Thanks to the campaigning efforts of middle-aged women, the menopause is being talked about a great deal more than it used to be. It has even made it on to the sex education curriculum in English schools, where children are now taught that periods usually end around age 51. With a private member’s bill that is due to be debated in the House of Commons on Friday, the Labour MP Carolyn Harris aims to formalise this rising awareness. Her bill would remove prescription charges for hormone replacement therapy (HRT) in England (there are no prescription charges in Northern Ireland and Scotland, while their reintroduction in Wales is being discussed), and compel the government to develop a UK-wide menopause support strategy.
Attitudes to HRT have shifted markedly as medical research has developed. In 2002, an American study of more than 16,000 women found a link with breast cancer. But the study has since been strongly criticised, while the treatments themselves have changed. Similarly, while there was once thought to be a possible link with dementia, one recent study found that taking HRT did not increase women’s risk of developing the disease. Campaigners think that more emphasis should be placed on the positive effects of hormone treatments, and Ms Harris’s bill would ensure that more attention is paid to the menopause in medical schools and in GP training.
Research is ongoing into the biology and genetics of menopause, which is a highly unusual trait that humans share with killer whales. As Baroness Warsi said in a recent documentary, the challenge is to increase public understanding without adding to the stigma surrounding the “change of life”. As it stands, ageing is often associated by women with a loss of status – sometimes described as a feeling of becoming invisible. While it is important to pay attention to the women for whom the menopause is a difficult, even a calamitous, experience, it must not be viewed as something to be universally dreaded. Most women experience symptoms including hot flushes, but only a minority find them seriously debilitating. The cessation of periods and other changes can also come as a relief. Getting older can be empowering.
Already, some employers have policies allowing menopausal women to make requests such as different working hours. An increase in the number of claims brought by women to employment tribunals that reference menopausal symptoms suggests that women are becoming more confident in asserting their right to be treated fairly. The current legal position is uncertain, with some claimants alleging sex discrimination, while others have sought to be recognised as disabled. Caroline Nokes, the chair of the women and equalities committee, has suggested that menopause could become an additional protected characteristic under the Equality Act (as pregnancy and maternity are).
The case for making HRT free, while other prescription charges remain, is not clearcut. Currently only contraception is exempt from the £9.35 charge (in England). But ministers and MPs should welcome Ms Harris’s advocacy on behalf of menopausal women, particularly in the workplace. She has taken up the challenge of turning women’s justified concerns into public policy rooted in evidence.