Practical conversations to help doctors, nurses and health professionals expand their skills and grow their practice.

Hi there, and thanks for joining me today.

We'll be discussing navigating perimenopause in general practice with practical approaches to diagnosis and management.

For most women over 45 with typical symptoms and a changing menstrual pattern, perimenopause is a clinical diagnosis.

Ovarian activity fluctuates, so a single FSH or estradiol result can be misleading.

A normal result does not exclude perimenopause and an elevated result does not tell us how severe the symptoms are or what treatment the patient needs.

So start with the story.

Welcome to HealthCert Insights, practical conversations to help doctors, nurses and health professionals expand their skills and grow their practice.

Hi everyone, I'm Dr Simone Gonzo.

Heavy menstrual bleeding is a common presentation in general practice and can have a significant impact on quality of life.

As GPs, we're often helping patients navigate a range of management options and supporting them to make informed decisions that align with their preferences and goals.

Today, I'd like to focus on one aspect of that conversation, which is how to discuss intrauterine systems with patients, address common questions and misconceptions, and support everyday practice.

So the device is only one part of the decision.

The most efficient way to start is not with a list of device features.

Simone, over to you.

Thanks Campbell for that fantastic introduction.

Thanks HealthCert as well and also to Bayer for allowing us to do this tonight.

As Campbell said, we have CPD accreditation and there is also further education that's available for you and I'd encourage you to take advantage of those free education courses for GPs.

They're very valuable.

So tonight we're learning about heavy menstrual bleeding and how we manage that in general practice across the age span.

We'll be applying the Palm-Cohen classification framework to structure assessment of abnormal urine bleeding and we'll also be discussing and consulting with patients how we frame the patient based on the Australian clinical care standard.

How long one can continue with the hormonal management and what are the long-term side effects and the risks associated, if you can comment on that?

Over to you, Simone.

Oh, thanks, Campbell, for that once again, lovely introduction.

Um, yes, as Campbell said, tonight we're speaking about polyendocrine metabolic ovarian syndrome, which is previously known as PCOS, polycystic ovarian syndrome.

Um, we'll go through our presentation tonight, starting with looking at our acknowledgment of country.

I'm north of Brisbane, so we will be acknowledging, or I will be acknowledging the Kabi Kabi people as traditional custodians of this land, recognizing their connection to the land, waterways, and community, paying respects to elders past and present.

As Campbell's already, um, outlined, um, I've spent a f- um, a fair amount of time, uh, in general practice, but also education and keeping up to date with guidelines is part of my interest as well.

So this evening we'll be looking at understanding the reason for the name change from PCOS to PMOS, and then we'll be just touching on the diagnosis, management, and treatment guidelines for, uh, PMOS, which is more like a revision rather than anything changing.

Now, let's try to give Mila a moment to handle that.

immunizations as well.

The things that should be making those red flags go up for us is when we see patients with neurological symptoms that they've never had before or that are new or extreme, macrocytosis with no clear cause, an unexplained cognitive decline.

And this can often be much more noticeable in the elderly patients.

And when they're coming in, the family's noticing that their memory is not as good as it was, or they're a bit flatter than they were.

That particular age group can suffer B12 deficiency quite easily.

through lots of these causes as well as just through their sort of older person tea and toast sort of diet.

Recurrent deficiency despite oral therapy also might be flagging that the patient is not absorbing the B12 like they should be, like we would expect them to.

They