Menopause

Claire Hanna Excerpts

Thursday 9th June 2022 Westminster Hall

[Claire Hanna (Belfast South) (SDLP)]

It is a pleasure to serve under your chairmanship, Mr Robertson, and I offer my warmest commendations and congratulations to the hon. Member for Swansea East (Carolyn Harris), who has done such a magnificent job of raising awareness and understanding of the menopause. She has ensured that many women feel heard and understood, but crucially has also galvanised change—information, services, policy, and a strategy—to normalise and support something that half of the population are going to go through at some point. Many of us share her righteous frustration about the delay in implementing many of these changes, but the conversations and actions of the hon. Member and others now constitute a real movement for change and progress in this area, so that fewer women will suffer in silence or experience anxiety and ill health.

I also commend the Chair of the Women and Equalities Committee, the right hon. Member for Romsey and Southampton North (Caroline Nokes), whose Committee is on the frontline of so many of the issues facing women, and the all-party parliamentary group on menopause that is capturing and organising all of the actions and ideas that are now flowing.

I particularly want to speak up for women in Northern Ireland, who feel that this—like other issues that affect women, women’s health and women’s lives—is an area in which we are lagging behind other parts of these islands. Over the past couple of years, primarily through the entry point of HRT supply issues, which Members have referenced, I have been engaging with constituents and others about the need for a co-ordinated approach to menopause support, one that is funded and joined up between the many Departments and areas of responsibility that have been identified today, and hopefully will be ultimately underpinned by legislation. That approach, of course, starts with awareness and understanding, which thankfully is improving as a result of many of the people in this room and others pushing the issue.

Last night, I posted on social media that I would be taking part in today’s debate. I was amazed by the number of replies from people who are experiencing challenges with the menopause and those who are just delighted by this fresh climate of support and action. Many had very developed and constructive ideas for how to improve the situation.

I am grateful to all the people who got in touch, particularly Siobhan Kearney of At One Wellbeing and Anne McGale at Menopause Wellbeing NI for sharing with me the benefit of their research and experience as practitioners. I also pay tribute to Marie-Louise Connolly, BBC Northern Ireland’s redoubtable health correspondent, who has been brilliant at forcing this issue on to the agenda in Northern Ireland and keeping it there; Members will appreciate that the policy agenda in Northern Ireland is fairly cluttered at the best of times.

Although many will experience few or manageable menopause symptoms, for some women the menopause is intense and bleak, and women often enter into it without having the right information or the right access to decisions. One woman—a robust and well-regarded professional at home—told me:

“I’m going through it. It’s something I find difficult to discuss. I’m surprised at myself but just can’t. Rotten symptoms, making life miserable. Open to HRT but due to personal and family medical history, it might be difficult. GP says I need to see specialist at the clinic in Belfast but the waiting list is 4 years...It feels like a death sentence, bringing back trauma about family and my own medical conditions, and my physical symptoms make me feel like a stranger in my own body which is attacking me. It feels like a death sentence, there is no escape.”

I found that really difficult to hear from somebody I regard as strong and confident and able to articulate herself well. I feel so much for others who may be unnecessarily going through this situation in the dark, without knowing that there is a definable cause and without knowing that there are things that can be done to help them. I also heard from other women who had been in a very difficult place but who now, having received the right support, are on the other side and desperate to ensure that other women need not fight the same battle that they have.

The dearth of appropriate services is a core problem. Although many GPs have been brilliant, and able to guide and advise their patients, we know that primary care is overwhelmed and under-resourced. Many people cannot get access to their GP, or there is inadequate continuing professional development and education for GPs on this issue, and insufficient time for them to explore and pinpoint some of the issues, so that they can holistically address them. Then, of course, there are few or no specialists to refer to. Enhanced specialist clinics now available in the south of Ireland. There are two in Northern Ireland, but the majority of NHS trusts do not have one, and I have already referred to the long waiting lists.

We know that many doctors are either not sold on HRT or are cautious about complicating factors, and people often tell me about the pushback that they have experienced. I am not sure whether other Members are watching “Borgen”; if they are not, I warmly recommend it, as it is an excellent series. I was struck, while watching the new episodes on Sunday night, that the brilliant character of Birgitte Nyborg, a former Prime Minister and former Foreign Minister, had a scene in which she explained her menopause symptoms and the impact they were having on her work. I was struck by her being, I suppose, brushed off. I mean, medical reasons were discussed, but I thought it was telling that a woman with all of that character’s powers of communication also felt unable to access the services that we need.

Numerous constituents report feeling brushed off or—of course—being offered inappropriate antidepressants. Members have addressed the acute problems caused by shortages of HRT drugs and I ask the Minister when the HRT tsar is expected to be able to report. That issue is causing real concern for people who are worried that, having finally found this solution to their problem, it will suddenly drop. I am hearing of people sharing medication, which obviously brings its own complications.

Menopause is also very much a workforce issue. Currently, about 9 million women in the UK are experiencing or will experience the menopause, and around 3.5 million of them are in the workplace. Policy is not in place to support and protect those women, who might be experiencing some of the symptoms that have been referred to here today, including tiredness, anxiety, brain fog, mood swings, headaches, joint pain and the spill-over effects from things such as insomnia and relationship challenges that the menopause can exacerbate.

There is no policy in place to protect and retain the huge skills and experience bank that these women offer. Other Members have referred to the point in people’s lives and careers when they are particularly valuable for the workplace, so the menopause is also an economic issue. If more women have to leave the workforce, that will exacerbate existing issues such as the gender pay gap. We are all increasingly aware of the benefits for public policy, decision making and economic activity when women are at the table. We know that childbearing and caring responsibilities mean that many women are deleted from that area of their lives and face marginalisation and exclusion later in their careers or soon after.

A growing number of employers are taking the issue very seriously and putting policy and guidance in place, but that is far from universal, perhaps due to lack of awareness, embarrassment, or not understanding the relevance. Workplaces need guidance and, in time, legislation to ensure that that guidance is in place. They also need support. Some practitioners have developed a really good skillset and go into workplaces big and small.

Menopause is an economic issue and an equality and public health issue. We need to normalise all aspects of women’s health so that they can be addressed like every other health and wellbeing issue, so that people do not feel alone, inadequate, confused or unprepared, and so that they feel empowered to make choices, whether about their lifestyle or medical support, to help them walk this path.

In her excellent speech, the right hon. Member for Romsey and Southampton North was right to say that this is not an ideological issue, but there is no doubt in my mind that if men experienced a similar, universal change, it would be a massive part of political discourse and culture. I can imagine all the movies and books that would be made and written about this time in life. Given that issues such as menstruation, women’s reproductive health, low-paid care work, the pension changes experienced by WASPI women, and childcare primarily affect women, they do not reach the top of the policy agenda. We need to address that.

We also have an opportunity to establish menopause as a rite of passage—hopefully, a rite of passage to a stage in a woman’s life when they are valued for the benefits, talents and wisdom that come with having lived decades of life. I commend the motion, the work and all the policy suggestions that have been made here today.