Dr Lucy Williams
Biography:
Dr Lucy Williams is a gynaecologist sub-specialising in reproductive endocrinology and fertility. She started clinical work in the field of menopause at the KEMH Menopause clinic as a junior doctor in 1991, then under the leadership of Professor Bronwyn Stuckey and Dr Margaret Smith and has continued an attachment with this clinic throughout her career. She undertook a fellowship with Professor Jerilynne Prior at the University of British Columbia examining the role of natural progesterones in management of menopause. As a senior clinician she has worked alongside Prof M Hickey and contributed to formation of the first dedicated clinic for management of Menopause Symptoms after Cancer (MSAC clinic) in Australia in 2001. She also has a thriving fertility practice being a senior clinician at Concept Fertility.
Abstract:
Menopausal symptoms frequently predate the final menstrual period. During the perimenopause characteristic vasomotor symptoms and mood changes often fluctuate and can occur in combination with less typical symptoms. This can cause a confusing presentation leading to a delay in diagnosis and undertreatment by healthcare providers.
Oestrogen based therapy is the most effective treatment for vasomotor symptoms and in the absence of contraindications is endorsed by all menopausal societies as first line. In the perimenopause however, consideration of menstrual changes and contraceptive needs create complexity in managing women during this phase. Effective non-hormonal options are also available when needed.
In the current era of women being inundated with information from many sources, often giving conflicting advice, a treatment approach with thorough explanation and individualised decision making can improve health and quality of life for midlife women.