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[Danz]

Hi everyone, I have been invited to meet with the shadow minister for women at the house of commons next week to talk about menopause and what can be done to improve care and support both in and out of the workplace. What would you like to see change? Thanks Diane

[Dancinggirl]

Employers need to be educated better about what women go through when the meno hits. It is still a taboo subject and something that women feel embarrassed about.
Comprehensive training for all GPs on how to diagnose and treat women going through the meno would really help - too many women are prescribed ADs which are not really appropriate. Women might feel more able to face their employers with their problems if they had better GP support. A women should be able to go to their employer and say ”I am suffering bad meno symptoms but my GP is helping me find the right hormone treatment that will enable me to get back to work. It may take a bit of time"
Leaflets and posters in all surgeries encouraging women to seek help. This information should be available at work as well.
Better awareness of the comprehensive problems the meno brings e.g. low mood, lack of sleep, loss of confidence, headaches, joint aches, bladder problems, vaginal problems, - the meno is not just about flushes and night sweats.
Basically more awareness all round. DG x

[wombat62]

Wow, that's great!

Certainly better training for GP's. Half of them have no idea how much a role oestrogen plays in bodily functions and the demise affects so many things. I've learnt so much from the ladies here than the doc or websites! It would give women that "thank goodness, it's not me, I'm not alone" security when things start getting weird.

Plus what Dancing Girls said!

Good luck, hope it goes well!

[dahliagirl]

I met someone who had been previously good at her job and very outgoing and appearing confident.

During menopause, she suffered badly from anxiety suddenly lost all her confidence and used to have to go for walks round the block to work up the courage to go back inside.  She lost her job and had to go through the process of suing for constructive dismissal.  She is now retraining for a new career she is interested in.  This was a LA job so you would have thought they were better.

There needs to be more help and support for this - it is a waste of time and money for the employee and the employer to have to go through this retrospective legal process.

There also needs to be more support from GPs for symptoms other than hot flushes.  There has historically been little training in this area and the hrt scares following the millennium studies have taken their toll on expertise.  A lot has been done to improve things, but GPs need to be encouraged to take up the training being offered.

One GP at my practice 'does not do women's stuff' and the female GP is part time.  Practices should be able to offer a service to the menopausal women in their area or have suitable clinics to refer them to.  There are quite a lot of women around and they will all have menopause when they reach middle age or before.

[peri]

I echo everything Dancing girl said especially about GP's not fobbing women off with anti-depressants when they're oestrogen defficient and understanding just how oestrogen (or lack of it) impacts. 

Also, more progesterone options (biodentical), as this is the part of Hrt most women struggle with.

Finally, testosterone prescribed routinely by GP's without the need for women to have to go private.

[Jenni]

I agree, more training is needed for GPs. I go to quite a big medical practice and asked the receptionist there yesterday, which of the Drs specialised in menopausal problems. She said "none of them do but you could see Dr ?? because she deals with contraception, or you could just see one of the nurses". A few years ago, I saw a male nurse practitioner (the only appointment I could get) and when I explained the problems I was having, he said "well lets face it, it's not going to kill you is it?". My reply was "no, but if I don't get some help, I may well kill myself".
Judging by the number of women on this website alone, there are a lot of us out there, facing this sort of attitude and worse, and not getting the help we need and deserve.
If men went through the menopause, things would be different!!!!

[Hurdity]

Hi danz

 

Great to hear you are meeting someone that might be able to influence things - there should be a cross party group on this!!!

I agree with everything that's already been said and here are my thoughts ( some have been said already).

Compulsory (re-)training for GPs throughout UK in the light of recent recommendations re HRT (NICE, British and International Menopause Societies, Women's Health Concern).

A well woman clinic and call for attendance (eg every two years?) incorporating menopause advice for every area but which also includes lifestyle advice – for all woman over 45.

Work-place – a right to part-time working for women who are struggling through peri-menopause but not sure how this could be legislated for? Women may be unwilling to admit what they are going through because of the stigma ( despite recent publicity).

A greater awareness and availability of advice, and development of support on how to deal/cope with new onset anxiety/depression around the time of peri-menopause and beyond – eg group support, talking therapies and strategies, lifestyle advice, to avoid the need for medicating routinely with anti-depressants – on NHS!

Specific changes re HRT (maybe outside the scope of your meeting?):

Along with greater variety of progestogens  and doses eg progesterone at 50 mg, dydrogesterone available separately and personalised dosing – routine scanning available on NHS (eg every two years)  to enable personalised dosing (usually less than licensed doses) to be monitored and ensure safety as well as efficacy. Eg Just as with mammograms, cervical smears – a routine endometrial/pelvic scan for all women over a certain age whether on HRT or not, and perhaps also blood tests for ovarian cancer.

More research on progestogens, dosing, duration and safety.

Ditto re testosterone – development of products specifically designed for women and research into efficacy and long term safety, along with education for GPs to be able to prescribe current products (designed for men) confidently. Maybe re-introduction of Intrinsa patch? Surely there is now more of a commercial reason to redevelop these in the light of the NICE Guidelines and the increasing prescription of testosterone to women?

More targeted advice and treatment for women in late reproductive stage who are experiencing symptoms – before the official start of the peri-menopausal transition. Reading this forum there are many women at this stage who are experiencing severe pms and perhaps the start of menopausal symptoms but for whom HRT may not work as oestrogen has not declined. Many would be given anti-depressants, and if they are over 50 CCP is not available. Perhaps therefore also more specific research and development into the safety “gentler” CCP types like Qlaira so that women over 50 can suppress their cycle safely if necessary?

That's all I can think of at the moment ....

Good luck with your meeting and do let us know how it went!

Hurdity x

[CLKD]

Dedicated Specialist Units in every Hospital: we have heart clinics, paediatric care, ICU, Obs/Gynea, why not Menopause Consultants with the opportunity of discussion groups for sufferers, apart from Obs/Gynae?

As per the Daisy web-site, menopause can strike at any age.  There should be no queries !

Good Luck!  Will you be able to report back?

[Wannabewell]

Hi,

That is really good.

I'd like GPs to be educated about the huge impact that fluctuating hormones have on a woman.

Particularly how it causes anxiety, mood changes, crashing fatigue and menstrual changes ie flooding.  They also need to know and accept that pre menopause symptoms can start much earlier than they think.

GPs need to take menopause seriously.  There should be specialists in menopause who a GP can refer to as well.  Currently (in my area) there isnt anywhere to refer to other than gynaecologist and endocrinologist and it's not obvious (at times) which would be the best.

Good luck.

[Maryjane]

I echo all the above , plus vaginal / bladder issues (mentioned by dancing girl)

VA can for some break up marriages , loose jobs ,
Due to the fact for some it is not possible to have sex and others can't sit at work etc.

I'm not going to go into loads-of details , as you no who I am.

Jane Lewis. Great what you are doing. 😊

[Mary G]

This is a specialised area of medicine and I think Menopause Clinics and Family Planning Clinics should merge to give a more joined up service.  There is a definite overlap between the two services with many women in both camps using the contraceptive pill and Mirena coil so it makes sense to go straight from one clinic to another.  These clinics should also have the facility for the all important uterine scans.
 
My personal view is that menopause symptoms are not something you should have to learn to live with, I think it is better to try and avoid them completely by starting hormone treatment at the right time and then continuing.  If properly monitored, women should be able to filter in oestrogen replacement as soon as their own levels start to fall. 

HRT needs to become the norm and the wretched, scaremongering, discredited studies must be consigned to the history books forever.

[Butterfly22]

That's great and very positive,

Just as everyone else is saying, I started at 25 and was getting support at the rvi Newcastle but when my gyno left I've had no help since that's about nine Years ago.

My doctor is grateful I go with info off this site to be honest, I've struggled so much.
I would of liked somewhere to go and talk about my menopause with other women as never had help that side of it and to start so Young was very traumatic, scary and devastating.
I had no one to talk to.

As suggested more menopause clinics that you can be referred to, GPs need to no more and it needs to be talked about openly a lot more.


Good luck xx

[Joaniepat]

I would like to put in a plea for women over 60.

The flawed and now discredited millennial studies (Women's Health Initiative Trials (2002) and British Millennial Women Study (2003)), and the media hype surrounding them, led to many women either being afraid to start HRT, or giving it up unnecessarily. Additionally, many GPs withheld further supplies from those already on HRT in their 50s and who still wished to continue. Having lost the protective effects of oestrogen, many older women are now presenting with conditions that might well have been avoided. These include Genitourinary Syndrome of Menopause (GSM), osteopaenia/osteoporosis, organ prolapse and cardiovascular disease.

Although localised oestrogen may be prescribed for those suffering with GSM, little consideration is given to any systemic hormone replacement for those over 60, with most patients being told by their GPs that they are "too old". There seems to be no reason to withhold transdermal oestrogen or, where appropriate, Tibolone, from older women, for whom it may prevent further deterioration of the affected tissues.

With increased life expectancy, and resulting pressure on the NHS and Social Services, the continuance or resumption of appropriate HRT could play an important role in maintaining the health of older women.

As stated by other contributors to this thread, the lack of training and general awareness about menopause and HRT among GPs needs to be urgently addressed. Furthermore, the millennial studies and their malign influence should be consigned to the dustbin of history.

Good luck with the meeting, and thank you for providing MM members with the opportunity to share their knowledge, experience and opinions.

[Hurdity]

Yes hear hear re women over 60! Much more research needed on really long term safety of all types of HRT. After all there are many women living until 90. The potential savings to NHS also (from adequate research leading to potentially to longer term treatment into old age) - through having improved menopause services and appropriate treatment, as well as better quality of life for all women - should not be under-estimated ie in terms of osteoporosis, VA and associated conditions (bladder etc), cardiovascular disease, depression and anxiety,  and more.

Hurdity x

[CLKD]

However: the media are quick to jump on various 'studies' but NEVER make it front page news when those are dis-credited - that is something that the Government should take on board ?!?!?