96: Senator Marielle Smith on Closing the Menopause Support Gap

Transcript

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Welcome to the Dear Menopause podcast.

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I'm Sonya Lovell, your host Now.

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I've been bringing you conversations with amazing menopause experts for over two years now.

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If you have missed any of those conversations, now's the time to go back and listen, and you can always share them with anyone you think needs to hear them.

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This way, more people can find these amazing conversations, needs to hear them.

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This way, more people can find these amazing conversations.

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On today's episode, I am joined by Senator Marielle Smith.

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We will be unpacking the recent Senate inquiry into perimenopause and menopause, and Marielle shares her hopes for the tabled recommendations and the future of menopause care in Australia.

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I hope you enjoy our chat.

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Good morning, marielle.

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How are you?

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I'm really good, Sonya, and it's great to be joining you again on your podcast.

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Thank you.

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I just actually did a little bit of a little bit of prep for our conversation, and it was early February when I released our first podcast episode that we did about the Senate Inquiry.

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So I feel that it's a great time to be revisiting everything that has happened in that time, which feels like so much, and to really get to unpack what the recommendations that were made as a result of the inquiry mean.

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But also, for anyone that is maybe listening and hasn't actually heard about the inquiry before or is really coming to this fresh, perhaps we could start with you just giving us a really brief summary of what the Senate inquiry actually entailed.

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Yeah, absolutely so.

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The inquiry was launched by myself and Green Senator Larissa Waters and in doing so we wanted to shine a light and a spotlight on menopause and perimenopause and the health and economic implications for women.

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Our inquiry went for almost a year.

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We travelled right around Australia.

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We received about 300 submissions and heard from so many women either appearing in person and telling us directly or writing and sharing their stories with us about what was going on and where they felt they were being let down at this stage of life.

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Yeah, and what was great was the submissions that you received obviously weren't just from women with lived experience or people with lived experience.

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You also received submissions from healthcare practitioners themselves, the medical bodies, some of the tertiary bodies that are actually out there teaching the healthcare practitioners.

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It was really, I think, from my perspective, heartening to hear from so many of the players in women's healthcare space.

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Absolutely, and that's something we're really lucky to be able to do in the Senate.

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We get to use the spotlight we have through the inquiry process to bring a range of stakeholders together, as well as women and their actual stories too, bring it together, analyse that work and develop a report with recommendations.

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And that's what we've done.

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So we presented our report to the Senate a couple of weeks ago.

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We've made a huge number of recommendations really for a Senate report, because they're multi-partisan, which means agreed by the Liberal Party, by Labor, by the Greens as well, and these recommendations go to the health treatment of perimenopause and menopause.

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They also go to women's experience in the workplace and what we can do, both from a government level but a community level, to break down some of the stigma and the siloing of information when it comes to perimenopause and menopause.

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Yeah, Now I want to touch just briefly there on the recommendations, particularly the number of recommendations that were made, because, as you mentioned, it was actually a really large amount of recommendations.

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Now, I have never been involved in a Senate inquiry before.

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So in the weeks leading up to knowing that the recommendations were coming, you know there were some conversations going around like what should we expect?

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Where is this number kind of going to land?

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And we're like, oh, you know, seven to 12 is, you know, often kind of a bit of a benchmark.

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And then, you know, listening to you live in the Senate the evening that it was presented, hearing that there was 25 recommendations and that there was multi-partisan agreement on all of those recommendations, was just so huge, it was such a huge moment for those of us that were, you know, hanging and waiting for the outcome.

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So talk me through the difference between, you know, this inquiry and something that does only come through with a few recommendations.

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Yeah, look, I think what was really clear during this inquiry was the body of evidence was unambiguous that women feel like they're not getting enough support when they go to see their GP or seek out health care for their symptoms of perimenopause and menopause.

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It was really clear that they felt like their GPs weren't always equipped to provide them with up-to-date, good quality information or even do that sensitively quality information or even do that sensitively.

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And it was also really clear that, when it came to women's experience of the workplace, flexibility was critical and key to them being able to stay connected and thriving if their symptoms were troubling and as you know, sonia, you know not every woman experiences menopause in the same way but for those women with really troubling symptoms, we've got to make sure that they can stay at work, stay connected, keep thriving during the prime of their lives and the peak of their careers.

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So I think that evidence was all very clear and we actually were able to develop quite a lot of consensus about the way forward and what needs to change to support these women.

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And I've got to tell you I mean, I've been in the parliament for five years and it's not often that you get such unanimous agreement of both the problem and what some of the solutions could be.

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Yeah, and I think another thing to kind of dwell on just for a moment is the impact of it being a multi-partisan agreement is that if there was to be a change of government and we do know that there will be elections soon and for your sake I'm really hoping there's not a change of government, but you know, if there is it does mean that the likelihood of these recommendations actually being acted on is much higher than if it hadn't been multi-partisan.

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Look, I hope so, sonya.

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And what happens from here is we've presented our recommendations to government.

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There's a fair bit of, you know, sharp elbows from me as we have the conversations about what happens next.

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But, to be clear, not all of our recommendations were made to government and we did that very deliberately, because if we're going to change the stigma which surrounds these issues, that needs to take place at a community level.

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If women are going to be supported in the workplace, that can't just be government workplaces.

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We need these conversations happening in every single workplace around the country.

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And if we're to tackle the issues of stigma, we really need to be working together on that.

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We need to be going right into the early education of teenagers at high school, when they're learning about physical health and development.

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Menopause should be part of that development.

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Menopause should be part of that.

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We need the colleges, the GPs, those professional development bodies on board as well, because we heard that GPs were only getting one hour of education on menopause in their whole careers, despite.

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You know, we know it's not an optional part of ageing.

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Half their clients, half their patients will need some advice at some point on these issues.

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So to really to see the change I think we need to see in this space, we actually need so much more than just actions and decisions of government.

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Yeah, absolutely, and one of the things that made me so happy when I was reading through the recommendations the evening that they were being presented was the need for a public awareness campaign that should be co-created with lived experience, and that meant so much to myself.

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Obviously, you know my presentation and a lot of the advocacy that I do is all coming from a place of lived experience and the connection and conversations that I have with you know people in the community day to day.

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So to hear that you didn't just want to do a campaign but you wanted that campaign to be co-driven with lived experience was so incredibly important to hear.

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Absolutely, and I think you know what.

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What I hear from women all the time, no matter what stage of life or their health journey they're at, is that when it comes to their health, too often they just don't feel listened to and too often they feel like their experiences or their pain is dismissed, and it's just not acceptable.

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If we're going to provide women with the support they need at this stage of life, listening is the first part of that, you know, whether that's in terms of what happens in the office of their GP, being listened to, being heard.

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But if we are going to do things like a public education campaign, making sure that we're actually listening to what women want to know and what they think others need to know is really really critical in that as well.

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Yeah, great, and thank you for including that.

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When we talk about listening, you did a lot of listening, a lot of reading of the over 300 submissions that were provided, mostly online, but there was the live Senate hearings that were, I think, seven in total that were held around the country.

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You spent a lot of time listening.

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They were big days.

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What surprised you the most from the stories that you heard across?

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Both, obviously, there was lived experience panels, but there was also the evidence that was provided by different bodies and organisations in this space.

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But what was your kind of biggest takeaway?

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It's a really good question, I think.

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For me, the evidence we received around how underprepared our GPs felt when they finished university and went into the workforce to support women with perimenopause and menopause was a really big one.

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And we had some brilliant GPs present to us who said look, we want to be providing great quality care.

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We think our colleagues should be providing great quality care at this period of life, but something needs to change in the way that we're educating our medical students.

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That was a really big one for me and also, I mean, I've worked in women's health for a long time and I wasn't surprised that women don't always feel heard and feel dismissed, because sadly, that's something we hear all the time, but just the extent of it and the extent that women felt, I mean, almost gaslit in a way, when they were trying to seek help and care, that was a big one too.

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And then I think, you know, when women were telling us they were seeking information, seeking advice, couldn't always get that from their GP, didn't always know where to get it online, and so they're turning to social media and whilst in a peer support sense, that's fantastic and there were great examples of support for women in these groups, we also heard evidence that women were turning to some pretty junk products and junk information which was being advertised to them either through these groups or on social platforms more generally, and I found that really alarming.

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I mean, if a woman's got really troubling symptoms, she should be able to get advice and care from a medical professional and not feel like she needs to go onto Instagram and buy some of these unregulated products.

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I get why she might feel like that, and when you're desperate for help, you know I know what it's like when you're scrolling and you're just you know you're just desperate for some support and some information or something which will work.

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That was really shocking too.

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Yeah, and that's it is a really big part of the issues that have, I guess, arisen alongside the raising of the conversation in the public space.

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It's, you know, there's a lot of opportunistic marketers out there.

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There's a lot of organizations that have cropped up from nowhere.

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There's others that have deviated and changed path to specifically cater to this niche that's been created.

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In many ways, it's similar to the beauty industry when it comes to aging.

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You know, there's this preying on women's vulnerabilities and there's this opportunity that comes up when you do raise the conversation.

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And it's such a shame because I know even my own Instagram feed is just full.

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Constantly there's a new product, there's a new organization, and I know, because I'm literate and I spend a lot of time in this space and I can tell what's good and what's not there's so much out there that is just literally preying on the fact that there are people out there looking for support and they're not able to get it in the right places.

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So that's when they do fall prey to these, and I think we do really need to highlight the unregulation of a lot of these organizations and their products.

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Yeah, absolutely.

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And look, I mean, I think you know more broadly.

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When you're a woman and you're learning about your health, it feels so often like you're taught about puberty and that that's going to be pretty tough and hard going and then you're taught that childbirth will really really hurt, but that's like almost nothing of consequence will happen in your life after that, like sort of job done, ladies like you've given birth, and that's sort of it end of story.

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And that's just nonsense too, and we heard evidence in the inquiry about that that women just felt like, you know, once they got through those childbirthing years, they just felt like they didn't matter to people and I think that's really sad and really terrible.

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So we need to change that too, to change the stigma around that.

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You know we're talking about women here in the absolute prime of their lives, peak of their careers, when they have everything to offer their families, their workplaces, their communities and they deserve to be listened to, they deserve good quality care and we should be talking about and celebrating this part of life right at the beginning when we're talking about women's health and what will happen to it.

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Absolutely, and a couple of the lived experience examples that I listened to that really also highlighted the diversity when it comes to experiences with menopause.

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There was an amazing mum who gave evidence in Canberra who spoke on behalf of her daughter who had experienced POI.

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And you know she was, I think she was maybe 17, 18 the daughter, I think and maybe she was 17 when she was diagnosed.

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I can't remember now, but you know, you think she probably started symptoms when she was in puberty years and then, you know, five or six years to actually be diagnosed.

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You know, in those such vulnerable years as it is as a young woman at that stage of life, you know that was that was.

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I found that really moving.

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And the other piece of evidence that we were reminded of was the women that are impacted by an early menopause, so perhaps in their face that become childless not by choice.

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And wow, that was hard to listen to.

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Absolutely, and I mean women who presented.

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And then we had a number of submissions from women who are childless, not by choice, to our inquiry and they said they just felt completely dropped out of this conversation too, and that's terrible.

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And again it goes to these stigmas and these stereotypes about what a woman's role is.

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You know all's terrible.

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And again it goes to these stigmas and these stereotypes about what a woman's role is.

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You know all this kind of thing and all these assumptions made around women and the choices, or lack of choices, they have in their lives.

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These stigmas are really powerful and pervasive and we know they actually affect the kind of care and quality of care women get, as well as their experience in the workplace.

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Yeah, yeah.

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An incredibly powerful process for you to be involved in, obviously, but also for those of us that you know really follow very closely along on the sidelines when to from here.

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So you've already mentioned that not all the recommendations were to the government, so what is the actual process for these recommendations to become implemented in real life?

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Yeah, absolutely so.

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We've made these recommendations.

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As I said, we've passed this report to government and the federal government will now go through and look at them and they have to respond to us in the senate.

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So they have to come back and say, yes, we agree with you, we'll go do that, or no, we don't agree, or we sort of partially agree, and they come back with a response to us In terms of the broader recommendations.

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We really just need to keep this conversation happening and I think we are in the midst of a national conversation about menopause and perimenopause at the moment.

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I really like to believe that our Senate inquiry has helped in that and helped push that national conversation along.

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But these recommendations, particularly which go to workplaces, require us all to be having those conversations in our workplaces working you know, if you're an employer working with your employees, to have a conversation, break down the stigma, raising your voice with your GP, putting pressure on the colleges and those sorts of things, so that we see this national conversation turn into national action.

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So I'll continue to be talking about these things so that we see this national conversation turn into national action.

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So I'll continue to be talking about these things, continue to be advocating them.

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I think we've got this great body of evidence now and a great guide, I guess, in terms of what we can do as a community, what we can do in workplaces and what we can do in government to make change.

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And what's the timeframe for that government response.

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So normally these responses are required to come within three months to the Senate.

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I'll be completely honest often they don't.

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There's a lot of work involved in looking at these recommendations and policy change, but they are with the government at the moment.

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And, as I said at the start of this conversation, Sonia, I'm having a lot of conversations with my colleagues now about what's possible here and what can be changed, and we do have an election coming up.

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I mean, I think women should be raising their voices as we lead up to the election.

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When you're, you know, hassled by your local MP at the train station or wherever it is that you bump into them at the shopping centre or you get a survey in your letterbox, you know, tell them you want to see some change here.

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We have to keep the pressure up on our politicians, on our employers, on the medical professions, on our schools.

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There are a whole range of things which need to change here.

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Our voices are powerful.

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Women's voices are powerful in politics and in their communities.

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We've given them a spotlight through this inquiry and let's keep raising them and see this change happen.

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Yeah, I think that's a really important point, because it felt a little bit like the Senate getting through the inquiry and then getting the recommendations, and then there was like this huge exhale of, okay, great, these recommendations have come down and it would be easy to kind of think, okay, now we can kind of sit back and just wait for it all to unfold.

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But there is absolutely that need to keep the spotlight on the conversation, raising the conversation even more and putting that pressure back onto local representatives.

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That's right.

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These are recommendations.

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They're not a change of the law.

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So now we really need to take this work further and continue to keep that pressure up.

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I do think, though I mean I really hope that our committee has helped tackle some of the stigma around these issues by having this national conversation, and we just need to keep doing that.

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You know, I want to keep opening my news apps and seeing stories about women's experience through menopause and menopause.

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I want women freely and comfortably talking about it, talking about it in their workplaces, because you know, we're not going to get change at a policy level if we're not having the conversations, if you don't bring an issue into the light that issue doesn't change.

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That's right, and you know the old adage if nothing changes, nothing changes.

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So I'm going to ask you one more question that might put you on the spot a little bit.

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If we are revisiting this conversation in 12 months time, what's the message that you would like to be bringing to that conversation?

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What would you hope has been achieved in that time?

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That's a really good question.

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I hope in 12 months time we're seeing more workplaces develop menopause policies and having those conversations with their employees about what they want to see in their particular workplaces and we're seeing that kind of change happen.

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I would hope in 12 months that a woman, when she walks into her GP, feels and listened to and that this has been, you know, a point of reflection across the medical profession.

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I mean, as I said, there's some really really amazing, tremendous GPs out there, but there is also we heard quite a lot who just aren't across the brief.

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So I would like to think that it changed and I also hope you know, to be honest, that we see a good response from government and some policy change and policy plans, whether they require legislation or regulation or other forms of change.

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I hope we see something there and that we use, you know, our power and influence as a government to do something meaningful.

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Whether you know, my party, the Labor Party, is in government or someone else.

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Fantastic and from a personal perspective, I would love to be seeing buses drive by with menopause.

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You know big ad campaigns on the side and billboards and when I'm driving down the street and you know not that I watch commercial television but ads on the TV you know thinking of things like the Slip Slop Slap campaign and things like that.

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That was so in your face and became ingrained in you know how we lived our lives.

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It would be amazing to see a you know a real strong awareness campaign out there in the public.

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Yeah, I mean, I don't watch a lot of commercial TV either, Sonia, but wouldn't it be great if we opened up our Instagram feeds in 12 months time and saw more positive health messages about menopause and advertisements for junky products?

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Yeah, 100%, 100%.

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Marielle, thank you so much for your time.

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Was there anything else that you wanted to leave us with today?

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No, I just wanted to say thank you to you, sonia, and I know there's a big community around you who's listened to your podcast whilst you've been doing it, whether you contributed to our report or you've contributed in another way to the national conversation we're having.

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We couldn't do any of this work without women being prepared to come and bring their voices forward and for their advocacy and passion to see change here.

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So it's a whole community effort of the women who care very deeply about these issues which led to the inquiry and has led to those recommendations.

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So thank you.

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Yeah, thank you, and thank you so much for all the work that you did to make this happen in the first place, and I know that you will be pushing and using those sharp elbows to keep prompting this into the forefront of conversation.

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Thanks, marielle.

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Absolutely.

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Thanks, Sonya.

96: Senator Marielle Smith on Closing the Menopause Support Gap

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