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Fragile X-associated Primary Ovarian Insufficiency (FXPOI): What Do I Need to Know?

2025-03-26T00:00:00+11:00

Webinar with Clinical Associate Professor Amanda Vincent

17 March 2025

Clinical Associate Professor Amanda Vincent is a leading Australian endocrinologist and menopause specialist, combining clinical practice in menopause with menopause related research, translation and education. Dr Vincent is lead endocrinologist in the Menopause and Menopause Oncology clinics, Monash Health, Clayton and Head of Early Menopause Research, Monash Centre for Health Research and Implementation, Monash University.

This webinar focuses on Fragile X-associated Primary Ovarian Insufficiency (FXPOI) and early menopause, covering health considerations and symptom management for women who are Fragile X premutation carriers. Dr Vincent also discusses the risk factors for FXPOI, and touched on fertility management considerations for young women who may be at risk of fertility issues related to the Fragile X premutation.

The webinar was hosted by the Fragile X Association of Australia.

Used with permission.

Fragile X and Premature Ovarian Insufficiency Webinar 4 April 2022

2022-04-25T23:11:02+10:00

The AMS partnered with the Fragile X Association of Australia for Fragile X and POI – What do I need to know?

This webinar, presented by AMS Past-President A/Professor Amanda Vincent is for women who are going through or at risk of POI due to FMR-1 pre-mutation.

The webinar covers:

What is POI?
What causes POI?
FXPOI
Risk factors
Impact of POI
Diagnosis
Management

The webinar is hosted by a Karen Lipworth, Board Member of the Fragile X Association of Australia who herself was diagnosed with POI and subsequently the FMR pre-mutation, and she discusses her journey.

Early Menopause: New digital resources for women and health professionals

2020-07-29T10:26:29+10:00

Two comprehensive new Australian digital resources have been developed for women with early menopause / primary ovarian insufficiency (POI) and health professionals caring for women with EM / POI.

Located on the Healthtalk Australia website, the resources feature women’s and health professionals’ experiences and perspectives (via short audio and video clips), a Question Prompt List for women with weblinks to information, diagnosis and management (treatment) algorithms for health professionals, and information and resource pages including a list of health services across Australia for women with EM / POI. The resources are designed to support, inform and help with diagnosis, management and improved communication between women and their HPs for better health outcomes.

Thinking of menopausal hormone therapy? Here's what you can expect from your GP

2020-01-23T22:13:36+11:00

There’s a lot of information to take in. So it’s OK to discuss options for managing your menopausal symptoms over several consultations with your GP. from www.shutterstock.com

Rhonda Garad, Monash University and Amanda Vincent, Monash University

We have seen increasingly dramatic headlines over the years on the risks of menopausal hormone therapy (MHT), also known as hormone replacement therapy.

An alarming study in 2002, which found an apparent increased risk of breast cancer in women who took MHT, prompted the first of these headlines.

But newer evidence has been reassuring. It’s also a reminder that when considering your options, any risk associated with taking MHT needs to be balanced with the benefits.

This balance is the main thing your GP will consider when discussing whether MHT is right for you.

Menopause and HRT

2019-10-22T15:18:34+11:00

21 October 2019:

This radio braodcast with Professor Martha Hickey and Dr Liz Farrell (AMS member and a past AMS President) is available to listen online of as a podcast.

ABC Radio
On Nightlife with Philip Clark

About half the population will go through menopause at some point in their lives - What are the symptoms? How effective is HRT is treating these symptoms? And How does menopause affect women at work?

Helping us better understand the impacts of menopause are: Professor Martha Hickey, Professor of Obstetrics and Gynaecology at the University of Melbourne, and Dr. Elizabeth Farrell, a gynaecologist and Medical Director of Jean Hailes for Women's Health.

Access here: www.abc.net.au/radio/melbourne/programs/nightlife/menopause-and-hormone-replacement-therapy/11625054

Testosterone and Women

2019-09-23T14:39:40+10:00

Androgens are hormones produced by the ovaries and adrenal glands, with the principal androgen being testosterone. In women, the ovaries directly release testosterone into the blood stream, but testosterone can also be made from other hormones that come from the ovaries and adrenal glands such as DHEA and androstenedione. In women and men, testosterone acts directly in cells, but it is also converted to estrogen, and has vital biological effects through estrogen action. ^[1.]

Testosterone blood levels in men are about 10-20 fold greater than in women and result in the male features we tend to associate with testosterone, such as deeper voice, more body hair, more muscle and so forth.

Testosterone blood levels in women tend to peak during their 20s. This is followed by a gradual decline with age. By the time a woman reaches menopause, blood testosterone levels are about one quarter of what they were at their peak. ^[2.] However, after the age of 65-70 years, women have testosterone blood levels similar to those seen in young women. ^[3.]

A sudden fall in testosterone blood levels occurs when women have both of their ovaries removed (surgical menopause). Other causes of low testosterone in women include:

Use of the oral contraceptive pill - switches off testosterone production by the ovaries and produces a liver protein (SHBG) which may reduce the effects of testosterone;
Oral steroid therapy - suppression of testosterone production by the adrenals;
Anti-androgen therapy for acne, hirsutism or scalp hair loss - drugs that block the actions of testosterone in body cells; and
Complete loss of pituitary function (panhypopituitarism).

To exclude other potential causes, we recommend you talk to your healthcare professional.

What are the consequences of low testosterone in women?

The effects of low testosterone in women have been greatly debated over many years. Firstly, and most importantly there is no blood level that can be used as a cut-off to “diagnose” low testosterone in women.

Some studies have indicated that there may be an association between low sexual desire and low testosterone, but this has not been a consistent finding in all studies. ^[4.]

How to make work menopause-friendly: don't think of it as a problem to be managed

2018-10-19T10:28:53+11:00

Kathleen Riach, Monash University and Gavin Jack, Monash University

For many, menopause conjures up feelings of embarrassment, hot flushes, mood swings and sleep disturbance. It doesn’t usually conjure up thoughts about the workplace.

Yet menopause at work is fast becoming a target of government and organisational concern.

Being positive about sexual wellbeing after menopause

2018-10-15T12:03:09+11:00

Free yourself and embrace positive sexual wellbeing

Download booklet here: Sexual wellbeing after menopause840.7 KB

Sexual wellbeing

Sexual health is a state of physical, emotional, mental and social wellbeing related to sexuality.

Sexuality is an integral part of the human psyche. Sexuality is expressed throughout life in all people both consciously and unconsciously in body movements and body language, speech, appearance and in every imaginable way people interact with each other. The way people demonstrate their innate sexuality varies according to their stage of life. Sexuality is not limited by age, relationship status or sexual preference.

Studies across a number of countries have shown that women place high value on sexual intimacy in their relationships and the majority of women continue to be sexually active into their later years. [1., 2.]

Consequently, a decrease in sexual wellbeing and loss of intimacy can have profoundly negative effects. After menopause 30-50% of women experience sexual difficulties that adversely impact their intimate relationship, psychological wellbeing health, social functioning and overall quality of life. [3., 4.] However, there is a range of treatment options for women to consider.

Changes before the Change: Perimenopausal bleeding

2017-10-16T16:35:21+11:00

Although some women may abruptly stop having periods leading up to the menopause, many will notice changes in patterns and irregular bleeding.

Whilst this can be a natural phase in your life, it may important to see your healthcare professional to rule out other health conditions if other worrying symptoms occur.

Many women experience Abnormal Uterine Bleeding (AUB) during perimenopause. AUB is defined as bleeding that differs in frequency, regularity, duration or amount to your regular menstrual bleeding. [1] Changes to the menstrual cycle often carry no significant consequences [2]; however, they could have a range of causes. Although it may simply be a symptom of perimenopause, it is still sensible to raise the issue with your healthcare professional. A thorough history and physical examination will indicate the cause of uterine bleeding and help discern the need for further investigation and treatment. [3] Other investigations for abnormal uterine bleeding include a PAP Smear, Endometrial or Uterine Sampling (Endometrial Biopsy), a Vaginal Ultrasound (Echography) and routine laboratory testing.

Changes before the Change1.06 MB

Do what makes your heart healthy

2016-10-13T23:43:00+11:00

Heart Health Matters

Menopause is the stage in your life when your periods stop permanently, signaling the end of your reproductive years. It happens when there are no more eggs in your ovaries. Because eggs stimulate your body to produce oestrogen, the levels of estrogen in the blood drop, resulting in menopausal changes in the body when they are exhausted.

As a result of the hormonal changes surrounding menopause, many women experience both physical and emotional symptoms:

Hot flushes / flashes
Night sweats
Insomnia and disrupted sleep
Racing heart / palpitations
Weight gain (especially around the waist and abdomen)
Headaches
Changes to the skin, hair and nails
Aches and pains in joints and muscles
Lower sex drive
Vaginal dryness, pain during sexual intercourse and increased risk of vaginal infections
Inability to control urination and increased risk of urinary infections
Difficulty concentrating and memory lapses
Fatigue / low energy levels
Mood swings and irritability
Depression

What comes to mind – menopause and the aging brain?

2015-10-14T11:38:01+11:00

This comprehensive booklet offers positive advice on preventative strategies to prevent cognitive decline. It explains the difference between cognitive decline and dementia, how to prevent memory loss in midlife and highlights the top 10 tips for women to improve brain health and function.

What comes to mind – menopause and the aging brain?810.25 KB

Prevention is key to reducing memory loss as women age

What happens during the menopause?

All women go through the menopause. When a woman's menstrual periods stop, her ovaries stop producing eggs and her oestrogen levels decline.

51 years is the average age for a woman to reach the menopause and the entire process can last anywhere from 2-10 years. [1]

Menopause Monologues

2008-08-16T22:04:31+10:00

Menopause Monologues was an information resource kit for women. Stocks have now been depleted and copies are no longer available.

For comprehensive resources go to Menopause Management for Information Sheets and Videos to support women through midlife health and the menopause.

This information is organised into the following management categories for ease of reference:

Menopause Basics
Menopause Treatment Options
Early Menopause
Risks and Benefits
Uro-genital
Bones
Sex and Psychological
Alternative Therapies
Contraception

The menopause transition - out of our comfort zone

2014-06-28T09:11:41+10:00

Presenter Natasha Mitchell, Jean Kittson and Professor Martha Hickey discuss all matters menopause in the final program in the ABC Radio National's Women's Health Series that aired on 28 June 2014, about menopause.

Listen here

Jean Kittson - comedienne and author

When Jean Kittson hit menopause, she was amazed at what she didn't know. Given that 1.5 million Australian women are menopausal at any one time, why, she wondered, was menopause so little discussed and then only in hushed tones?

So Jean set out to write the sort of book she felt she needed to read: 'An easy-to-read book full of useful information that didn't make you want to put on an old chenille dressing-gown and a pair of comfortable slippers and throw yourself under a marching band.'

You're Still Hot to Me is a chatty - sometimes robust - conversation between women and with some of Australia's top experts.

Professor Martha Hickey, BA (Hons) MSc (Clin Psych) MBChB FRANZCOG MD

Professor Martha Hickey is Professor of Obstetrics and Gynaecology at the University of Melbourne and Adjunct Professor of OBGYN at Yale University, CT. In her clinical practice she runs the menopause services at The Women's Hospital, Melbourne. She initially trained as a Clinical Psychologist in the UK and then qualified in medicine in 1990 from the University of Bristol. She completed her specialist training in Obstetrics and Gynecology in 2000 at Imperial College School of Medicine, London. She then moved permanently to Australia.

Professor Hickey is an experienced clinician researcher in gynaecology. Her main areas of interest are abnormal uterine bleeding and menopause. In the field of menopause she runs a large clinical service, offering unique multidisciplinary care for women with menopausal symptoms following a cancer diagnosis. She has clinical and research interests in the development of non-hormonal treatments for menopausal symptoms and in the mechanisms of abnormal bleeding in women using sex steroids for contraception or HRT.