Women's health: Menopause
The menopause happens to all women, however the degree of impact on a woman’s quality of life and the symptoms experienced are very individual. It is important that all health care professionals understand the changes that women face at the time of their menopause and the issues related to improving health after menopause.
All nurses should be able to demonstrate some understanding of the impact of the menopause and provide support and advice to women and men. Those working specifically in women’s health need to understand the safety and efficacy of modern therapy options and be aware of the myriad of complementary therapies. They also need to balance these options with the fact that for many women the menopause is an event that needs no intervention, and all that’s required is general health promotion advice.
NICE (2015) defines menopause as:
"Menopause is when a woman stops having periods as she reaches the end of her natural reproductive life. This is not usually abrupt, but a gradual process during which women experience peri-menopause before reaching post-menopause (NICE, 2015)
We have published the following guidance:
- Menopause and mental health pocket cards (2022). These cards are aimed at those involved in the health care of women as well as themselves. The guide contains information on the signs and symptoms of the menopause as well details on how it could have wider impacts on health and wellbeing, including where women may have an existing mental health issue when they enter the menopause. The pocket guide also aims to bust myths around the menopause and the treatments that are linked to it. Alongside this it has information on the impact the menopause can have on mental health. With a number of studies showing that the menopause can significantly impact mood and mental health, including stress levels and depression the booklet encourages women to speak up and seek the right help and support. See: Menopause and mental health pocket cards
- Nurse specialist in menopause (2022). The menopause happens to all women, however the degree of its impact on a woman’s quality of life and the symptoms experienced are very individual. The role of a specialist in menopause was included in the 2015 NICE guidelines on managing menopause, however the detail of how this role might be implemented in practice was less clear and subsequently the British Menopause Society (BMS) produced a guide for all health care professionals. This updated booklet builds on the BMS agreed standards, focusing on the options for nurses who may choose a career pathway towards becoming a specialist practitioner in menopause. See: Nurse specialist in menopause.
- Menopause. RCN guidance for nurses, midwives and health visitors (2020). This publication aims to help all health care professionals gain awareness of what happens to the body during menopause and in the post-menopausal stage, and examines the impact of these changes on women, outlining the options for health after menopause. See: Menopause: RCN guidance for nurses and midwives.
- The menopause and work: guidance for RCN representatives (2020). This publication provides guidance to RCN Reps when working with colleagues going through the menopause. The document discusses symptoms, workplace policies, and recommendations for changes to both work patterns and the work environment. See: The menopause and work: guidance for RCN representatives.
RCN Womens Health Forum members Debby Holloway FRCN and Katharine Gale, Chair of the Womens Health ForFree resource for training available at m facilitated a discussion at RCN Congress 2022 on Menopause in the workplace. Their PowerPoint presentations can be found below:
A free resource for training is also available, see: Menopause awareness elearning session
European Society of Human Reproduction and Embryology. Guideline on the management of premature ovarian insufficiency. This guideline offers best practice advice on the care of women with premature ovarian insufficiency, both primary and secondary.
NICE quality standards (2017). Menopause. This quality standard covers diagnosing and managing menopause in women, including women who have premature ovarian insufficiency.
NICE (2015) Menopause: diagnosis and management. This guideline covers the diagnosis and management of menopause, including in women who have premature ovarian insufficiency. It also aims to improve the consistency of support and information provided to women in menopause.
APPG Menopause. Manifesto for Menopause. Manifesto launched on World Menopause Day 2023, calling for free NHS menopause checks for women at 40.
Against Violence and Abuse and IRISi Interventions (2021) Menopause and Domestic Abuse. Brief guidance for staff and clinicians in general practice.
British Menopause Society. The British Menopause Society provides education, information and guidance to healthcare professionals specialising in all aspects of post reproductive health.
British Menopause Society. BMS TV. This page includes videos with healthcare professionals talking about different aspects of the menopause.
Daisy Network. The Daisy Network is dedicated to providing information and support to women diagnosed with Premature Ovarian Insufficiency (POI), also known as Premature Menopause.
Guidelines for nurses. Women's health. Guideline summaries and featured articles on women's health.
Menopause Matters. This website provides up-to-date, accurate information about the menopause, menopausal symptoms and treatment options.
Royal College of Obstetricians & Gynaecologists. Menopause and women’s health in later life. An information hub looking at women’s health around the menopause and beyond.
Wales TUC Learning Services (2017). The menopause in the workplace. A toolkit for trade unionists. This toolkit provides information to help reps in recognising and addressing the workplace issues that can worsen women’s symptoms.
Women's Health Concern. Women’s Health Concern provides an independent service to advise, reassure and educate women of all ages about their gynaecological and sexual health, wellbeing and lifestyle concerns.
Banks, S. (2019) Menopause and the NHS: caring for and retaining the older workforce.
Costeria, R et al (2023) Estrogen and COVID-19 symptoms: associations in women from the COVID Symptom Study.
Devlin R (2019) How can we support patients through the menopause if the NHS can’t support staff?, Nursing Standard website, 9 May. Available at: https://rcni.com/nursing-standard/opinion/comment/how-can-we-support-patients-through-menopause-if-nhs-cant-support-staff-148391 (accessed 09/05/19) (Web).
Holloway D (2022) The menopause: symptoms, treatments and implications for women’s health and well-being. Primary Health Care. doi: 10.7748/phc.2022.e1759.
Holloway, D (2015) Managing the menopause: symptoms, consequences and treatment. Primary Health Care, 26: 7, 40-49.
Noble N (2021) Helping and supporting staff to manage menopause symptoms at work. Nursing Times [online]; 117: 6, 39-41.
Nursing Standard Editorial (2022) Menopause leave: NHS can be ‘trailblazer, Nursing Standard, 37 (9).
Ryman, J. Holloway, D. & Bowen, J. (2022) Looking after our menopausal workforce: A model for NHS staff, British Menopause Journal, (open access).
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British Menopause Society. Menopause education for nurses
Cross Government Menopause publications
The Cross Government Menopause group has published the following publications on the menopause:
'Find a Menopause Specialist' service
To mark World Menopause Day, the British Menopause Society launched a UK-wide register of BMS recognised menopause specialists, covering both NHS and private clinics and services.
The register can be accessed via an online search tool on the BMS website and the interactive map makes it easy to search by geographic location. It contains contact details of each of the recognised specialists across England, Scotland, Ireland and Wales.
Menopause HRT PPC
The new HRT PPC new (Prescription Prepayment Certificate (PPC) to reduce the cost of certain hormone replacement therapy (HRT) prescriptions) Toolkit has been published, see: HRT PPC communications toolkit