World Menopause Day 2024: Let us commit to breaking down barriers

As we mark World Menopause Day (Friday 18 October), the University of Sunderland’s Professor Yitka Graham, an expert in the field of women’s health, discusses inequities in menopause care, cultural and social norms around women’s health issues and why it is vital that we are able to have honest, open communication about the menopause.

“I first became interested and in involved with the menopause in my former career in pharmaceuticals, working for two specialist pharmaceutical companies. I oversaw a portfolio of women’s health products and became aware of the misconceptions around the menopause and Menopause Hormone Therapy (MHT) early on.

I noticed that many women’s voices were not being heard. The menopause was something that they were expected to get on with and not complain about, and that MHT was largely perceived as a cosmetic intervention, especially in the media, and not taken as serious medicine. 

I searched for and found healthcare professionals who were strong advocates for the menopause, in particular a group of forward-thinking gynaecologists and practice nurses, who also felt strongly about the lack of awareness and negativity towards menopause and MHT, along with the need to support and empower women at this stage of their lives.

Together we advocated for women through meetings, education and awareness campaigns about the menopause, with the aim of ensuring women were aware of the signs and symptoms of the menopause, and what support was available, including MHT, and most importantly, they were not alone. 

After all, many women will live a third of their lives post-menopause, and they deserve to have a good quality of life. This commitment to equitable women’s health has carried on into my academic career, and I am passionate about carrying out rigorous, patient-centred research in order to gain evidence to shape healthcare services for all women in the UK, whether pre- peri- or post-menopausal and to ensure that research findings can be used by women to make informed decisions about their health and any treatments.

The International Menopause Society (IMS), founders of the annual World Menopause Day commemorated every October 18, is committed to raising awareness of the menopause and to support options for health and wellbeing for women in mid-life and beyond the menopause.

Despite being a natural phenomenon, the menopause may be overlooked, dismissed or not taken seriously. The menopause marks the end of a woman’s reproductive years, and this may be associated, both personally and publicly, as a loss of both fertility and femininity, which can be a source of shame and stigma. For women who are experiencing symptoms of the menopause, this lack of understanding and empathy can make a difficult situation worse. Every women’s experience of the menopause is different, and we must honour and respect the uniqueness of each women’s journey.

Many of the symptoms of the menopause such as hot flushes and night sweats can adversely affect a woman’s daily life, and for many women, there are treatments available to improve symptoms and increase quality of life. This year’s World Menopause Day focuses on MHT to increase awareness and understanding of hormonal interventions for menopausal symptoms and to provide information for women to make evidence-based, informed choices about their health and wellbeing.

To provide clear information, the IMS has developed ‘The 5 Ws of Menopause Hormone Therapy’, which discusses who MHT may be for (and who may not be suitable), what MHT is, when MHT should be commenced and stopped, why MHT is important, and finally, where women can obtain MHT

The Women’s Health Strategy for England showed that a third of women were uncomfortable talking about the menopause and highlighted a reluctance by healthcare professionals to prescribe MHT. It is vital that we can have honest, open communication about the menopause, whether this is in the workplace, education, social situations and healthcare settings. It needs to be acknowledged that it may be difficult for women to initiate conversations about the menopause, and there are varying levels of health literacy, cultural issues and knowledge levels that must be taken into account.

We need to acknowledge and consider cultural and social norms around women’s health issues. Research has shown that in many cultures, the menopause may be a taboo subject, shrouded in stigma, which may impact on help seeking and support. Conversations and support must be equitable and inclusive.

Research has highlighted inequities in menopause care. Two groups we are looking at within the Helen McArdle Nursing and Care Research Institute at the University of Sunderland are women with learning disabilities and their experiences of care, and women who have undergone metabolic and bariatric (weight-loss) surgery, as these are not insignificant groups of women who need further understanding and support. 

Our Menopause Staff Network at the University provide support to our staff, and we as an organisation are committed to supporting the menopause in the workplace.  On this World Menopause Day, let us commit to breaking down barriers and having open and supportive conversations to empower women during this time.”

Professor Graham is also the Head of the Helen McArdle Nursing and Care Research Institute and Professor of Health Services Research at the University of Sunderland.