World Menopause Month

– in the House of Commons at 3:33 pm on 21st October 2021.

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Photo of Carolyn Harris Carolyn Harris Labour, Swansea East 3:33 pm, 21st October 2021

I beg to move,

That this House
has considered World Menopause Month.

It is rare to stand up in this place and open with the words, “This is not a political issue”, but that is what I am doing today. Women’s health is too important to be used to gain political advantage or score points against each other. Women’s health is so important, and women have suffered for far too long. To stop that we must work together across the House to bring about change. Today is just the start. Today we can talk about the perimenopause and menopause, and we can share our experiences and discuss all the areas that desperately need change. In doing so, we will break the taboo. Breaking the taboo is a huge step forward, but it does not stop there. Talking is great, but action is better.

The menopause is something that every woman will experience at some point in her lifetime. When and how we experience it is unique to each of us. For some, it will be a simple transition with relatively few side-effects. For others, the side-effects will be extreme—physically painful, mentally challenging and, at their peak, completely debilitating.

It is estimated that 13 million women in the UK are either perimenopausal or menopausal. That is almost a fifth of the population. Can we imagine any other condition that affects that many people being so woefully overlooked and misunderstood? This issue is not just about the women experiencing the symptoms; its impact directly affects husbands, partners, children, friends and colleagues. It really is an issue that we need to take seriously.

Next Friday, my private Member’s Bill, the Menopause (Support and Services) Bill, comes to this place for its Second Reading. I have been blown away by the support I have received from Members right across this House and the other place, and from outside—the press, celebrities, the general public and businesses. It seems that finally, after years of whispered comments and clandestine conversations, everyone is ready to talk about the menopause. Women are ready to stand up and share their experiences.

Hot flushes, night sweats, brain fog, weight gain, insomnia, anxiety, vaginal dryness, poor concentration—I could go on; the list is endless. Hormone imbalance does all those things to our bodies. For many, help is available in the form of hormone replacement therapy. It is not for everyone, but for those of us it does suit, including me, it is honestly life changing. After 11 years on antidepressants, I am now on HRT and weaning myself off antidepressants, having realised that I was not having a nervous breakdown but actually going through the menopause. I have been on HRT for only a relatively short time, but I did not realise how much of me I had lost to the menopause until I started taking it.

Despite the fact that HRT makes such a difference to so many of us—it is no exaggeration to say that it can quite literally save women’s lives—it remains the only hormone medication that is not exempt from prescription charges in England. For many, because they need both progesterone and oestrogen, the cost is double. I can guarantee that mums on a tight budget will make sure that their kids have everything they need before finding the £20 to pay for the prescription, which means that that cost is a real barrier for many women up and down the country. But we can change that—and I hope that we will with my Bill. Every MP in England will have constituents who would benefit from that change in legislation. We cannot let them down.

Let us look at what else we can do, once we have broken down the financial barrier, to reduce the impact on women’s lives during the perimenopause and menopause. Let us look at where else women are being failed. Menopause training in medical schools is unacceptably poor, with 41% offering no mandatory menopause training at all. Curriculum content in schools needs to be reviewed so that the next generation of girls and boys are educated and prepared for this stage of their lives.

Support in the workplace is still a lottery, with some employers excelling but others letting their employees down at a really difficult time. Caroline Nokes, with whom I work closely on this issue, will speak later about workplace support and the excellent work being done by the Women and Equalities Committee, but I want briefly to mention a few companies that are really taking the issue seriously. Yesterday, the all-party parliamentary group on menopause held a session focused on workplace support, and we heard some really good examples of best practice from PricewaterhouseCoopers, Network Rail, Bristol Myers Squibb, Tesco and John Lewis. We also heard from Timpson. James Timpson—the man walks on water! He announced on Monday that Timpson will be allowing staff to claim back their HRT prescription charges on expenses. I cannot praise the man enough. This is a true example of a company that cares about the welfare of its employees and understands that in offering this benefit it will retain its experienced workforce who are invaluable.

The fact that so many organisations are starting to wake up to this is such a positive step forward. It is a joy to be able to stand here today and celebrate that, but we need it to be the norm, not the exception. The UK’s workforce is changing. More than three-quarters of menopausal women are now in employment. We need employers to change, too, so that women feel comfortable speaking to their managers about their symptoms and what adjustments they need. In fact, we need to educate everyone, so that talking about the menopause with medical professionals, among friends and within families, as well as in the workplace, becomes a natural thing for women to do.

Earlier this year, ahead of a Westminster Hall debate that had the topic of menopause support, the Chamber engagement team helped me hugely by creating a survey for anyone impacted by the menopause to share their experiences. I was taken aback by the number of responses we received in just a couple of days, and by how honest and insightful they were. Looking again at those responses and at the hundreds of emails coming into my inbox makes me realise just how many women out there are now ready to reach out and share their experiences. I am honoured that they are choosing to do that, but it saddens me that many of them have never spoken about their symptoms with anyone else.

Photo of William Wragg William Wragg Chair, Public Administration and Constitutional Affairs Committee, Chair, Public Administration and Constitutional Affairs Committee

It is impossible to resist any campaign spearheaded by the hon. Lady and this is one I am very proud indeed to be able to support. I look forward to the Second Reading of her private Member’s Bill next week, which I will be here to support. What would she say to the men out there as to how they can be supportive and better understand the menopause, rather than treat it as a taboo subject?

Photo of Carolyn Harris Carolyn Harris Labour, Swansea East

I would say, “Take the example of the hon. Gentleman, who has become a menopause warrior: be there for the women in your lives and make sure you provide listening ears and thoughtful words on how you can support your loved ones and the women in your workplaces.”

I understand that women have found it difficult to talk, because across society we have been encouraged not to. A funny story, but a very true story, is that I remember my mum ushering me out of a room when her and my aunts were discussing a “rather difficult sensitive issue”. One of my aunts will probably be absolutely horrified that I am talking about this now. They were discussing her menopause. I hasten to add that I was 36 years of age at the time—[Laughter.]—but that just goes to show the taboo around talking about this subject. There will be some people out there who will be absolutely astounded that I used the expression “vaginal dryness” in the Chamber of the House of Commons, but it is a fact of life.

The stories that women are sharing with me are often really distressing: from women who have struggled for years with no support and feel it has ruined their lives, to women who have experienced early menopause due to medication or surgery and feel that they are literally on their own; and from women who have experienced some of the most extreme physical symptoms and those whose mental health has really suffered, struggling in silence because that is what they thought they had to do and did not know what was happening to them.

In the public engagement survey earlier this year, Helen shared her story. She told us:

“My perimenopause symptoms started at 41....by the time I was 42, I had developed palpitations and anxiety attacks. I suddenly couldn’t leave the house or meet people and was scared all the time that something was seriously wrong with my heart. I was a shell of the woman I used to be.”

Then there are those who have taken the next step and visited their GP to ask for help, only to be turned away or sent packing with a prescription for antidepressants. I am not pointing the finger at GPs because I know how hard they work, but there is a woeful lack in their training and understanding of the menopause. Many are not able to join up the dots and women go undiagnosed.

In our survey, Catherine explained how she had experienced that exact problem. She said:

“With my own research I’ve had to work hard to convince my GP that constant increases and changes in antidepressants weren’t working and my difficulties were hormonal. I nearly lost my job and my husband...it’s taken 6 months to finally receive the HRT I need. Within 2 months of taking HRT I have successfully weaned off antidepressants, been able to start exercising and my home, work and personal life is” completely “transformed”.

It does feel like we are starting to turn a corner. If we can just bring all the pieces of the jigsaw together, we can change the future for ourselves, our daughters, for our daughters’ daughters and for women who follow on behind us forever more. We can stop menopause being something people are afraid to talk about. We can help to ensure that everyone understands the symptoms so that women know what is happening to them and family and friends are able to support them. We can make sure that women get the right diagnosis and the right treatment plan for them to help to alleviate their symptoms, and we can ensure that every workplace is a menopause-friendly workplace so that women can continue to succeed in their careers. It is time for change. It is time for the menopause revolution. Women want it, women need it, and women deserve it.

Photo of Nigel Evans Nigel Evans Deputy Speaker (Second Deputy Chairman of Ways and Means)

I am going to try to have this debate without putting a clock on. If people can show discipline and keep their speeches to about six minutes, we will get everybody in with an equal time.

Photo of Caroline Nokes Caroline Nokes Chair, Women and Equalities Committee, Chair, Women and Equalities Committee 3:46 pm, 21st October 2021

It is a pleasure to be able to contribute to this debate to mark World Menopause Day earlier this week, and the whole of October being Menopause Awareness Month. Carolyn Harris is absolutely bang on: this is not a political issue. I pay tribute to her tireless work, and it is a privilege to follow her excellent contribution. She and I have become something of a tag team on this issue, and it was notable that when we went to request that the Backbench Business Committee give time for the debate, we were quite definitely discussing when, not if.

In July, the Women and Equalities Committee launched our inquiry into menopause in the workplace, and since then we have collected evidence from a wide range of sources about the impact that menopause can have on women and work. However, before I highlight some of the issues that we have so far uncovered, I want to make a quick comment about the menopause and Westminster, or more specifically, the menopause and Whitehall.

Back in 2018, I had the privilege to be a member of the employment taskforce, and I have never forgotten the introduction given by one of the most senior civil servants in Whitehall to one of those meetings, where he spoke of the economy being “menopausal”—like it is some sort of insult, as if it is something to be ashamed of or ridiculed. I challenged him then in the same way that we must all challenge it now, because we have to beat down that stigma, that taboo, and make sure that the menopause is something that we can actually celebrate. I am talking about those brilliant menopausal women who have contributed so much during the course of their careers up to that point; the ones who are approaching the peak of their careers; the ones who have learned the ropes, gained the experience, given confidence to those following behind them and been role models to younger colleagues; the ones who have demonstrated that you can do it. If we allow menopause to be an insult, we are saying that the women who have achieved are suddenly of no use any more, and that is not the case.

But the workplace can be phenomenally difficult when experiencing menopausal symptoms. Goodness, anywhere can be difficult, but a recent survey carried out by the Fawcett Society on behalf of Standard Chartered and the Financial Services Skills Commission, specifically about women in finance who are experiencing the menopause, highlighted some really stark findings. Over 50% of women are worried about taking on additional responsibilities because of the menopause—that is the promotion gone. Twenty-five per cent. of women considered leaving their career altogether because of the menopause—that is the job gone; that is the income gone.

We talk about 1 million women being lost to the workforce. Let that sink in: a million women. Those are experienced, talented, confident, knowledgeable women no longer playing a role in the boardroom and lost to the management tier—decades of experience and advice to younger colleagues simply gone. In stark economic terms, we cannot afford to let that happen. No business, no school, no fire service, no organisation, no Parliament can afford to lose its best and its most experienced.

The really scary thing about the evidence that my Committee has so far received is the number of requests for anonymity from women who want their evidence kept confidential because they are worried about its impact on their careers. That is not acceptable.

Yes, of course the menopause can be difficult. We will all have different symptoms at different times; some will be phenomenally lucky and have no symptoms at all, but some will have symptoms so severe that they cannot carry on at work. We have to break down the stigma and start the conversations so that I never again get an email like the one that I received from a company’s HR director because she did not want her name attached to evidence to the Committee; she wanted it kept private because she was scared about what would happen to her career if anybody in her organisation even thought that she was menopausal.

I cannot predict where the evidence will take the Committee or what recommendations we might make to the Government. We have not even started taking oral evidence, so we are some way off my beating a path to the Minister’s door, or to the door of Ministers in the Department for Business, Energy and Industrial Strategy, to ask for change.

I do not wish to make out that everything is negative. Far from it: the hon. Member for Swansea East gave some fabulous examples of companies that are real trailblazers. In our evidence-taking, I have been completely candid with employers and said, “I want to hear the good as well as the bad—I want to be able to celebrate you and hold you up as a role model to other companies and organisations.”

We have already heard some of the names: Timpson, John Lewis, Tesco, PwC and all the companies that have signed the menopause workplace pledge organised by Wellbeing of Women and supported by Bupa. To all the companies and organisations such as the NAO, which invited me in to talk about the menopause as if I were some sort of expert—it should have had the hon. Lady, who is a far greater expert—I say thank you, because they are starting the conversations. They are just talking about it, and that is the first step.

Nowadays, I am pretty happy to talk to anybody about my menopause or perimenopause symptoms, whatever they are. My induction to that came from GB News, which bluntly came straight out with “What are your symptoms?” I had to give the answer, “I don’t know”—I do not know whether the sweats at night are the start of the menopause or a result of my absolute addiction to a 13.5-tog duvet, which could explain it. Even I baulked at the prospect of using the term “vaginal dryness” in the presence of the Countess of Wessex; others were not quite so reticent.

I am conscious of time, but I want to mention briefly an individual champion. She is not quite my constituent—she is just over the border in North West Hampshire—but Claire Hattrick in Andover runs clipboardclaire.com, a blog dedicated to giving help and advice to other women. In the past week, she has published a whole book on the subject; she is coming to Parliament next week to support the hon. Member for Swansea East, give me a copy of her booklet and make sure that together we champion the brilliant advice out there for menopausal and perimenopausal women and spread the word.

We women born in the late 1960s and early 1970s are the ones most likely to be going through the perimenopause or menopause now. We are determined to speak up, speak out and find paths through the menopause that work for us. We will not be hiding away, because although we might be a pretty unlikely bunch of revolutionaries, it is a revolution that we need.

Photo of Judith Cummins Judith Cummins Labour, Bradford South 3:53 pm, 21st October 2021

It is a pleasure to speak in this important debate. I thank the Backbench Business Committee for the opportunity to highlight World Menopause Month and the critical issues associated with menopause, and I thank my hon. Friend Carolyn Harris and the Chair of the Women and Equalities Committee, Caroline Nokes, for securing the debate. I will speak on one aspect of menopause: its link with osteoporosis. I do so as co-chair with Lord Black of Brentwood of the all-party parliamentary group on osteoporosis and bone health.

Menopause is an important time for bone health. When women reach the menopause, oestrogen levels decrease, which causes many women to develop symptoms such as hot flushes and sweats, as we have heard today. According to the Royal Osteoporosis Society, the decrease in oestrogen levels causes loss of bone density, so the menopause is an important cause of osteoporosis. Everyone loses bone density and strength as they get older, but women lose more bone density more rapidly in the years following the menopause, and they can lose up to 20% of their bone density during this time. With that loss of bone density comes reduced bone strength, and a greater risk of breaking bones.

Now for some facts about osteoporosis. Half all women and one in five men over 50 will break a bone as a result of poor bone health. As someone very wise put it to me yesterday, that is literally every other person. Osteoporosis causes more than half a million broken bones every year, which equates to almost one broken bone every minute. Breaking a bone usually means significant short-term pain and inconvenience, but it does not stop there. Many people with osteoporosis who break a bone live with long-term pain and disability, especially if their backs are affected. The reality of broken bones and the fear of falling have an impact on people’s everyday lives and activities, preventing them from doing the things they love and, essentially, from being the people they are.

Yesterday was World Osteoporosis Day, and the Royal Osteoporosis Society marked the day by releasing findings from a new survey of over 3,000 people with osteoporosis, the 2021 “Life with osteoporosis” survey.

Photo of Peter Dowd Peter Dowd Labour, Bootle

I am pleased to be a member of the all-party parliamentary group on menopause, led by my indefatigable hon. Friend Carolyn Harris. I am also pleased that my hon. Friend Judith Cummins has raised the significant links between osteoporosis and the menopause. Does she agree that the four actions called for by the Royal Osteoporosis Society in its manifesto for a future without osteoporosis, including an expansion of the fracture liaison services, are not too much to ask for the 3.5 million people affected by the curse of osteoporosis?

Photo of Judith Cummins Judith Cummins Labour, Bradford South

I could not agree more wholeheartedly with my hon. Friend. Yesterday I had the honour of supporting the ROS, and a group of fantastic and passionate patient advocates who had helped with its report so enthusiastically, in delivering the report to the doorstep of No 10. Following that, we had a meeting with the Minister’s counterpart, the Minister for Care and Mental Health, Gillian Keegan, who received the report on behalf of the Government. I hope that both Ministers, working together with us, will carefully consider the points raised in the report—alongside the ROS’s new policy manifesto, to which my hon. Friend just referred—and will make sure that the needs and wellbeing of all those with osteoporosis, as well as women as they approach and go through the menopause, are at the heart of the Government’s health policies.

I have visited my local fracture liaison service at Bradford Royal Infirmary. It is an excellent and award-winning service. I spent time with the team discussing how good their work was at a local level, and how we could make improvements at a national level. We discussed the inconsistencies in terms of delivery of treatment across the country to which my hon. Friend referred. But one of the astounding things that stood out was their pride, their enthusiasm and their dedication to providing such excellent treatment for the people of Bradford in respect of a disease which, although important, is rarely spoken about.

Significant harm could be prevented if we put prevention at the heart of primary care. Digital solutions which could support that already exist, but they are not properly integrated into IT systems in our GP surgeries. Such systems could easily identify people at risk of osteoporosis before that all-important first fracture. Those who experience early menopause—before the age of 45, and especially before the age of 40—are at particular risk of osteoporosis and fractures in later life. They are advised to take HRT at least up until the normal age of menopause, which is around the age of 50.

I am proud to stand here today to help break the silence of this silent disease, a disease that affects so many women—young women in today’s society; women who have much to offer, women who should not be left undiagnosed, women whose quality of life is left literally to crumble, women who are left to suffer in pain—when in fact this is a treatable condition, because our bones are alive and can be built back stronger with the right treatment. I hope that the Minister will see why it is essential that, around the time of the menopause, women are properly supported to assess their risk of osteoporosis and fractures. I welcome her to her place, and I would also welcome any further conversations with her and her counterparts to ensure that we have the right policies in place to support women at this important time.

Photo of Nigel Evans Nigel Evans Deputy Speaker (Second Deputy Chairman of Ways and Means)

Just to talk through the timings, the wind-ups will start no later than 4.36. There will be six minutes for Marion Fellows, eight minutes for the other two Front Benchers and the last two minutes for Carolyn Harris.

Photo of Nickie Aiken Nickie Aiken Conservative, Cities of London and Westminster 4:00 pm, 21st October 2021

I should like to start by thanking the Backbench Business Committee for allowing this debate today. I also want to thank my right hon. Friend Caroline Nokes and of course my friend Carolyn Harris not only for this debate but for their brilliant work on the menopause. The fact that we have a menopause awareness month, and a day, demonstrates how far we have come in this debate. Clearly there needs to be a continuous, bigger conversation on women’s health issues and about how our bodies change as we get older, and it is important to reinforce the fact that the Government have a clear policy on addressing women’s health. I look forward to the strategy being published—sooner rather than later, I hope.

As a perimenopausal woman myself—I say that with pride—I think it is right that we discuss these issues now, in public and with our friends and families. We have heard loud and clear today that access to information about the menopause remains critical to enabling women to feel empowered to make informed decisions about their own health. Right now, we need women themselves to be well informed, to have positive reinforcement and to be supported by sympathetic networks. That is why I am delighted to have met Elizabeth and Clare, the founders of Pausitivity, a not-for-profit campaign dedicated to helping women feel empowered to talk about the menopause and to provide tools to make informed decisions. I have a copy here of its “Know Your Menopause” poster. I have a copy in Welsh—Cymraeg—and one in English. It is also available in Urdu, Scottish Gaelic, German, French and Dutch on the campaign’s website. The posters follow the National Institute for Health and Care Excellence guidelines. I would recommend all clinical commissioning groups across the country to talk to their GPs about putting these posters up in their surgeries, to provide women with the information and signposting that they need.

I was first struck by the menopause—it was like being struck by a truck, to be honest—when I was 48. That was when I started to feel the many different symptoms. I had a blood test, but it showed that my hormones were fine. Apparently I was not having any issues with the menopause. I remember my GP phoning me about something and she said, “How are you?” I said, “Well, apart from the acne, the hair loss, the weight gain, the stress, the insomnia and the anxiety, I am absolutely fine!” To which she said, “Okay: HRT.” I went on to HRT straightaway and have never looked back. It has been a lifeline. I also have to declare an interest as I pay for the prescription charge myself.

Photo of Tonia Antoniazzi Tonia Antoniazzi Labour, Gower

I would like to commend the hon. Lady for her speech and to commend my hon. Friend Carolyn Harris for the excellent work that she has been doing. I also commend everybody in the Chamber this afternoon. I had a very similar experience to that of the hon. Lady at the age of 48 or 49. On the point about prescriptions, we are fortunate in Wales and I did not have to pay for my HRT prescriptions. I would like to give a shout-out to the Welsh Labour Government for looking after women in that way.

Photo of Nickie Aiken Nickie Aiken Conservative, Cities of London and Westminster

I thank the hon. Lady for her intervention.

I had a discussion with the Secretary of State for Health and Social Care this week about the costs of HRT and the stresses and strains on the NHS budget following covid, which I understand. With this in mind, will the Minister reiterate to the House the current NICE guidelines and ask NICE to reach out to GPs and encourage them to tell their patients about all the options available to them, as well as any associated costs? I understand that there is a system in place where women can get an annual prescription for their HRT, but there is a lot of confusion about that, so I would appreciate it if the Minister could address that in her summing up.

As has already been said, and I completely agree, the menopause is not just a women’s issue. This is a people’s issue, and men have to be part of the discussion, too. I thank my hon. Friends the Members for Totnes (Anthony Mangnall), for Eastleigh (Paul Holmes) and for Heywood and Middleton (Chris Clarkson) for sitting down with me last week to ask about the menopause—my hon. Friend the Member for Totnes asked, “Will you please talk me through the menopause?” because he knows how important it is—and I gave them a complete and utter description. They were quite horrified, to be honest.

It goes back to what my hon. Friend Mr Wragg said: men have to understand what their mothers, sisters, partners and work colleagues are going through if we are ever to break down the barriers and make the menopause less of a taboo. I reiterated that to the Secretary of State for Health and Social Care this week, and he agreed with me that men have a huge part to play in breaking down the barriers.

It is important that we consider the workplace. I take my hat off to the likes of Timpson and PwC for their brilliant work. Women, and particularly menopausal women, make up so much of the workforce. I am a woman in the prime of my life and hopefully just beginning my political career in this place. I believe I have so much to offer, and knowing that I have the HRT and the support will help me. We need to ensure that companies focus on developing strategies to help their women, and to help their colleagues to help women through this.

I am proud to support the Government’s ambitious project to set women’s health as a huge priority. We are making women’s voices heard and putting them at the centre of their own care, to make sure that our national health system truly works for the whole nation. I believe the Minister is listening and I look forward to her response.

Photo of Jessica Morden Jessica Morden Chair, Statutory Instruments (Joint Committee), Chair, Statutory Instruments (Select Committee), Chair, Statutory Instruments (Joint Committee), Chair, Statutory Instruments (Select Committee), Shadow Vice Chamberlain of HM Household (Whip) 4:07 pm, 21st October 2021

It is a pleasure to follow Nickie Aiken, who made some excellent points, and it is great to take part in this debate on World Menopause Month. I am pleased to be a member of the all-party parliamentary group on menopause, chaired with typical passion and panache by my hon. Friend Carolyn Harris.

I add my support to the call for the menopause revolution across policy making to finally address the personal, social and professional impact of the menopause on the lives of women in the UK. The issues faced by so many women were outlined so ably by my hon. Friend that I will not repeat them, but we will have another opportunity to discuss some of these issues next Friday when we consider her private Member’s Bill. The menopause is an issue that has been woefully overlooked, and I particularly welcome her reference to menopause training, which is important.

As other Members want to speak, I will make a short contribution to add my support for the awareness raising and the calls for change. We need to see an urgent change of attitude in our workplaces to reflect the changing make-up of the workforce. Menopausal women are the fastest growing working demographic in the UK. In Wales, nearly half of all working women are over 50 and are likely to be experiencing the perimenopause or the menopause.

However, a cut-off age of 50 does not reflect the number of women affected, many of whom will be experiencing symptoms of the perimenopause in their mid-to-late 40s, while many younger women experience an early menopause, whether premature, surgical or medical. This includes younger women experiencing common conditions such as endometriosis, who may receive treatment that induces menopausal symptoms. I am sure we all pay tribute to the all-party parliamentary group on endometriosis and its former chair, David Amess, who we are thinking about very much this week.

What is clear is that support for women suffering from the potentially debilitating symptoms of the menopause is not widespread in many workplaces. Although the Equality Act 2010 prohibits discrimination on the grounds of sex, research from the Wales TUC, which has done great work on this for many years and I commend it to the Minister, highlights how many women feel that managers simply do not recognise problems associated with the menopause in the way that they would for other health conditions, even those with similar symptoms arising from different causes. In studies conducted ahead of the publication of its superb menopause toolkit, the Wales TUC found that almost a third of women with direct experience of the menopause felt that it was treated negatively in their workplace and nearly 60% reported witnessing the menopause being treated as a joke. That clearly highlights the pressing need for menopause workplace policies, particularly in large organisations, so that women know they have the support, the flexibility and the time off without the worry of losing out on pay.

I also want to mention the link between the menopause and osteoporosis, as my hon. Friend Judith Cummins did. She is our lead on this, as chair of the all-party group on osteoporosis and bone health. That affects 3.5 million people across the UK. Half of women over 50 will suffer a broken bone due to osteoporosis, which, as she said, is a condition closely tied with changes in oestrogen levels. As she said, the menopause is an important time for bone health and bone density. Like the menopause itself, osteoporosis is not something policy makers can merely dismiss as a mild feature of getting older, as many people die from fracture-related causes. Although people living with the disease can live a healthy life with prompt diagnosis and the right support, millions are suffering the consequences of long-term pain and even disability because of under-diagnosis and under-treatment.

The day-to-day impact of osteoporosis cannot be underestimated. Research from the Royal Osteoporosis Society shows that a quarter of osteoporosis sufferers will be living with long-term pain; that 71% have trouble with cleaning and cooking; and that 52% say the condition affects their ability to get around, to drive or to use public transport. There is much more on that. Work is going on in many areas, including in the Aneurin Bevan University Health Board in my area, where we have the specialist first fracture clinic in Pontypool, and a fracture liaison service based at Nevill Hall Hospital. However, that needs to be more widespread. I implore Ministers to work with the ROS on its request for the Government to match-fund their research investment, as part of a much-needed rebalancing of research investment towards musculoskeletal conditions, which account for 9% of the health burden, but a mere 3% of the research spend.

Finally, I commend my hon. Friend the Member for Swansea East for her Menopause (Support and Services) Bill to end English prescription charges for hormone replacement therapy, which can help to prevent osteoporosis and other menopause symptoms. As has been mentioned by my hon. Friend Tonia Antoniazzi, thanks to the Welsh Labour Government, our constituents in Wales do not have to pay to access that essential treatment. The Bill aims to ensure that that is also true for our neighbours across the River Severn.

Photo of Julie Marson Julie Marson Conservative, Hertford and Stortford 4:13 pm, 21st October 2021

It is a pleasure to follow Jessica Morden and I, too, congratulate Carolyn Harris on securing this debate and on her words earlier, because this is an important debate on an important issue. I mean no disrespect to any of the male Members here, because I know they are champions as well, but I have a suspicion that, if this was a male issue, it may have been discussed and medicated out of existence by now.

I had a career in my 20s and 30s, as many of us did. I took a career break for 16 years and when I came back I realised why women in their 50s sometimes do not start new careers—I will leave it at that and not go into any more detail—although I highly recommend that they do.

I wish to make one point about access to HRT for those of us who have a family history of breast cancer, and how difficult—in my case, nigh on impossible—that has been. There is an issue about the training of GPs, misinformation about the issue, and surveys and research that may be out of date. It is so important that diagnosis, treatments and information are based on the latest research and data, and are proportionate. Other issues, including osteoporosis, are important counterbalances to the risk of breast cancer.

One of the biggest things this Government are doing is the women’s health strategy. I pay tribute to my right hon. Friend Ms Dorries, who was previously the Minister responsible, for her work on the strategy, which I know the new Minister will continue. Women’s health, physiology and biology have not always been taken as a central point of reference for medicine, diagnosis and the way we devise and deliver health services in this country. Making sure that that changes is a crucial part of our work in this House.

I wish to make one final point. A few years ago, probably around the time of World Menopause Month, a prominent female parliamentarian with many years of experience used social media to say to women, “Recognise the symptoms and get treatment, help and advice.” The first response was from someone who said that she should not use the term menopause because it was not inclusive enough. If we have a problem, we have to name it and understand it and who it affects. We should be clear that biological sex is a reality and that this affects women, along with lots of other things. To recognise it, treat it and talk about it, we have to be very clear about that biological fact.

Photo of Alex Davies-Jones Alex Davies-Jones Shadow Minister (Northern Ireland) 4:16 pm, 21st October 2021

It is an honour to follow Julie Marson, but I remind the House that when it comes to medical conditions, inclusive language matters, and although the menopause does impact women, it also impacts trans men and nonbinary people. It is important that that is reflected in language so that they get accurate healthcare.

Like so many colleagues in the House, I am delighted that the Backbench Business Committee has granted time today for us to debate this important issue. I am especially grateful to my fantastic friends, my hon. Friend Carolyn Harris and Caroline Nokes, who are both leading the way when it comes to improving the discourse on menopause. It is a credit to their tireless campaigning that we have now reached this point and are able to speak openly about the need for greater Government action and support; for improved education in GP surgeries, the workplace and schools; and ultimately to work together to remove the stigma that surrounds the menopause.

I am pleased to see so many Members and friends from all parties participating in this debate, and I am particularly grateful to and inspired by those who have shared their personal experiences with the menopause. We must be mindful that the menopause impacts a huge range of people, as I said, and is no longer just an issue that impacts those over a certain age. When I was undergoing fertility treatment, I experienced a kind of early menopause as a consequence of the hormones and medication that the treatment required, and it truly knocked me for six. I experienced it all: from the hot flushes and headaches to fatigue and terrible concentration. It truly made me appreciate what my own mam, and so many others before me, have been through, and it opened my eyes to the impact that the menopause can have on everyday lives.

I join colleagues in raising the fantastic Pausitivity campaign and the vital resources that its team provides. Everyone who has experienced menopausal symptoms, whether medically induced or as part of the ageing process, will have different gripes, but it is vital that we start speaking up at every opportunity to make others who may not experience the menopause more aware. Indeed, as colleagues have said, we now know that around one in 100 women in the UK will experience menopausal symptoms before they turn 40, and it is estimated that in total around 13 million women in the UK are currently perimenopausal or menopausal. It is a completely normal part of life for some but, sadly, many women feel a huge amount of stigma and experience difficulty in talking about and dealing with the symptoms.

But there is hope. Alongside the Pausitivity campaign, my union, Unison, has a fantastic menopause-awareness campaign that I am a long-time supporter of. From my own experiences, I know at first hand just how important flexible working patterns are when going through the menopause. Simple changes such as paid leave and temperature controls in the workplace can have such a major impact on women who are experiencing menopausal symptoms. We now know that around eight out of 10 menopausal women are in work, so a significant proportion of the population is being impacted.

Despite the challenges that we still face, I am proud that a number of businesses are leading the way in creating real change in how women are facing the menopause and how they are treated in the workplace. As my hon. Friend the Member for Swansea East has already mentioned, only this week the fantastic James Timpson, the chief executive of the Timpson Group, has announced that all colleagues will be able to claim on expenses their prescription costs when they are recommended HRT. This is a small step, but I know that it will help so many.

As colleagues will also be aware, earlier this month, fashion giant ASOS began to offer staff flexible work and paid leave during the menopause. This comes alongside several new policies that the company has announced, including paid leave for staff who have experienced a pregnancy loss or are undergoing fertility treatment, with five days paid leave provided per cycle to ensure that appointments can be attended and their work will not suffer. This is fantastic progress and it must now be backed up by legislation, urging other companies to follow suit. I therefore urge the Minister to please work with her colleagues in Government to bring forward this much-needed legislation that will finally protect women in the workplace who are experiencing the menopause, baby loss or infertility.

It is clear from the popularity of today’s debate and the widespread nature of the contributions that the menopause is far from a niche issue. It does not take a genius to work out that it will affect about half of us in our lifetimes. I sincerely hope that the Government are listening and are finally ready to take this issue seriously both for women suffering now, and for those of future generations, too.

Photo of Suzanne Webb Suzanne Webb Conservative, Stourbridge 4:20 pm, 21st October 2021

Periods, labour, childbirth, breast feeding and the menopause—oh, mother nature, please give us a break. Today, we are talking specifically about the menopause. Here we go again: migraines, insomnia, anxiety, aching joints, confidence dips, brain fog, tiredness, flushes, irritation, tears and AC-130—Members may ask what that is. It is fair to say that they will get the picture when I say that my ex-ex-boyfriend described me at one point as being similar to an AC-130, the world’s biggest flying artillery gunship nicknamed “Hell in the Sky”, with three side firing weapons, a 25 mm Gatling gun, a 40mm Bofors cannon, and a 105 mm howitzer firing on all sides. We are talking about the joys of menopausal rage. Members will be pleased to know that the AC-130, so described, was only temporarily in action and was retired some time ago, as was the ex-ex-boyfriend.

Seriously, I do not want to be here talking about this today. I do not like baring my soul about something so deeply personal, let alone here in this great place. This is the only time, Mr Deputy Speaker, that I wish there was a time limit. The taboo around the subject is evident when we consider who is, or who is not, sitting in this Chamber. It is a shame that there are not more people of all ages in here contributing to the debate. Clearly, speaking in this debate is what I needed to do to give women hope that, while this is a club that no one wants to join, ultimately we all do—as a woman. But you know what? Once in, it is a lovely club with some amazing and awesome women.

I thank Carolyn Harris and my right hon. Friend Caroline Nokes for ensuring that we actually had this debate and that I actually came here and spoke out. I came through all of this very early and unscathed. However, I do wish to raise the issue of bone density, which Judith Cummins mentioned. Unbelievably, I did not realise what was happening at first—it was some years ago now—but I do now in hindsight. The horror was to do with my bone density. I did not have HRT at the time, so there was a sudden rush to put me on it once we realised that I had practically gone through the menopause. I had a bone density scan and everything was tickety-boo in that area—thank the Lord for that.

Talking about the menopause is a big deal for women. It is for me. I feel that we often have to defend ourselves. We are very much judged on it and women are embarrassed about it, as am I. It is often not talked about, even between women. We just do not want to talk about it. Men are embarrassed about it, too. As I was leaving for this debate, I was speaking to one of the guys in the flat. I told him that I was just about to go and talk in a menopause debate. He said, “Oh, all right. We can’t talk about that, so good luck.” Young women just see something that they think is unique to their mothers and that will not ever happen to them, but, trust me, it actually will and they will certainly know about it when it does happen. Look we must talk about it. We have to educate those who sadly believe that a women’s identity is built only on biological fertility and educate those who think that being menopausal indicates that a woman’s sell-by date has well and truly expired. Well, to whoever said any of the above or thinks it: just look at the amazing number of women sitting on these Benches who entered politics at their supposed sell-by date. We must talk about this so that it is no longer a taboo. And please—so I do not have to stand here talking about it ever again—can we just get it out there? Of course, also for the partners, colleagues and employers of menopausal women, we must share and understand the physical and mental impacts that the menopause can have on women.

The menopause is an entirely natural biological process. I thank the Government for putting it on the agenda. If I remember rightly, it was my hon. Friend Rachel Maclean who started to do so. The Government are in the process of developing a women’s health strategy, which will look to tackle menopause education. I have long thought that we needed to do more in schools to normalise hormones. From September 2020, relationships and sex education and health education have been compulsory in all state-funded schools. As part of this, pupils are taught about menstrual health and the menopause. A positive attitude to hormones is crucial and much needed, with more education in schools to break the myth that women are only defined by and are relevant through their biological fertility.

Society needs to reframe its attitude. It is okay to be grumpy. Tears are okay. Hot flushes are okay. Hot necks are okay. Layering clothes is the new “en vogue” for any perimenopausal woman, who can go from ambient temperature to extreme heat in the blink of an eye. The coldness in this Chamber is actually so welcome for anyone who is perimenopausal—so I thank the House! Some women fly through the menopause, some deny it and others suffer symptoms that affect their family and professional lives, and they deserve empathy, support and practical solutions.

Let me touch on HRT. As I said, I did end up having some HRT towards the end of that time, but it did not work for me. I think it is important to say that it does not always work for everybody, and it is important for people to have the right conversations with their doctor and to share that experience. If people start to feel other symptoms, as I did, they must go back to their doctor to have that conversation.

Photo of Caroline Nokes Caroline Nokes Chair, Women and Equalities Committee, Chair, Women and Equalities Committee

My hon. Friend makes an important point about HRT not working for everyone. What is also true is that different types of HRT work differently. Of course, the issue of prescription costs comes in for people who have to try several versions.

Photo of Suzanne Webb Suzanne Webb Conservative, Stourbridge

My right hon. Friend makes an important point. That is exactly what happened with me. We went through the process and tried the various options, although I ultimately ended up coming off HRT because it just did not suit me.

Talking about menopause is so important, especially when we often do not realise that we are starting to go through the process. We are not tapped on the shoulder one day and told, “This is it.” It is a slow and confusing process that can create anxiety and depression. Some say that it can be akin to a grieving process. The menopause brings on deep and profound changes, which should not be underestimated, but somewhat embraced, and perimenopausal women should not be confined to the out-of-date shelf. It is for all of us to think about this issue and do something about it; we all need to do something about this.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health) 4:28 pm, 21st October 2021

I commend Carolyn Harris on her contribution. I cannot think of any debate that we have not been together on. Indeed, the hon. Lady usually puts forward her suggestion of what she wants me to do and I easily fall in with whatever she says. She is infectious; she makes others want to be part of the debate and enthuses them.

As a man, I am pleased to speak in this debate because, as other Members have said, it is important that we understand the issues. I am pleased to be part of the growing call to bring living through menopause out of the shadows and into mainstream life. Some cynics might wonder what gives me the authority to speak when I do not have the necessary equipment to understand fully. I acknowledge that, because, in much the same way, unless someone is a diabetic, as I am, they can never fully grasp the life-impacting changes that diabetes brings. Although I cannot bring first-hand experience to this issue, I believe that I can bring compassion and a desire for other men to understand that we have a role to play in the cycle of menopause about which each and every person who has spoken today has referred.

I was recently asked to make comment on the menopause for a blog. The hon. Member for Swansea East had made the bloggers aware that I would be very keen to do so, and I did, of course, as she knows. I said that I was raised by a very strong lady in my mother, who gave me a real appreciation for the work ethic with the kind and no-nonsense approach of a good woman. Sandra and I have been married for some 34 years. Some people may say, “How has she stuck it that length of time?” Well, there must be something right, otherwise we would not be together, let us put it that way. She raised our three boys. She volunteered in the local charity. She kept our home going while I worked incredibly long hours. I am so grateful for her support in every aspect of my life.

However, as Sandra has approached menopause, it is clear that while she can and does continue to bear the load of minding the grandchildren and all those other responsibilities, she does need my support, and others’ as well. It has been hard for me to understand as I have watched her go through all these changes. I have learned that I do not need to understand but I simply need to be there, and she needs to know that I am not there expecting her to facilitate my normal standard of life, but rather there for her. I came home one day and she said to me, “Oh, I heard you were on ‘Loose Women’ today.” Right away, I felt the cold sweat on my brow and my heart missed a beat, and then I realised that it was because the hon. Member for Swansea East was asked on that programme whether there were any men who were supporting her, and she referred to me. My wife was then greatly encouraged when she realised that I was supportive of this.

I joined the APPG to highlight the fact that menopause is not an experience that a woman must suffer through alone; it is an experience in which we can all stand together as she comes through what can be a very difficult time in her life. It is an experience that men must better understand to provide the help and support that will change the experience. It is an experience that is a certainty of life for most ladies, but women do not have to walk alone. That is why on this World Menopause Day I am proud say that I stand alongside my wife, Sandra, my mother and indeed every other woman to offer my support and encourage other men to understand that we can make a difference and be a help. That is our role—to help.

I commend Judith Cummins for the work that she does on osteo-porosis. A prolonged lack of oestrogen affects the bones and the cardiovascular system, leaving those who are post-menopausal at increased risk of a number of long-term conditions such as osteoporosis. Women’s Health Concern, the patient arm of the British Menopause Society, emphasises that, unlike hot flushes—it is important for the Minister to address this when she responds—there are often no obvious symptoms of osteoporosis and the first sign is usually the fracture of a bone. The hon. Lady illustrated that only too well.

Osteoporosis makes bones fragile, which causes painful and disabling fractures. Women aged over 45 years spend more days in hospital due to osteoporosis than diabetes, heart attack or breast cancer, and osteoporotic or fragility fractures can have a profound impact on everyday life, causing loss of independence, misery and death. A post-menopausal woman has a 50% chance of sustaining an osteoporosis-related fracture in her lifetime. Once a fragility fracture has occurred, the risk of future fractures at least doubles. In women over 50 years of age, the lifetime risk of a vertebral fracture is one in three and is one in five for a hip fracture. The link is clear. I commend the hon. Lady, and others as well, for outlining that. I congratulate the International Menopause Society on highlighting this issue as a real and present danger that occurs after menopause.

I end with a further plea to all the men who are in this House and all the men who are watching on the screens outside: do not be embarrassed but be involved. Help your partner. Be informed about what your partner is going through and be part of the process and a help. I know what it is to feel helpless, and sometimes even clueless, as I am often reminded in my home by my good lady, but I have learned the truth of the scripture: two are better than one, for if one falls, the other is there to help them up. I may not have the right words—I often do not; although I have lots of words, I often maybe do not have the right ones—but kindness and understanding is worth more than an encyclopaedia. I encourage families to be involved and be of use.

Eighty per cent. of women suffer from menopausal symptoms; 100% of women deserve support. That is what we are calling for today—support from Government, support from employers, and support in families. I commend the hon. Member for Swansea East, and Caroline Nokes as well, for putting forward this case. I hope that, as a man, I have made a worthwhile contribution.

Photo of Marion Fellows Marion Fellows SNP Whip, Shadow SNP Spokesperson (Disabilities) 4:34 pm, 21st October 2021

How do you follow that? I thank Jim Shannon. I was looking around the Chamber before I started thinking about what I would say, and I think I am probably the oldest woman here who has gone through the menopause. It must have been 15, 20 years ago. You can ask my children or, if you could, my late husband, and they would tell you. It is absolutely wonderful that we can have this debate today. I am someone who started to squirm when they showed sanitary products in adverts on telly a few years ago. In my lifetime, growing up and becoming a woman and having children, none of this was ever discussed. I am of the Cissie and Ada generation, with Les Dawson— I cannot do the impression—but that is how everyone did not speak about the menopause. This debate is refreshing, important and, beyond everything, it lets people outside this Chamber see that there are issues we can come together on—men and women, and different parties.

I will rush through my speech now. This debate has been great. I will not list everyone who has spoken, but many important issues have been raised. I want to give some hope to people. The Scottish Government have a women’s health plan, which we are pressing forward with. There might be ideas there that the Minister can take forward, and I urge her to do that. I am not saying this as anything other than help. We have all these different things such as, through NHS Education for Scotland, the training of GPs, frontline providers and everyone else to do the kinds of things that make doctors think about menopause when women turn up to their surgeries and other places. It is important. We have a menopause specialists network, and that helps move things forward. The SNP Scottish Government want all women to have access to proper, high-quality and appropriate information and support, and they will shortly be starting on a campaign to make people more aware of menopause and menopausal symptoms.

As most Members will know, we do not pay prescription charges in Scotland, and that helps a lot of women. It makes it easier for people to go to their doctor, knowing that they can get treatment that is paid for by way of prescription. That encourages people to do things.

The menopause, as we have heard this afternoon, has a serious physical and psychological impact on women, from memory loss to pain, and it has to be taken seriously by health professionals and society more widely. More support in the workplace is particularly needed. We have had examples of good companies this afternoon, but that is not the point; it has to be across the board. We have to get all organisations and companies to understand what is needed.

In Scotland, the Scottish Government use their fair work policy to promote fairer work practices. They work with women’s organisations and trade unions to improve workplace equality and push for the full devolution of employment powers. However, I make an appeal to the UK Government. They must stop delaying and move forward with their long-awaited Employment Bill, including a day one right to request flexible working, as has been mentioned. That would begin to address the pressing issue of workplace inequality, which has only been worsened by the pandemic.

It is essential that women have access to the right support and are met with understanding in the workplace when managing menopausal symptoms. I was lucky. I had a room full of students, and if I said, “Is it hot in here?”, and they all went, “No, Marion”, I said, “I don’t care. I’m opening every window”, and they sat and froze through the rest of their lecture. I am not saying that everyone should do that, but I do say that dealing with this issue is important, because we could lose the best of the workforce with so many women who are going or will go through it.

There is an obvious and huge need to improve healthcare for women and to tackle the stigma around women’s health that still exists. World Menopause Month is a welcome opportunity to break down that stigma and to push for greater action to tackle health inequalities that have an impact on women’s day-to-day lives. I will write to the Minister with more detail about what we are doing in Scotland if she would be willing to receive that.

Photo of Rosena Allin-Khan Rosena Allin-Khan Shadow Minister (Mental Health) 4:40 pm, 21st October 2021

I am proud of everyone who has spoken today. I thank my hon. Friend Carolyn Harris for all her work on this important topic. She never ceases to amaze me with her tireless campaigning, which has earned her a formidable reputation across all our nations. Many issues divide us in this place, but we have seen the best of the House in this debate. We are here only because of the work of fantastic campaigners. In a short time, we have moved from hearing whispers of “the change” in people’s living rooms to addressing what real change is needed to support women. We are doing that here in such an important way.

It is only possible to reduce the stigma around the menopause by talking and listening as we have today. I thank all hon. Members who have contributed—men and women—on both sides, because they and their solidarity matter. Along with the many accounts we have heard, it has been incredibly important to read accounts of high-profile women realising that they are experiencing the menopause.

We have heard a heady mix of humour and heartfelt tributes today, but it is a daunting space to navigate. As a woman who has not yet entered the menopausal phase of her life, but who has been through starting a period, worrying about having children, having children and understanding her body, after today’s debate I feel less anxious than ever about a topic that many women find extremely worrying to talk about. We have celebrities to thank for raising awareness.

How many of us have never had those much-needed conversations with our families? For how many of us is it too taboo to even start discussing our periods, let alone have conversations about the menopause? It is damaging to our society that far too many women simply do not know what to look out for. More and more women are learning about the menopause from celebrity accounts. There is still far too much mystery around our bodies, despite making up 51% of the population, and that simply has to change.

It is our duty to tackle the misinformation about the menopause and HRT. I hope that this debate goes some way to addressing some of those myths. Better information about the menopause and HRT would likely mean that more women would receive treatment before their symptoms became debilitating. For example, we have heard about osteoporosis, as well as moving accounts of people living with serious mental illness and wondering why they do not feel like themselves. For many women, that lasts more than a decade.

It is important that we recognise GPs’ essential work and pay due thanks for it, but it is also important to address the lack of understanding that some GPs demonstrate. I have heard accounts of GPs refusing to diagnose women as menopausal, resulting in a frustratingly long drawn-out process that has led far too many women to give up and suffer in silence.

Photo of Karin Smyth Karin Smyth Labour, Bristol South

My hon. Friend is making excellent points. I first encountered the issue as a young woman writing a draft women’s strategy for a regional health authority in 1989, in which it did not feature. We hear much about strategies and the education of medics, but actually they have not transformed and changed in that time. Does she agree that they are important?

Evidence shows that osteoporosis disproportionately affects women with lower incomes and that there is huge variability of services across the country. Does my hon. Friend agree that that also needs to be addressed?

Photo of Rosena Allin-Khan Rosena Allin-Khan Shadow Minister (Mental Health)

I wholeheartedly agree with both of my hon. Friend’s points. In fact, we have heard today the statistics about just how much there is a lack of education about the menopause in medical school. It was something that we did not really talk very much about when I was at medical school. It is also really important to highlight the fact that we live in a very diverse country and a diverse society, where information has to be available in a number of languages and where there has to be proper outreach to communities in which people certainly would not think of speaking about it at home.

As I have touched on, the effect that the menopause can have on women’s mental health must not be ignored. It should not be underestimated. How many of us throughout our lives have been dismissed as hormonal, hysterical even, or too emotional? Suzanne Webb spoke about her ex-ex, and I am glad to hear he is such, but unfortunately we do get labelled—women get labelled—as hysterical or hormonal as an excuse. I have actually experienced it at first hand right here at the Dispatch Box. Is it any wonder then that women are scared to speak about what is happening to their bodies?

Women who experience mood changes during menopause are often not taken seriously. The symptoms of mental ill health are often condescendingly brushed aside as simple mood swings or unnecessary aggression as a result of the menopause. The reinforcement of women as hysterical or highly emotional is incredibly damaging. No wonder some women feel they are unable to reach out for support. So many hon. Members have mentioned, so importantly, the workplace, and for so many women, support simply is not available. They are often forced to suffer in silence for fear of repercussions. This is at a time when women should be reaching their professional peaks in their careers—the heady heights of what it means to be a CEO, run a hospital, run a business or sit here in Parliament—but, instead, women are forced to make up excuses about why they are taking days off or feel that they have to take early retirement. Well, this has to end, because women are a powerful force and able to achieve anything at any point in their life, and it has been wonderful to have reminders of that today.

Besides a seismic change in attitude and an eradication of stigma, what action do we need to ensure real change to support women undergoing the menopause? We need menopause awareness training for employers to help reduce stigma and to ensure that women are getting appropriate support and advice. This not only benefits those with menopausal symptoms, but has economic benefits for employers and wider society by helping to improve productivity and reduce absenteeism. We need to ensure that medical professionals are able to recognise when women are menopausal so that HRT can be prescribed, eradicating the lengthy waits, and women must be able to access accurate information on menopause to dispel the myths once and for all.

I would like to end by again thanking every Member for their contribution today, and I eagerly await to hear from the Minister how the Government plan to tackle the stigma surrounding menopause and offer real support for women once and for all.

Photo of Maria Caulfield Maria Caulfield The Parliamentary Under-Secretary for Health and Social Care 4:47 pm, 21st October 2021

How amazing it is that, at last, women’s issues and the menopause are finally getting the coverage they deserve. I want to start by paying tribute to Sir David Amess, who was such a long-standing campaigner on women’s health issues, particularly endometriosis. I feel sure he would have been with us here this afternoon, standing in solidarity on this very issue.

I want to thank Carolyn Harris—a woman not to be messed with, quite frankly—and my right hon. Friend Caroline Nokes for, and congratulate them on, securing this debate. I also thank them for their work on the all-party parliamentary group and on the Women and Equalities Committee, including for the launch of the inquiry that the Committee is about to undertake. For too long, the menopause has been a grubby little secret for women. It is often just called “the change” because women are just not confident enough even to call it the menopause.

I also want to thank all the Members across the House, and particularly the men, actually, for taking part—Alex Davies-Jones, my hon. Friend Julie Marson, the hon. Members for Newport East (Jessica Morden) and for Bradford South (Judith Cummins), my hon. Friends the Members for Cities of London and Westminster (Nickie Aiken) and for Stourbridge (Suzanne Webb), Jim Shannon and Marion Fellows. I completely agree with the hon. Member for Swansea East that this is not a political issue; this is something on which we need to be working cross-party, and I am confident we can make some serious progress on it.

It is so important that we raise awareness of these important issues and, in doing so, play our part in ending the taboo and stigma that surrounds the menopause. As a fellow member of the menopausal club, what frightens me is that most women are unaware that they are actually going through the menopause. We are talking about women in their 40s and 50s, which is a very busy time in their lives—they are often looking after children and have heavy work responsibilities, and maybe responsibilities for elderly parents—who suddenly feel that they cannot cope, are exhausted and are failing, but simply do not realise that they are going through a natural ageing process. A lot of women assume that the menopause is just hot flushes and their periods stop. They do not realise that it is about brain fog, low mood, weight gain, headaches, or not being able to sleep. It is a lightbulb moment when they realise that they are going through the menopause.

There are more than 30 symptoms of the menopause. Some women will experience some, some will experience all, and some will experience debilitating symptoms that completely transform their life. With around 400,000 women entering the menopause each year, access to high quality healthcare support is essential. All women going through the menopause should be able to have conversations with healthcare practitioners, whether that is a practice nurse, their GP, a councillor or a pharmacist. Guidelines from the National Institute for Health and Care Excellence on diagnosing and managing the menopause state that an individualised approach should be adopted at all stages, including diagnosis, investigation, and management of the menopause. I confirm to my hon. Friend the Member for Cities of London and Westminster that NICE guidelines state that after three months of taking HRT, it is recommended that GPs prescribe it for women annually, although we know that in practice, that does not always happen.

The guidelines outline the information that menopausal women should be given by clinicians to support the management of symptoms, and they include guidance on HRT, non-hormonal treatment and non-pharmaceutical approaches. They recommend that HRT is appropriate for most women, but unfortunately we find that levels of prescribing are relatively low, and only a minority of women currently get access to it. That is mainly based on flawed research from about a decade ago, which raised concerns for both women and healthcare practitioners, who are not necessarily confident in prescribing HRT. It is so important that work is undertaken with stakeholders to develop and implement optimal care pathways for women.

Let me touch on some of the issues raised in the debate, particularly about the workplace. I know that the Women and Equalities Committee will soon undertake its inquiry, and I am keen to work with it on that and see its findings. With one in four women in the workplace being either menopausal or post-menopausal, it is important that employers play their part. Companies such as Channel 4, Asos, Vodafone, HSBC and many others mentioned today are doing tremendous work. The NHS workforce is 77% female, and it is working to develop a menopause workplace support package, which will be pioneered in the NHS through local health systems. Some green shoots of progress are being made, but there is a huge amount more to be done and the Government are considering how we can influence that debate.

My right hon. Friend the Member for Romsey and Southampton North spoke about this issue, and I am keen to work with her and her Committee to make progress on that. We have mentioned the women’s healthcare strategy, and I am pleased that the Government launched a consultation on that in March this year. This is the establishment of England’s first ever women’s healthcare strategy, and the response was huge. In the call for evidence, more than 110,000 responses were given to the online survey, and more than 500 organisations provided written submissions. For women aged 40 to 49 and 50 to 59, the menopause was the No. 1 issue that they wanted the women’s health strategy to cover. I am pleased to announce today that the menopause will be a priority when we publish the women’s health strategy in the coming months.

The lesson from today is that we do not need just to talk about the menopause; we need to act and support women through it, whether in the workplace or by supporting them to get access to the treatment they need. This is about raising awareness among women themselves, so that they know they are going through the menopause, but also to get better recognition of it in society as a whole. We do not talk enough about how the menopause affects women. My hon. Friend Caroline Ansell contacted me to tell me that they are not just talking about the menopause in Eastbourne; they are singing about it, too, with the theatre running “Menopause the Musical”. It is up in lights down in Eastbourne if anyone wants to attend.

The hon. Member for Swansea East is completely right: we need to do much more than talk about this issue. We will have another opportunity to continue the debate next Friday, and I will talk to her between now and then to see what progress we can make. As we have heard today, the damaging taboos—the stigmas—that prevent women from speaking about their experience need to change. It is difficult to access support at the moment, and we need to do something about it.

As the Minister responsible for women’s health, I am committed to supporting women through the menopause to reach their potential and live healthier and happier lives, and I am convinced that we can make progress. Maybe a revolution is about to happen. I believe that we are about to see a seismic change in the way society and healthcare systems understand and support women experiencing the menopause.

Photo of Carolyn Harris Carolyn Harris Labour, Swansea East 4:55 pm, 21st October 2021

I hope that colleagues truly appreciate the impact that us in this place talking about this subject has on those watching and listening. I have lost count of the people who have contacted me and thanked me for raising the issue. The emotion and gratitude from those women, who finally feel that they have a voice, is truly overwhelming. But Parliament is not just being watched today by the women out there; we are being watched on the global stage. Me on the global stage—terrifying, isn’t it? But I am absolutely loving the fact that I have legislators, press, medical professionals and academics from right across the world saying, “You were talking about something in the UK Parliament; we want to learn from you.” We will be world leaders on this.

We have warriors such as Davina McCall, Louise Newson, Penny Lancaster, Louise Minchin, Lisa Snowdon, Gabby Logan, Nadia Sawalha, Mariella Frostrup and Kate Muir—prominent women in the media who are telling their story—as well as the Countess of Wessex and so many more voices. Everyone in this place brave enough to embrace talking about the menopause is a menopause warrior and is playing a huge role in allowing women to be fabulous all their lives. So, words I never thought we would say in the House of Commons Chamber—long live the revolution!

Photo of Nigel Evans Nigel Evans Deputy Speaker (Second Deputy Chairman of Ways and Means)

They don’t come more fabulous than you, Carolyn.

Congratulations to everyone on taking part in the debate. I am really pleased that Sir David Amess was mentioned today. I am absolutely certain that, had the tragedy not happened, he would have been here today cheering you all on.

Question put and agreed to.

Resolved,

That this House
has considered World Menopause Month.