Menopause

Jim Shannon Excerpts

Thursday 26th October 2023 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for raising this issue. It is a massive issue for my constituents and the personal experience through my own wife is very clear. Given that 10% of women leave work during the menopause, saying that they feel and have felt unsupported and unable to continue—which really should not be the case—does he agree that there should be a greater obligation on businesses to help women?

[Peter Dowd]

That is another point that I will touch on later, but the hon. Gentleman is spot on.

Anyone who happened to be in Westminster Hall on Wednesday last week will be able to testify to the work that the APPG has done. More than 100 Members and others gathered for a photograph to mark and celebrate World Menopause Day. My hon. Friend the Member for Swansea East said she was not sure that visitors to Westminster Hall were ready to see so many women parliamentarians and others doing impromptu exercise squats. However, she also said that, if it was a good enough location for Henry VIII to play real tennis, it was certainly good enough for a group of menopausal women to highlight the benefits of exercise to their physical health and mental wellbeing.

The fact that those influential women, grassroots campaigners and clinical experts were brought together in Parliament showed the world that Westminster was listening; but listening alone is not enough while women continue to suffer. Listening will not help them get a diagnosis or access to treatment, or find the support they need. That requires action, and on World Menopause Day the APPG, which is chaired by my hon. Friend the Member for Swansea East, launched the menopause manifesto. Based on evidence that the group gathered by speaking to those affected by the menopause and experts in the field, the manifesto sets out seven recommendations, which we are urging all parties to adopt in their own manifestos ahead of the next general election.

I cannot stress enough how important it is to the 13 million women in the UK who are currently perimenopausal or menopausal, and to all around them who are indirectly affected—the hon. Member for Strangford (Jim Shannon) raised that point—to know that those in power will support them. The first recommendation in the manifesto is for health checks. Every time that is mentioned in conversation, people are genuinely surprised that it does not already happen. Many will remember receiving, on turning 40—along with the cards, gifts and the good wishes—an invitation to a 40+ NHS health check. Those “MOTs” monitor our weight and blood pressure, and are used to assess the risk of developing conditions such as diabetes, heart disease and strokes. What they do not include for women, at present, are any questions about, advice on or reference to the menopause, which is at best a surprise and at worst quite shocking.

There is strong evidence showing that many women are accessing primary care and being treated for individual symptoms because neither they nor their clinicians are recognising the root cause of those symptoms—a point raised earlier by my hon. Friend the Member for Blaenau Gwent (Nick Smith).

By raising awareness among medical professionals, who can, in turn, help to educate women at their 40-plus health checks, we can reduce the number of extra visits that women make to surgeries and prevent further misdiagnosis and inaccurate prescribing. We can also dramatically increase the number of women who get prompt and correct diagnoses and access to treatment pathways. We know that this would save the NHS money in the long run.

Many healthcare providers are now starting to include menopause in their standard packages, having identified the fact that patients are being sent for appointments in secondary care for an array of symptoms that have not been correctly diagnosed as menopause. By including menopause treatment as standard, they are reducing the cost to the NHS of these unnecessary appointments.

The second recommendation of the APPG’s manifesto is a national formulary for hormone replacement therapy. Although HRT is not the answer for all women, millions across the country rely on this treatment to manage their symptoms. We know that, in a 10-minute consultation, prescribers do not have the capacity to go searching for alternative treatments if a patient’s usual product is out of stock, and we have seen a supply shortage for many of these products. A national formulary would resolve this issue, as all eligible products would be easily accessible on surgery systems, thus eliminating the postcode lottery and regional variations that women are currently experiencing.

[Jim Shannon]

The hon. Gentleman is most gracious in giving way. He mentioned that there are sometimes disparities from, say, county to county. There are also regional disparities. I know he accepts that, and the Minister has taken note too. When it comes to providing better treatment, a recommendation has to be that every part of the United Kingdom—England, Scotland, Wales and Northern Ireland—should have an agreed strategy for helping women. Does he agree that there should be the same policy, the same strategy and the same response everywhere?

[Peter Dowd]

I agree with the hon. Gentleman. It is crucial that women are able to go to any surgery and, although there may be marginal differences in treatment or access to treatment, the substance is that they should ultimately get more or less the same access and the same treatment, depending on their needs.

The third recommendation also relates to prescribers. The manifesto calls for the inclusion of menopause as an indicator within the GP quality and outcomes framework. This change would help to balance the deficit in knowledge and understanding among GPs by incentivising improvement in diagnosis levels and treatment provision within primary care. If clinicians were better informed, they would be more confident in discussing menopause with patients at their health checks and in prescribing appropriate treatment, which would greatly benefit patients who visit their GP to seek support.

Moving away from healthcare, I am proud to say that, earlier this year, Labour committed to the fourth recommendation: mandating that all companies with more than 250 employees introduce menopause action plans to support those experiencing symptoms. That goes some way to addressing the points raised by hon. Members.

Alongside this, the APPG would like to see the provision of specific guidance for small and medium-sized enterprises and the introduction of tax incentives to encourage companies to integrate menopause in their occupational health plans. There are great examples of companies embracing the issue, and there are some excellent tools available to help, such as the British Standards Institute’s menstruation, menstrual health and menopause in the workplace standard. With research showing that one in 10 women are leaving the workforce and thousands more are reducing their hours or avoiding promotion, it is vital that more is done to address the impact of menopause on women’s economic participation.

The APPG is not asking for women to be given special treatment; we are asking merely for an understanding that working arrangements and environments may need to be flexible. This willingness to incorporate flexibility will benefit businesses, boost the economy and give women the confidence to progress in their career.

The manifesto’s fifth requirement is about the licensing of testosterone for women. It has always struck me as odd that when women reach menopausal age, which is different for everyone, they become deficient in three hormones—oestrogen, progesterone and testosterone—yet only the first two are available to women when they are prescribed hormone replacement therapy on the NHS. As my hon. Friend the Member for Swansea East has noted previously, if a woman wants the third hormone, they have to pay for a private prescription. The all-party group is calling for an evaluation of female-specific testosterone treatments, with a view to their being licensed by the Medicines and Healthcare products Regulatory Agency.

In the sixth recommendation, we are calling for better funding for research into the potential links between menopause and other health conditions, as well as the varying experiences of women from different backgrounds and ethnicities—that is very important. We know from the evidence that the APPG has received that those with conditions such as autism and attention deficit hyperactivity disorder can struggle more with their menopausal symptoms, and that those who have been treated for cancer often experience early menopause. So it is vital that much more is done to better understand the different journeys that women from different backgrounds are experiencing. In the past week, my hon. Friend told me said that she had been lucky enough to visit two universities, one in London and the other in her own home city of Swansea. Both are keen to do more to support their staff and to bridge the significant gaps in understanding around more complex menopause experiences.

[Jim Shannon]

I thank the hon. Gentleman very much for the scene he is setting. Small and micro-businesses are predominantly male-owned, so the issue for them is understanding how to put over the requests on behalf of ladies who are going through the menopause. Does he feel that the Government and the Minister should take that on board as well, to ensure that those businesses have the relevant information and guidance to do that within the small workforce that they look after?

[Peter Dowd]

The hon. Gentleman makes a good point and sets out an excellent idea. I am sure that the Minister, as part of the expansion or integration of the manifesto, can take it on board.

As I was saying, my hon. Friend was delighted that Swansea University announced last Friday that it would be introducing menopause into the curriculum for all of its medical students, as well as launching a menopause clinic for staff and students. I truly hope that it will be the first of many universities to do this. Future policy in this area, and an improved women’s health strategy, will be possible only if more funding is dedicated to this vital research.

The seventh and final part of the manifesto calls for a review of the demand for specialist menopause care. We need to look at existing provision, evaluate where increased secondary care is needed and assess other ways in which women could seek help. That might, for example, include access to specialist nurses in primary care and pharmacists, to ease the demand on GPs. That is another simple recommendation that would be easy to achieve, while having a significant impact on the care and support that women are able to access.

Nothing in the all-party group’s manifesto is difficult to achieve; no big contracts or big budgets are needed to make the changes that will significantly improve women’s experiences. The only thing that is needed is a commitment to prioritise this area of women’s health. We need a commitment to improve support, diagnosis and access to treatment for all those who need it. Who would not want that? I know that every Member of this House would want it. We need a commitment to show the 51% of the population who will directly experience menopause that they matter—that they really matter.

[Eddie Hughes (Walsall North) (Con)]

It is an absolute pleasure to follow my good friend the hon. Member for Bootle (Peter Dowd). I was originally excited to see that the hon. Member for Swansea East (Carolyn Harris) was going to be opening the debate, simply because her enthusiasm for this subject is contagious and draws people in, but he has done incredible justice to the opening of the debate.

It is marvellous to see a number of male colleagues in the Chamber. I grew up in a house with five brothers and an Irish Catholic mother, and the word “menopause” would in no circumstances ever have crossed her lips. I then went to an all-boys school and went on to do civil engineering at university. There were no girls at my school and just two women on my civil engineering course, in the whole of the department, so my exposure to women was somewhat limited until I finally got off the building site and into a traditional workplace. There I found that men whose experience was not as sheltered as mine had no greater knowledge or understanding of this topic, although I felt they had far less excuse.

So when my wife began to experience the symptoms of the menopause, originally neither she nor I, nor her GP, fully understood what was going on—certainly, menopause was not the initial diagnosis. That highlighted for me how difficult and challenging it must be for some women: they present to their GP, the GP misdiagnoses or misunderstands their symptoms, and then the problem is protracted because the appropriate treatment is not identified quickly enough.

With an understanding of that and as an MP representing the good people of Willenhall, Bloxwich and Walsall North, it was important to me to engage as much as possible with people who could help. We found a place for a menopause café—somewhere where women and men could come and sit down and talk about this topic, over a cup of tea and a slice of cake, in a relaxed environment. I think it is beholden on us, particularly male colleagues, in our role as MPs, to do everything we can to ensure that everybody is as well informed as possible. As I said in my intervention, in our male roles as family members, friends and relatives, it is incredibly important for us to first understand the symptoms and the range of appropriate treatments available, so that we can fully provide the necessary support.

[Jim Shannon]

The hon. Gentleman has mentioned families, groups and work colleagues. Does he agree that women who go through early menopause may find it difficult to discuss the subject with their employers? Those conversations need to be had, to ensure that women of any age are supported and enabled to engage fully in all aspects of their workplace instead of being excluded, perhaps unintentionally.

[Eddie Hughes]

I thank the hon. Gentleman for that intervention. Given that my wife, myself and her GP did not fully understand what the symptoms were and at what age they could arise, it is completely understandable that an employer might be challenged in terms of providing such support. That is why it is vital that we do our best to ensure that everybody is as well informed as possible, because, exactly as the hon. Gentleman says, such symptoms might start to appear at any age, so it is important that their root cause is identified quickly and people can provide that support.

I am delighted to say that, now that my wife has a very senior role in her company, it is easier for her to drive that ethos throughout the company. I pay credit to phs Group for its work countrywide. I have invited the hon. Member for Swansea East to come and speak at one of its offices in the south of Wales—I hope we can arrange that soon.

I pay tribute to all colleagues in the Chamber today, particularly the men in our role as champions, fighting side by side with the women to ensure that this topic is completely understood by as many people as possible, so that we can all provide the support that is so well deserved.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Member for Bootle (Peter Dowd) for setting the scene so well. I have made a few interventions, but I will add a few words to put on record my support for the motion, as I am here on behalf of my party.

The hon. Member for Walsall North (Eddie Hughes) made an interesting point to which I subscribe from a personal point of view. My wife Sandra went through this, and it was quite difficult for her, not just physically but emotionally. The hon. Gentleman put forward some incredibly helpful ideas: better understanding in the home, better understanding in the family and better understanding in the workplace. I employ seven girls and one fella in full-time and part-time roles, and although I am not better or more knowledgeable than anyone else, I do understand some of the issues that are apparent in the office. That understanding has to start with me and end with everyone in the staff to ensure that the right things happen.

Over the last period, we have had a menopause support group in Northern Ireland. It was created for one reason. The hon. Member for Walsall North referred to a private place. Sometimes people need a private place where they can discuss their experiences and talk about what is happening with others, sharing information on the perimenopause, the menopause and any hormone-related issues. I know the knowledge that women will be able to give each other in those private circumstances and discussions. That is so very important.

The hon. Member for Bradford South (Judith Cummins), who has the Adjournment debate on osteoporosis, reminded us all of the increased risk of osteoporosis, fractures and brittle bones through menopause. She clearly and helpfully reminded us that when it comes to understanding those things better, the health sector needs to be a bigger part of the picture.

[Wera Hobhouse]

It is important that everybody understands that osteoporosis leads to many premature deaths. That is why we need to talk more about it. I am glad that we have all been talking about osteoporosis in connection with the menopause. Does the hon. Gentleman agree that we need to raise awareness of it, because it leads to many premature deaths?

[Jim Shannon]

I thank the hon. Lady for her intervention. I referred to the groups in Northern Ireland because, in many cases, we find that it is the women themselves who are initiating the private support groups and ensuring that things are happening. I ask the Minister, is there any help from Government to ensure that these advice groups are available?

To go back to the subject of osteoporosis, the hon. Member for Bradford South is right. In my office, I have a staff member specifically tasked with looking after benefit issues, and the work for that lady is enormous; she is probably working the equivalent of a five or six-day week. She tells me that, in many cases, the issue is access to personal independence payments. I know that this does not come under the Minister’s Department, but is there a process in place to help ladies understand and apply for that benefit, which is there for a purpose? Government have created the benefits system, and people should never feel that they should not apply for a benefit if it is there for them, which I believe it is.

When people are drained and emotionally raw, which many are, and when the sweats mean they have to shower several times a day and they need prompting to eat and take care of themselves, we need a system, and we need someone there to help along the way. I am my party’s health spokesperson, and I want to add my support to all those who have spoken.

The Government need to be proactive and ensure that guidance is given to businesses, so that they can do things the right way. Some 45% of women felt that menopausal symptoms had a negative impact on their work, and 47% said they needed to take a day off work due to the menopause. That underlines the need for support.

With that, I will conclude, ever mindful that we are fortunate to have a shadow Minister, the hon. Member for Erith and Thamesmead (Abena Oppong-Asare), who will add her support to the debate—I look forward to hearing from her—and a Minister who well understands our requests. I am very confident that we will have the help we need, not for us, but for our constituents, for the women who contact me, for my wife and for all the other women who find it very hard to deal with these issues.

[Mr Deputy Speaker (Sir Roger Gale)]

I call the shadow Minister.