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World Menopause Day

Volume 647: debated on Thursday 18 October 2018

I beg to move,

That this House has considered world menopause day 2018.

As always, I thank the Backbench Business Committee for facilitating the debate and all those from across the House who supported the application, including my hon. Friend the Member for Swansea East (Carolyn Harris). Today is World Menopause Day, the day that the International Menopause Society, in collaboration with the World Health Organisation, has designated for a focus on the menopause—from hot flushes through to heart health and everything in between. It was only in July 2018 that the hon. Member for Redditch (Rachel Maclean), who is in her place, discussed her experiences with the menopause in this House. I want to take this opportunity to congratulate her on her honesty and, I must say, her bravery in raising the matter in this Chamber. It is my hope that we will no longer have to note or make newsworthy such honest representations and statements.

Discussions and understanding of the menopause should be commonplace and should go almost unnoticed but not unactioned, which is the important point. Many women spend a third of their lives postmenopausal, often at the peak of their careers and still with huge plans and ambitions for the future. In fact, as the pension age for women increases to 68, our society is demanding that women have those careers and those ambitions. Women could now spend well over 20 years of their working lives living perimenopausal and postmenopausal. Three and a half million women over 50 are employed in the UK, and 80% of them will experience notable changes due to the menopause. Recent research has found that 50% of working women reported finding work difficult due to the menopause, and 10% give up work altogether as a result.

I embarked on a new career in my 50s as a newly elected MP. I was privileged to enter this House of Commons just over a year ago, and I cannot imagine embarking on a new career struggling with some of the symptoms that my female counterparts experience and suffering them without help and support. Indeed, it is unthinkable that society would ask men at the height of their careers to simply tolerate the symptoms, to carry on and, actually, to do so quietly. Why should women? All too often, the menopause is seen as something women need simply to cope with. They are afraid to discuss the symptoms openly with their friends, family and, sometimes most importantly, work colleagues, because they are afraid of being undermined and perhaps marginalised. Some 70% of women do not discuss their symptoms at work, a third do not visit their GP and 50% report that the menopause affects their mental health and their ability at work.

Michelle Heaton, who went through the menopause in her 30s, is a diligent and vocal campaigner who is doing an excellent job of raising awareness of the menopause today in a white paper report with Glenmark Pharma—a critically important document.

My hon. Friend is making an excellent speech. Does he agree that raising awareness of early menopause among the general public and, crucially, the medical profession is critical for women who need diagnosis and support while they are going through it?

Absolutely, and I am grateful for that intervention. I will come to the matter of the medical profession in just a moment.

The report that Michelle is promoting is intended to increase understanding of symptoms and, in particular, the age at which the menopause begins. Too frequently, it is considered a condition of a certain age, which is so far from the truth. Indeed, when the symptoms start to show, we need to educate not just the general population but health providers in particular so they understand what is being presented.

Just yesterday, a colleague from the Scottish Parliament, Monica Lennon MSP, lodged a motion requesting “equal access” to the menopause clinics that exist up there. I compliment her and the unions for their work up there. They raise the issue that employers have been slow to recognise that those experiencing menopausal symptoms may need special consideration. For too long it has been a private matter. As a result, it is rarely discussed. Many managers will have no awareness of the issues involved, which means that many workers feel they have to hide their symptoms and are less likely to ask for the adjustments they need in order to work. I agree with the motion when it says that this must change. The menopause is an occupational health issue that rests on the desks of managers—male as well as female managers, and managers who are frequently younger than the person who presents before them. There needs to be education about this so that it can be dealt with sensitively but positively, as it will affect 50% of our population at some stage.

Gender equality is not just a women’s issue, it is an issue for society as a whole. We should all wish to live in a society that is fair and equitable for all. There is nothing equitable about a large proportion of our workforce being forced to suffer these health issues in silence. Women are often not comfortable disclosing these difficulties to managers, particularly if they are younger and particularly if they are male. Women still sometimes require time off work to deal with the symptoms, and many are not comfortable with disclosing the real reason for their time off, so it goes unnoticed by employers.

The menopause should be recognised as, among other things, an occupational health issue. With all due respect, employers have been far, far too slow to take on board the requirement to recognise those who are experiencing symptoms. Today is World Menopause Day and a number of things are being asked for, all of which are based on the simple hashtag that has been adopted today: #makemenopausematter. It is a simple request, and it spans schools and education, the workplace and our health professionals, who have a duty and obligation to understand the symptoms presented to them by women who are finding the menopause frightening and challenging and who often find it difficult to discuss the matter within their own families. Today is an opportunity to look at that and address the educational needs that the whole of society requires.

I stand here introducing this debate as a man, and it has to be said that it is time for men to show their solidarity and to break a taboo about talking about the menopause. I ask every man in this place, every man who is watching on and every man in the UK—let me go further and just ask all men—to be brave enough to have the guts to say, “Can you tell me? Can you explain? Will you please share?” I ask them to do that while listening with sympathy and empathy. Sadly, I am all too convinced that if the menopause affected men, it perhaps would not be the problem it is today and we would not be having this debate—it would have certainly have been first raised in this House before July 2018.

My mother has six daughters, the eldest of whom turns 55 tomorrow—happy birthday, Claire. The youngest turns 44 at the end of the month—happy birthday Aimi. I am clearly intervening just so that I can say happy birthday to my sisters in the House. I get plenty of discussion about this issue at home, but I want to thank my hon. Friend for making the point that men need to talk about it, too. He has been brave in bringing this debate forward today.

I am grateful for that intervention. It is true that men need to discuss this, but not dominate. It is also important that they listen. I have often stood here and been critical of social media, but if we examine social media today, we see that the support for World Menopause Day out there is very positive. A huge amount of work is being done; there is a huge amount of medical and academic research, and it is good to see people drawing attention to it. Today has also been an opportunity for women to share their experiences on television, radio and social media, which in itself is a huge step forward in breaking the taboo, and it is for men to listen.

I commend the hon. Gentleman for bringing this debate to the House. He is making some very good points, but I just want to ask that we do not lose sight in this debate of women who have the menopause brought on earlier in life than they may have anticipated by chemotherapy treatment. Some younger women also experience it earlier than others might expect, so we need to have an understanding of the full spectrum of the menopause and not just assume that it affects only women of a certain age.

That is an excellent point. One of the most important things to come out of today, particularly with the work that Michelle is pushing forward, is that society’s view of what the menopause is just happens to be wrong—I use those words carefully. We need open discussion, with women being able to talk about symptoms when they attend clinics and go to their general practitioner. On behalf of the NHS, I must say that a huge amount of good work is going on in explaining to women who present for other matters what the potential outcomes of treatment are, but this should never be a frightening experience for a woman to speak about, whatever her age. We should live in a society where women can share that and expect to be heard empathetically and with respect.

As I move on to the request being made of employers, let me say that society should be able to amend its ways to facilitate dealing with these symptoms, because women who are going through the menopause have enormous amounts to contribute, and employers should not see it as a barrier and as an excuse to leave work. We should have facilities and methods of support—it does not take a lot to provide those. I know some of my colleagues have fans, but here we are in 2018 unable to cool or heat buildings to a point where they are acceptable to work in. These are the simple things that would make a huge difference to people’s lives. As I have said, these are people who are still expected to contribute to society, to be driven and to make changes and take steps up—and why shouldn’t they? The menopause should not be a blockage to that.

I am aware that others wish to speak, and it would unforgivable for a man to steal all of their time. I would just like to finish by saying that I ask all men, myself included, to take up the challenge of discussing the menopause with the people close to us. We should discuss it openly at home and in the workplace, so that for once our mothers, wives, sisters and friends do not need to feel that they suffer in silence.

I was surprised and very pleased when I saw that a man had tabled this motion, and the hon. Gentleman has been courageous in standing up and saying what he has said. I am also delighted that we have a male Minister answering in this debate. We all look forward to hearing what he has to say, too. We are making breakthroughs in this place that people would never have imagined.

Thank you so much, Madam Deputy Speaker. You speak so much truth and I am glad that you have put those words on the record from your position—they will carry a lot of weight.

I pay tribute to the hon. Member for East Lothian (Martin Whitfield), who gave an absolutely brilliant and heartfelt speech that I know will resonate with all the women throughout the country and around the world who are watching this debate. They will be so happy that he, as a man, is championing this issue. If only every man was as warm, empathetic and well informed as he is, we would not be having this debate. I look forward to working assiduously with him and colleagues from all parties to reach that position, which I very much believe we will.

As has been said, we have already tackled many taboos in this place and in our society, and this is genuinely one of the last taboos. It is now okay to talk about mental health, and that is a really good thing. A lot of celebrities now talk about their mental health. It is all over social media, in the press and on the television. People are backing that, and people are coming forward to say, “It’s okay not to be okay.” Somehow, however, menopause is still left out, and this debate is a fantastic chance to put that right.

I started on this journey pretty much as the hon. Member for Lothian East described—

East Lothian—I am so sorry. Please forgive me.

I was 50 when I was elected, so I was of course well within that perimenopausal/menopausal age myself. I did not conform to the menopause stereotypes, as I shall touch on later in my speech. There is so much ignorance out there. It is generally believed that someone has to suffer from the key symptoms, such as hot flushes and night sweats—that that is basically all that menopause is—but menopause is so much more than that. It is not just hot flushes and night sweats, and I am living proof of that. I have never had a hot flush or a night sweat, but I am most definitely menopausal. My symptoms revolve around quite debilitating migraines, sometimes on an almost daily basis when I am not able to manage the stress of this job. As was rightly said, this is an incredibly stressful job and an incredibly stressful workplace, and we cannot just take a day off and go and lie down in a dark room to sleep off a migraine, much as we all might like to, even if we are not menopausal. Many women working in other walks of life who are perhaps at the peak of their careers, or who work in any stressful environment, are not able to get the support that they need.

We saw a shocking demonstration of the ignorance in society from no less a figure than the Governor of the Bank of England, Mark Carney, who not long ago compared the economy with the menopause. He said that we are suffering a menopausal economy. He came back and defended that, saying that he did not mean it or whatever, but his casual use of those words demonstrated a fundamental lack of awareness of a leading figure in our country. It is not right. With that phrase, he made me so angry—and not only me but many other people. That made me think that I could not sit there and not be a voice for all the women out there who do not have the privilege of being able to raise the issue in this place.

So, I had my personal journey, and I started to look on social media and do some more research to educate myself. As the hon. Member for East—[Hon. Members: “Lothian.”] I will get there in the end!

Yes; thank you.

The hon. Member for East Lothian said that social media plays a big part in this, and it is where I started my journey. From my research and conversations, I recognise that millions of women in this country do not feel listened to at this time of their lives. That was where my campaign started—from a place of wanting to represent those women.

We still have a long way to go. Last night, when I was voting in the Lobby, wearing this #MakeMenopauseMatter badge, I was approached by a very senior colleague, who shall remain nameless. His comment was: “Why—are you having a hot flush, dear?” That was said to my face. My goodness, does not that illustrate how we need to raise awareness? This is not a women’s issue; it is a society issue. It is for everybody, because every man works with a woman, is related to a woman or lives with a woman. People cannot just denigrate and belittle experiences that can be incredibly difficult for women to push through. I pride myself on being quite a feisty person. I am not afraid to say what I think and I definitely told that Member what I thought about that comment. I said, “Please, come to the World Menopause Day debate and find out why that comment is completely inappropriate and, hopefully, learn a bit more.” I am delighted to say that he is in a minority. I pay tribute to the many male colleagues from all parties who have been supportive of the debate and this issue.

I am not asking for a lot—perhaps I am, but I do not regard it as a lot. I regard these things as quite basic. The hon. Member for East Lothian has already touched on the key issues, the first of which is the workplace. We are in an extraordinarily unusual workplace where there are issues for not only the people who work here, but Members ourselves, but there are many more workplaces up and down the country. It is not too much to ask—is it?—for workplaces to be better prepared for women going through this change of life. The process can be extremely positive. If women get the support, understanding and empathy that they need from their colleagues, there is absolutely no reason why they cannot make this into a fantastic time in which they can move on to a new chapter of their lives, and flourish and contribute in different ways.

The hon. Lady is making a powerful speech. Does she agree that it is strange that our high schools and education system are perfectly set up to support young people through their teenage years, when substantial changes are going on in their bodies, and to launch them into their careers, but society seems unable to have the same sympathy and empathy at a different part of someone’s career?

Yes, I completely agree. The hon. Gentleman must be psychic, because he has made a point that I was going to make. Before I do so, however, I want to speak about the workplace.

Let me pay tribute to some organisations that are doing an absolutely fantastic job in this regard. I have had quite a lot of contact with West Midlands police through various women who have championed this issue in the workplace. There is a lady called Lesley Byrne—Lesley, if you are watching, keep going! Yvonne Bruton has been running menopause awareness workshops for the police. Imagine the West Midlands police—a very male-dominated and, in many ways, traditional organisation. Female police officers are incredibly brave to say, “I have these experiences. I am not supported and I need adjustments to my working patterns.” They are working through the issues and finding ways to support their female colleagues. At the end of the day, we need good police officers and we need them to stay in the police force, to be motivated and to progress to higher levels.

That work is absolutely brilliant, and there is no reason why every single police force in the country could not talk to West Midlands police, find out what they are doing and disseminate the information among themselves. Indeed, there is no reason why other organisations cannot have a menopause policy, just as they have policies on childcare and maternity leave. It does not cost anything; it is a question of saying, “We’re here and we will listen to you if you need support.” That is my first ask.

My second ask is about education, which the hon. Member for East Lothian just spoke about so eloquently. We of course talk to young girls and boys—I presume this still happens; it is a long time since it happened to me—about puberty, periods, where babies come from and so on. We educate our young people about all those important issues to equip them for life and relationships; why can we not educate them about what happens at the end of their reproductive lives? It is very simple. I spoke to a male colleague earlier who said, “I have no personal experience of the menopause, so how can I talk about it?” I said, “Well, okay, your mother went through it,” but then we did not talk to our mothers about these sorts of things. This needs to come into the school curriculum and to be part of what schools are talking about. Let us look at how we can do that, because surely it is not that hard.

The third aspect of my campaign is around access to advice in GP surgeries. This is where we really do need to do more. I have been absolutely inundated with people contacting me. I have heard quite horrific stories from women who did not get the treatment that is medically proven to be effective, which is hormone replacement therapy. HRT is available on the NHS and actually advocated for women in the guidelines of the National Institute for Health and Care Excellence. However, it seems that there is—I don’t know—a lack of awareness, a lack of information and a lack of empathy among GPs who are not prescribing HRT for women when they need it. I have heard story after story from women who went to their GP, saying, “Look, I am suffering these symptoms.” Again, the reason might be that they are not having hot flushes or night sweats, but they have the other symptoms that are associated with the menopause, and they are just not getting that treatment. GPs are sending them away. Why do some women battle for years to get HRT?

I am delighted to say that the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), has already met me to discuss this issue. We very much hope to move things forward with the all-party group on women’s health, which is led by the hon. Member for Dewsbury (Paula Sherriff), and obviously with any other Member who wishes to take part. We really need to do more.

If I may, I will draw my comments to a close by quickly paying tribute to a few campaigners who have given me so much support and information.

The hon. Lady has been very brave in speaking out. So far our focus has been on dealing with the symptoms and the problems. Has she had the opportunity to look into whether diet-related changes could help to alleviate some of those symptoms rather than just medical solutions? In Japan and China, for example, there seems to be much lower incidence of things such as hot flushes, and some suggest that that might be because of the consumption of soya, which has oestrogen in it, although I am not quite sure how it works. Has she looked at that at all?

I thank the hon. Lady very much for her intervention. I am certainly aware that my research has only scratched the surface. She is absolutely right to say that diet has a strong connection with wellbeing and health at any point in life. In fact, I am seeking help from a nutritionist myself to try to tackle some of these issues, because they are all interlinked. Perhaps that illustrates some of the lack of understanding that we have generally.

In my list of people to whom I wish to pay tribute, I will, if I may, mention the menopause chef who came to my Menopause Café in Redditch. The Menopause Café is an amazing national organisation. It is about bringing women together to have conversations about the menopause. I held mine in Redditch a couple of weeks ago. I encourage anyone to host a Menopause Café in their constituency. The experience was really moving. Women said that they had learned more about the menopause in that time than they had learned over five years. The menopause chef works out diets that meet women’s dietary requirements.

Diane Danzebrink, a fantastic consultant, tutor and coach, is very active in this space and does a lot of work in the area—I believe that other Members have met her. Dr Louise Newson, a GP, set up the country’s first menopause-only clinic, which is a fantastic innovation. We would all like to see such clinics more widely spread. Lynda Bailey, the co-founder of Talking Menopause, is one of the pioneers in the West Midlands police. Then there is the incredible Hot Flush, which describes the menopause as a club that no one wants to join. It does a lot to demystify some of the symptoms of menopause and to talk about them frankly. Let us just be honest about some of the things that can happen at menopause. Let us just be comfortable talking about things such as vaginal dryness, loss of libido, incontinence and pelvic floor weakness. These are not easy things to put on record standing here in the House of Commons. If women experience these things, it can negatively impact on their ability to form a relationship, to have a relationship with their partner and a whole host of other things. All those things can be connected to the menopause. More importantly, they can be alleviated with the right information and support. Why should women not have the right to a happy, healthy later chapter of their life in all aspects, including in their intimate life? I believe in that very passionately and think that it is so important.

Very quickly, let me mention Detective Chief Inspector Yvonne Bruton, who has pioneered this work in the West Midlands police. Liz Earle, a health magazine and beauty product founder, is also a passionate champion of this issue. Obviously there are many more people involved, but I do not have the space to mention them. Needless to say it is a space that is well populated by passionate women who are just keen to share their knowledge with others.

I will draw my remarks to a close. I could probably talk for hours, but I am aware that I am detaining the House. Let me thank again the hon. Member for East Lothian. I am so delighted that he contacted me and that he applied for the debate. I very much look forward to the Minister’s closing remarks.

I also congratulate the hon. Member for East Lothian (Martin Whitfield) on securing this important debate—it seems to be a day for Scottish accents. I am delighted that he felt able to bring forward such an important matter. It was a real pleasure to follow the hon. Member for Redditch (Rachel Maclean) who courageously outlined some of her own experiences and made a very wide-ranging and powerful speech. She advocated and highlighted so many other women who are doing their very best to give this subject the prominence that it most assuredly deserves.

I am delighted to be speaking about World Menopause Day and about this important subject. My hon. Friend the Member for Glasgow East (David Linden) is, I believe, even more delighted. He is quite young, and I think that he thought that he would be replying to this debate instead of me. My daughter is extremely apprehensive about the content of my speech, as she frequently accuses me of oversharing. She need have no fears today—or at least not too many.

I have been there, I have done that and I have got the T-shirt, and that really does cover my experience of menopause. I started early and it seemed to go on for quite a long time. I remarked earlier to you, Madam Deputy Speaker, that my mother was born in 1919, so how I was raised very much reflected the way that she was raised by a mother who was born in the 19th century, so no one talked about it.

I have some vivid memories. I was teaching in a further education college as I was going through quite a large part of my menopausal experience. Standing in front of 25 bored teenagers, I asked, “Is it hot in here, or is it just me?” I was told, “No, it’s just you”, to which I responded, “Well, I’m opening the windows anyway.” It really was good that I was in charge of that class.

Another story that, in many ways, illustrates how the menopause used to be discussed is through the brilliant comic creations of Les Dawson, Cissie and Ada. They only ever mouthed the words, “The change” when discussing their menopause experiences as well as those of other women. I am very glad that that is no longer the case. World Menopause Day is an important opportunity for women to speak out about their real experiences of the menopause, contributing to breaking the taboo around both the menopause and women’s reproductive health.

As we should all know, the menopause can have a significant psychological and physical impact on women, and it is vital that these effects and symptoms are taken seriously by health professionals and society at large and that women can access the right support. Women’s health issues often do not come under the spotlight owing to ongoing taboos around women’s health, and it is time for women—younger and older—to speak out in support of each other to raise awareness. The days when women are literally put outside the tent or igloo when they are past child-bearing age are long gone, but we still have these taboos. We must work hard to speak about our experiences and contribute to breaking these taboos.

This year’s World Menopause Day is about recognising the impact that the menopause can have on women’s sexual wellbeing. Both during and after the menopause, it is not uncommon for women to experience some sexual dysfunction, which can have a severe impact on their relationships, self-esteem and wider mental health. It is so important that women going through this can access the right support to reassure them that it is totally normal and they are not alone. Sharing experiences with other women is also extremely important, and women speaking to other women about their experience is to be encouraged, but we must engage with the wider world too. As I have said, the menopause can have a significant psychological and physical impact on women, and it is vital that these effects and symptoms are taken seriously by health professionals.

I commend the hon. Lady’s bravery in speaking from the heart and from her personal experience. She is talking about the psychological impact of the menopause. Does she agree that women sometimes report that they do not feel like themselves at all—that they experience depression and anxiety, and often feel effects on their memory, making it very difficult to perform in the workplace and often leading to their leaving work early?

The hon. Lady is absolutely right, and this is a wonderful occasion to highlight such things and to motivate women to speak more frankly, because every woman has a different menopause. We all have to accept that and to share our experiences so that no one feels that they are the only one going through this.

The Scottish National party and the Scottish Government support World Menopause Day. Through the Scottish Primary Care Information Resource, the Scottish Government support general practice to identify patients with conditions such as osteoporosis and cardiovascular disease, which are clearly and directly associated with the menopause. We need to anticipate health needs for women in this situation and ensure the best possible care for them. There are some NHS menopause clinics in Scotland, located in Dumfries and Galloway, Fife, Grampian, Lothian and Tayside. In other areas, health boards provide menopause help through general practice and specialist referral if needed. The British Menopause Society really wants to encourage that, because doctors and other health professionals also need to be trained in how to talk to women and encourage them to talk about their symptoms.

There are also some great initiatives at a local government level. For example, South Lanarkshire Council is today launching its menopause policy, and it is to be very much commended for that. The council worked out that 68% of its workforce are women, who could go through the menopause at any point, and it sees it as its duty to take care of these women and to allow them to talk to managers. In fact, they are training managers properly to help with this issue. It can be very difficult for some women to talk to a younger man, as the hon. Member for East Lothian has mentioned.

South Lanarkshire Council’s plan includes the provision of fans for women to manage hot flushes and the ability to take time out when coping with low moods. There is also a requirement to ensure that women experiencing menopause have easy access to toilet facilities. This is not difficult; it is something that all employers should be doing. Women will have somewhere to rest or to go for a little while if they feel tired due to a lack of sleep caused by things such as hot flushes, and if they are suffering from anxiety at this time, they will also be able to access the employee counselling services. This is a great initiative that I wholly commend, and it should be emulated by other employers right across the country. This is exactly the kind of proactive support that both the public and private sectors should be adopting.

A BBC survey earlier this year found that 70% of respondents do not tell their bosses that they are experiencing symptoms when they are going through the menopause. I certainly did not, but then I am well beyond menopause and have seen quite a large variety of changes in how we speak about women’s issues throughout my lifetime, so I am really happy to be able to speak on the subject today. Employers must take the lead in creating a safe environment for women to speak up if their symptoms are making their work difficult. It is actually better for employers to do that, because if they treat women with consideration at this time in their lives, they will get the best possible work out of them.

Is it not the case, though, that a woman should never feel obliged to tell her employer? She should work in an environment that is open and sensitive enough for that to be understood, so that she has the confidence to share that, rather than it being an employment requirement to announce it.

Yes, I agree; but it does have to be a two-way process. Employers have to create workplaces where people feel confident talking about mental health issues and about the menopause.

Women’s health issues often do not see the spotlight due to ongoing taboos, and it is time for women—younger and older—to speak out. Women are often expected to put up and shut up about the symptoms associated with the menopause or periods, and to feel that talking about it is inappropriate or just moaning, when it is clear that this attitude is just thinly-veiled sexism. The fact is that the menopause and periods, as well as other hormonal conditions such as polycystic ovary syndrome, can have a really debilitating effect on women day to day.

It is great to see fantastic initiatives such as the menopause cafés mentioned by the hon. Member for Redditch that are now up and down the country after they were started by Rachel Weiss in June 2017 in her home city of Perth in Scotland. Weiss was reportedly inspired by “Newsnight” presenter Kirsty Wark’s documentary on the menopause, in which she talked about her own experience. This was a fantastic and brave project that no doubt touched many women across the UK who felt that their experiences were given a voice.

I draw the attention of the House to an article by Mandy Rhodes, the editor of Holyrood Magazine and columnist of the year. She has written, much more eloquently than I could, about some of her experiences, saying:

“One of my funnier moments in life was going to a menopause support group—a bit like an AA for women of a certain age—where one woman confessed she had no menopausal symptoms but was there to make friends. Why would you even do that? The idea that you might want to seek out new friends, from among a group of women who were in the middle of a hormonal-induced”—

expletive deleted—

“storm that had likely helped alienate them from all their own friends and family, smacked of a certain kind of desperation. But that is where this can take you…Over the last 20 years, many barriers have been broken down regarding a whole range of issues that impact on our working lives, including gender, race, physical and mental health. And whilst people feel more comfortable opening up about some of these issues, there are others that remain taboo. The menopause and the symptoms associated with it are, for many women, that last taboo. And it’s something of a paradox that on the journey women have travelled towards equality, that that same generation of women”—

Mandy’s generation, who are younger than me, it has to be said—

“who were at the fore of getting their voices heard in the fight for gender equality, are now, in middle-age, silenced by a uniquely female condition that has done more to disempower them than any male chauvinist could ever do. Many women live a third of their lives post-menopausal, often at the peak of their careers and still with big plans. And so, dealing with it…matters to us all.”

I echo that quotation in its entirety and recommend that hon. Members read that article, which is well written, personal and effective.

I congratulate my hon. Friend the Member for East Lothian (Martin Whitfield) and the Minister on their bravery, and I say to every man in the Chamber today: welcome to the sisterhood.

Some 49.6% of the population worldwide are women, which equates to close to 3.8 billion of us, and with the vast majority of women—in the developed world at least—living way beyond menopausal age, it is about time this issue was taken seriously. For too long the menopause has been one of two things: a taboo subject that women do not dare to admit they are suffering from, or the punchline of a joke that is actually anything but funny.

Most women will experience the menopause at some time in their lives, and the severity of their suffering varies greatly. About 25% of women are lucky enough to barely notice any changes to their body or experience any of the well-documented symptoms, but for others the menopause can be an unbearable time—stressful, debilitating and completely life changing. Yet many women are completely unprepared for this phase of their lives, which is something that we desperately need to change for future generations. We need to be educating our children—boys as well as girls—so that they understand the impact the menopause could one day have on their lives and relationships.

The Government’s draft sex and relationships education guidance includes advice on teaching young people about menstruation, but it makes no mention of the menopause, which is just as important and often more difficult. Will the Minister ask the Department for Education, as part of its consultation, to consider extending the guidance to include teaching on the menopause? In doing this, we could help to educate the next generation and put an end to the lack of knowledge around the menopause, which is having a hugely detrimental effect on those suffering today.

Also having a detrimental effect is the limited training given to GPs on this subject. Too many women struggle when doctors either do not recognise their symptoms, do not prescribe hormone replacement therapy—because they are relying on inaccurate and outdated information—or incorrectly diagnose those symptoms as depression and subsequently offer the wrong medication. This needs to change, and the Department of Health and Social Care needs to play its role and work with patients, experts, the NHS, the Royal College of General Practitioners, medical schools and all health professionals to better educate them about the menopause.

The NICE guidelines on the menopause were first published almost three years ago, yet many doctors admit that they are either not aware of them or have not read them. Women are therefore relying on the chance that the GP they visit is one of those who has. Healthcare should not be a lottery. Every woman suffering the effects of the menopause is entitled to the same quality of care, but the quality of that care in the UK at the moment needs serious attention. Current treatment options for women are woefully poor. Referrals to NHS menopause clinics take up to six months because of the limited number of places—the result of the ongoing cuts to services. For many women unable to take HRT, particularly those who have had breast or gynaecological cancers, there is no support at all.

It is not just medical support we are here to talk about. In the UK, the average age women reach the menopause is 51, but about one woman in every 100 experiences early menopause owing to medical conditions, treatment or surgery. The loss of fertility as a result can be devastating for some women, and their psychological health is as affected as their physical health. These women need to be offered counselling as well as advice on how to maintain their long-term health, which can be affected by early oestrogen depletion.

I have heard cases of women going into debt to fund appointments with private doctors and gynaecologists because they cannot access the care that should be available to them on the NHS. Even more worryingly, the Samaritans’ 2017 report on suicide figures shows that the highest suicide rate for women is for those aged between 50 and 54. It cannot be coincidence that the age of menopause is 51. I find it deplorable that in this country something that affects so many people is so underfunded and misunderstood.

It is not just the treatment of the symptoms that needs serious attention. Life does not stop for women when they reach the menopause—I am testament to that—even if they are suffering from crippling side effects, and for many this means continuing to work. Women are working in greater numbers than ever, making up 47% of the UK workforce. About 4.3 million of these employed women are aged 50 or over, and this number is set to increase over the next few years. With studies showing that menopause symptoms can have a significant impact on attendance and performance in the workplace, employers need to start looking at what they can do to help these women and improve their own productivity.

Does the hon. Lady also agree that it is in those businesses’ and organisations’ own interests to retain these members of staff, whom they have trained and invested in over many years, and who have so many skills and so much knowledge?

I do, and I was just coming to that.

Employers have a duty of care to all their employees. While no respectable company would even consider running their business without a maternity policy, very few will have given any thought to the introduction of a menopause policy. Simple adjustments, such as relaxed uniform policies, flexible working conditions and temperature control in offices, could have a huge impact on a woman’s decision to remain in work. It is a win-win situation: employers would benefit from retaining valuable, trustworthy and experienced employees, saving money on sickness cover and training new staff, while women would find it easier to cope with the physical symptoms of the menopause. With simple adjustments, such as being able to travel outside rush hour or to wear cooler, less restrictive clothing, they would also feel valued and supported in their professional roles, which in turn would help with the psychological barriers associated with the menopause.

Yet current figures show that two thirds of women going through the menopause say they have no support at all in their workplace. Some 25% of women say they have considered leaving their job because of it, and one in 10 actually ends up handing in her notice. Women in our emergency services, nurses, frontline retail staff and office workers—in fact, women from all sectors of industry—are leaving the workplace owing to a lack of support from their employers. These are not small businesses, but massive national and global companies. We need big business and workplaces to take this seriously.

Many unions are already championing the call for a menopause policy. An excellent example is the Union of Shop, Distributive and Allied Workers, which I have worked with, and the very wonderful Julie Bird, who has encouraged Tesco to set up pilot menopause support groups. The scheme started in Swansea and is now being rolled out across the south-west.

Nottinghamshire police was the first force in the country to introduce a menopause policy that includes flexible working and lighter uniforms. The hon. Member for Motherwell and Wishaw (Marion Fellows) talked about local authorities. I am pleased to say that I have just received a message informing me that my own local authority, City and County of Swansea—I think it knew I would want to say this—is going to introduce a menopause policy.

These discussions can take place in local authorities, unions such as the CWU and the GMB, and employers such as the civil nuclear constabulary. This does not cost a lot of money, but it does require understanding.

People need to talk. We must take the best practice from these examples, share them with other employers and ensure that menopause guidelines become compulsory for all businesses.

On this World Menopause Day, let us educate children—girls and boys—within the school curriculum so that for future generations the menopause ceases to be a taboo subject or a joking matter. Let us improve public understanding of the menopause and its symptoms so that women no longer feel that they need to suffer in silence. Let us ensure that our medical professions know how to diagnose and best treat these symptoms so that women’s experiences are less painful and less distressing. Let us pledge to work towards a mandatory menopause policy within workplaces so that women can carry on with a normal life, however severe their symptoms may be. On this World Menopause Day, let us make a commitment to make a difference.

I congratulate the hon. Member for East Lothian (Martin Whitfield) on securing this very important debate on World Menopause Day. This is a very welcome opportunity to discuss, and raise the profile of, the menopause. Is it not encouraging that a man has come to this Chamber on World Menopause Day and introduced this debate? Who would have thought, a couple of years ago, that that would happen? Who would have thought that a male Minister would be responding to this debate? Well, a week ago, I did not think I would be doing that, but it has been an absolute privilege for me to listen to the contributions made here today.

It is fantastic to see the hon. Member for Motherwell and Wishaw (Marion Fellows) in her place. She talked about how nervous her daughter was about what her speech might contain. I can tell the hon. Lady that there are those who are very nervous about what my speech might contain, not least in the Adams household, and also in the Whips Office. As Members can see, I am surrounded by Whips today, so I am going to stay on message, especially if I am to stay in the sisterhood referenced by the hon. Member for Swansea East (Carolyn Harris).

I am here today on behalf of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock (Jackie Doyle-Price). She has responsibility for women’s health and would very much have liked to be here to discuss a topic that she is incredibly passionate about. She has taken a very close interest in women’s health, including the menopause, and I know that she will be watching this debate.

The debate has provided us with a number of positive opportunities. First, we, as Members of Parliament, can play a role by helping to raise awareness of the menopause and by encouraging people to have more open conversations about this topic. This is a very significant life stage for every woman, as we have heard, and it has been all too rarely discussed in the House. Today, we have this opportunity to put that right.

Secondly, this debate gives us the opportunity to reflect on the positive things that employers and the health system are already doing to support women who are suffering from menopausal symptoms. More women are likely to have a better experience of the menopause if we share and promote the best examples of existing support.

We also have the opportunity to discuss what more needs to be done. We know, for example, that there are inconsistent levels of awareness around the menopause, and that that reflects a history of stigma attached to the issue. The benefits of tackling stigma head on and having the right menopause support in place are clear. That is the right thing to do for women who are suffering from adverse symptoms or who feel unable to have open conversations about how they are feeling.

Openness, as we have heard, goes for men as well as women. It is important that we improve how we educate men about the menopause for the benefit of their partners, relatives and colleagues—and, crucially, for the benefit of their own understanding. There is also a strong argument based on economic inclusion. Our national workforce is ageing, and positive action by employers will benefit employee engagement, productivity and retention.

We cannot stress enough that the menopause is a natural part of ageing and will be experienced in one way or another by every single woman. As we have heard from several Members, every woman will experience the menopause differently, and the types and severity of symptoms can vary. The menopause can occur naturally or be triggered or accelerated by medical interventions such as some surgeries or cancer treatments. The menopause can have physical and non-physical symptoms, but both can cause discomfort and, in many cases, social embarrassment. There are clear consequences for wellbeing. Women experiencing troublesome menopausal symptoms report lower health-related quality of life and greater use of healthcare services than women without symptoms.

Let us look at the numbers. There are more than 3.5 million women between the ages of 50 and 65 in employment in the UK. One in four women in the workplace is going through or has gone through the menopause. Over half of those women report that they experience symptoms that impact their work. The number of women over the age of 50 continues to grow, and the employment rate for women in the UK has never been higher. Women go through the menopause at a life stage when they are often dealing with demanding responsibilities such as work, caring for elderly relatives and dealing with teenage and adolescent children. Difficult symptoms can really add to the challenges of life.

No two menopauses are exactly alike. That is why the guidance produced by NICE recommends adopting an individualised approach at all stages of diagnosis, investigation and management of menopause. NICE also recommends that information on menopause is given in different ways, to encourage women to discuss their symptoms and needs.

Hormone replacement therapy can be an effective way of relieving many menopausal symptoms, as well as preventing osteoporosis. Usually, women may start HRT as soon as they begin experiencing menopausal symptoms, and their GP can advise on the different types of HRT that are available. However, HRT is not always the most suitable treatment, and women can discuss alternatives with their GP. Psychological interventions can be helpful for symptoms of anxiety or for those suffering from low mood. When making judgments about treatment, healthcare professionals can draw on advice from the British Menopause Society, a specialist society affiliated to the Royal College of Obstetricians and Gynaecologists.

But we can always do more. I know that the Mental Health Minister, my hon. Friend the Member for Thurrock, is leading work on improving women’s health and their experiences of healthcare. Her work partly focuses on raising awareness and breaking taboos—we have heard that word many times this afternoon—around common health morbidities, such as problem periods and incontinence. She is working closely with the Royal College of Obstetricians and Gynaecologists to achieve that. I know that one of her concerns is that women’s experience of the diagnosis and treatment of common gynaecological issues is not always what it could be. The all-party parliamentary group on women’s health pointed that out in its report earlier this year, and I am sure that the Minister will have more to say about that when she returns to the Commons.

For many women experiencing the menopause, the best help often comes from other women. Services can build on that support so that women can make lifestyle choices that will help to give them a better experience of the menopause, including stopping smoking, exercising regularly and eating healthily. Partners in the healthcare system can also offer support. Menopause Matters is a website that provides up-to-date information about the menopause and treatment options, as well as hosting a forum for women to discuss their experiences of the menopause. The Daisy Network is a charity that provides information and support specifically for women who are going through premature menopause.

As has been mentioned several times this afternoon, we also need to look to workplaces as a source of support for women with menopausal symptoms. Many women report that they feel they do not have the opportunity to have open conversations with their employer about menopausal symptoms at work. That needs to change—I am specifically targeting these remarks at male managers in the workplace. This has to change. If two men can get up in the House of Commons and talk about the menopause, male managers in the workplace should be doing exactly the same.

We know from a 2017 review of the effects of menopause transition on women’s economic participation that the menopause is not well understood or provided for in workplace cultures, policies and training. Sources of guidance are available for employers who want to do more to support women with menopausal symptoms. The Faculty of Occupational Medicine has produced a factsheet and infographic on menopause and the workplace, as requested by the chief medical officer in her 2014 report on women’s health. It contains practical guidance for employers on how to improve workplace environments for menopausal women, and it stresses the importance of regular, informed conversations between managers and employees.

It can often be important for managers simply to acknowledge the menopause as a natural stage of life and reassure women that their employer is open to making adjustments that they may find helpful. Equally, some women may not be comfortable discussing their symptoms with a manager, and access to occupational health can also be very valuable. Specific actions that employers can take to help women experiencing menopausal symptoms include considering changes to working patterns or responsibilities, providing employees with sources of information about the menopause, and challenging taboos and negative expectations about the menopause.

There are good examples of employers—we have heard one or two in this excellent debate—who have taken action to make their workplaces menopause-friendly. We have heard from my hon. Friend the Member for Redditch (Rachel Maclean), who takes a really close interest in this issue. She spoke so passionately this afternoon, as she has done previously in this House. She highlighted the example of the West Midlands police, which provides tailored support that helps women to build their confidence and stay in the workplace. As the hon. Member for East Lothian mentioned, she has spoken openly and bravely on this subject in the Chamber on several occasions. I know she is also working closely with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock.

I want to respond to the question my hon. Friend the Member for Redditch posed about GPs not prescribing HRT on some occasions for women who need it. HRT can help to relieve most of the menopausal symptoms. The guidelines from NICE—NG23 on the diagnosis and management of the menopause—recommend HRT as part of an individualised approach to treatment and management, and women must be able to access the treatment they need to manage such symptoms effectively.

My hon. Friend, like the hon. Member for Swansea East, correctly mentioned teaching children about the menopause in schools, which is absolutely critical. The Government are making relationships education compulsory in all primary schools, sex and relationships education compulsory in all secondary schools and health education compulsory in primary and secondary state schools. The Department for Education has launched a consultation on the draft guidance and regulations, which closes on 7 November. I am sure my colleagues in the Department for Education will have heard the well-qualified remarks made this afternoon.

The draft guidance currently does not mention the menopause explicitly, but at primary level it includes teaching about puberty, menstruation and changes to the adolescent body, and at secondary level pupils will be taught about sexual and reproductive health and wellbeing, including fertility. The underpinning focus in these subjects is to equip young people to develop positive attitudes to health, relationships and wellbeing both now and as they progress through adult life.

Does the Minister agree that when there is teaching about fertility in high school or secondary school education, the fact that the menopause is not mentioned almost plays into the taboo he mentioned earlier? Such a discussion is not had, and our children are therefore not getting a full picture or understanding of what is going to come to most of them.

I agree with the hon. Gentleman. It is absolutely crucial to have teaching about puberty, periods and reproductive health, which provides crucial opportunities for schools to refer to the menopause. I had no idea when my mother was going through the menopause, which was referred to as “the change”. She was very, very poorly. I remember being in the living room —my dad was at work—when the doctor was called. My mother was 50 years old and having a really bad experience. She was taken off to a mental institution. She was carted out of the house and ended up in what can only be described as a Victorian asylum. I am really glad that things have moved on in that regard—this was some time ago. It is absolutely crucial that we get to children early enough to make sure they understand the causes of a condition that affects every single woman.

Turning to the brilliant and characteristically brave speech by the hon. Member for Motherwell and Wishaw, she referred to the fact that every woman has a different type of menopause. That is absolutely correct. She talked about breaking the taboo around menopause and women’s health. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Thurrock, is leading work on improving the health of women and their experiences of healthcare. That work is partly focused on raising awareness and breaking taboos around common health morbidities, including problem periods and incontinence, not just the menopause.

The hon. Member for Motherwell and Wishaw also talked about sexual wellbeing during the menopause. It is important that women experiencing menopause have access to support and advice on that. It is common for women to lose interest in sex around the time of menopause, but treatments are available. We have heard that HRT often helps. If it is not effective, testosterone supplements can be offered.

The hon. Lady also rightly talked about the importance of the workplace. The hon. Member for Swansea East also wisely focused on that area. Workplace policies that take the menopause into account can benefit both women and their employers. The Government commissioned an evidence review into the menopause, which was published last July and highlighted the important role that employers can play in supporting women. Following that, the Women’s Business Council developed a toolkit for employers of all sizes, which enables employers to make the right adaptations to physical workplace environments, supporting flexible working and raising awareness to tackle this issue.

I want to close by restating the importance of approaching the menopause as a natural and normal stage of a woman’s life, while recognising that, as we have heard, for many women that life stage comes with some incredibly challenging symptoms. It is essential that all employers and health professionals are fully informed and ready to provide women with the best options for treatment and support. The right thing for individuals is also the right thing for our economy.

We have had a fascinating and fantastic debate this afternoon. It is important that we continue to speak openly and confidently about the menopause, so that embarrassment does not prevent women from accessing treatment and support where necessary. I thank all hon. Members for their brilliant contributions and for this opportunity to mark World Menopause Day.

This has been a fascinating debate. As one of the two men here, I extend the hand of friendship to the Minister. We have survived the discussion, so any man can survive it. I would also like to take the opportunity to thank him for sharing his personal experience in a very moving part of his speech.

I would just like to pick up on two elements of the debate very quickly. One is humour. It can be used to hurt and as a punchline. However, as we heard in a lovely extract from Holyrood magazine, it can also be used to open up a discussion that is so very important.

I again thank the hon. Member for Redditch (Rachel Maclean), and I would particularly like to speak to her colleague who said that we did not talk to our mothers about this. To quote from earlier on, Madam Deputy Speaker, this is a place where breakthroughs can be made. I think we have made a breakthrough today. It is a breakthrough that we should all, men and women, continue.

Question put and agreed to.


That this House has considered world menopause day 2018.

Business of the House


That, in respect of the Northern Ireland (Executive Formation and Exercise of Functions) Bill, notices of Amendments, new Clauses and new Schedules to be moved in Committee may be accepted by the Clerks at the Table before the Bill has been read a second time.—(Andrea Leadsom.)