Abstract 1
A/Prof Talat Uppal
Midlife and Menopausal Bleeding: When Should We Worry and What Investigations Are Needed?
Abnormal uterine bleeding (AUB) during the midlife and menopausal transition is a common yet clinically challenging presentation, balancing high prevalence with the need to exclude significant pathology. Hormonal fluctuations in the perimenopause may result in irregular and/or heavy menstrual bleeding (HMB); however, the risk of endometrial hyperplasia and malignancy increases with age, obesity, metabolic disease, and prolonged unopposed oestrogen exposure. This presentation will provide a pragmatic, evidence‑based framework for evaluating bleeding in women aged over 40, with a focus on diagnosis and management.
Using FIGO Abnormal Uterine Bleeding parameters, and clinical scenarios, we will explore when reassurance is appropriate, when investigation is recommended, and how to tailor assessment to individual risk profiles. The role and limitations of transvaginal ultrasound, hysteroscopy, endometrial biopsy, and emerging outpatient techniques will be reviewed, alongside considerations for women using menopausal hormone therapy, with unscheduled vaginal bleeding.
Emphasis will be placed on HMB management with a view to optimising patient quality of life. Practical algorithms applicable to primary and specialist care will be included in this presentation, to support confident decision‑making in midlife bleeding.
Abstract 2
Is the Menopause Experience Different Across Cultures?
Menopause is a universal biological transition, yet womens lived experiences vary substantially across cultures, environments, and health systems.
Symptoms commonly associated with menopause in the Caucasian context, such as vasomotor symptoms, mood disturbance, and sleep disruption – are reported differently across cultures, influenced by social norms, community expectations, comorbidities, and access to health care.
This panel discussion will explore whether differences in menopausal experience reflect biological variation, cultural framing, health literacy, or structural inequities in healthcare delivery.
Drawing on global research, clinical practice, and lived experience, the panel will examine how culture shapes symptom reporting and acceptance of treatments such as menopausal hormone therapy, non‑hormonal options, and traditional or complementary approaches. Attention will be given to migrant populations and First Nations women, where menopause may intersect with stigma, gender roles, and limited access to evidence‑based care.
The discussion will challenge a “one‑size‑fits‑all” model of menopausal care and highlight the importance of culturally safe, and individualised approaches. Practical insights will be offered to help clinicians recognise cultural influences, improve communication, and deliver menopause care that is both evidence‑based and culturally responsive.