on their journey and that they can embrace otherhood.

It will also help you when well-intentioned people ask the question: ‘Do you have children?’ 

Instead of going into a state of panic when hearing these words, you can say this phrase “I really wanted children, however it never happened. So I’m now embracing otherhood”. And by raising awareness of otherhood more people will understand — with no judgement or further interrogation about your fertility journey — that you are not childless by choice. You really wanted children, but it didn’t happen for you and now you are excited about all the other possibilities that life has to offer.

Are you childless, but not by choice, and embracing otherhood? You can share stories and get in contact here.

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For Mary*, being told she’d entered menopause much earlier than expected was a shock …

It was sort of like I’d gone from 39 […] instead of turning 40, I’d almost turned 80. So I’d sort of skipped 40 years.

Around 10% of women – including many who believe they have the prospect having children ahead of them – are suddenly told they are at the end of their fertile life, and at greater risk of diseases normally associated with middle age.

In the course of our work with women and research, hundreds of women have shared their experiences of early menopause. They provide insights into how the physical changes have affected their sense of self and their relationships.

What is early menopause?

Menopause refers to the time in a woman’s life when the ovaries stop producing eggs, periods stop, and oestrogen levels dramatically drop.

The usual age of menopause, defined as 12 months without periods, is around 51 years. Early menopause occurs before 45 years. Premature menopause or premature ovarian insufficiency (POI), occurs before age 40.

Early menopause can happen without warning and the causes may never be known; although a family history of POI, autoimmune disease, smoking, early development and social factors are risk factors. It can also result from medical care such as chemotherapy, radiotherapy or the surgical removal of both ovaries. Except for women who have their ovaries removed, predicting who will experience early menopause is very difficult.

Hot flushes, night sweats and the rest

The symptoms of early menopause can be similar to those associated with usual menopause (hot flushes, night sweats, mood changes, vaginal dryness, sleep disturbance, sexual problems, fatigue, joint pain, and brain fade), but happen to much younger women and may be more severe. The problem is that no one expects young women to be experiencing menopausal symptoms.

Some women may not have any menopausal symptoms and only experience their periods stopping without warning. Others discover they are unable to become pregnant. Sonia* remembers:

Around 35, 36 I started to skip periods […] I just thought it was stress and overwork, and that sort of thing. But then the gaps between periods got longer and longer, and I started to experience night sweats. And I became concerned at that point, not because I thought that I was going through menopause – it didn’t occur to me.

Although we think of oestrogen as a reproductive hormone, it also plays an important role in brain function, particularly memory. Women who experience early menopause often report frustration at not mentally performing in the way they used to, and also find mood changes difficult to cope with. The cause of early menopause (such as chemotherapy) and the symptoms experienced (like sleep disturbance) can also impact thinking and mood.

Feeling less than sexy

Early menopause can affect sexual function in many ways. Vaginal dryness can cause pain with sexual intercourse. Women often say they lose desire for sex, which can strain intimate relationships.

Cathy told us she wanted to be left alone:

It changed who I felt I was […] It’s hard to be sexy when you’re cranky […] To think of yourself as a sexual being [is difficult] when you are experiencing hot flushes every hour and you’re going, ‘I don’t want anyone near me. All I want to do is feel cool.‘

Losing a future family

For many women who go through early menopause the sudden lose of fertility can be devastating. Jenni remembers going through menopause at an age when many of her peers were becoming parents:

Watching the joy my friends were experiencing getting pregnant and giving birth, felt like a special kind of hell. I was so happy for them, but I had to distance myself because it was just too hard.

Women describe feelings of shock and trauma after being told they were infertile. They feel grief for the children they had hoped to have.

Rarely, women with spontaneous POI will conceive. For the majority, pregnancy is only possible with assisted reproduction technology using donor egg or embryo.

No cure but symptoms can be treated

There is no cure for early menopause and no way to restore egg production. Instead, the focus of treatment is on managing symptoms and the increased risks of bone and heart disease after menopause.

Hormone replacement therapy (HRT) is usually recommended up until the age of usual menopause to manage symptoms and reduce your risk of heart disease and osteoporosis. The risks of taking HRT seen in older women do not necessarily apply to younger women. Consult with your doctor about the best HRT for you.

If you have not had a period for 4-6 months (and you are not pregnant or on treatment that stops periods) then you should see your doctor about whether you may be experiencing early menopause or POI. You can also find doctors who have a special interest in women’s health and menopause.

We developed the AskEarlyMenopause website and app to provide accurate information and a discussion forum for women to share experiences and get expert advice.

*Names changed for privacy

Rhonda Garad, Senior Lecturer and Research Fellow in Knowledge Translation, Monash University and Amanda Vincent, Adjunct Clinical Associate Professor and Endocrinologist, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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