Warwick Medical School research has explored how women experience menopause and access care within the NHS, focusing on inequalities shaped by ethnicity, socioeconomic status, and cultural norms.
In recent years, menopause has gained significant visibility in mainstream media and public discourse, but the benefits of this awareness are not being felt equally across the UK, with Black and Asian women about 80% less likely to get hormone replacement therapy (HRT).
To provide answers and recommendation, The MenopauseGAP study - carried out at Warwick Medical School (WMS) - has published its findings in two studies in the British Journal of General Practice.
These qualitative studies involved in-depth interviews and focus groups to explore a range of people's experiences of menopause and menopause care. In one study, a diverse sample of forty women, aged 40-60, and in the other 15 healthcare professional, were interviewed to examine a diverse range of experiences in accessing and providing primary care.
Dr Claire Mann, Research Associate in WMS at University of Warwick, said: "Our findings show that menopause care is not reaching all women equally, for a variety of factors. Future work to improve menopause care within the NHS should include targeted and intersectional health education for both patients and clinicians; especially for women who may want holistic treatment but cannot access this due to the limitations of current consultation frameworks."
The first study identified three overarching themes in women's experiences:
1. Context of care: Modern life's pressures often amplify menopause symptoms. Many women expressed frustration at the commercialisation of menopause treatments and confusion about reliable sources of information.
2. Experience of care: Consultations were often emotionally charged, with women feeling they had to advocate strongly for HRT or adjust their behaviour to avoid stereotypes.
3. Social and cultural influences: Cultural norms in many Black and South Asian communities discourage open discussion about menopause, leaving women without relatable information or representation in healthcare materials.
The second study saw healthcare professionals interviewed for the study reported similar challenges:
1. Uneven awareness: Rising public attention has encouraged more women to seek HRT, but cultural stigma and limited education still prevent many from accessing care.
2. Clinical challenges: Diagnosing menopause can be difficult, with symptoms overlapping with mental health disorders and growing demand for unlicensed HRT and testosterone treatments.
3. Systemic barriers: Language gaps, underfunded interpretation services, and time-limited consultations hinder communication - leaving disadvantaged women less likely to seek or receive support.
Dr Sarah Hillman, Clinical Associate Professor of Women's Health and Primary Care, University of Birmingham (formerly at WMS), said: "We must recognise that menopause care is not one-size-fits-all. Cultural sensitivity, representation, and clear information are key to ensuring all women receive the support they need.
"GPs should not assume that all women will advocate for themselves. Our findings show that initiating sensitive conversations about menopause and its management options, especially with women from underrepresented groups, can make a real difference in patient outcomes and satisfaction."
The team worked closely with community leaders and organisations including Cysters and Black Women in Menopause, who contributed to recruitment, terminology, and interpretation of findings.
Nina Kuypers, PPIE and founder of Black women in Menopause, added: "It's clear that current care provisions are failing to capture a whole range of experiences and voices of those experiencing the menopause, resulting in multiple demographics of people - especially those within Black and South Asian communities - being left behind to struggle in silence or excluded from conversations.
"We need to redefine how the menopause is being represented; everyone deserves a personalised, 'menopause-centric medicine' approach to their care. Moving forwards, I hope studies like the MenopauseGAP can make people aware of the diversity of menopause experiences within different ethnic groups."
Recommendations for change
Funded by the National Institute for Health and Care Research (NIHR), the MenopauseGAP study calls for urgent action to address these inequalities, including:
- Culturally tailored education for both patients and healthcare professionals.
- Specialist menopause training for GPs and practice staff, with a focus on diverse communities.
- Community outreach programmes to raise awareness and support among underrepresented groups.
- Accessible resources in multiple languages and formats, including video and audio.
- Improved funding and time allocation for menopause consultations in primary care.
- Better integration with secondary care services to support complex cases.
