HRT shortages in the UK have left women from all walks of life struggling to access menopause treatment. But research shows some women face more barriers than others. LEW investigates who’s falling through the net and what can be done to ensure a better second half for all.
At any one time, 13 million UK women are going through menopause – and research shows HRT can help to ease symptoms and protect the long-term health of the vast majority of these women. Unfortunately, a number of women find themselves significantly disadvantaged when it comes to receiving this menopause care.
We might (rightly!) complain about having to fight for a GP appointment but, for many, this is just the first of a number of hurdles. For instance, ‘ethnic minority women have historically experienced issues related to systematic racism within healthcare,’ states Dr Nighat Arif, a GP specialising in women’s health and author of The Knowledge: Your Guide to Female Health – From Menstruation to the Menopause (£22, Aster). ‘The medical model used today is founded on white patriarchy. Unfortunately, this means that Black and Brown women are not afforded the same access to care.’
Ethnic minorities aren’t the only group facing adversity when accessing menopause treatment. ‘People with a learning disability (LD) face challenges due to gaps in understanding their needs and communication barriers,’ explains Dr Kuki Avery, a GP and menopause specialist at Chelvey Menopause (chelveymenopause.com). ‘A survey conducted by Dimensions, a charity supporting people with LD, revealed that out of 272 GPs, 64% had received less than a day’s training on meeting the needs of patients with LD.’
Women with a lower socioeconomic status also struggle to obtain menopause treatments, found a 2020 study by the University of Warwick. Those from deprived backgrounds are 29% less likely to be prescribed HRT – and when they do get a prescription, they’re more likely to be given an oral treatment rather than HRT applied via the skin (a gel, patch or spray). Studies have linked oral HRT to a small increased risk of blood clots, while gels, patches and sprays – also known as transdermal estrogen – have no associated risk.
Both ethnic minority and LD patients are frequently excluded from clinical research, meaning factors specific to their health and care needs aren’t considered when shaping policies and treatments. ‘The discussion around HRT often overlooks women with LD,’ Kuki explains. This leads ‘to their exclusion from the decision-making process and the potential long-term health benefits of HR
