Menopausal symptoms: Awareness is growing among patients and GPs
Over the past year, increasing media attention on women’s health and the menopause has had a striking impact on women’s awareness of these important issues.
With celebrities like Davina McCall talking openly about their experiences of menopause, and MPs debating the issues in Parliament, more women now know about the symptoms and are seeking help when they need it. Yet, many women are still not finding the support they require from their GP. Instead they are resorting to private practice and menopause clinics.
Unfortunately, many GP practices are not yet fully equipped with the expertise to help women deal with menopausal issues. However, awareness is increasing among GPs too.
The impact of menopausal symptoms on daily life
The vast majority of women will experience symptoms related to the menopause. Some symptoms can be severe and interfere with daily life for many years. In fact, 10% of women leave their jobs due to the menopause. Even among NHS workers, including GPs, menopausal symptoms often lead women to cut back their hours and even quit medicine.
With symptoms including hot flushes, insomnia, brain fog, mood disorders and osteoporosis, the physical and mental consequences of menopause can be devastating for women and their families. A recent article highlights the impact on mental health and risk of suicide. Importantly, suicide among women peaks during the time of perimenopause and menopause, between the ages of 45 to 54 years.
GPs need more up-to-date knowledge on treating menopausal symptoms
Despite the availability of effective treatments, only a small proportion of women with menopausal symptoms receive help and there is marked inequality of access to hormone-replacement therapy (HRT). Historically, many women have suffered in silence because of taboo and lack of awareness. When they have sought help, many have felt ignored or fobbed off by GPs. Diagnosis often takes years and misdiagnoses are all too common.
Unfortunately, some GPs lack the knowledge and skills to manage menopause-related symptoms, and after years of negative press about HRT, many remain unwilling to prescribe this effective treatment. However, with awareness growing, there are signs of change.
Fortunately, the government recently committed to cut the cost of HRT prescriptions, a welcome move for those who need treatment.
Increasing appetite for information among GPs
The Menopause Charity was launched in May 2021. This provides a wealth of information about menopause symptoms and treatments. The charity also provides a free, CPD-accredited video course for healthcare professionals, Confidence in the Menopause, which shows how to provide evidence-based information and prescribe HRT safely. Already more than 14,000 have downloaded this course, reflecting the increasing appetite for up-to-date information.
GPs have limited mandatory training on menopausal issues. However, Clinical Lead for Women’s Health for the Royal College of GPs, Dr Anne Connolly, said: “The College has worked with partners including the British Menopause Society and Royal College of Obstetricians and Gynaecologists to develop educational resources for GPs on women’s health.”
“This includes resources about menopause as part of toolkits on women’s health and menstrual wellbeing, e-learning resources and events, and our popular Women’s Health Online Library.”
Women are also seeking more information. GPs can encourage patients who are perimenopausal or menopausal to download a free app containing easy-to-read information and a symptom tracker, which will generate a health report to form the basis of a conversation.
Menopause support for women in the workplace
With menopausal women being the fastest growing demographic in the workforce, campaigners have been calling for more menopause support in the workplace. Importantly, there are signs that trade unions and other strategic bodies are starting to take this seriously.
It is a win-win for all if employers can support staff to work through the menopause by fostering an environment where they feel comfortable raising the topic with managers and are signposted to appropriate information and support.
Good advice and training on menopause issues is available for employers, including from NHS Employers and from Acas, the independent Advisory, Conciliation and Arbitration Service.
Medical Defense Society is happy to help any GP needing medico-legal support to develop their work in managing menopausal symptoms.
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