Study finds millions of women face ‘unnecessary misery’ in menopause


Menopausal women are caught up in a ‘national scandal’ which sees as many as one in ten forced to leave jobs due to debilitating symptoms, according to the largest study of its kind. 

Researchers say women are put through ‘unnecessary misery’ – with the equivalent of 333,000 aged 45 to 55 quitting work while suffering from symptoms such as brain fog, lack of sleep, hot flushes and depression. 

A further 14 per cent of women in the UK have reduced their hours at work, 14 per cent decided to go part-time and 8 per cent had not applied for promotion while going through the menopause. 

And 77 per cent of women find at least one menopause symptom ‘very difficult’ to cope with. 

So if you can’t get hold of HRT, what are the alternatives — and do they work?

The survey of more than 4,000 women aged 45 to 55 lays bare the hardships faced by menopausal women – and the dire need to remedy the nation’s HRT crisis. 

On Saturday, the Daily Mail launched a manifesto calling for urgent changes to the way HRT medication is prescribed, processed and distributed. 

It also demands an immediate curriculum change, making it mandatory for medical students to be taught about the menopause, and for women to be given menopause information at NHS health checks. 

Our HRT manifesto 

1. Allow pharmacists to dispense substitutes if the prescribed HRT is out of stock

Currently, if an HRT product is unavailable, a pharmacist cannot substitute another product without consulting the prescribing GP, forcing patients to go back and forth between doctor and pharmacy. This could be avoided if pharmacists are allowed to alter prescriptions themselves. They should also be able to move stock between different pharmacies.

2. End the postcode lottery

Local areas all have different formularies – or lists – of approved HRT products, meaning women face a postcode lottery of treatments. A national list of all approved HRT products would ensure women have equal access, and that alternative treatments are available faster.

3. Immediately introduce the once-a-year payment for HRT medication

An annual prescription payment for HRT, which could save women up to £200 a year, is planned for April 2023. This must be implemented urgently, especially during the cost-of-living squeeze, so all women can afford treatment.

4. Bring forward mandatory requirement for medical students to be taught about the menopause

A curriculum change needs to be introduced sooner than January 2023, when it is planned. This will ensure all doctors have the training to recognise menopause symptoms, which will help reduce the rate of misdiagnoses.

5. Provide menopause information to women at their NHS health check

Everyone who doesn’t have a pre-existing medical condition is invited for a free check-up every five years between the ages of 40 and 74. Women should be given information at these health checks to raise awareness of the menopause and treatment options.

It comes after supply chain problems and poor planning amid unprecedented demand have led to a shortage of HRT, mostly a type of oestrogen gel. 

In recent months women who rely on the treatment to ease the side-effects of the menopause have been left ‘suicidal’, and desperation has led to a ‘gold rush’ on pharmacies with stock, with some likening the situation to wartime rationing.

The new research, which is believed to be the largest survey of menopausal women conducted in the UK, was commissioned as part of a Channel 4 documentary presented by campaigner Davina McCall, which airs tonight at 9pm. 

The study revealed nearly a third of women agreed it took many appointments for their GP to realise they were menopausal or perimenopausal. 

Just 39 per cent of women who spoke to a GP or nurse said they had been offered HRT after diagnosis, and 44 per cent experience three or more symptoms they class as ‘very difficult’, such as brain fog and joint pain. 

The survey was supported by the Fawcett Society, a women’s rights charity, which has produced a report, Menopause And The Workplace. 

Its chief executive Jemima Olchawski said: ‘Menopausal women are experiencing unnecessary misery and it’s a national scandal. From waiting too long for the right care, to uniforms that cause unnecessary discomfort, women are being badly let down. Too often menopause symptoms have been dismissed as a joke and HRT has been labelled a lifestyle drug. 

‘The Government needs to make urgent changes, from requiring employers to have menopause action plans, to creating a route into menopause healthcare, to ensuring that GPs are adequately trained to spot menopause symptoms.’ 

Miss McCall, 54, added: ‘One out of ten women quit their jobs due to menopause. This really broke my heart… because these are women at the top of their game and then they just can’t cope in their jobs any more. We’re talking teachers, doctors and nurses. And if we don’t look after them, who is going to look after us?’ 

Prescriptions for HRT have more than doubled in England over the past five years, according to NHS data. 

Figures from OpenPrescribing, an Oxford University project that analyses prescription trends, suggest that nearly 538,000 for HRT treatment were issued in December, compared with 238,000 in January 2017.

I’ve thrown plates and sobbed… don’t deny others the help I got

By Penny Lancaster for the Daily Mail

Not long after the start of the first lockdown, I called Rod and our boys Alastair and Aiden down to the kitchen for dinner. 

No one came, not even after the third call – and when they finally did arrive, they were arguing. 

I lost it, throwing their dinner plates across the room and breaking down in floods of tears on the floor.

I remember Rod asking me what on earth was wrong, but the truth was that I really didn’t have a clue why I was experiencing such violent and upsetting mood swings, which meant some days I would feel completely devoid of feeling, while on other days I would be hyper. 

I thought I was losing my mind and it was only months later, while appearing as a panellist on Loose Women, that my colleagues put me straight. 

‘Penny, you’re perimenopausal,’ they told me. ‘It’s all down to your hormones.’ I could hardly believe it, especially as I’d described my symptoms to my doctor and he had promptly put me on anti-depressants. 

Penny Lancaster with her husband Sir Rod Stewart, who she says felt worried about her mood swings when she became perimenopausal

Penny Lancaster with her husband Sir Rod Stewart, who she says felt worried about her mood swings when she became perimenopausal

Of course, they were correct. After all, I was 49, exactly the right age. With their urging, I consulted a menopause specialist, started on HRT and within a few months, I felt like I was back to my old self. 

The hot flushes, the night sweats, the brain fog and the heart-palpitating anxiety that had blighted the previous year and left me feeling like I was going mad – all gone. It’s one reason I am so angry about the difficulties women face in accessing this vital treatment, whether it’s getting their hands on it or being able to afford to pay for it. 

It seems extraordinary to me that a life stage that affects half our population is still not being treated with the importance it deserves, and as someone in a position where I have a platform to speak out, I became passionate about campaigning for better access to HRT – and making it subject to just a one-off annual prescription charge.

So  I’m delighted that the Mail is throwing its weight behind a cause so close to my heart. 

Like many women, I was in the dark about the changes the menopause would bring. I started having hot flushes at the beginning of the pandemic back in early 2020 and at first, I was convinced I had the virus. I was terrified – back then we were all in the dark. 

All I knew was that I would wake up in the middle of the night feeling like the bed was on fire. I’d move on top of the covers to try to cool down, only to wake up freezing cold 20 minutes later. 

I was anxious and irritable too, prone to bursting into tears, but like everyone else, Rod and I were juggling the stress of home-schooling as well as worrying about loved ones, so I put my occasional meltdowns down to the situation we – everyone – were in. 

Covid probably played a part, but there was no question my symptoms were getting worse. I’ve always been able to pull myself out of a crisis, but this time I couldn’t. I’d go to bed anxious and wake up anxious. 

Some days I felt so low, so flat, that you could prick me with a pin and I wouldn’t feel it, but on other days it was the complete opposite – I’d be worked up over the smallest thing, just like when Rod and the boys were late for dinner.

 Naturally, Rod was worried. ‘What’s happening with you Penny?’ he would ask. ‘I hate seeing you like this.’ 

We’ve talked since about how hard it was for him to see the happy-go-lucky woman he married change so dramatically and not be able to do anything about it. In fact, it was Rod who persuaded me to go to the doctor, who promptly put me on antidepressants. They didn’t work, because I wasn’t depressed – I was perimenopausal. 

Anti-depressants were like putting a sticking plaster over a deep wound – a mask, but not tackling the root cause. I now know this is a very common error. It wasn’t until several months later, in spring last year, that I had that lightbulb moment. 

I’ll be honest: a part of me didn’t want to resign myself to getting old. The word menopause can feel terrifying, something that signifies the end of everything – your youth, your sex appeal and your sex drive. It’s hard to say goodbye to that. My Loose Women friends got me to see it differently – not as an ending but a new beginning, an exciting new chapter that I should embrace. 

A nurse also made me recognise something profound. She said that after years of putting their own needs last, this was a life stage where women could look in the mirror and say: ‘I see you.’ 

She told me: ‘Life isn’t just about making sure everyone else is OK.’ It took time, but as my hormones started to rebalance, it was like magic. I could feel the old Penny coming back, but this time with a renewed sense of purpose.

Today, I can still get emotional, both happy and sad, but I feel back in control – albeit more opinionated, as Rod has pointed out. As I told him, maybe that was one bit of my pre-HRT life that I didn’t want to let go! I know I’m lucky that Rod has been so supportive. 

We’ve always been good at communicating with one another and his empathy for what I was going through turned into a determination to encourage other men to educate themselves. He recognises that this isn’t just a women’s problem, but everyone’s problem – or it should be. 

I’m so proud of him for speaking up about it. Not everyone is so lucky: since becoming an ambassador for the Menopause Mandate, which is campaigning to raise vital awareness and to support the cause for change, I’ve realised just how many of us are suffering in silence, or whose lives have been horribly affected by the transformation the menopause has brought for them. 

Women have lost their jobs, their homes and their partners from being unable to manage their symptoms. 

Some have been left so devastated that they have taken their own lives. I was shocked to learn that the biggest risk group for suicide for women is 45-54, but it’s not hard to work out why. 

It’s heart-breaking – especially when for most of them help is out there, if only they can get their hands on it. I think it’s ridiculous that we have a postcode lottery in terms of access to treatment. 

NHS prescriptions for HRT are free in Scotland and Wales, yet in England women can face paying nearly £20 a month to get their life-changing treatment. At a time when we are facing a cost-of-living crisis, I have no doubt that for some women this will put it out of reach.

 What kind of a society are we when women have to make a choice between looking after themselves and putting food on the table for their children? Hopefully, with the work of the Mail and the Menopause Mandate, all this will change. 

We’re climbing this mountain now and we won’t stop until every man and woman can hear us. I hope that when we reach the top, we can ensure that the millions of women in the UK who are going through the menopause right now can get easy access to the treatment they need.

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