Written evidence from Kate Muir [MEW0033]
Writer/producer of the documentary Davina McCall: Sex, Myths and the Menopause
Author of Everything You Want to Know About the Menopause (but were too afraid to ask)
Published January 2022, Simon and Schuster.
I want to make a submission as I have been researching this subject for both the Channel 4 documentary and my book for two years. I have interviewed leading NHS and private menopause experts, campaigners and ordinary women in the UK, USA and Australia, and read the latest science papers. I also helped create The Menopause Charity and their campaign to provide a free professional online Confidence in the Menopause Course (including HRT prescribing), which has now been taken up by 13,000 GPs and healthcare professionals – an indication in itself for the desperate need for proper menopause education in the NHS.
Perimenopause and menopause symptoms can have a devastating effect on women at work – one unpublished 2021 Newson Health Survey of 3,000 patients shows one in eight quit their jobs due to menopause, and 21% did not apply for promotion, or took lesser roles. This is an incredible loss of wisdom and expertise to the economy, and leaves women unemployed and unhappy when they should be at the peak of their careers, when children have left home and they have more time.
There is much talk about workplace policies, reasonable adjustments, and flexible working, all of which are great – but what struggling women need most is evidence-based information and medical help, either hormone replacement therapy or other remedies. This is the best way to keep them in the workplace. The menopause is not a transition, but a long-term hormonal deficiency, and lack of estrogen causes long-term health problems including osteoporosis which affects one in two women over 50, heart disease, diabetes and dementia.
While hot flushes are the obvious symptom to notice, it is important to realise that 60% of women complain of cognitive problems during menopause, including brain fog and memory loss, and this has a devastating effect in the workplace. Brain fog is real. Lack of estrogen causes loss of grey matter and white matter in the brain, and while some women’s brains rewire, others find they cannot do the job they previously did. This group are most in need of HRT. Huge numbers of women suffer bouts of extreme anxiety, loss of confidence and hormonal depression, thanks to the estrogen, testosterone and progesterone draining away in perimenopause and menopause.
(I speak from experience. In early menopause I found myself thinking, ‘I must shave my legs’ and could only remember the word ‘shaver’ to write on the shopping list. The word ‘razor’ had disappeared from my vocabulary. Losing a proper noun is different from forgetting the name of an acquaintance, and I panicked. I went to get HRT, which included estrogen and testosterone, and within a week my memory was firing at full speed again.)
Women still associate HRT with a risk of breast cancer, and are more willing to suffer and lose jobs than take it. But HRT actually puts them on a hormonal even keel, and makes work easier than ever before.
An essential part of the change that needs to be made for the 4.5m menopausal women of working age is providing knowledge that all HRT is not the same. The new plant-based body-identical HRT is much safer than the old oral combined pills, which were used in the Women’s Health Initiative survey which terrified women and created shocking headlines in 2002.
According to experts at the British Menopause Society, the newer NHS approved plant-based transdermal estrogen is synthesised from yams, and French studies show it has no breast cancer risk over 5 years and a negligible one over 10. (www.tandfonline.com/doi/full/10.1080/13697137.2017.1421925). The new transdermal HRT also has no risk of clots, or cardiovascular disease. But in most parts of Britain and Northern Ireland, women are still being offered the older HRT. Yet 95% of prescriptions in the major NHS menopause clinics are the new HRT. Women need to ask for the safest HRT.
Giving women the medical information to make the choice which is right for them will make a huge difference to retention of staff. We also need a cultural change which celebrates and explains menopause to everyone. We’ve had Period Power. Now we need Menopause Power.