Last day of IMS.
Debate: are we over-treating with hormone therapy?
First speaker Prof Martha Hickey (Australia)
For the motion. #IMS2022 Argues that the only primary indication for MHT is VMS (not mood, not sleep and not for primary prevention of disease).
Quotes US preventive task force.

Final plenary for today.
The microbiome: endocrine nexus in human health.
Prof Jack Gilbert (US). #IMS2022 Our immune system regulates our microbiome.
Can be in a state of homeostasis or dysbiosis.
Dysbiosis can lead to diseases.

IMS symposium on CVD at midlife.
First speaker Prof Chrisandra Shufelt (USA).
MHT and CVD: looking back before moving forward. KEEPS looked transdermal vs oral estrogen, using annual CIMT. No sigt diff.
#IMS2022

IMS Congress day 3.
Starting very early with concurrent presentations from menopause societies.
AMS presentation on Menopause and work.
Chaired by Dr Sylvia Rosevear (Aotearoa/NZ). menopause.org.au I was the first speaker.
Case studies in menopause at work.
I began by acknowledging that some people who experience menopause don’t identify as women. Gender diverse people can also experience menopause.
#IMS2022

Next session. Hormones.
First speaker Prof Alfred Mueck.
Principles to select estrogens.
Conjugated equine estrogens - contain a lot of substances, in variable amounts.
Suggests we move away from its use. #IMS2022 Estradiol containing COCPs. Took a while to develop because of bleeding issues.
Now we have pills with good cycle control, because of the progestogen. Dienogest or nomegestrol. #IMS2022

Next session. Debate. MHT for primary prevention. For: Prof Robert Langer. Begins by revisiting WHI #IMS2022 Describes preventive effects of MHT on CHD and other conditions. Choice of progestogen important. #IMS2022

I’ll be tweeting when I can from the International Menopause Society Congress.
#IMS2022 Starting with the meeting before the meeting.
The Council of Affiliated Menopause Societies.
Societies from around the world connecting and collaborating.
Welcome from IMS President Steven Goldstein.
#IMS2022

Myth: Menopausal hormone therapy (MHT) increases the risk of coronary heart disease. ❤️❤️

The question of whether MHT causes or protects from heart disease has been a subject of debate.

Here’s my take. 🧵
1/10 Prior to menopause women are relatively protected from heart disease, and this is related to the role of estrogen.
The menopause transition is associated with an increase in risk of heart disease which has been shown to be separate from the effects of chronological aging. 2/10

Excellent thread from @mariamtokhi about access to primary health care for people in disadvantaged communities.

GPs working in disadvantaged and rural areas report that it is increasingly difficult to provide care for their patients. Worse since Covid.

My thoughts:

https://twitter.com/mariamtokhi/status/1438665368424255489

All Australians deserve to have access to quality GP services that provide the time and care that they need. Especially if they have complex health problems or mental health care concerns.

What prevents perimenopausal and menopausal people from accessing the health care they need?
Doctor education and gender bias are not the biggest factors (though they are v important and need to be improved).

Structural barriers to long consultations are most important. 1/8 Our Medicare system is set up to incentivise short consults for one simple problem. It penalises patients (and their doctors) for needing longer consults for more complex issues.
And it makes it harder to access longer consults, especially in rural or disadvantaged areas. 2/8