Menopause

Peter Dowd Excerpts

Thursday 26th October 2023 Commons Chamber

[Peter Dowd (Bootle) (Lab)]

I beg to move,

That this House has considered the matter of the menopause.

I thank the Backbench Business Committee for granting my hon. Friend the Member for Swansea East (Carolyn Harris) this important and timely debate in October, which is World Menopause Awareness Month. Regrettably, she is unable to attend or open the debate, so she has asked me, as a member and the treasurer of the all-party parliamentary group on menopause, to open the debate in her place. I am pleased and privileged to do so. I hope to do justice to her work, and that of the APPG and its supporters in this vital area affecting the lives of millions of women.

[Eddie Hughes (Walsall North) (Con)]

The hon. Gentleman says that this affects millions of women but, as the husband of a menopausal woman, I feel it is incredibly important that men, in their role as colleagues, friends or family members, have a deep understanding of the challenges of menopause, so that they can best support the women in their lives. Does he agree?

[Peter Dowd]

The hon. Member is absolutely spot on. That is why the APPG is working across so many areas to develop people’s understanding of menopause—not just women but, importantly, men as well.

The days of whispering the word “menopause” and keeping the changes in women’s bodies a secret and just getting on with it, so to speak, are thankfully beginning to be a thing of the past. The “Manifesto for Menopause” was launched last week at a celebratory breakfast in Parliament to mark World Menopause Day. Alongside the publication of the group’s “Manifesto for Menopause”, the reception featured new findings from a recent survey by Menopause Mandate of over 2,000 women. It found—it is important to get this into context—that 96% of menopausal women’s quality of life suffered as a result of their symptoms and almost 50% took over a year to realise that they might be peri or menopausal.

[Nick Smith (Blaenau Gwent) (Lab)]

My hon. Friend is making a great contribution. Women have told me that, when they experience symptoms such as itchy skin, aching bones, depression and anxiety, their GPs advise them on how to treat those symptoms, although the cause could be the menopause. Does he agree that extra training and support could help GPs to recognise menopause symptoms better, and could therefore help many women across the country?

[Peter Dowd]

That is a valid point and I shall be touching on it later.

According to the survey, only 12% of menopausal women were diagnosed by healthcare professionals, with a huge 60% discovering through their own research that they might be menopausal, and only 20% having had a positive GP experience. Among working women, 64% said that the menopause had a negative impact on them, but only 29% of their employers had a menopause policy.

[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.

--- Later in debate ---

[Peter Dowd]

I thank all hon. Members who took part in the debate. I also thank my hon. Friend the Member for Swansea East, who regrettably cannot be here. I hope that I have been able to do justice to the points she raised with me.

I thank the hon. Member for Walsall North (Eddie Hughes) for relating his personal experiences and reinforcing the need to provide the support that women so rightly deserve. I also thank my hon. Friend the Member for Bradford South (Judith Cummins), who has done sterling work in relation to the Better Bones campaign and the inextricable links between osteoporosis and menopause.

My hon. Friend the Member for Merthyr Tydfil and Rhymney (Gerald Jones) is, as ever, working in his constituency. He referred to his menopause workshop. I am really interested in the word bingo. I am intrigued about that and will speak to him about it in due course. The hon. Member for Bath (Wera Hobhouse) referred among other things to the review of the prescription regime, which is really needed. As ever, the interventions by the hon. Member for Strangford (Jim Shannon) were spot-on, clear and precise. I am pleased to have his party’s support on this matter. My hon. Friend the Member for Blaenau Gwent (Nick Smith), who intervened a couple of times—once on me—was focused on the key element of clinical awareness.

I thank the shadow Minister, my hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare), for her response, particularly in relation to Labour’s workplace charter. I am pleased about the reaffirmation of that. I also thank the Minister for referring to the four-point plan for the workplace that is in progress, to the QOF review and to training in menopause.

We have covered a wide-ranging area. The seven recommendations or asks in the manifesto are out there for all to see. No doubt, we will return to this matter time and again. I hope that in the next 12 to 18 months we can make even more progress than we have in the past couple of years.

Question put and agreed to.

Resolved,

That this House has considered the matter of the menopause.

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