Public Policy Projects is currently developing a long-term ‘State of the Globe’ policy project on the women’s preventative healthcare agenda, which hopes to address the international gender inequities in women’s health data, research and policy.

The insights from this online event will be consolidated, developed and used to inform the future of this project. The State of the Globe report will propose gender sensitive indicators and implementation plans which aim to create a more equitable healthcare landscape and will be launched at the Commission on the Status of Women (CSW) in 2022.

All the one hour programme is worth watching but especially the presentation by the BMS chairman (at approximately 14:40), whose ten minutes script on Menopause is reproduced below the video. The final session by Dr Alison Giles, Public Health England, on healthy ageing (37.40 – 50.13), is also most interesting, including her concerns about women as an integral part of the work force.

Transcript: Haitham Hamoda, BMS Chairman

Thank you very much for inviting me to take part in this event to celebrate International Women’s Day.

Menopause is a major life event that can affect women in a variety of ways. The menopause marks the end of the reproductive life cycle and its impact can be both short and long term.

The average age of the menopause in western countries is 51 years and with average life expectancy in developed countries now exceeding 80, it is likely that many women will have approximately a 1/3 of their lives after the menopause and many women may experience troublesome symptoms related to the menopause for a number of years. This can have a detrimental impact on their quality of life, wellbeing and may also have a significant impact on their personal relationships and work.

Whilst most women attribute hot flushes, night sweats and perhaps the impact of urogenital atrophy to the menopause, many do not associate other symptoms (such as tiredness, low mood, anxiety, poor memory and concentration, sensation of brain fog) to the menopause and worry about the cause of these symptoms or may fail to understand why they are experiencing them.

Menopausal symptoms affect >75% of women. So whilst not all women going through the menopause will experience menopausal symptoms, the majority will and over 25% describe severe symptoms.

Menopausal symptoms may last for a long time with an average duration of 7 years, and 1 in 3 women experience symptoms beyond the 7 years.

In addition, to menopausal symptoms the menopause can have a detrimental effect on bone health and CV heath, increasing the risk of osteoporosis and cardiovascular disease.

HRT remains the most effective treatment for menopausal symptoms and in addition has a protective effect on bone and CV health.

However, the risk of breast cancer with HRT is a cause for concern for many women. And whilst there is an increase in this risk, it remains low in both medical and statistical terms, particularly when compared to other modifiable risk factors such as obesity (6 fold higher increase in risk of breast cancer compared to HRT) and alcohol intake (a small glass of wine a night has a higher risk of breast cancer than that associated with HRT.

This slight additional risk should be taken in the context of the overall benefits obtained from using HRT in improving quality of life as well as improving bone and cardiovascular health. As such for the majority of women taking HRT the benefits outweigh the risks.

In addition to its personal impact on individual women, the menopause can have a significant impact on the workforce. It is reported that 70% of women are in paid employment. Women constitute approximately 50% of the UK workforce and it is estimated that there are more than 4 million women aged 50 and above in employment in the UK. Over last 30 years employment for women aged 55 and over has gone up by approximately 30% and this is likely to continue to rise.

What would we like to see?

Patient perspective: The BMS believes that all women should have access to accurate information, and be able to seek advice on how to optimise their menopause transition and the years beyond.

It is important to look not only at the role of HRT when discussing the menopause with women but also the impact of lifestyle and diet (exercise, optimizing weight and reducing alcohol intake) which can all help in alleviating menopausal symptoms. Management should also be individualized to the needs of each woman rather than a one size fits all approach.

Healthcare provision: The BMS also believes that all healthcare professionals should have a basic understanding of the menopause and know where to signpost women for advice, support and treatment where appropriate.

In this respect, we advise that primary care teams should aim to have at least one nominated healthcare professional with a special interest and knowledge in menopause.

Employment: The BMS also believes that there is an urgent need to raise menopause awareness in the workplace including among all managers and staff.

There is also a need to ensure in the recovery phase of the pandemic that menopause services are not overlooked. And there is also an ongoing need to support GPs to maintain menopause service delivery in the current climate.

To further support the training of HCP, in 2020 the BMS launched a new training programme to further support the provision of menopause care in the UK and also developed virtual educational programme and meetings to ensure the provision of education continues during the pandemic.

And finally, we would encourage HCP looking after women to guide them to the BMS website and to the website of Women’s Health Concern, the patient arm of the BMS, where they can access written information and educational videos, identify their local menopause services based on their post code as well as links for further resources to guide and support them.

Many thanks and I would be happy to take any questions on this during the Q&A session.