Dr Katie Barber

GP, accredited British Menopause Society Specialist

Irina Spirieva

General Manager, Besins Healthcare UK

While awareness of the impact of menopause has risen in the public health agenda, many women are still encountering obstacles when accessing information and support.

To drive meaningful change in menopause healthcare, it’s crucial to understand the barriers women face in accessing treatment, including whether ethnicity or socioeconomic background plays a part.

Dr Katie Barber explains how obstacles can be overcome to ensure better healthcare for menopausal women.

A qualitative study, ‘Barriers to Accessing Effective Treatment and Support for Menopausal Symptoms’¹ — initiated and funded by Besins Healthcare UK, a pharmaceutical company specialising in hormone therapies — explored menopause care today by gathering insights from the voices of 20 women and the views of 40 UK healthcare professionals.

Stigma, embarrassment and a lack of knowledge about the range of menopause symptoms, as well as the belief that this was something they needed to soldier through, were revealed as initial barriers by the women. Previous negative experiences in accessing advice or treatment also discouraged women from seeking help.

GPs play a vital role in helping women
make sense of the diverse range
of menopause symptoms.

Importance of GP education

GPs play a vital role in helping women make sense of the diverse range of menopause symptoms. Yet, our research revealed varying GP attitudes and often a lack of confidence in prescribing HRT, which can hinder effective diagnosis and treatment.

Offering valuable insights for the NHS and its partners, this study shows the importance of updating GP education and providing culturally appropriate, personalised support to improve the healthcare experience for peri-menopausal and menopausal women.

Closing the menopause care gap

The Women’s Health Strategy has made real progress to improve women’s access to health services and enable informed choice. Yet, many barriers remain, which hinder women from getting the effective support and healthcare they need. Besins Healthcare UK is committed to addressing health inequalities in the access and delivery of menopausal care in alignment with the NHS’s commitments and the NHS’s Long-Term Plan.

To help close this information gap, Besins Healthcare UK has launched a suite of multi-language resources to help women have better conversations with their GP and healthcare providers. These are available in Urdu, Punjabi, Gujarati and English from LanguageOfMenopause.co.uk.

By expanding knowledge and working together, we can better support women to live healthy, fulfilling lives and continue to contribute to their communities and in the workplace, should they wish to do so.

Funded and reviewed by Besins Healthcare UK

[1] Barber K, Charles A. Barriers to Accessing Effective Treatment and Support for Menopausal Symptoms: A Qualitative Study Capturing the Behaviours, Beliefs and Experiences of Key Stakeholders. Patient Preference and Adherence. Paper downloadable free from: https://doi.org/10.2147/PPA.S430203 (Last accessed September 2024).

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With increased awareness of menopause, there has also been an increase in misinformation. Here, we tackle some common narratives to help women ask the right questions and make informed decisions about their own health.

Every woman experiences the menopause, yet symptoms can vary from one individual to the next. What works for one may not work for everyone. The British Menopause Society (BMS) aims to separate fact from fiction and provide information based on scientific, rather than anecdotal, evidence.

Testosterone levels need a boost during menopause

The allure of testosterone is real. Does it work? The honest answer is that research shows testosterone is most effective at improving sex drive during menopause.¹ While some swear by it for other reasons (such as memory, brain fog and energy levels), there is not yet the scientific evidence to support these claims. UK NICE guidelines concur with the international consensus — that its use is primarily for those with a significant dip in sex drive, which is causing distress.

While many see testosterone as the answer to their low libido, it’s not that simple. Stress, body image and relationship issues all play a role. Physical symptoms like vaginal discomfort and painful sex all contribute to whether or not you desire sex. Testosterone can be a piece of the puzzle but is rarely the whole solution.

Not everyone needs HRT, and
some are advised against it.

The higher the HRT dose, the better

Hormone replacement therapy (HRT) dose should be tailored to the individual, and a higher dose doesn’t necessarily deliver added benefits. Taking a higher-than-recommended dose might also be harmful. High doses of oestrogen without the protective balance of progesterone cause unexpected bleeding for many women.² This can lead to a lot of stress, referrals for unnecessary tests and an increase in the risk of womb cancer. If you have been advised to take a high dose of oestrogen and are experiencing unexpected bleeding on HRT, seek advice from your healthcare professional.

All peri and post-menopausal women should have HRT

Not everyone needs HRT, and some are advised against it. There are non-hormonal prescribed treatments available that can improve symptoms. Some prefer to try herbal or dietary supplements, which may ease some symptoms. Studies show that cognitive behavioural therapy (CBT) can also help with sleep during menopause and reduce the impact of symptoms such as hot flushes, low mood and anxiety.³ Lifestyle changes, including nutrition and exercise, play a key role in improving wellbeing and maintaining health at this important time.

[1] Achilli, Chiara et al. Fertility and sterility vol. 107,2 (2017): 475-482.e15. doi:10.1016/j.fertnstert.2016.10.028
[2] British Menopause Society. (2024). Management of unscheduled bleeding on hormone replacement therapy (HRT).
[3] Mann, Eleanor et al. The Lancet. Oncology vol. 13,3 (2012): 309-18. doi:10.1016/S1470-2045(11)70364-3

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