‘The menopause industry is thriving because women aren’t getting the care they need from the NHS’
On Monday morning I logged into my weekly Zoom check-in with a fellow freelancer, who greeted me with: ‘have you seen the news about tonight’s Panorama?’
Oh God, I thought – still fresh from the nursery run and severely under-caffeinated – as I took in the headline on the BBC website. I could already sense the storm that was coming.
Titled The Menopause Industry Uncovered, the programme revealed how some women are paying for scantily-evidenced products and supplements and spending hundreds or thousands of pounds to speak to specialists at private hormonal clinics, with some being prescribed oestrogen more than triple the upper limits tested in clinical research.
The commercialisation of the menopause is a regular topic of non-work chat during these calls – my friend being a perimenopausal woman, whose targeted ads are full of the latest ‘menopause solutions’, and me having spent most of my career writing about women’s health.
Barely an hour goes by without a press release popping into my inbox, promoting some supplement, wearable, treatment or clinic which – they say – is set to revolutionise women’s healthcare. I’m as bamboozled by all these claims as the next woman, but I at least have a little black book of medical experts up my sleeve, to help me make sense of the evidence.
In that sense, there wasn’t much in Kirsty Wark’s 30-minute investigation that surprised me. But Panorama missed one vital point: this burgeoning industry is only able to thrive because too many women still aren’t getting the care they need from the NHS.
In the six years I’ve been writing about the gender health gap, I’ve heard countless women’s stories of feeling dismissed, disbelieved and generally not taken seriously by their doctors. These issues go way beyond any one particular health issue or time of life, but it’s fair to say the menopause comes up a lot.
I commonly hear about women being told they’re ‘too young’, ‘probably just stressed’, or that debilitating menopause symptoms are ‘just something all women have to go through’. And it’s not too hard to work out where all this comes from: women going through menopause face a perfect storm of sexism, ageism, gaps in medical knowledge, and gaps in NHS services.
Doctors typically receive no specialist training in menopause, despite it having wide-reaching implications for the bodies of half the population. Access to specialist services is patchy, and often involves long waiting lists.
And then, of course, there’s HRT. Bad science and media scaremongering put doctors and patients off the treatment for decades. Much of that fear and misinformation still lingers today, despite the fact that evidence now shows the benefits of HRT will outweigh the risks for the majority of women.
Public awareness, both of menopause and the benefits of HRT, has improved hugely in recent years. This is largely thanks to the dedication of advocates and campaigners, who have worked tirelessly to get menopause on the agenda and keep it there.
Yet Panorama also highlighted my worry that, in correcting the myths around HRT, it may have been placed on too high a pedestal. There’s no doubt that, for many women, HRT is life changing. But women who can’t or don’t want to use it – and those for whom it wasn’t a silver bullet – tell me they feel increasingly excluded from the mainstream discussion.
Similarly, clinicians who’ve (quite reasonably) pointed out that not everyone wants or needs HRT tell me they’ve been pilloried online. This kind of polarisation serves nobody. We must ensure all women’s voices and experiences are heard, and that they’re supported to make informed choices about the best options for them.
While the public conversation rages on, it’s clear that frontline care still has a lot of catching up to do. For women struggling with severe symptoms, who can’t access adequate care through the NHS, the big question is where else can they turn?
Across menstrual and reproductive health, chronic illness, menopause and more, women who feel let down by the health service are turning to online communities, the wellness industry and private practice – desperate for the validation, support and solutions they can’t find at their local surgery.
I’ve heard worrying stories of women spending vast sums on products and alternative therapies that aren’t regulated or evidence-based, or going into debt to fund private treatment. Of course it’s vital we talk about the potential harms.
The bigger picture, here, though? The systemic failings that are driving women to look elsewhere in the first place.
The expert view
Dr Hannah Short is a GP specialising in menopause, premature ovarian insufficiency (POI, or premature menopause) and premenstrual disorders. Here's her advice on what to do if you’re feeling anxious after watching the Panorama episode.
‘Do not change your HRT dose, or stop it altogether, without first consulting your doctor. If you’re still unsure, remember you’re also entitled to ask another doctor for a second opinion. HRT prescription is very individual. Some women will, under specialist supervision, require higher than standard doses of HRT, particularly if they have a diagnosis of premature ovarian insufficiency (POI), early or surgical menopause (when the ovaries have been removed).
‘In these cases, sufficient HRT is paramount for long-term health protection as well as symptom control.’
Sarah Graham is an award-winning health journalist and author of Rebel Bodies: A guide to the gender health gap revolution.
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