Five studies were included, reporting the experiences of more than 7000 women with a variety of occupations within the NHS. The results showed that in addition to hot flushes, the most troublesome symptoms were brain fog, anxiety, poor concentration, fatigue and poor memory. Vasomotor symptoms were particularly difficult to manage because of the lack of ventilation in many clinical areas combined with standard uniforms of thick fabric and the need to wear personal protective equipment (PPE). Anxiety was heightened by work pressures and insufficient breaks. As a result, the women tended to take more sick leave, changed their working hours or even resigned.  According to one report in 2023, menopause-related occupational changes were estimated to cost the NHS £116,000,000 annually for nurses, midwives & health visitors alone.¹

The authors made three recommendations to mitigate the impacts described:

• Offer flexible working
• Increase support and education available for both employees and employers
• Supply uniforms that are more suitable for menopausal women

Dr Carding said: “There remains a marked lack of menopause education within undergraduate medical curricula, despite its profound impact on health, wellbeing, and healthcare systems. This project is particularly important in drawing attention to how menopause affects NHS clinicians, and in emphasising the need for better training and support. It has therefore been a privilege to supervise Isobel, a third-year medical student at The University of Manchester, whose enthusiasm and rigour highlight the important contribution that students can make in addressing this gap. Through this work and at Newson Education, where I serve as Education Lead, we are committed to advancing this agenda by developing high-quality, evidence-based resources that equip learners and healthcare professionals with the knowledge and confidence they need. Further information can be found at www.newsoneducation.co.uk.”

Ms Blanksby commented: “The impact of menopause on the NHS workforce is felt by many but spoken about by few. This project was a valuable opportunity to explore the wider effects of menopause and to develop recommendations that may help support NHS staff”.

References

The Strategy Unit.  Menopause and the NHS workforce.  October 2023 https://www.strategyunitwm.nhs.uk/publications/menopause-and-nhs-workforce

Holly Carding is a GP and menopause specialist. She is Education Lead for Newson Education www.newsoneducation.co.uk

The National Menopause Education and Support Programme will be led by Professor Joyce Harper (UCL EGA Institute for Women’s Health), Dr Shema Tariq (UCL Institute for Global Health) and Dr Nicky Keay (UCL Division of Medicine). It is in partnership with two charities, Wellbeing of Women and Sophia Forum. The programme also has the support of the Royal College of Obstetricians and Gynaecologists and British Menopause Society (BMS).

Recent research by Professor Harper has shown that more than 90% of women were never educated about the menopause at school. Over 60% only started looking for information about it once they began to experience menopausal symptoms*.

It is hoped that this new programme will allow women reaching menopausal age to gain a greater understanding of what is happening to their bodies.

The programme will consist of a course spread over several weeks, where women will be taught alongside other women who are experiencing similar life changes as themselves. The course has been inspired by those offered to pregnant people via the National Childbirth Trust (NCT).

Women will receive independent, up-to-date and evidence-based menopause education, covering areas such as symptoms and treatments. This will be delivered by trained healthcare professionals. An important element of this new programme will be building connections with other women going through similar experiences, to develop local networks of support.

Professor Harper said: “Research has shown that women are currently poorly educated about the menopause and often go into it not understanding what to expect. Some menopausal symptoms can cause psychological issues and women may mistake their symptoms for mental health issues or other concerning causes, and this can have a negative effect on their wellbeing.

“We want to ensure that all women get the information they need to manage the changes they experience in this part of their life, in the best way possible.”

Dr Tariq said: “An important component of this programme will be peer support. Research consistently shows that support from people experiencing similar things to yourself (for instance pregnancy, mental health issues and other health conditions) improves understanding of health conditions or experiences, empowers people to manage their conditions or life experiences, and improves the ability to cope. Research I have conducted with women living with HIV has highlighted the need and strong desire for peer support around menopause.”

This programme is being supported by the Business and Innovation Partnerships and Knowledge exchange funding teams in UCL Innovation & Enterprise.

The team was recently awarded an Innovation Network grant from UCL’s Economics and Social Research Council (ESRC)”s Impact Acceleration Account, managed by UCL Innovation & Enterprise. The funding supports the network to co-design, implement and evaluate the programme with the public. It will ensure women are at the heart of the programme alongside key educators, academics, clinicians and businesses.

Professor Geraint Rees, UCL Vice-Provost (Research, Innovation and Global Engagement), said: “The National Menopause Education and Support Programme has the potential to positively impact the lives of women across the country. This project is a wonderful example of how UCL’s knowledge exchange funding and support can help multidisciplinary teams target global issues. I extend my congratulations to the team and wish them every success for the future.”

The team are committed to ensuring this programme has a broad reach and is inclusive of women in all their diversity, as well as ensuring that it is accessible regardless of income.

Janet Lindsay, CEO of Wellbeing of Women, said: “We’re thrilled to be part of this exciting new project to improve menopause education, and we welcome the research approach of co-designing with the voices of women affected.

“Every woman deserves access to high-quality information and menopause support, yet as research from Professor Harper shows, too many women haven’t been given the knowledge they desperately need and deserve. We hope this work will empower a generation of women to understand the changes to their bodies during menopause and access help to manage their symptoms.”

Professor Harper said: “We want to keep the price of the programme low to make it accessible to everyone. We plan to work with companies so they can offer the course to their employees.”

Work to develop the programme will start at UCL in September.

Alongside Professor Harper, Dr Tariq and Dr Keay, those currently on the advisory board** include menopause campaigner and columnist Alice Smellie, founder and host of the Menopause Whilst Black podcast, Karen Arthur, and certified menopause specialist Vikram Talaulikar (Honorary Professor at UCL EGA Institute for Women’s Health and Reproductive Medicine Unit UCLH, BMS).

Mr Talaulikar said: “Women deserve to have easy access to scientific evidence-based information so that they understand the menopausal transition and can make the best choices for them.”

“A lot of people think that testosterone treatments are only something men need, but it helps so many women feel better within days of treatment,” said Terrence Peppy, MD, chief of obstetrics and gynecology for Orlando Health Physician Associates. “They have more energy, they’re sleeping at night and they can get up and do things that they want to do.”

In women, low-dose testosterone is delivered through a pellet injected under the skin during a quick in-office procedure, but the treatment is drastically underused. The survey found that these testosterone treatments ranked lowest (12%) of all interventions known to improve menopausal symptoms. Estrogen treatments are much more commonly known (43%), ranking below only diet and exercise.

Testosterone therapy is felt to significantly treat the nine symptoms commonly associated with menopause including hot flashes, night sweats, anxiety, difficulty sleeping, vaginal dryness, mood swings, brain fog, weight gain and decreased sex drive, while the more commonly used estrogen therapy only treats two. While testosterone therapy is not currently approved by the FDA for use in women, there is growing evidence to support the use of physiologic doses of testosterone in women. A recent publication on the complications of subcutaneous hormone-pellet therapy demonstrated long-term safety. In England and Australia, testosterone has been licensed for use in women for more than 60 years.

“Testosterone pellets are a simple solution and are an option for virtually every patient regardless of their medical condition or history,” Peppy said. “For many, easing symptoms improves their relationships with their partners, gives them energy to exercise and allows them to live their lives as they did before menopause.”

This was the case for Laurie Lane, whose normally fast-paced lifestyle was derailed by progressing fatigue and brain fog. Until she spoke with Dr. Peppy, she was unaware that these major changes to her mood and energy were caused by menopause.

“Nobody says, ‘Here’s the date that menopause is coming, and this is what is going to happen,’” said Lane. “So, over time, I was getting more tired, had no desire to be with my husband, my thinking was foggy, things like that, and I had to put two and two together. I finally realized, ‘Oh, this is menopause. This is what happens to women as we get older. Lucky us.’”

Rather than accepting these symptoms as a fact of life, Laurie asked Dr. Peppy for solutions.

“I was very surprised because I’d always heard about estrogen. I’d never heard about testosterone. And I think one of the big fallacies out there is that women should not be putting testosterone in their bodies,” said Lane. “A lot of women just live with these terrible symptoms, but there’s something you can do, and everybody needs to know about it.”

Laurie is now back to running and feels better than she has in years. She has shared her results with friends and family, many of whom have since started receiving testosterone pellet injections as well, and she encourages all women to speak with their doctor about how they can take control of their symptoms. Dr. Peppy and his colleagues hope that the treatment will become more widely available as more women share their positive results and speak more openly about their experiences throughout menopause.

Testosterone pellets are released into the bloodstream over time and usually provide about three to four months of symptom relief. Before treatment, patients receive a blood test to measure their hormone levels to determine the needed dosage. After finding what works best for each patient and how long the benefits last, most patients schedule their next injection before leaving the doctor’s office.

Survey Method:

This survey was conducted online within the United States by The Harris Poll on behalf of Orlando Health from February 16-21, 2023 among 2,048 U.S. adults ages 18+. The sampling precision of Harris online polls is measured by using a Bayesian credible interval.  For this study, the sample data is accurate to within +/- 2.8 percentage points using a 95% confidence level. For complete survey methodology, including weighting variables and subgroup sample sizes, please contact ally@mediasourcetv.com.