By Laura Tantum, Director Incisive Health
Following an Incisive Health breakfast event exploring opportunities to improve NHS menopause care, Laura Tantum reflects on progress made under the previous government’s Women’s Health Strategy – and what needs to happen next as the government seeks to “prioritise women’s health”.
Every woman will experience the 30+ potential symptoms of menopause differently, yet our current approach can often oversimplify menopause care, failing to look across women’s lives and health needs.
In 2022, the first-ever Women’s Health Strategy for England highlighted menopause as a priority area of focus, after 48% of the 100,000 women responding to the national call for evidence called for its inclusion. While campaigns spearheaded by Davina McCall in the years before the strategy’s launch made huge progress bringing menopause into the public consciousness, the strategy acknowledged that women were still struggling to find enough information on the menopause, access appropriate care, and navigate menopause in the workplace against pervasive stigma.
Two years later, successive governments have begun to tackle these challenges through helping more women to access hormone replacement therapy (HRT) and encouraging more employers to adopt menopause-friendly practices. However, this is by no means a job done: in October, the British Menopause Society published a survey of members showing that, despite welcome increases in the number of women seeking support for menopause, many healthcare professionals (HCPs) are concerned about poor access to services and growing misinformation. These concerns were echoed at a recent Incisive Health breakfast event, chaired by Dr Janet Barter, President of the Faculty of Sexual and Reproductive Healthcare, where attendees highlighted that too many women are still excluded from the “menopause conversation”.
The government’s proposed shift to a prevention-first, digitally-driven and community-based healthcare system should, in theory, provide the ideal conditions to transform women’s access to information, care and multidisciplinary support throughout menopause. However, it will only do so in practice if we go beyond the ‘one size fits all’ approach:
The right information, at the right time, in the right place
To help women seek appropriate care, we must improve access to accurate and culturally-sensitive information on the menopause – and crucially, ensure women are educated on menopause before they begin to experience it.
In a recent survey, 80% of millennial women surveyed felt most menopause information they see online or in the media was negative, and 60% felt anxious about what the menopause might hold for them. With misinformation also on the rise, NHS-led initiatives such as women’s health hubs, a “pharmacy first” approach to primary care, and the NHS website and App should all provide an accessible front door to trusted, accurate information, that effectively prepares women for menopause without scaremongering. For inspiration, NHS England could look north of the border: under its own Women’s Health Plan, Scotland has launched public awareness materials to improve awareness on the range of menopause systems, while addressing common menopause myths.
Complementing the NHS’s offer, FemTech is well-placed to provide more personalised, data-informed information and education to different segments of the population.
Social, cultural and psychological perspectives of menopause
We must also be mindful of how women’s role in society interplays with their experiences of menopause. Many women of menopausal age will be juggling careers and an unpaid care burden, with teenage children and older parents to look after. As a result, their own health needs will all too often fall to the bottom of the list. How can we build upon action on menopause in the workplace to not only make society as a whole more menopause-friendly, but empower women to take steps to take control of their health?
In doing so, we must put recognise cultural differences in the perception of menopause. At our event, Shireen Noor, a licensed psychotherapist and champion for the South Asian community, spoke powerfully about the religious, cultural and community influences that mean menopause often “sits behind closed doors” and is not spoken about openly. Furthermore, stigmatisation of mental health problems within South Asian communities can be particularly detrimental for women experiencing mental health symptoms during menopause.
As Shireen notes, “if women don't speak out, they will not be heard.” For equitable progress across communities, sensitive and community-based advocacy to normalise menopause, and encourage women to find their voice, is key.
Ensuring a holistic, balanced approach
While HRT can be life-changing for many women throughout the menopause, participants at our breakfast event discussed the importance of a more holistic approach that facilitates access to a wider range of interventions, including physiotherapy, counselling, and social prescribing to support healthy lifestyles. The network of women’s health hubs currently being rolled-out across England has a clear role to play in providing this more tailored, joined-up support, and attendees were keen to see plans from the new government to embed and further strengthen the hubs.
Menopause should also provide a useful touchpoint with the health system to educate women on connected conditions, such as osteoporosis and cardiovascular disease – and signpost women to specialist care when required. Menopause affects more than the reproductive system, and we cannot “divide women into bits”.
This is particularly pertinent for women who enter menopause early following cancer treatment, and who can be particularly isolated by the current status quo. While the focus during treatment itself is rightly centred on survival, fragmentation and limited touchpoints across the system create a cliff-edge in support: almost 90% of relevant women do not receive “any or adequate” help managing the onset of menopause. As the new government seeks to integrate more services in the community, it must begin to join these dots.
What’s next?
If the government is to fulfil its promise that “never again will women’s health be neglected”, finding a new balance in menopause should be front of mind. Our approach to menopause needs to be as nuanced as the experiences of women going through it – this means taking an inclusive approach to information sharing, accounting for social, cultural and psychological factors that influences a woman’s experience; and ensuring a holistic and joined-up approach to care delivery.
To find out more about Incisive Health’s women’s health policy work in the UK and internationally, or how we can support your organisation to help transform women’s health, contact our team of experts at womenshealth@incisivehealth.com.