A blank documentation skeleton mirroring the six required components, with placeholders. Edit to fit the consult — informational, not advice.
Introduced via the Health Insurance (Section 3C General Medical Services – Menopause and Perimenopause Health Assessment Services) Determination 2025 (F2025L00583). Schedule fee $104.55 for item 695 (GP) and $83.60 for item 19000 (prescribed medical practitioner). Benefit 100% of schedule fee. EMSN cap $305.70 (item 695) / $244.50 (item 19000).
| Criterion | Requirement |
|---|---|
| Minimum time | 20 minutes face-to-face |
| Patient eligibility | Medicare-eligible AND experiencing peri/menopause symptoms, premature ovarian insufficiency, or early menopause, OR undergoing treatment for symptoms |
| Frequency | Once per 12 months (per patient) |
| Usual GP rule | Patient must access via their usual GP or PMP if reasonably practicable (Clause 2.15.14) |
| Co-claiming | Cannot be co-claimed with a separate consultation unless clinically necessary. CAN be co-claimed with a different category of health assessment (e.g. 715 or Type 2 diabetes risk evaluation) — no minimum interval |
| Practice nurse | May assist (information collection, providing information at GP's direction). On-behalf-of items 10997/10987 NOT claimable alongside |
Source: MBS Book July 2026, explanatory note AN.14.3. Practitioners may refer to A Practitioner's Toolkit for Managing Menopause (Monash University), explicitly referenced in the explanatory notes.
The Determination requires all six components be included. Tick as you complete them — useful as a mid-consult check or a notes-template prompt.
Source: Health Insurance (Section 3C General Medical Services – Menopause and Perimenopause Health Assessment Services) Determination 2025; MBS Book explanatory note AN.14.3.
The Australasian Menopause Society publishes information sheets and a clinician toolkit. This picker summarises what they (and the Monash Practitioner's Toolkit) describe for common scenarios. It's a guidance summary — individual prescribing remains your clinical decision.
A blank documentation skeleton with placeholders — edit to fit the consult. Not a recommendation.
Sources: Australasian Menopause Society Position Statement on MHT and Types of MHT available in Australia patient information sheet; A Practitioner's Toolkit for Managing Menopause (Monash University); RACGP Silver Book — menopause section. Always check current AMS information sheets at menopause.org.au as guidance evolves.
What's broadly available in Australia, by route. Specific PBS-listed brands and current restrictions: verify at pbs.gov.au. The Australasian Menopause Society publishes a current Types of MHT available in Australia patient information sheet with branded product detail.
| Route | Active ingredients | Typical use case |
|---|---|---|
| Oral combined Continuous or sequential | Oestradiol + progestogen (norethisterone, dydrogesterone, drospirenone or medroxyprogesterone, depending on product) | Convenient, broadly used. Higher VTE risk than transdermal per AMS guidance. |
| Oral oestrogen-alone | Oestradiol or oestradiol valerate | Post-hysterectomy. Add separate progestogen if uterus present. |
| Transdermal patch Combined or oestrogen-alone | Oestradiol ± norethisterone | AMS notes lower VTE risk and may be preferred in higher-risk patients (obesity, migraine, smoker, age >60). |
| Transdermal gel/spray | Oestradiol | Dose flexibility. Combine with separate progestogen if uterus present. |
| Vaginal — local oestrogen | Oestriol cream, oestradiol pessary/tablet, oestradiol ring | Genitourinary syndrome of menopause (vaginal dryness, dyspareunia, recurrent UTI). Minimal systemic absorption — generally usable when systemic MHT is contraindicated, per AMS. |
| Separate progestogens | Micronised progesterone, medroxyprogesterone acetate, norethisterone, dydrogesterone | Endometrial protection when oestrogen-alone used in women with uterus. AMS notes micronised progesterone has the lowest breast cancer signal per WHI re-analysis and is increasingly preferred. |
| Tibolone STEAR — separate category | Tibolone (synthetic steroid with oestrogenic, progestogenic, and androgenic effects) | Alternative to combined MHT. Postmenopausal only (per AMS, generally ≥12 months amenorrhoea). |
Source: Australasian Menopause Society Types of MHT available in Australia; AMS Position Statement. For PBS listing status and restricted indications of any specific brand, see pbs.gov.au.
Oestradiol transdermal patch shortages continue through 2026. A Serious Scarcity Substitution Instrument (SSSI) is in effect to 28 Feb 2027 — pharmacists may dispense a specified alternative brand/strength patch without a new script within its parameters; counsel patients they may receive a different brand. Some products are discontinued (e.g. Climara, all doses); the TGA has approved certain overseas-registered products under s19A as substitutes (supply varies).
For formulation or dose switches, the AMS Guide to MHT Doses (Australia) gives approximate equivalences across products and routes. Practical: direct stable patients to the pharmacist for like-for-like SSSI substitution; reserve appointments for formulation changes, titration or new starts.
Sources: AMS MHT Shortages & Guide to MHT Doses (Australia); TGA Medicine Shortage Reports; DoH Serious Scarcity Substitution Instrument. Verify current status — shortages and instruments change.
| Category | What AMS lists |
|---|---|
| Absolute contraindications (systemic MHT) |
|
| Cautions / relative contraindications |
|
| Generally NOT contraindicating local vaginal therapy | Most of the above absolute contraindications relate to systemic MHT. AMS notes vaginal oestrogen has minimal systemic absorption and is generally usable in many situations where systemic MHT is contraindicated, including a history of breast cancer (consultation with oncology recommended). Decision is individual. |
Source: Australasian Menopause Society Position Statement on MHT (current version at menopause.org.au); A Practitioner's Toolkit for Managing Menopause (Monash). This is a summary — refer to original guidance for full criteria and update history.
Used when MHT is declined, contraindicated, or inadequate. The AMS publishes a Non-hormonal treatment of menopausal symptoms information sheet. Summary of categories described:
| Category | What AMS lists |
|---|---|
| SSRIs / SNRIs | Some agents have evidence for vasomotor symptoms (off-label in Australia for most). AMS notes paroxetine, escitalopram, venlafaxine and desvenlafaxine among those with VMS evidence. Avoid paroxetine with tamoxifen (CYP2D6 interaction). |
| Gabapentin | Evidence for VMS, particularly night sweats. Sedating — often dosed nocte. |
| Clonidine | Modest VMS benefit. Older option, less commonly used now due to side-effect profile. |
| Oxybutynin | VMS evidence; anticholinergic burden caveat in older patients. |
| Neurokinin-3 receptor antagonists e.g. fezolinetant | Newer class targeting VMS specifically. Check current TGA approval status and Australian availability at tga.gov.au. |
| Vaginal moisturisers & lubricants | For GSM when local oestrogen not used/wanted. Non-prescription, ongoing rather than as-needed dosing. |
| CBT | AMS notes evidence for CBT in managing VMS impact and associated sleep/mood. Available via psychologist referral (MHCP if criteria met). |
Source: Australasian Menopause Society Non-hormonal treatment of menopausal symptoms patient information sheet (menopause.org.au).
Source: AMS Bleeding after menopause information sheet; RACGP Red Book chapter on women's health.
| Scenario | To whom |
|---|---|
| Postmenopausal bleeding | Gynaecology (TVUS first; referral if ET ≥4mm or persistent bleeding) |
| Premature ovarian insufficiency (<40) | Endocrinology or specialist menopause clinic — investigations to determine cause, fertility implications, long-term hormone management |
| Early menopause (<45) with complex management | Specialist menopause clinic if available; gynaecology or endocrinology otherwise |
| MHT contraindicated, severe symptoms not controlled | Specialist menopause clinic; consider gynaecology / endocrinology / psychiatry depending on dominant symptom |
| Personal history of hormone-sensitive cancer | Discuss with treating oncologist before any MHT (including vaginal) |
| Endometrial thickness, ovarian mass, abnormal screening | Gynaecology |
| Significant osteoporosis / fragility fracture | Endocrinology or specialist bone clinic (also consider FRAX-driven Tx) |
Specialist menopause clinics exist in most capital cities; the Australasian Menopause Society maintains a Find a Doctor directory at menopause.org.au.
Item 695 explicitly requires consideration of cervical screening, mammography and bone densitometry. Other investigations per clinical context.
Source: AMS information sheets; RACGP Red Book 10th edition (preventive activities); MBS Book item 695 component (c).
About this reference: Last reviewed May 2026. AskMyGP summarises Australian guidance — it is not a substitute for the original source documents, which should be consulted directly for full criteria and updates. Clinical decisions remain the prescriber's responsibility.