Menopausal Symptoms: Support

Judith Cummins Excerpts

Wednesday 9th June 2021 Westminster Hall

[Judith Cummins (Bradford South) (Lab)]

It is a pleasure to be called to speak in this important debate and I thank my hon. Friend the Member for Swansea East (Carolyn Harris) for securing it. I know that menopause is shrouded in mystery and certainly used to be a taboo topic, but this is changing and it needs to, as its impact can be complex and numerous as regards health outcomes for women. I will speak on one aspect of menopause—its link with osteoporosis. I do this as co-chair, with Guy Black, Lord Black of Brentwood, of the newly formed all-party parliamentary group on osteoporosis and bone health.

A key factor in women’s health is the protection of bones. Menopause is a crucial time to protect our bone health. When women reach the menopause, oestrogen levels decrease, which causes many to develop the well-known systems of hot flushes and sweats. According to the Royal Osteoporosis Society, a decrease in oestrogen levels also causes a loss of bone density—so the menopause is an important cause of osteoporosis.

Everyone loses bone density and strength as they get older, but women lose it more rapidly in the years following the menopause, losing up to 20% of their bone density during this time. With that loss comes reduced bone strength and a greater risk of breaking bones. According to a survey by the ROS, a fifth of women who have broken a bone break three or more before their osteoporosis is diagnosed. Breaking a bone normally means significant short-term pain and inconvenience, but it does not stop there. Many people with osteoporosis who break a bone live with long-term pain and disability, especially if their back is affected. The reality of broken bones and the fear of falling impacts on everyday activity, stopping people from doing the activities they love. As women lose the protective effect of oestrogen at the menopause, it is a critical time for their bone health and a time to consider many factors, whether that is positive life changes to help maintain bone strength, having a health bone assessment or considering whether osteoporosis drugs are needed to strengthen bones and reduce the risk of fractures. A number of medications are available for those with a significant fracture risk, including hormone replacement therapy, which, crucially, reduces bone loss and the risk of fractures.

It is tragic that the loss of bone strength, and the associated pain and disabilities that fractures cause, is preventable in so many cases, and that is why it is important that around the time of menopause women receive the support needed to consider whether they have a fracture risk that needs treating with osteoporosis medication. To support this, the Royal Osteoporosis Society is calling for GP surgeries to be incentivised routinely to use digital tools to assess risk and prevent fractures, as recommended in the NICE guidelines. Frustratingly, accessible digital solutions already exist and are not integrated properly into IT systems in GP surgeries.

Sadly, many GPs and other healthcare professionals lack the confidence to manage osteoporosis, missing opportunities to identify people at risk early and to prevent that important first fracture. A recent study showed that 75% of older women seen in primary care at high risk of fractures were not given the medication they needed, due partly to a failure to diagnose osteoporosis. These IT solutions can identify people with risk factors for developing osteoporosis before that first fracture. Patients found to be at higher risk can be offered anti-osteoporosis treatment proactively, with a personalised pain management plan comprising medication, lifestyle advice, vitamin D supplementation and fall prevention strategies. That is why it is essential that around the time of menopause, women are properly supported to assess their risk of osteoporosis and fractures. Provided that we support GPs with education and training, including on menopause and bone health, test those at risk and provide preventive medication such as HRT and vitamin D, the vision for early intervention can become a reality.

[Ms Nusrat Ghani (in the Chair)]

I now call Alex Davies- Jones.