World Menopause Day

Nigel Adams Excerpts

Thursday 18th October 2018 Commons Chamber

[The Lord Commissioner of Her Majesty’s Treasury (Nigel Adams)]

I congratulate the hon. Member for East Lothian (Martin Whitfield) on securing this very important debate on World Menopause Day. This is a very welcome opportunity to discuss, and raise the profile of, the menopause. Is it not encouraging that a man has come to this Chamber on World Menopause Day and introduced this debate? Who would have thought, a couple of years ago, that that would happen? Who would have thought that a male Minister would be responding to this debate? Well, a week ago, I did not think I would be doing that, but it has been an absolute privilege for me to listen to the contributions made here today.

It is fantastic to see the hon. Member for Motherwell and Wishaw (Marion Fellows) in her place. She talked about how nervous her daughter was about what her speech might contain. I can tell the hon. Lady that there are those who are very nervous about what my speech might contain, not least in the Adams household, and also in the Whips Office. As Members can see, I am surrounded by Whips today, so I am going to stay on message, especially if I am to stay in the sisterhood referenced by the hon. Member for Swansea East (Carolyn Harris).

I am here today on behalf of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock (Jackie Doyle-Price). She has responsibility for women’s health and would very much have liked to be here to discuss a topic that she is incredibly passionate about. She has taken a very close interest in women’s health, including the menopause, and I know that she will be watching this debate.

The debate has provided us with a number of positive opportunities. First, we, as Members of Parliament, can play a role by helping to raise awareness of the menopause and by encouraging people to have more open conversations about this topic. This is a very significant life stage for every woman, as we have heard, and it has been all too rarely discussed in the House. Today, we have this opportunity to put that right.

Secondly, this debate gives us the opportunity to reflect on the positive things that employers and the health system are already doing to support women who are suffering from menopausal symptoms. More women are likely to have a better experience of the menopause if we share and promote the best examples of existing support.

We also have the opportunity to discuss what more needs to be done. We know, for example, that there are inconsistent levels of awareness around the menopause, and that that reflects a history of stigma attached to the issue. The benefits of tackling stigma head on and having the right menopause support in place are clear. That is the right thing to do for women who are suffering from adverse symptoms or who feel unable to have open conversations about how they are feeling.

Openness, as we have heard, goes for men as well as women. It is important that we improve how we educate men about the menopause for the benefit of their partners, relatives and colleagues—and, crucially, for the benefit of their own understanding. There is also a strong argument based on economic inclusion. Our national workforce is ageing, and positive action by employers will benefit employee engagement, productivity and retention.

We cannot stress enough that the menopause is a natural part of ageing and will be experienced in one way or another by every single woman. As we have heard from several Members, every woman will experience the menopause differently, and the types and severity of symptoms can vary. The menopause can occur naturally or be triggered or accelerated by medical interventions such as some surgeries or cancer treatments. The menopause can have physical and non-physical symptoms, but both can cause discomfort and, in many cases, social embarrassment. There are clear consequences for wellbeing. Women experiencing troublesome menopausal symptoms report lower health-related quality of life and greater use of healthcare services than women without symptoms.

Let us look at the numbers. There are more than 3.5 million women between the ages of 50 and 65 in employment in the UK. One in four women in the workplace is going through or has gone through the menopause. Over half of those women report that they experience symptoms that impact their work. The number of women over the age of 50 continues to grow, and the employment rate for women in the UK has never been higher. Women go through the menopause at a life stage when they are often dealing with demanding responsibilities such as work, caring for elderly relatives and dealing with teenage and adolescent children. Difficult symptoms can really add to the challenges of life.

No two menopauses are exactly alike. That is why the guidance produced by NICE recommends adopting an individualised approach at all stages of diagnosis, investigation and management of menopause. NICE also recommends that information on menopause is given in different ways, to encourage women to discuss their symptoms and needs.

Hormone replacement therapy can be an effective way of relieving many menopausal symptoms, as well as preventing osteoporosis. Usually, women may start HRT as soon as they begin experiencing menopausal symptoms, and their GP can advise on the different types of HRT that are available. However, HRT is not always the most suitable treatment, and women can discuss alternatives with their GP. Psychological interventions can be helpful for symptoms of anxiety or for those suffering from low mood. When making judgments about treatment, healthcare professionals can draw on advice from the British Menopause Society, a specialist society affiliated to the Royal College of Obstetricians and Gynaecologists.

But we can always do more. I know that the Mental Health Minister, my hon. Friend the Member for Thurrock, is leading work on improving women’s health and their experiences of healthcare. Her work partly focuses on raising awareness and breaking taboos—we have heard that word many times this afternoon—around common health morbidities, such as problem periods and incontinence. She is working closely with the Royal College of Obstetricians and Gynaecologists to achieve that. I know that one of her concerns is that women’s experience of the diagnosis and treatment of common gynaecological issues is not always what it could be. The all-party parliamentary group on women’s health pointed that out in its report earlier this year, and I am sure that the Minister will have more to say about that when she returns to the Commons.

For many women experiencing the menopause, the best help often comes from other women. Services can build on that support so that women can make lifestyle choices that will help to give them a better experience of the menopause, including stopping smoking, exercising regularly and eating healthily. Partners in the healthcare system can also offer support. Menopause Matters is a website that provides up-to-date information about the menopause and treatment options, as well as hosting a forum for women to discuss their experiences of the menopause. The Daisy Network is a charity that provides information and support specifically for women who are going through premature menopause.

As has been mentioned several times this afternoon, we also need to look to workplaces as a source of support for women with menopausal symptoms. Many women report that they feel they do not have the opportunity to have open conversations with their employer about menopausal symptoms at work. That needs to change—I am specifically targeting these remarks at male managers in the workplace. This has to change. If two men can get up in the House of Commons and talk about the menopause, male managers in the workplace should be doing exactly the same.

We know from a 2017 review of the effects of menopause transition on women’s economic participation that the menopause is not well understood or provided for in workplace cultures, policies and training. Sources of guidance are available for employers who want to do more to support women with menopausal symptoms. The Faculty of Occupational Medicine has produced a factsheet and infographic on menopause and the workplace, as requested by the chief medical officer in her 2014 report on women’s health. It contains practical guidance for employers on how to improve workplace environments for menopausal women, and it stresses the importance of regular, informed conversations between managers and employees.

It can often be important for managers simply to acknowledge the menopause as a natural stage of life and reassure women that their employer is open to making adjustments that they may find helpful. Equally, some women may not be comfortable discussing their symptoms with a manager, and access to occupational health can also be very valuable. Specific actions that employers can take to help women experiencing menopausal symptoms include considering changes to working patterns or responsibilities, providing employees with sources of information about the menopause, and challenging taboos and negative expectations about the menopause.

There are good examples of employers—we have heard one or two in this excellent debate—who have taken action to make their workplaces menopause-friendly. We have heard from my hon. Friend the Member for Redditch (Rachel Maclean), who takes a really close interest in this issue. She spoke so passionately this afternoon, as she has done previously in this House. She highlighted the example of the West Midlands police, which provides tailored support that helps women to build their confidence and stay in the workplace. As the hon. Member for East Lothian mentioned, she has spoken openly and bravely on this subject in the Chamber on several occasions. I know she is also working closely with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock.

I want to respond to the question my hon. Friend the Member for Redditch posed about GPs not prescribing HRT on some occasions for women who need it. HRT can help to relieve most of the menopausal symptoms. The guidelines from NICE—NG23 on the diagnosis and management of the menopause—recommend HRT as part of an individualised approach to treatment and management, and women must be able to access the treatment they need to manage such symptoms effectively.

My hon. Friend, like the hon. Member for Swansea East, correctly mentioned teaching children about the menopause in schools, which is absolutely critical. The Government are making relationships education compulsory in all primary schools, sex and relationships education compulsory in all secondary schools and health education compulsory in primary and secondary state schools. The Department for Education has launched a consultation on the draft guidance and regulations, which closes on 7 November. I am sure my colleagues in the Department for Education will have heard the well-qualified remarks made this afternoon.

The draft guidance currently does not mention the menopause explicitly, but at primary level it includes teaching about puberty, menstruation and changes to the adolescent body, and at secondary level pupils will be taught about sexual and reproductive health and wellbeing, including fertility. The underpinning focus in these subjects is to equip young people to develop positive attitudes to health, relationships and wellbeing both now and as they progress through adult life.

[Martin Whitfield]

Does the Minister agree that when there is teaching about fertility in high school or secondary school education, the fact that the menopause is not mentioned almost plays into the taboo he mentioned earlier? Such a discussion is not had, and our children are therefore not getting a full picture or understanding of what is going to come to most of them.

[Nigel Adams]

I agree with the hon. Gentleman. It is absolutely crucial to have teaching about puberty, periods and reproductive health, which provides crucial opportunities for schools to refer to the menopause. I had no idea when my mother was going through the menopause, which was referred to as “the change”. She was very, very poorly. I remember being in the living room —my dad was at work—when the doctor was called. My mother was 50 years old and having a really bad experience. She was taken off to a mental institution. She was carted out of the house and ended up in what can only be described as a Victorian asylum. I am really glad that things have moved on in that regard—this was some time ago. It is absolutely crucial that we get to children early enough to make sure they understand the causes of a condition that affects every single woman.

Turning to the brilliant and characteristically brave speech by the hon. Member for Motherwell and Wishaw, she referred to the fact that every woman has a different type of menopause. That is absolutely correct. She talked about breaking the taboo around menopause and women’s health. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock, is leading work on improving the health of women and their experiences of healthcare. That work is partly focused on raising awareness and breaking taboos around common health morbidities, including problem periods and incontinence, not just the menopause.

The hon. Member for Motherwell and Wishaw also talked about sexual wellbeing during the menopause. It is important that women experiencing menopause have access to support and advice on that. It is common for women to lose interest in sex around the time of menopause, but treatments are available. We have heard that HRT often helps. If it is not effective, testosterone supplements can be offered.

The hon. Lady also rightly talked about the importance of the workplace. The hon. Member for Swansea East also wisely focused on that area. Workplace policies that take the menopause into account can benefit both women and their employers. The Government commissioned an evidence review into the menopause, which was published last July and highlighted the important role that employers can play in supporting women. Following that, the Women’s Business Council developed a toolkit for employers of all sizes, which enables employers to make the right adaptations to physical workplace environments, supporting flexible working and raising awareness to tackle this issue.

I want to close by restating the importance of approaching the menopause as a natural and normal stage of a woman’s life, while recognising that, as we have heard, for many women that life stage comes with some incredibly challenging symptoms. It is essential that all employers and health professionals are fully informed and ready to provide women with the best options for treatment and support. The right thing for individuals is also the right thing for our economy.

We have had a fascinating and fantastic debate this afternoon. It is important that we continue to speak openly and confidently about the menopause, so that embarrassment does not prevent women from accessing treatment and support where necessary. I thank all hon. Members for their brilliant contributions and for this opportunity to mark World Menopause Day.