Menopause is having a bit of a moment, with less stigma and more awareness about the changes it can bring.

A recent senate inquiry recommended public education about perimenopause and menopause, more affordable treatments and flexible work arrangements.

But like many things in life the experiences of menopause are on a continuum. While some women find it challenging and require support, others experience some physical and emotional benefits. These are rarely reported – but we can learn from the research available and, importantly, from people’s lived experiences.

Here are four changes to look forward to once you reach menopause.

1. No more periods or related issues

Menopause is considered “complete” 12 months after the final period of a woman (or person assigned female at birth) who previously menstruated.

Perhaps unsurprisingly, the benefit at the top of the list is no more periods (unless you are taking hormone therapy and still have your womb). This can be particularly beneficial for women who have had to manage erratic, unpredictable and heavy bleeding.

At last, you don’t need to keep sanitary protection in every bag “just in case”. No more planning where the bathroom is or having to take extra clothes. And you’ll save money by not purchasing sanitary products.

There is also good news for women who have had heavy bleeding due to uterine fibroids – common benign gynaecological tumours that affect up to 80% of women. The evidence suggests hormonal changes (for women not taking hormone therapy) can lead to a reduction in the size of fibroids and relieve symptoms.

Women who suffer from menstrual migraine may experience an improvement in migraines post-menopause as their hormonal fluctuations begin to settle – but the timeframe for this remains unclear.

For some women, no more periods also means more participation in social activities from which they may have been excluded due to periods. For example, religious activities or food preparation in some cultures.

2. Getting your body and your groove back

Throughout their reproductive lives, women in heterosexual relationships are usually the ones expected to be proactive about preventing pregnancy.

Some post-menopausal women describe a re-emergence of their sexuality and a sense of sexual freedom that they had not previously experienced (despite contraceptive availability) as there is no longer a risk of pregnancy.

A participant in my research into women’s experiences of menopause described the joy of no longer being child-bearing age:

I’ve got a body back for me, you know, coz I can’t get pregnant, not that I haven’t enjoyed having [children] and things like that and it was a decision to get pregnant but I feel like, ooh my body isn’t for anybody now but me, people, you know?

For women who have chosen to be child-free there may also be a sense of freedom from social expectations. People will likely stop asking them when they are planning to have children.

3. A new chapter and a time to focus on yourself

Another participant described menopause as an unexpected “acceleration point” for change.

Women told us they were more accepting of themselves and their needs rather than being focused on the needs of other people. Researchers have previously tracked this shift from “living for others” to “a life of one’s own”.

Some women find the strength of emotions at this time a challenge, whereas others find their potency can facilitate liberation – enabling them to speak their minds or be more assertive than at any other time in their lives.

4. Increased self-confidence

A new sense of liberation can fuel increased self-confidence at menopause. This has been reported in studies based on in-depth interviews with women.

Confidence boosts can coincide with changes in career and sometimes in relationships as priorities and self-advocacy transform.

Life on the other side

It can be hard to think about what is good about menopause, particularly if you are having challenges during perimenopause – but these can get better with time.

In cultures where women are valued as they become older, women describe themselves as positively contributing to the community. They find they gain power and respect as they age.

We need to work towards more positive societal attitudes on this front. Our bodies change across the lifespan and are remarkable at every stage, including menopause.

Yvonne Middlewick, Nurse, Lecturer & Director of Post-graduate Studies in the School of Nursing and Midwifery, Edith Cowan University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

For many Australians the emergency department (ED) is the physical and emblematic front door to accessing urgent health-care services.

But health-care services are evolving rapidly to meet the population’s changing needs. In recent years, we’ve seen growing use of telephone, video, and online health services, including the national healthdirect helpline, 13YARN (a crisis support service for First Nations people), state-funded lines like 13 HEALTH, and bulk-billed telehealth services, which have helped millions of Australians to access health care on demand and from home.

The ED is similarly expanding into new telehealth models to improve access to emergency medical care. Virtual EDs allow people to access the expertise of a hospital ED through their phone, computer or tablet.

All Australian states and the Northern Territory have some form of virtual ED at least in development, although not all of these services are available to the general public at this stage.

So what is a virtual ED, and when is it appropriate to consider using one?

How does a virtual ED work?

A virtual ED is set up to mirror the way you would enter the physical ED front door. First you provide some basic information to administration staff, then you are triaged by a nurse (this means they categorise the level of urgency of your case), then you see the ED doctor. Generally, this all takes place in a single video call.

In some instances, virtual ED clinicians may consult with other specialists such as neurologists, cardiologists or trauma experts to make clinical decisions.

A virtual ED is not suitable for managing medical emergencies which would require immediate resuscitation, or potentially serious chest pains, difficulty breathing or severe injuries.

A virtual ED is best suited to conditions that require immediate attention but are not life-threatening. These could include wounds, sprains, respiratory illnesses, allergic reactions, rashes, bites, pain, infections, minor burns, children with fevers, gastroenteritis, vertigo, high blood pressure, and many more.

People with these sorts of conditions and concerns may not be able to get in to see a GP straight away and may feel they need emergency advice, care or treatment.

When attending the ED, they can be subject to long wait times and delayed specialist attention because more serious cases are naturally prioritised. Attending a virtual ED may mean they’re seen by a doctor more quickly, and can begin any relevant treatment sooner.

From the perspective of the health-care system, virtual EDs are about redirecting unnecessary presentations away from physical EDs, helping them be ready to respond to emergencies. The virtual ED will not hesitate in directing callers to come into the physical ED if staff believe it is an emergency.

The doctor in the virtual ED may also direct the patient to a GP or other health professional, for example if their condition can’t be assessed visually, or if they need physical treatment.

The results so far

Virtual EDs have developed significantly over the past three years, predominantly driven by the COVID pandemic. We are now starting to slowly see assessments of these services.

A recent evaluation my colleagues and I did of Queensland’s Metro North Virtual ED found roughly 30% of calls were directed to the physical ED. This suggests 70% of the time, cases could be managed effectively by the virtual ED.

Preliminary data from a Victorian virtual ED indicates it curbed a similar rate of avoidable ED presentations – 72% of patients were successfully managed by the virtual ED alone. A study on the cost-effectiveness of another Victorian virtual ED suggested it has the potential to generate savings in health-care costs if it prevents physical ED visits.

Only 1.2% of people assessed in Queensland’s Metro North Virtual ED required unexpected hospital admission within 48 hours of being “discharged” from the virtual ED. None of these cases were life-threatening. This indicates the virtual ED is very safe.

The service experienced an average growth rate of 65% each month over a two-year evaluation period, highlighting increasing demand and confidence in the service. Surveys suggested clinicians also view the virtual ED positively.

What now?

We need further research into patient outcomes and satisfaction, as well as the demographics of those using virtual EDs, and how these measures compare to the physical ED across different triage categories.

There are also challenges associated with virtual EDs, including around technology (connection and skills among patients and health professionals), training (for health professionals) and the importance of maintaining security and privacy.

Nonetheless, these services have the potential to reduce congestion in physical EDs, and offer greater convenience for patients.

Eligibility differs between different programs, so if you want to use a virtual ED, you may need to check you are eligible in your jurisdiction. Most virtual EDs can be accessed online, and some have direct phone numbers.

Jaimon Kelly, Senior Research Fellow in Telehealth delivered health services, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.