Delayed diagnosis and treatment of menopause is wasting NHS appointments and resources
Published: 30th June 2021
Research of over 5,000 women has found that women in the UK are often struggling to receive treatment to improve their perimenopausal and menopausal symptoms, which is having a negative effect on their future health and quality of life.
Perimenopausal and menopausal symptoms can negatively impact a woman’s wellbeing and quality of life. Women who would benefit from taking HRT (which provides more benefits than risks for most women) are still being denied this treatment option.
The survey of 5187 women has provided shocking results, clearly showing that women are struggling to receive prompt and accurate diagnosis for their menopause. 70% of the women surveyed were aged 45–55 years. Nearly all respondents (96%) reported experiencing menopausal symptoms (eg hot flushes, low mood, anxiety, memory problems, brain fog, joint pains), only 39% were menopausal and the others were perimenopausal. The majority (74%) had been experiencing menopausal symptoms for more than one year, 15% for more than six years.
Most women, 79%, had visited a GP with their symptoms and 7% attended more than 10 times before receiving adequate help or advice. Of those women who did eventually receive treatment, 44% of women had waited at least one year, and 12% had waited more than 5 years. However, the majority of women should be starting treatment in the first consultation as HRT is a safe treatment.
In terms of treatment, only 37% of women were given HRT and 23% were given antidepressants. The NICE menopause guidelines clearly state that the majority of women benefit from taking HRT and that antidepressants should not be given for the low mood associated with the menopause so these results are disappointing and contradict the guidance.
27% of women had seen more than three doctors in hospital about their symptoms and 99% of these women had hospital investigations undertaken for their menopausal symptoms; 8% had more than six hospital investigations. Of those women who had taken time off work to attend their hospital appointments, 76% had taken at least two days off work to attend them.
These figures alone highlight the wasted financial and other resources that are being used to help perimenopausal and menopausal women within an already stretched and exhausted healthcare system. In addition, the personal costs to these women attending unnecessary appointments and taking time off work to attend should not be underestimated.
The perimenopause and menopause can usually be diagnosed without any blood tests or investigations. Many women can actually make the diagnosis themselves and downloading the free app, balance enables them to have individualised and evidence-based information to support the diagnosis.
There are health risks of delaying the diagnosis of the menopause including an increased risk of cardiovascular disease, type 2 diabetes, osteoporosis and dementia which are diseases that all cost the NHS billions of pounds each year. Women who take HRT have a lower risk of these diseases and evidence has shown that the earlier women take HRT, the better it is for their future health.
Dr Louise Newson comments: “Our survey of over 5,000 women confirmed that women are still facing delays in getting a diagnosis for their perimenopause and menopause (44% waited more than a year) and they’re waiting too long to get HRT, if it’s prescribed at all. Only 37% of women were offered HRT, and nearly half of these had to wait over a year to get it. A third of respondents were referred to at least 3 different hospital specialists for further investigations when in most cases the perimenopause and menopause should be managed by a local GP practice. This is a huge waste of NHS resources including increasing the strain and workload to primary care not to mention women’s time. Since May of this year, we are seeing a greater appetite from medical professionals, especially in primary care, to learn more about managing the menopause. This can’t come soon enough for women who are struggling.”
Newson, L & Lewis, R. (2021) Delayed diagnosis and treatment of menopause is wasting NHS appointments and resources [Paper Presentation], Royal College of GP Annual Conference, London, UK