When Maria Harran suddenly started experiencing brain fog and poor mental health at the age of 43, she didn't know what was happening to her.
"I just was like, 'What's wrong with me? Why do I feel like this? I'm in a very loving relationship, got two very amazing kids, got a roof over my head'," the now 48-year-old told SBS News.
Maria's sisters suggested she could be perimenopausal, but when she went to her GP, she was told she was "too young".
"I was basically, sort of, sent away," she says.
What followed was five years of suffering from an ever-increasing list of worsening symptoms that affected her family, work, and social lives, with no diagnosis from her GP.
"It was just one thing after another, and I was starting to feel a bit like a hypochondriac," she says.
"I could tick off all the boxes, like depression, anxiety, sore joints, hair loss, dry mouth, tinnitus, weight gain, swollen hands, brain fog. Then came the hot flushes, the night sweats, the rage, the heart palpitations, the sore breasts, and the heavy periods.
"I just felt like I wasn't being listened to — I think that's the biggest thing."
Maria Harran was told by her GP that, at 43, she was "too young" to be experiencing perimenopause. Source: Supplied
One particularly disappointing encounter happened when she sought treatment for her mood swings and other new symptoms.
"He just literally printed out a black and white piece of paper that obviously he must have found, and handed that to me," the 52-year-old told SBS News.
One of the key things he pointed out — a priority above neurological and psychological symptoms — was vaginal dryness.
"If I'd have had a conversation with him prior to say, 'I'm having problems with my sex drive, and I'm having problems being intimate with my partner', I think that would have been appropriate. But for a lot of women at our age, sex is the last thing on our mind, so my feeling was him saying that as a priority was about not just me, but about my partner, and that upset me."
Julia Browne has had "upsetting" experiences with a number of GPs. Source: Supplied
"I said, 'Only last for five years? People have prison sentences that are shorter, and also, that's incorrect'," she says.
Julia's "worst" experience came when she sought treatment for her low mood.
"He literally gave me a piece of paper, with all the different types of antidepressants, [and said] to me, 'Go and have a look at these and tell me which one you want'," she says.
"I lucky dip chose one … and I felt absolutely horrendous, the worst I've ever felt in my life. It was horrible."
Calls for comprehensive menopause education
After starting an Instagram chat group called the Peri Pausers to share their experiences with other friends, the women noticed a recurring theme.
"Everyone has had the same kind of bad advice or just lack of knowledge or lack of empathy, I think. Lack of understanding, having not been heard," Julia says.
"If you look up images of menopause, it's predominantly white, able-bodied women, and so this is the other thing when you don't take in a full approach to giving an individualised assessment and diagnosis, is that you're not taking those factors into account."
Julia says while she doesn't expect GPs to have a thorough understanding of every condition under the sun, she did have an expectation that they would have "a lot more education, knowledge, and support" around menopause.
"This is over half the population that we're talking about that it's going to happen to," she said.
"It's really disappointing, knowing how much impact it can have on a woman's life at this stage of our lives, that it's not a priority with our GPs — that's the most upsetting thing."
Around 80 per cent of Australians who go through menopause will experience symptoms, ranging from moderate to severe.
While menopause is included in the curriculum for general practice training, it's just one of a large number of subject areas covered.
"It is really difficult for each topic to be taught in a really comprehensive way," Karen Magraith, a Hobart-based GP and president of the Australasian Menopause Society, told SBS News.
Dr Karen Magraith is a Hobart-based GP and president of the Australasian Menopause Society. Source: Supplied
"The education in menopause probably really needs to start at undergraduate level … right through their training," she said.
"Whether you're a psychiatrist, or gynaecologist, or an orthopaedic surgeon treating women with fractured bones due to osteoporosis — all of those practitioners also need good menopause education."
But better training won't significantly improve patients' experiences on its own, Magraith said.
"There are a whole lot of structural barriers.
"The Medicare system is set up for short consultations, dealing with one simple issue … you cannot do a menopause consult in 15 minutes.
"We really need to restructure the Medicare system so that women who need longer consultations are not disadvantaged, because often they end up having to pay larger gap fees or they just can't get into a doctor that's providing those services.
"I think that's really at the heart of the issue."
"I think the other overarching thing is education of the general public, so good quality resources for patients, for women, and others."
Is the federal government doing anything to help?
Supporting women and their healthcare providers to manage the effects of menopause, including increasing training for health professionals, was identified as a key action in the National Women’s Health Strategy 2020-2030.
A spokesperson for the Department of Health and Aged Care said the federal government's National Women's Health Advisory Council is working to address gender bias in the health system.
When it comes to Medicare, they said the government is "committed" to making the system "stronger for all Australians".
The 2023-24 federal budget allocated $99.1 million over five years to establish a new Medicare Benefits Schedule (MBS) item for GP consultations over 60 minutes long.
"We know that over 60 per cent of women use longer MBS consultations and this new item will support consultations on reproductive health matters like menopause," the department spokesperson told SBS News in a statement.
Additionally, the government has invested $1.1 million through the National Health and Medical Research Council’s Partnership Project scheme to develop MenoPROMPT — a menopause assessment and decision-making tool for practitioners.
Life on the other side
After seeing a new GP, Maria was able to get the treatment she needed.
"I feel like I really have got my life back," she says.
"My headspace is so much clearer, and my body feels so much better because I don't have the aches and pains while I'm exercising.
"I'm feeling like I'm there for my kids a bit more than I was, and just overall feeling a bit better about life in the world, to be honest."
Beyond doing your own research, Maria has a couple of nuggets of advice for others who suspect they may be going through perimenopause or menopause.
"I think the best thing to do would be to get a journal of your symptoms and note them down so that when you do go to the GP, they can see exactly where your symptoms are peaking and troughing," she says.
"There's no one-size-fits-all, so your story will probably be different to someone else, and I think that's probably the hardest hurdle to get over, really."
SBS News contacted the RACGP, one of two medical colleges responsible for general practitioner training, for comment.
Readers seeking support with mental health can contact Beyond Blue on 1300 22 4636. More information is available at . supports people from culturally and linguistically diverse backgrounds.
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