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Content ArticleSurgical menopause is the removal of both ovaries (bilateral oophorectomy) before a woman goes through biological menopause. Symptoms of surgical menopause are generally similar to that of a natural or chemically induced menopause, with a few established differences. Due to the sudden loss of ovarian function in surgical menopause, pre-menopausal women might experience more severe consequences, including increased rates of overall mortality, coronary heart disease, stroke, cognitive impairment, osteoporosis and sexual dysfunction. Surgical menopause can have significant consequences both short term and long term. Clear information and advice should be provided both before and after surgery to both the patient and their primary care team.
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Content ArticleThis guide by the charity Menopause Support offers advice for women who may be experiencing menopause symptoms about how to approach an appointment with their GP. It covers preparing for the appointment with research, making a note of your symptoms, how to ask questions, taking a friend or family member to support you, and further support you can request during the consultation.
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Content ArticleThe All Party Parliamentary Group on Menopause (the APPG), chaired by leading parliamentary campaigner Carolyn Harris MP, has published its final report following a year-long inquiry into the subject. The MPs findings demonstrate that widespread action is needed across all spheres to improve the situation for those going through the menopause, and the families, friends and colleagues affected by it. Menopause symptoms can have a debilitating impact on the day-to-day lives of women. Whether from the inability to get the right diagnosis at the right time, difficulties in accessing HRT, a lack of support from their employer while struggling at work, or simply not being able to recognise what is happening to them and their bodies and seek help. Despite the fact that 51% of the population will experience the menopause, the entrenched taboo around women’s health issues has meant that the support for the 13 million women currently going through peri-menopause or menopause is completely inadequate. The APPG is particularly concerned about the socio-economic divide emerging between women who are able to access the right treatment, and those who lose out in the postcode lottery and do not have the financial means to seek treatment elsewhere.
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News Article
Give all women a menopause check at 45, MPs told
Patient Safety Learning posted a news article in News
Women should be invited for a menopause check-up when they turn 45, a report for MPs says, criticising the current support as completely inadequate. The Menopause All-Party Parliamentary Group says it has listened carefully to women's experiences, including difficulties getting a diagnosis and accessing hormone-replacement therapy (HRT). Many had long waits or were offered antidepressants, against guidelines. The report covers a year-long inquiry. It says action is needed to improve the situation for those going through the menopause, and the families, friends and colleagues affected by it. And a health check offered to all women in their mid-40s, as they approach the perimenopause - when hormones decline and menopausal symptoms, such as hot flushes and night sweats, can begin - should help ensure the necessary support and care as early as possible. The inquiry heard a 39-year-old who suspected she was perimenopausal was turned away by her GP and told to "wait and see". Some 18 months later, she was "almost at the verge of collapsing, struggling to keep my usually happy marriage on track and not functioning well physically or mentally". The report also warns a socio-economic divide is emerging between women able to access the right treatment and those who lose out in the postcode lottery and do not have the financial means to seek treatment elsewhere. Read full story Source: BBC News, 12 October 2022 -
News Article
HRT medicine to be sold over the counter for first time
Patient Safety Learning posted a news article in News
Previously offered as prescription only, estradiol tablets, sold under the brand name Gina10, will now be available to women over the age of 50 who have not had a period for more than a year, as part of hormone replacement therapy treatment (HRT). Pharmacists have been offered training to identify who needs the tablets. The Medicines and Healthcare products Regulatory Agency (MHRA) made the decision as part of a strategy to make menopause treatment more accessible for women. Estradiol tablets treat vaginal symptoms caused by a lack of oestrogen, such as dryness, soreness, itching, burning and uncomfortable sex. The product is inserted into the vagina rather than taken by mouth. MHRA chief healthcare quality and access officer Dr Laura Squire called the move a "landmark reclassification for millions of women in the UK". "In reaching this decision, we have seen positive support from a wide range of people, including many women aged 50 years and above who could benefit from this decision," she said. The MHRA hopes the move will relieve pressure on front-line NHS services and give women more freedom in choosing treatments that work for them. Read full story Source: BBC News, 8 September 2022 -
Content ArticleResearch suggests that there is a wide gap in knowledge about how medical conditions affect men and women differently, and about the conditions that only affect women. As a result, women are receiving poorer medical advice and diagnosis, often leading to worse outcomes. This handbook published by digital healthcare provider Livi looks at some of the evidence surrounding sex-based health inequalities and how they are affecting women in the UK.
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News Article
Working women need greater menopause rights
Patient Safety Learning posted a news article in News
Women going through menopause should be given greater rights and protection in the workplace, MPs say. The Women and Equalities Committee said a lack of support in the UK was pushing women out of work. The cross-party group wants menopause to become a protected characteristic like pregnancy, to give working women more rights. Caroline Nokes, who chairs the committee said: "Stigma, shame and dismissive cultures can, and must, be dismantled." The government, speaking on the issue for England as health issues is devolved to the national governments in Scotland, Wales and Northern Ireland, said the issue was a priority, highlighting it had recently appointed a women's health ambassador and set up a menopause taskforce to look into workplace support. Read full story Source: BBC News, 28 July 2022 -
Content ArticleIs good-quality health care being provided for women in prison? As the government proceeds with plans to build 500 more prison places for women, this new Nuffield Trust analysis uses HES data to look at women prisoners' use of hospital services, finding that they face a series of challenges and risks in prison because of barriers to accessing health and care services.
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News ArticleHormone replacement therapy is to be offered over the counter for the first time in the UK after the medicines watchdog gave the green light. Millions of women go through the menopause every year, with the majority experiencing some symptoms that can be severe and have a negative impact on everyday life. In a landmark move hailed as a “huge step forward” for women’s health, the first type of HRT to become available at pharmacies without a prescription will be Gina 10 microgram vaginal tablets (containing estradiol). The Medicines and Healthcare products Regulatory Agency (MHRA) said the vaginal tablets would be available for post-menopausal women from September after a safety review. Maria Caulfield, the minister for women’s health, said: “Menopause affects hundreds of thousands of women every year, but for some its symptoms can be debilitating and for many they can be misunderstood or ignored. “Making Gina available over the counter is a huge step forward in enabling women to access HRT as easily as possible, ensuring they can continue living their life as they navigate the menopause.” Read full story Source: The Guardian, 20 July 2022
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Content ArticleThe government has published the first ever Women's Health Strategy for England to tackle the gender health gap.
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News Article
Doctors warn against over-medicalising menopause after UK criticism
Patient Safety Learning posted a news article in News
Doctors have hit back at critics saying they are failing menopausal women, and said that treating menopause as a hormone deficiency that requires medical treatment could fuel negative expectations and make matters worse. Writing in the British Medical Journal they said there was an urgent need for a more realistic and balanced narrative which actively challenges the idea that menopause is synonymous with an inevitable decline in women’s health and wellbeing, and called for continued efforts to improve awareness about the symptoms and how to deal with them. “Menopause is a natural event for half of humankind. While media attention in the UK may give the impression that growing numbers of women are struggling to cope with menopausal symptoms and are seeking hormonal treatment, there is no universal experience and most women prefer not to take medication unless their symptoms are severe,” wrote Martha Hickey, a professor of obstetrics and gynaecology at the University of Melbourne, Australia, and colleagues. They added that over-medicalisation of the menopause risked collapsing this wide range of experiences into a narrowly defined disease requiring treatment. “It tends to emphasise the negative aspects of menopause and, while effective treatments are important for those with troublesome symptoms, medicalisation may increase women’s anxiety and apprehension about this natural life stage.” Women’s experiences of menopause were strongly influenced by personal, family and social factors, they said. For instance, a recent review found that negative attitudes and expectations before menopause predicted the likelihood of women experiencing distressing symptoms. “Changing the narrative by normalising menopause and emphasising positive or neutral aspects such as freedom from menstruation, pregnancy and contraception, together with information about managing troublesome symptoms might empower women to manage menopause with greater confidence,” Hickey said. Read full story Source: The Guardian, 15 June 2022 -
Content Article
BMJ analysis: Normalising menopause (15 June 2022)
Patient Safety Learning posted an article in Women's health
Martha Hickey and colleagues argue that social and cultural attitudes contribute to the varied experience of menopause and that medicalisation fuels negative perceptions. -
News Article
Home menopause tests are waste of time and money, say doctors
Patient Safety Learning posted a news article in News
Women are wasting their time and money buying do-at-home menopause testing kits, doctors have warned. The urine tests are not predictive enough to tell whether a woman is going through the phase when her periods will stop, doctors have told the BBC. The tests, which give a result within minutes, accurately measure levels of follicle-stimulating hormone (FSH), which helps manage the menstrual cycle. But experts say it is not a reliable marker of the menopause or perimenopause. Dr Annice Mukherjee, a leading menopause and hormone doctor from the Society of Endocrinology, told the BBC the FSH urine tests were “another example of exploitation of midlife women by the commercial menopause industry, who have financial conflicts of interest”. “It’s not helpful for women to access [FSH] directly,” she said. “It is not a reliable marker of perimenopause and can cause more confusion among women taking the test. At worst, misinterpretation of results can cause harm.” The Royal College of Obstetricians and Gynaecologists (RCOG), along with other leading experts in women’s health, said the tests could be unhelpful and potentially misleading. Read full story Source: The Guardian, 10 June 2022 -
News Article
Menopausal women lack basic support, landmark survey finds
Patient Safety Learning posted a news article in News
Eight in 10 respondents in the largest survey of menopausal women in the UK said their workplace had no basic support in place and 41% said menopause symptoms were treated as a joke by colleagues. The landmark study found menopausal women were being ignored in the workplace and by healthcare providers, with a third saying it took many GP appointments before they were diagnosed with menopause or perimenopause. This rose to 45% for black and minoritised women. The findings were revealed in a report by the Fawcett Society, based on a survey of more than 4,000 women commissioned by Channel 4 for a documentary by Davina McCall. “Menopausal women are experiencing unnecessary misery and it’s a national scandal,” said Jemima Olchawski, the chief executive of the Fawcett Society. “For too long, menopause has been shrouded in stigma. We need to break the culture of silence and ensure menopausal women are treated with the dignity and support they deserve instead of being expected to just get on with it.” Official guidance states hormone replacement therapy (HRT) should be offered to women struggling with menopause symptoms, but there have been acute shortages of some HRT products and demand is expected to rise. The survey found 39% of women said their GP or nurse offered HRT as soon as they knew they were experiencing menopause, but only 14% of menopausal women said they were currently taking HRT. Read full story Source: The Guardian, 5 May 2022 -
Content Article
Menopause and the workplace: Fawcett Society 2022
Patient Safety Learning posted an article in Women's health
Workplaces are failing menopausal women and change is urgently needed. A report from the Fawcett Society 'Menopause and the Workplace'' delves into women’s experiences at work and is the largest representative survey of menopausal women conducted in the UK. -
News Article
'The thought of running out of HRT is terrifying'
Patient Safety Learning posted a news article in News
A shortage of specific types of hormone-replacement therapy (HRT) has left women struggling with untreated symptoms of the menopause. Demand for prescriptions has more than doubled since 2017 - partly because of work by campaigners to extend access - but supply of some products has not kept up. Yasmin Darling's experience of the menopause was sudden and profound. Two years ago, she had two operations to reduce her risk of inherited cancer which plunged her into an early menopause. "It's really hard to navigate medical menopause 10 years early," the 45-year-old says. "When you don't have the product you need, it makes it much more difficult to navigate." Because of Covid, Yasmin has never been seen by a specialist at a menopause clinic, so she is managing as best she can on her own. Claire Lopez, 59, spent three weeks trying to obtain her usual HRT patches from different local chemists but they were out of stock. Without them, her body becomes "very stiff", leading to slipped discs and severe back pain. "I have severe anxiety if I do not have these patches, so the total lack of coordination between GPs and pharmacists was extremely frustrating," Claire says. In the end, she had to arrange a private prescription through a local clinic, in the Midlands, costing £50. The government has said it is determined to ensure supplies of HRT can meet high demand. Minister for Women's Health Maria Caulfield said: "There are over 70 HRT products available in the UK, most of which remain in good supply. "However, we are aware of some issues with women being unable to access certain products. "We will be appointing a new HRT-supply chairperson and convening an urgent meeting of suppliers to look at ways we can work together to improve supply." Read full story Source: BBC News, 27 April 2022 -
Content ArticleThis report represents the views of organisations and experts who responded to the Department of Health & Social Care's call for evidence on its Women's Health Strategy. The call for evidence was released in March 2021. This report focuses on submissions received from 436 organisations and individuals with expertise in women’s health, including the charity sector (34%), academia (22%), industry (10%), clinicians (7%), professional bodies (7%), pressure groups (7%), NHS organisations (3%), parliamentary groups (2%), royal colleges (1%), local government (1%), think tanks (1%) and others (6%).
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News Article
Women struggling to ‘sleep and work competently’ amid England’s HRT shortages
Patient Safety Learning posted a news article in News
Women are being left unable to sleep or work competently because of the shortages of hormone replacement therapy (HRT) products used to treat symptoms of the menopause, the former cabinet minister, Caroline Nokes, has said. Millions of women go through the menopause every year, with many experiencing symptoms that can be severe, such as low mood, anxiety, hot flushes and difficulty sleeping, and have a negative impact on everyday life. The number of prescriptions for HRT in England has doubled in the last five years to more than 500,000 a month. But the rise in prescriptions has come amid several years of HRT shortages, with pharmacists often unable to fulfil prescriptions. Shortages have been blamed on manufacturing and supply issues, and have been exacerbated by the growing numbers of women seeking the products. Speaking in the Commons on Thursday, Nokes, chair of the women and equalities committee, called for an urgent debate on the issue to ensure women “can get the supplies that we need”. In October, the government announced that the cost of repeat prescriptions for HRT would be significantly reduced in England. In the Commons on Thursday, Labour MP Nick Smith asked Spencer why there was “no date yet for the HRT prescription changes in England”. Spencer said it was “something the health secretary is looking at, at this moment in time”. Read full story Source: The Guardian, 21 April 2022 -
News ArticleIn an ongoing effort to improve care and support for elderly women and women’s health satisfaction and outcomes in general, the government have published their report summarising written responses from 436 organisations and experts from the Women’s Health Strategy call for evidence. The organisations that contributed to the report included participants from the charity sector, academia, professional bodies, clinicians, royal colleges and other general experts in women’s health. The topics highlighted in the report include: Menstrual health and gynaecological conditions, including the impact of premenstrual syndrome on someone’s quality of life. Fertility, pregnancy, pregnancy loss and maternal health, including women not feeling listened to during and after pregnancy and the provision of bereavement support services. Menopause, including suggestions for improvements in training and guidelines for healthcare professionals. Gynaecological and other cancers, including barriers to accessing high-quality, up to date information on risk factors for female cancers. Mental health, including its interaction with other health conditions across women’s life course. Healthy ageing, including the need to increase focus on the health needs of older women and emphasise women may experience the same conditions as men in different ways. Violence against women and girls, including the complications associated with hymenoplasty and barriers to accessing healthcare support for those who’ve been subject to years of violence and abuse. Minister for Women’s Health Maria Caulfield said: “For generations, women have lived in a healthcare system primarily designed by men, for men. We are committed to tackling the gender health gap, and the publication of our strategy later this year will mark a significant step forward.” She added: “I want to thank the expert individuals and organisations who took the time to respond to our call for evidence. The insights you have provided have been stark and sobering but will be pivotal to ensuring our strategy represents the first-hand experiences of the health care system.” Read full story Source: NHE, 13 April 2022
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Content ArticleThe Department for Health and Social Care (DHSC) launched a call for evidence in March 2021 to inform the first-ever government-led Women’s Health Strategy for England. This report focuses on the survey component of the consultation. Nearly 100,000 people in England got in touch to share: their personal views and experiences as a woman the experiences of a female family member, friend or partner their reflections as a self-identified health or care professional. The results highlight priority areas for action and further research and underpin DHSC’s vision statement for England’s Women’s Health Strategy (published in December 2021). The full strategy will be published in spring 2022.
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News Article
Sajid Javid: Doctors too often ‘ignore’ women’s pain
Patient Safety Learning posted a news article in News
Doctors too often "ignore" women's pain, Sajid Javid said as he called for change in the wake of the Shrewsbury maternity scandal. Writing for The Telegraph, the Health Secretary said the wider NHS needed to do much more to listen to women, adding that too many are left in pain and ignored by clinicians. On Wednesday, the Ockenden report revealed that the deaths of 201 babies and nine mothers at Shrewsbury and Telford NHS Trust could have been avoided, citing a failure to listen to women. Mr Javid wrote: "This week we have seen the tragic reality of what can happen when women's voices are not listened to when it comes to their care. "Donna Ockenden's report into maternity failings at Shrewsbury and Telford Hospitals raises specific concerns for maternity services, but more widely we must address issues across the whole of the health and care system when it comes to listening to women's concerns and recognising their pain." In the joint piece with Maria Caulfield, the minister for women’s health, Mr Javid welcomed a "shift in the way we talk about women's health", with more open discussions about areas once seen as taboo. But the pair said more needed to be done – specifically to improve the treatment of endometriosis, an extremely painful gynaecological condition. "We must ensure all women feel confident in going to their GP when they experience symptoms of endometriosis and, when they do, that they are listened to," they said. Too many were "spending too long in pain waiting for a diagnosis, often feeling ignored by clinicians", they warned. Later this year the Government will publish a women's health strategy, which will examine issues including fertility, menopause, and prevention and treatment of diseases. Read full story (paywalled) Source: The Telegraph, 31 March 2022 -
Content ArticleThis report highlights the importance of embracing a culture of change in the design and delivery of women’s health to achieve national systems and local services fit to meet the expectations and needs of the 21st century woman. It describes the many failings of health services across the world whose default position is to treat women as second-class citizens and place unnecessary barriers to the delivery of high-quality accessible care. The report sets out recommendations, founded on common sense and rooted in the belief that women should be in control of their own bodies.
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News ArticleHormone replacement therapy (HRT) could be made available to buy over the counter. Health watchdogs are proposing a re-classification of the medication so women would be able to buy it in pharmacies without a prescription, it’s claimed. HRT is mainly used to treat menopause symptoms but it is not yet known which version of the medication will be a part of the proposal, the Daily Telegraph reports. Symptoms can include hot flushes, reduced sex drive and mood swings and usually pass after a few years. More than one million women a year are believed to suffer each year but treatment is currently only available after consultation with a GP or a specialist. A spokesperson for the Department of Health and Social Care said: "We understand that for some women menopause symptoms can have a significant impact on their quality of life, and we are committed to improving the care and support they receive. "That’s why we’re developing the first ever government-led Women’s Health Strategy, informed by women’s lived experience. Menopause, including improving access to Hormone Replacement Therapy, will be a priority under the Strategy." Read full story Source: The Independent, 2 February 2022
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News Article
Ministers pledge to ‘reset the dial’ on women’s health in England
Patient Safety Learning posted a news article in News
Ministers have pledged to “reset the dial” on women’s health to tackle decades of gender inequality in England, with plans to appoint a women’s health tsar, eradicate medical taboos, boost menopause support and ban harmful “virginity repair” operations. The Department of Health and Social Care has published its Vision for Women’s Health strategy after 100,000 women came forward to share their healthcare concerns. Maria Caulfield, the minister for women’s health, described some of their experiences as “shocking”. The vision document sets out initial government commitments on women’s health, recognising that “systemwide changes” are needed to tackle “decades of gender health inequality”. The final plan – the Women’s Health Strategy – will be published in spring 2022. On Wednesday night, ministers pledged to introduce legislation criminalising hymenoplasty or any procedure to rebuild or repair the hymen. Such surgery creates scar tissue so that a woman will bleed the next time she has intercourse, making it appear she has never had sex. Young women can be forced to prove they are “pure” on their wedding night. Doctors have called for a ban on the surgery for years, saying it can never be justified on health grounds and is harmful. Separately, the government will appoint a women’s health ambassador to raise the profile of key issues and boost awareness of taboo topics. Ministers will also establish a UK-wide menopause taskforce to investigate how women going through the menopause can be better supported. The cost of hormone replacement therapy (HRT) prescriptions will also be cut by implementing longer prescribing cycles so women will need fewer prescriptions and therefore pay less. The consultation provided “stark and sobering insights” into women’s experiences of health and care and highlighted entrenched problems within the NHS, officials said. Ministers are also considering compulsory training for GPs on women’s health after the idea was raised by women who came forward. The vision document said: “We also heard about a lack of awareness amongst some GPs of the causes of infertility, miscarriages and their relationship with infertility, and the reasons for in vitro fertilisation (IVF) failure.” Read full story Source: The Guardian, 22 December 2021 Related reading Gender bias: A threat to women’s health (August 2020) Dangerous exclusions: The risk to patient safety of sex and gender bias Patient Safety Learning: Women’s Health Strategy Consultation Response -
Content ArticleThis policy paper from the Department of Health and Social Care (DHSC) details the government's vision for the Women’s Health Strategy for England, informed by the call for evidence. The call for evidence published in spring 2021 received nearly 100,000 responses from women across the country, and over 400 written responses from organisations and experts working in the health sector and beyond. The consultation response demonstrated that the system and the values that drive it need extensive reform to make women's health provision in England safer and more effective.
