New Australian medical guidelines could help women find relief from menopause symptoms that persist well beyond their 50s, with clearer advice on hormone therapy, treatment risks and available alternatives.

For many Australian women, menopause symptoms don’t simply disappear once they reach 60. Hot flushes can linger, night sweats interrupt sleep, and vaginal discomfort or urinary problems can continue for years.

Now, new medical guidelines could help women who have been living with these symptoms better understand their treatment options.

Released on Friday by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the evidence-based guidelines aim to bring greater consistency to menopause care and clear up confusion surrounding hormone therapy.

Importantly, they recognise that treatment decisions can be different for older women.

What changes for women over 60?

One of the key messages concerns menopausal hormone therapy (MHT), previously widely known as hormone replacement therapy.

For women aged 60 and older considering starting oral hormone therapy, the guidelines recommend discussing small increased risks of cardiovascular events, blood clots and dementia.

That doesn’t mean women must automatically stop treatment when they turn 60.

The guidelines place no fixed time limit on hormone therapy, instead recommending individual decisions based on symptoms, medical history and personal risk factors.

Women already taking MHT should have their treatment reviewed annually.

Relief for symptoms that won’t go away

The guidance also addresses vaginal dryness, painful intercourse and urinary symptoms, which can continue long after hot flushes have eased.

Low-dose vaginal oestrogen is recommended as a treatment option for troublesome vaginal symptoms. Unlike systemic hormone therapy, it acts primarily in the affected area, with minimal absorption into the bloodstream.

Significantly, it may also be considered for some women with a history of breast cancer, following individual medical assessment. Particular caution is needed for women taking certain breast cancer medications.

What about natural alternatives?

The guidelines examine non-hormonal medications and therapies including acupuncture, hypnosis and cognitive behavioural therapy.

However, the evidence supporting some alternatives remains uncertain. Exercise offers substantial health benefits, but evidence that it directly reduces hot flushes is limited.

What should you ask your GP?

Women still experiencing symptoms should consider discussing whether their current treatment remains appropriate, what alternatives are available and whether their age or medical history changes the balance of benefits and risks.

The message is reassuring: menopause care doesn’t necessarily end at 60, and persistent symptoms deserve medical attention.

The new guidelines don’t offer a single answer for every woman. They provide a clearer basis for finding treatment that suits her circumstances.

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