Australia’s new menopause guidance covers vaginal and urinary symptoms, excludes libido and recommends annual review for women using MHT.
On October 17, 2026, ABC reported on RANZCOG’s first evidence-based guidelines for managing menopausal symptoms. The guidance puts vaginal dryness and frequent urination on the same clinical page as hot flushes and night sweats. Libido is outside its scope.
That distinction matters when a menopause headline raises questions about sexual wellbeing. Guidance addressing vaginal symptoms may be relevant to sexual comfort without answering questions about sexual interest. Those are different subjects, even when someone wants to discuss both in the same appointment.
Catriona Melville chairs the guideline development group. According to ABC, she said the recommendations aim to help clinicians discuss treatment options with patients and “cut through the noise.” Understanding the document’s boundaries is part of making that aim useful.
The guidance applies to women aged 40 and over. It addresses two groups of symptoms that appear in the ABC report:
Here, genitourinary refers to vaginal and urinary symptoms. It is not another term for low desire. The report’s opening also mentions painful sex, which helps explain why the guidance is relevant to sexual wellbeing despite its narrower remit.
The age threshold describes the population covered by the recommendations. It does not suggest that everyone reaches menopause at the same age. ABC gives Australia’s average age at menopause as 51 and says most women reach menopause between 45 and 55.
This is clinical guidance rather than a study testing one intervention in a single group of participants. Its purpose is to support decisions across the symptoms it covers. It should therefore be read as a set of recommendations, not as one experiment with a single result.
The boundaries extend beyond libido. ABC says the guidance does not cover bone density, joint pain, depression or anxiety. Readers seeking broader background can find context in Sexential’s guide to changing symptoms and needs around perimenopause.
The ABC report says the guidelines clarify when menopausal hormone therapy, or MHT, should be used over other medicines. It also names acupuncture and hypnosis among the treatment options discussed. The strength of evidence behind those options is a separate question, addressed below.
One clear follow-up recommendation concerns women already using MHT: they should have an annual review with their doctor. The recommendation makes continuing review part of care rather than treating the original treatment decision as the end of the conversation.
An annual review does not mean treatment must change every year. As the research summary explains, it offers a prompt to discuss ongoing symptoms and treatment options with a doctor. The recommendation is about reassessment, not an automatic instruction to stop or switch a medicine.
The report also describes guidance for women with a history of breast cancer. Specifically, ABC says vaginal oestrogen is an option that can be offered to women in this group. That is an important point in the reporting, but its clinical interpretation requires the individual context discussed below.
For sexual wellbeing, another significant feature is the explicit inclusion of vaginal and urinary concerns. The guidance is not limited to hot flushes and night sweats. It gives these physical symptoms a place in the menopause treatment discussion without presenting them as a substitute for questions about desire.
ABC says the guideline evidence is graded from very low to high. That range matters: appearing in a list of options does not mean every treatment has equally strong support. The report does not provide detailed evidence ratings for each option, so it cannot support a treatment ranking based on those ratings.
The report identifies several specific areas of uncertainty. It says evidence is insufficient to conclude that weight loss or physical activity alone improves hot flushes or night sweats. It also reports insufficient evidence that hypnosis improves sleep.
Insufficient evidence is not the same as proof that something never helps. It means the evidence described does not justify the particular conclusion being considered. Those statements concern specified symptoms and should not be turned into broader judgements about every possible benefit of an activity.
ABC does not report whether acupuncture is effective. Its inclusion among the options discussed therefore should not be presented as an endorsement supported by a particular level of evidence. Similarly, the report supplies no comparative effect sizes that would justify numerical claims about one option outperforming another.
The vaginal-oestrogen point also needs a firm boundary. ABC’s account does not provide the detailed circumstances or individual risk criteria behind offering it to someone with a history of breast cancer. It is not a blanket safety statement for every person with that history; suitability belongs in an individual clinical discussion.
Taken together, these limits mean the update supports an informed conversation about options. It does not support choosing a treatment from a headline or assuming that a listed option has been shown to address every menopause-related concern.
According to ABC, RANZCOG had previously published statements about menopause. The change described in this announcement is the College’s first evidence-based guidelines for managing menopausal symptoms. That is a change in the form of its guidance, not evidence that menopause care began with this publication.
A separate report on the announcement describes the intended goals as greater consistency in care and less confusion about hormone therapy. Those goals fit Melville’s emphasis on helping clinicians discuss options clearly. They describe what the guidance is intended to support rather than a measured improvement in patient outcomes.
Sarah White is chief executive of Jean Hailes for Women’s Health and was not involved in developing the guidance. As reported by ABC, she said the guidelines could help health professionals talk patients through their options and reassure them about the advice they receive.
This is also not the only guideline project described in the reporting. ABC says the Australian government has funded separate perimenopause and menopause guidelines expected in 2027. RANZCOG is contributing to that work, with ongoing updates planned as evidence emerges.
The useful perspective is therefore one of continuing development. This document adds evidence-based recommendations within a defined scope. It need not answer every midlife health question to be useful, and its boundaries should not be mistaken for a judgement about which concerns matter most.
For readers, the practical starting point is to name the concern rather than assume that “menopause symptoms” describes it precisely enough. Vaginal dryness and urinary frequency are among the symptoms covered here. A question about changing sexual interest needs to be expressed in its own terms.
That is a distinction in the conversation, not a diagnosis. Separating questions about dryness from questions about desire helps keep the discussion focused on the experience being described. It also avoids expecting a recommendation about one symptom to answer a different question.
Useful discussion points arising from the guidance include:
These are prompts for a clinical conversation rather than a way to select treatment independently. They keep the symptom, the evidence and the follow-up question connected. Personal choices still require a qualified clinician’s assessment of the individual situation.
Magdalena Simonis is a practising GP and University of Melbourne women’s health expert who was not involved in developing the guidelines. ABC reports that she encouraged clinicians to consider the whole person, including lifestyle and other risk factors. She also encouraged people with troublesome symptoms to book a GP appointment.
Her comments provide a useful balance to the document’s defined scope. A guideline organises evidence around selected questions; a consultation concerns the person bringing those questions. Simonis also described menopause as a natural phase of life rather than something to fear.
There is a separate practical issue for some people already using hormone therapy. ABC reports that supplies of some HRT patches may not return to normal until at least the end of 2026. That is a supply caveat, not a statement that all patches are unavailable or that a particular alternative suits everyone.
Return to the clinical page introduced at the start. Vaginal dryness and urinary symptoms now have an explicit place beside hot flushes and night sweats in this guidance. The clearer perspective is not that this page contains every answer, but that readers can see which questions belong on it and which need a wider conversation.
A menopause guideline is not a complete account of sexual desire; Sexential places sexual wellbeing within a wider discussion of biology and daily life. Its evidence-aware explanations give adults aged 35 to 65 context for uncertainty about libido or arousal without presenting general education as an individual medical assessment.
Follow Sexential for thoughtful guidance on desire, sexual function, hormones, confidence, relationships and intimacy. Explore new articles and evidence-aware resources for sexual wellbeing across adulthood.
A report on a student survey links attention with men’s sexual satisfaction. Here’s the evidence, its limits and the practical context for midlife.
A new report puts men’s midlife testosterone changes in context, with guidance on assessment, partner conversations and fertility considerations.
The Menopause Society’s 2026 program places lifestyle, sleep and sexual health together. Here is what the agenda and partner research actually report.
Explore practical resources on desire, function, hormones, confidence, intimacy and sexual wellbeing.
Read the Blog
