Menopausal hormone therapy can address the short- and long-term impacts of menopause, but many women are not able to access it
For many women, menopausal hormone therapy can be transformational in relieving symptoms and improving quality of life. Menopausal hormone therapy can also help prevent cardiovascular disease and osteoporosis. But it is not suitable for all women and clinical guidelines recommend an individualised approach to treatment that takes into account a broad range of risk factors. Ideally, healthcare professionals should provide enough information about menopausal hormone therapy that women can decide for themselves whether or not to use it.
Many women are not able to access the treatment they need. A UK survey of more than 5,000 women experiencing menopause or perimenopause found that although 79% visited their GP about menopause symptoms, only 37% were given menopausal hormone therapy. Despite national menopause guidelines clearly stating that antidepressants are not a suitable first-line treatment, 23% of the women were prescribed them instead.
The survey also highlighted significant delays in care, with 44% of the women who received treatment waiting a year or longer, and 12% waiting more than five years. As a result of this waiting time, many women who can afford to pay for healthcare turn to private clinics, contributing to health inequalities.
These challenges are worrying for all women, but they may disproportionately affect those belonging to ethnic minority groups and LGBTQ+ communities. These individuals have reported having negative experiences when seeking appropriate care and feeling under-represented in the research and narratives surrounding menopause.
Stigma, shame and a lack of representation contribute to low awareness of symptoms and a hesitancy to seek care
Women experiencing menopause can only get support and treatment if they recognise the symptoms and know to reach out to a healthcare professional for advice and information. However, many women are not aware of what to expect from menopause and do not feel well informed.
This may be due in part to a huge void in the public and cultural discourse around menopause. Rarely is menopause mentioned in films or television, which may make the women who are experiencing it feel invisible. It may also mean that some women do not recognise their symptoms as menopause related.
Alongside the stigma and shame around menopause, and around ageing more broadly, this lack of knowledge can be a barrier to seeking care.
Gaps in knowledge about menopause among healthcare professionals are exacerbating the problem. In fact, an unacceptable 40% of the UK’s medical schools that responded to a 2021 survey do not include mandatory menopause education as part of their curriculum. Instead, they assume that healthcare professionals will receive this education during their early years of medical practice, which may not always be the case.
This means that accessing appropriate treatment and care for menopause is often not straightforward.