World Menopause Day

Rachel Maclean Excerpts

Thursday 18th October 2018 Commons Chamber

[Rachel Maclean (Redditch) (Con)]

Thank you so much, Madam Deputy Speaker. You speak so much truth and I am glad that you have put those words on the record from your position—they will carry a lot of weight.

I pay tribute to the hon. Member for East Lothian (Martin Whitfield), who gave an absolutely brilliant and heartfelt speech that I know will resonate with all the women throughout the country and around the world who are watching this debate. They will be so happy that he, as a man, is championing this issue. If only every man was as warm, empathetic and well informed as he is, we would not be having this debate. I look forward to working assiduously with him and colleagues from all parties to reach that position, which I very much believe we will.

As has been said, we have already tackled many taboos in this place and in our society, and this is genuinely one of the last taboos. It is now okay to talk about mental health, and that is a really good thing. A lot of celebrities now talk about their mental health. It is all over social media, in the press and on the television. People are backing that, and people are coming forward to say, “It’s okay not to be okay.” Somehow, however, menopause is still left out, and this debate is a fantastic chance to put that right.

I started on this journey pretty much as the hon. Member for Lothian East described—

[Alex Chalk (Cheltenham) (Con)]

East Lothian.

[Rachel Maclean]

East Lothian—I am so sorry. Please forgive me.

I was 50 when I was elected, so I was of course well within that perimenopausal/menopausal age myself. I did not conform to the menopause stereotypes, as I shall touch on later in my speech. There is so much ignorance out there. It is generally believed that someone has to suffer from the key symptoms, such as hot flushes and night sweats—that that is basically all that menopause is—but menopause is so much more than that. It is not just hot flushes and night sweats, and I am living proof of that. I have never had a hot flush or a night sweat, but I am most definitely menopausal. My symptoms revolve around quite debilitating migraines, sometimes on an almost daily basis when I am not able to manage the stress of this job. As was rightly said, this is an incredibly stressful job and an incredibly stressful workplace, and we cannot just take a day off and go and lie down in a dark room to sleep off a migraine, much as we all might like to, even if we are not menopausal. Many women working in other walks of life who are perhaps at the peak of their careers, or who work in any stressful environment, are not able to get the support that they need.

We saw a shocking demonstration of the ignorance in society from no less a figure than the Governor of the Bank of England, Mark Carney, who not long ago compared the economy with the menopause. He said that we are suffering a menopausal economy. He came back and defended that, saying that he did not mean it or whatever, but his casual use of those words demonstrated a fundamental lack of awareness of a leading figure in our country. It is not right. With that phrase, he made me so angry—and not only me but many other people. That made me think that I could not sit there and not be a voice for all the women out there who do not have the privilege of being able to raise the issue in this place.

So, I had my personal journey, and I started to look on social media and do some more research to educate myself. As the hon. Member for East—[Hon. Members: “Lothian.”] I will get there in the end!

[Alex Chalk]

The East Lothian question.

[Rachel Maclean]

Yes; thank you.

The hon. Member for East Lothian said that social media plays a big part in this, and it is where I started my journey. From my research and conversations, I recognise that millions of women in this country do not feel listened to at this time of their lives. That was where my campaign started—from a place of wanting to represent those women.

We still have a long way to go. Last night, when I was voting in the Lobby, wearing this #MakeMenopauseMatter badge, I was approached by a very senior colleague, who shall remain nameless. His comment was: “Why—are you having a hot flush, dear?” That was said to my face. My goodness, does not that illustrate how we need to raise awareness? This is not a women’s issue; it is a society issue. It is for everybody, because every man works with a woman, is related to a woman or lives with a woman. People cannot just denigrate and belittle experiences that can be incredibly difficult for women to push through. I pride myself on being quite a feisty person. I am not afraid to say what I think and I definitely told that Member what I thought about that comment. I said, “Please, come to the World Menopause Day debate and find out why that comment is completely inappropriate and, hopefully, learn a bit more.” I am delighted to say that he is in a minority. I pay tribute to the many male colleagues from all parties who have been supportive of the debate and this issue.

I am not asking for a lot—perhaps I am, but I do not regard it as a lot. I regard these things as quite basic. The hon. Member for East Lothian has already touched on the key issues, the first of which is the workplace. We are in an extraordinarily unusual workplace where there are issues for not only the people who work here, but Members ourselves, but there are many more workplaces up and down the country. It is not too much to ask—is it?—for workplaces to be better prepared for women going through this change of life. The process can be extremely positive. If women get the support, understanding and empathy that they need from their colleagues, there is absolutely no reason why they cannot make this into a fantastic time in which they can move on to a new chapter of their lives, and flourish and contribute in different ways.

[Martin Whitfield]

The hon. Lady is making a powerful speech. Does she agree that it is strange that our high schools and education system are perfectly set up to support young people through their teenage years, when substantial changes are going on in their bodies, and to launch them into their careers, but society seems unable to have the same sympathy and empathy at a different part of someone’s career?

[Rachel Maclean]

Yes, I completely agree. The hon. Gentleman must be psychic, because he has made a point that I was going to make. Before I do so, however, I want to speak about the workplace.

Let me pay tribute to some organisations that are doing an absolutely fantastic job in this regard. I have had quite a lot of contact with West Midlands police through various women who have championed this issue in the workplace. There is a lady called Lesley Byrne—Lesley, if you are watching, keep going! Yvonne Bruton has been running menopause awareness workshops for the police. Imagine the West Midlands police—a very male-dominated and, in many ways, traditional organisation. Female police officers are incredibly brave to say, “I have these experiences. I am not supported and I need adjustments to my working patterns.” They are working through the issues and finding ways to support their female colleagues. At the end of the day, we need good police officers and we need them to stay in the police force, to be motivated and to progress to higher levels.

That work is absolutely brilliant, and there is no reason why every single police force in the country could not talk to West Midlands police, find out what they are doing and disseminate the information among themselves. Indeed, there is no reason why other organisations cannot have a menopause policy, just as they have policies on childcare and maternity leave. It does not cost anything; it is a question of saying, “We’re here and we will listen to you if you need support.” That is my first ask.

My second ask is about education, which the hon. Member for East Lothian just spoke about so eloquently. We of course talk to young girls and boys—I presume this still happens; it is a long time since it happened to me—about puberty, periods, where babies come from and so on. We educate our young people about all those important issues to equip them for life and relationships; why can we not educate them about what happens at the end of their reproductive lives? It is very simple. I spoke to a male colleague earlier who said, “I have no personal experience of the menopause, so how can I talk about it?” I said, “Well, okay, your mother went through it,” but then we did not talk to our mothers about these sorts of things. This needs to come into the school curriculum and to be part of what schools are talking about. Let us look at how we can do that, because surely it is not that hard.

The third aspect of my campaign is around access to advice in GP surgeries. This is where we really do need to do more. I have been absolutely inundated with people contacting me. I have heard quite horrific stories from women who did not get the treatment that is medically proven to be effective, which is hormone replacement therapy. HRT is available on the NHS and actually advocated for women in the guidelines of the National Institute for Health and Care Excellence. However, it seems that there is—I don’t know—a lack of awareness, a lack of information and a lack of empathy among GPs who are not prescribing HRT for women when they need it. I have heard story after story from women who went to their GP, saying, “Look, I am suffering these symptoms.” Again, the reason might be that they are not having hot flushes or night sweats, but they have the other symptoms that are associated with the menopause, and they are just not getting that treatment. GPs are sending them away. Why do some women battle for years to get HRT?

I am delighted to say that the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), has already met me to discuss this issue. We very much hope to move things forward with the all-party group on women’s health, which is led by the hon. Member for Dewsbury (Paula Sherriff), and obviously with any other Member who wishes to take part. We really need to do more.

If I may, I will draw my comments to a close by quickly paying tribute to a few campaigners who have given me so much support and information.

[Kerry McCarthy]

The hon. Lady has been very brave in speaking out. So far our focus has been on dealing with the symptoms and the problems. Has she had the opportunity to look into whether diet-related changes could help to alleviate some of those symptoms rather than just medical solutions? In Japan and China, for example, there seems to be much lower incidence of things such as hot flushes, and some suggest that that might be because of the consumption of soya, which has oestrogen in it, although I am not quite sure how it works. Has she looked at that at all?

[Rachel Maclean]

I thank the hon. Lady very much for her intervention. I am certainly aware that my research has only scratched the surface. She is absolutely right to say that diet has a strong connection with wellbeing and health at any point in life. In fact, I am seeking help from a nutritionist myself to try to tackle some of these issues, because they are all interlinked. Perhaps that illustrates some of the lack of understanding that we have generally.

In my list of people to whom I wish to pay tribute, I will, if I may, mention the menopause chef who came to my Menopause Café in Redditch. The Menopause Café is an amazing national organisation. It is about bringing women together to have conversations about the menopause. I held mine in Redditch a couple of weeks ago. I encourage anyone to host a Menopause Café in their constituency. The experience was really moving. Women said that they had learned more about the menopause in that time than they had learned over five years. The menopause chef works out diets that meet women’s dietary requirements.

Diane Danzebrink, a fantastic consultant, tutor and coach, is very active in this space and does a lot of work in the area—I believe that other Members have met her. Dr Louise Newson, a GP, set up the country’s first menopause-only clinic, which is a fantastic innovation. We would all like to see such clinics more widely spread. Lynda Bailey, the co-founder of Talking Menopause, is one of the pioneers in the West Midlands police. Then there is the incredible Hot Flush, which describes the menopause as a club that no one wants to join. It does a lot to demystify some of the symptoms of menopause and to talk about them frankly. Let us just be honest about some of the things that can happen at menopause. Let us just be comfortable talking about things such as vaginal dryness, loss of libido, incontinence and pelvic floor weakness. These are not easy things to put on record standing here in the House of Commons. If women experience these things, it can negatively impact on their ability to form a relationship, to have a relationship with their partner and a whole host of other things. All those things can be connected to the menopause. More importantly, they can be alleviated with the right information and support. Why should women not have the right to a happy, healthy later chapter of their life in all aspects, including in their intimate life? I believe in that very passionately and think that it is so important.

Very quickly, let me mention Detective Chief Inspector Yvonne Bruton, who has pioneered this work in the West Midlands police. Liz Earle, a health magazine and beauty product founder, is also a passionate champion of this issue. Obviously there are many more people involved, but I do not have the space to mention them. Needless to say it is a space that is well populated by passionate women who are just keen to share their knowledge with others.

I will draw my remarks to a close. I could probably talk for hours, but I am aware that I am detaining the House. Let me thank again the hon. Member for East Lothian. I am so delighted that he contacted me and that he applied for the debate. I very much look forward to the Minister’s closing remarks.

[Marion Fellows (Motherwell and Wishaw) (SNP)]

I also congratulate the hon. Member for East Lothian (Martin Whitfield) on securing this important debate—it seems to be a day for Scottish accents. I am delighted that he felt able to bring forward such an important matter. It was a real pleasure to follow the hon. Member for Redditch (Rachel Maclean) who courageously outlined some of her own experiences and made a very wide-ranging and powerful speech. She advocated and highlighted so many other women who are doing their very best to give this subject the prominence that it most assuredly deserves.

I am delighted to be speaking about World Menopause Day and about this important subject. My hon. Friend the Member for Glasgow East (David Linden) is, I believe, even more delighted. He is quite young, and I think that he thought that he would be replying to this debate instead of me. My daughter is extremely apprehensive about the content of my speech, as she frequently accuses me of oversharing. She need have no fears today—or at least not too many.

I have been there, I have done that and I have got the T-shirt, and that really does cover my experience of menopause. I started early and it seemed to go on for quite a long time. I remarked earlier to you, Madam Deputy Speaker, that my mother was born in 1919, so how I was raised very much reflected the way that she was raised by a mother who was born in the 19th century, so no one talked about it.

I have some vivid memories. I was teaching in a further education college as I was going through quite a large part of my menopausal experience. Standing in front of 25 bored teenagers, I asked, “Is it hot in here, or is it just me?” I was told, “No, it’s just you”, to which I responded, “Well, I’m opening the windows anyway.” It really was good that I was in charge of that class.

Another story that, in many ways, illustrates how the menopause used to be discussed is through the brilliant comic creations of Les Dawson, Cissie and Ada. They only ever mouthed the words, “The change” when discussing their menopause experiences as well as those of other women. I am very glad that that is no longer the case. World Menopause Day is an important opportunity for women to speak out about their real experiences of the menopause, contributing to breaking the taboo around both the menopause and women’s reproductive health.

As we should all know, the menopause can have a significant psychological and physical impact on women, and it is vital that these effects and symptoms are taken seriously by health professionals and society at large and that women can access the right support. Women’s health issues often do not come under the spotlight owing to ongoing taboos around women’s health, and it is time for women—younger and older—to speak out in support of each other to raise awareness. The days when women are literally put outside the tent or igloo when they are past child-bearing age are long gone, but we still have these taboos. We must work hard to speak about our experiences and contribute to breaking these taboos.

This year’s World Menopause Day is about recognising the impact that the menopause can have on women’s sexual wellbeing. Both during and after the menopause, it is not uncommon for women to experience some sexual dysfunction, which can have a severe impact on their relationships, self-esteem and wider mental health. It is so important that women going through this can access the right support to reassure them that it is totally normal and they are not alone. Sharing experiences with other women is also extremely important, and women speaking to other women about their experience is to be encouraged, but we must engage with the wider world too. As I have said, the menopause can have a significant psychological and physical impact on women, and it is vital that these effects and symptoms are taken seriously by health professionals.

[Rachel Maclean]

I commend the hon. Lady’s bravery in speaking from the heart and from her personal experience. She is talking about the psychological impact of the menopause. Does she agree that women sometimes report that they do not feel like themselves at all—that they experience depression and anxiety, and often feel effects on their memory, making it very difficult to perform in the workplace and often leading to their leaving work early?

[Marion Fellows]

The hon. Lady is absolutely right, and this is a wonderful occasion to highlight such things and to motivate women to speak more frankly, because every woman has a different menopause. We all have to accept that and to share our experiences so that no one feels that they are the only one going through this.

The Scottish National party and the Scottish Government support World Menopause Day. Through the Scottish Primary Care Information Resource, the Scottish Government support general practice to identify patients with conditions such as osteoporosis and cardiovascular disease, which are clearly and directly associated with the menopause. We need to anticipate health needs for women in this situation and ensure the best possible care for them. There are some NHS menopause clinics in Scotland, located in Dumfries and Galloway, Fife, Grampian, Lothian and Tayside. In other areas, health boards provide menopause help through general practice and specialist referral if needed. The British Menopause Society really wants to encourage that, because doctors and other health professionals also need to be trained in how to talk to women and encourage them to talk about their symptoms.

There are also some great initiatives at a local government level. For example, South Lanarkshire Council is today launching its menopause policy, and it is to be very much commended for that. The council worked out that 68% of its workforce are women, who could go through the menopause at any point, and it sees it as its duty to take care of these women and to allow them to talk to managers. In fact, they are training managers properly to help with this issue. It can be very difficult for some women to talk to a younger man, as the hon. Member for East Lothian has mentioned.

South Lanarkshire Council’s plan includes the provision of fans for women to manage hot flushes and the ability to take time out when coping with low moods. There is also a requirement to ensure that women experiencing menopause have easy access to toilet facilities. This is not difficult; it is something that all employers should be doing. Women will have somewhere to rest or to go for a little while if they feel tired due to a lack of sleep caused by things such as hot flushes, and if they are suffering from anxiety at this time, they will also be able to access the employee counselling services. This is a great initiative that I wholly commend, and it should be emulated by other employers right across the country. This is exactly the kind of proactive support that both the public and private sectors should be adopting.

A BBC survey earlier this year found that 70% of respondents do not tell their bosses that they are experiencing symptoms when they are going through the menopause. I certainly did not, but then I am well beyond menopause and have seen quite a large variety of changes in how we speak about women’s issues throughout my lifetime, so I am really happy to be able to speak on the subject today. Employers must take the lead in creating a safe environment for women to speak up if their symptoms are making their work difficult. It is actually better for employers to do that, because if they treat women with consideration at this time in their lives, they will get the best possible work out of them.

--- Later in debate ---

[Carolyn Harris (Swansea East) (Lab)]

I congratulate my hon. Friend the Member for East Lothian (Martin Whitfield) and the Minister on their bravery, and I say to every man in the Chamber today: welcome to the sisterhood.

Some 49.6% of the population worldwide are women, which equates to close to 3.8 billion of us, and with the vast majority of women—in the developed world at least—living way beyond menopausal age, it is about time this issue was taken seriously. For too long the menopause has been one of two things: a taboo subject that women do not dare to admit they are suffering from, or the punchline of a joke that is actually anything but funny.

Most women will experience the menopause at some time in their lives, and the severity of their suffering varies greatly. About 25% of women are lucky enough to barely notice any changes to their body or experience any of the well-documented symptoms, but for others the menopause can be an unbearable time—stressful, debilitating and completely life changing. Yet many women are completely unprepared for this phase of their lives, which is something that we desperately need to change for future generations. We need to be educating our children—boys as well as girls—so that they understand the impact the menopause could one day have on their lives and relationships.

The Government’s draft sex and relationships education guidance includes advice on teaching young people about menstruation, but it makes no mention of the menopause, which is just as important and often more difficult. Will the Minister ask the Department for Education, as part of its consultation, to consider extending the guidance to include teaching on the menopause? In doing this, we could help to educate the next generation and put an end to the lack of knowledge around the menopause, which is having a hugely detrimental effect on those suffering today.

Also having a detrimental effect is the limited training given to GPs on this subject. Too many women struggle when doctors either do not recognise their symptoms, do not prescribe hormone replacement therapy—because they are relying on inaccurate and outdated information—or incorrectly diagnose those symptoms as depression and subsequently offer the wrong medication. This needs to change, and the Department of Health and Social Care needs to play its role and work with patients, experts, the NHS, the Royal College of General Practitioners, medical schools and all health professionals to better educate them about the menopause.

The NICE guidelines on the menopause were first published almost three years ago, yet many doctors admit that they are either not aware of them or have not read them. Women are therefore relying on the chance that the GP they visit is one of those who has. Healthcare should not be a lottery. Every woman suffering the effects of the menopause is entitled to the same quality of care, but the quality of that care in the UK at the moment needs serious attention. Current treatment options for women are woefully poor. Referrals to NHS menopause clinics take up to six months because of the limited number of places—the result of the ongoing cuts to services. For many women unable to take HRT, particularly those who have had breast or gynaecological cancers, there is no support at all.

It is not just medical support we are here to talk about. In the UK, the average age women reach the menopause is 51, but about one woman in every 100 experiences early menopause owing to medical conditions, treatment or surgery. The loss of fertility as a result can be devastating for some women, and their psychological health is as affected as their physical health. These women need to be offered counselling as well as advice on how to maintain their long-term health, which can be affected by early oestrogen depletion.

I have heard cases of women going into debt to fund appointments with private doctors and gynaecologists because they cannot access the care that should be available to them on the NHS. Even more worryingly, the Samaritans’ 2017 report on suicide figures shows that the highest suicide rate for women is for those aged between 50 and 54. It cannot be coincidence that the age of menopause is 51. I find it deplorable that in this country something that affects so many people is so underfunded and misunderstood.

It is not just the treatment of the symptoms that needs serious attention. Life does not stop for women when they reach the menopause—I am testament to that—even if they are suffering from crippling side effects, and for many this means continuing to work. Women are working in greater numbers than ever, making up 47% of the UK workforce. About 4.3 million of these employed women are aged 50 or over, and this number is set to increase over the next few years. With studies showing that menopause symptoms can have a significant impact on attendance and performance in the workplace, employers need to start looking at what they can do to help these women and improve their own productivity.

[Rachel Maclean]

Does the hon. Lady also agree that it is in those businesses’ and organisations’ own interests to retain these members of staff, whom they have trained and invested in over many years, and who have so many skills and so much knowledge?

[Carolyn Harris]

I do, and I was just coming to that.

Employers have a duty of care to all their employees. While no respectable company would even consider running their business without a maternity policy, very few will have given any thought to the introduction of a menopause policy. Simple adjustments, such as relaxed uniform policies, flexible working conditions and temperature control in offices, could have a huge impact on a woman’s decision to remain in work. It is a win-win situation: employers would benefit from retaining valuable, trustworthy and experienced employees, saving money on sickness cover and training new staff, while women would find it easier to cope with the physical symptoms of the menopause. With simple adjustments, such as being able to travel outside rush hour or to wear cooler, less restrictive clothing, they would also feel valued and supported in their professional roles, which in turn would help with the psychological barriers associated with the menopause.

Yet current figures show that two thirds of women going through the menopause say they have no support at all in their workplace. Some 25% of women say they have considered leaving their job because of it, and one in 10 actually ends up handing in her notice. Women in our emergency services, nurses, frontline retail staff and office workers—in fact, women from all sectors of industry—are leaving the workplace owing to a lack of support from their employers. These are not small businesses, but massive national and global companies. We need big business and workplaces to take this seriously.

Many unions are already championing the call for a menopause policy. An excellent example is the Union of Shop, Distributive and Allied Workers, which I have worked with, and the very wonderful Julie Bird, who has encouraged Tesco to set up pilot menopause support groups. The scheme started in Swansea and is now being rolled out across the south-west.

Nottinghamshire police was the first force in the country to introduce a menopause policy that includes flexible working and lighter uniforms. The hon. Member for Motherwell and Wishaw (Marion Fellows) talked about local authorities. I am pleased to say that I have just received a message informing me that my own local authority, City and County of Swansea—I think it knew I would want to say this—is going to introduce a menopause policy.