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Menopause: 1 year on from my Private Member’s Bill

carolyn harris

Carolyn Harris MP

Deputy Leader of Welsh Labour and MP for Swansea East

Carolyn Harris has been MP for Swansea East since 2015 and Chairs the All-Party Parliamentary Group on Menopause.

There are roughly 12 million people being affected by menopause in the UK today. The experience can range from ‘sailed through’ to excruciating, with over 40 recognised symptoms varying from brain fog, anxiety and insomnia to night sweats, joint pain and vaginal dryness. Whilst the average age that women reach the menopause is 51, Premature Ovarian Insufficiency (POI)¾which can be caused by cancer treatment, surgery, or other medical interventions¾means that for some women, the experience happens much sooner. No one menopause is the same as another, so women should be treated holistically and as individuals.

Progress? Or the lack thereof?

We have seen some real progress towards a society that recognises and embraces the menopause. The taboo surrounding it has been broken down considerably thanks to grassroots campaigners getting the menopause message into communities that need to hear it most. Davina McCall’s Sex, Myths and the Menopause documentary has also paved the way for so much menopause enlightenment.

Such awareness led to Sir Lyndsey Hoyle, the Commons Speaker, joining the NHS and civil service in signing the Wellbeing of Women’s Menopause Workplace Pledge. The pledge commits these great institutions and employers to be more menopause conscious by making simple adjustments, such as better ventilation and flexible working. These changes cannot be overlooked as they will help drive through the much-needed change and education that our society needs.

There has been cross-party support for taking the issue seriously. Change has already come in the Welsh Senedd, where Labour’s Minister for Education and Welsh Language, Jeremy Miles, has announced that menopause will now be on the curriculum for schools. I hope that the appointment of Wellbeing of Women’s Dame Lesley Regan as the first Women’s Health Ambassador is a sign of the UK Government’s commitment to long overdue change.

However, I will not hold my breath, as the very real legislative and societal change that is so desperately needed is still pending. Take my Private Member’s Bill (PMB) for example, in late October 2021, my PMB led to the Government committing to reducing the cost of Hormone Replacement Therapy (HRT) NHS prescriptions in England. Perhaps naively on my part, I patiently waited for the changes¾which would help more women access this much-needed treatment¾to be implemented.  However, despite co-chairing the UK Menopause Taskforce, it was at a Women and Equalities Select Committee meeting, in March of this year, that I learned that the promised single Annual Prescription Certificate for HRT would not now be implemented until April 2023¾a staggering 18 months after the Government committed to it.

This is a further cruel blow when access to HRT is already inequitably erratic across the country. Women face a postcode lottery, both in terms of whether their GP is confident in diagnosing and treating menopause and in the quality of the product being prescribed in their local area.

Continued HRT shortages

This farce is compounded by the staggeringly protracted HRT shortages. In England, HRT prescriptions increased from 238,000 in January 2017 to 538,000 in December 2021 and, following Davina’s most recent documentary, we are now seeing well over 600,000 prescriptions. Early spring this year saw the shortage reach record levels, as the most popular HRT product, Oestrogel, was in such high demand that it was being resold at hugely inflated costs online. The stock of suitable alternatives, Sandrena and Lenzetto, subsequently fell short, creating a crisis. The destabilising effect caused by frequently changing medication, and the anxiety of hunting for it, is unacceptable in 21st-century Britain.

I was reassured by the Health and Care Secretary at the time, that the shortages would be resolved by the end of June. A new HRT Tsar was appointed and Serious Shortage Protocols (SSP) were put in place, which gave pharmacists the ability to give alternatives for out-of-stock HRT without patients having to go back to GPs. Over 48 hours, I heard from well over 1000 women on my social media, all telling me just how desperate the ongoing shortages had become. I consistently heard how the SSPs weren’t being followed in parts of the country and how they were obstructive for those whose dosage was too high or intricate to be covered by the blanket SSP.

menopause HRT treatment
HRT Shortages have greatly affected many women across the UK

Long Term Aims

As we look to the future and the innovative ideas that World Menopause Day may bring, my long-term objectives remain clear:

  • 41% of medical schools do not have mandatory training for the menopause on their curriculums. Whilst we have been told that this will change¾women suffering now cannot wait¾this also needs to be accompanied by an enhanced training programme for current GPs and medical professionals.
  • There needs to be a national formulary created to tackle the postcode lottery of equal access to HRT and to help prevent future shortages by removing the anomalous geographical disparities between areas.
  • Whilst there are some excellent examples of good practice, we still need to see widespread workplace support for menopausal women through empathetic cultures, flexible working, lighter uniforms, better ventilation and other such policies.
  • It is vital that testosterone becomes available through the NHS. When we go through the menopause, we become deficient in all three hormones, so it is unacceptable that only two are being replaced for women who are unable to access private healthcare.
  • We need a public awareness campaign to be spearheaded by the NHS. It needs to target class, ethnicity and culture, reaching those that may be isolated from vital information so that it does not become a white middle-class issue. I recently learned that in South Asian communities, there is no word for menopause, so just imagine the disparity in understanding across our country.

I sincerely hope that this coming year will see the changes we need. There is no area of social policy that the menopause does not touch and so, by making these changes, our whole society will be better off. I will continue to hold the Government to account on this to ensure that they honour their commitments to improve menopause support and services¾for women today, for our daughters and for generations to come.

This article was first published in Chamber’s quarterly journal. If you wish to read more fascinating insights, you can access a pdf of the journal here and register to receive the next journal when it is published here.

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