Meeting of the Parliament

Meeting date: Tuesday, November 1, 2022

Official Report 1006KB pdf

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World Menopause Month

The final item of business is a members’ business debate on motion S6M-06225, in the name of Siobhian Brown, on world menopause month. The debate will be concluded without any question being put. I invite members who wish to participate to press their request-to-speak buttons or place an “RTS” in the chat function if they are joining us remotely.

Motion debated,

That the Parliament recognises that the World Health Organization and the International Menopause Society have designated October as World Menopause Month, and October 18 as World Menopause Day; understands that both events aim to raise awareness of menopause and to support options to improve health and wellbeing for women in mid-life and beyond; believes that women across Scotland, including those in Ayr, will benefit from an open conversation about menopause; notes that no two women will experience menopause in the same way and that being aware of symptoms is the first step in managing them, and recognises that Scotland is the first country in the UK to have a women’s health plan, which, it believes, outlines ambitious improvements to women’s health issues including menopause.

17:19  

I thank every member who has supported the motion. This is such an important issue that affects so many women, so I really look forward to hearing contributions from members from all sides of the chamber.

“Menopause”, “the change of life” and “being a woman of a certain age” are just some of the terms that are used to describe a time of life that happens to every woman, regardless of race, colour, social status or background. A total of 51 per cent of Scotland’s population are women, and will go through it. Although some are lucky enough to breeze through it, others have negative experiences.

In general, menopause happens between the ages of 45 and 55, when periods stop as a result of hormone levels dropping. The phase before that is called perimenopause, when women might experience night sweats, hot flashes, joint pain, migraines and trouble sleeping. Those are just some of the physical symptoms; we can add to them mental fog, anxiety, panic attacks and depression.

Historically, the menopause and, indeed, the perimenopause have rarely been talked about. The subject was mentioned with embarrassment, in hushed tones, and was most certainly never discussed in public or around men: it was taboo. That has left women with questions—sometimes with no answers—such as, “What are the symptoms?”, “How do I know if I am going through the menopause?” and “Where can I get help?”

That has been the case until now. The conversation has started, which has been branded “the Davina effect”, as celebrities and women in the public eye such as Davina McCall have been sharing their experiences of menopause symptoms and treatments. Davina and others like her, including Penny Lancaster, Carol Vorderman and our own First Minister, have become increasingly willing to share their stories. Some are part of a wider menopause movement down south and are challenging the notion that women should just shut up, put up and carry on.

The conversation for me starts on a very personal note, as I recently started menopause treatment. To be honest, I investigated it only after having discussions with colleagues. I am 51 and I believe that I have been perimenopausal for several years without even knowing it. About four years ago, I started to get pain in my lower back. It would wake me up at night, and every morning, when I got up, I was totally crippled. As the day went on, things got better, but the pain always returned at night. I went to the doctor—I even had a magnetic resonance imaging scan, but everything came back clear. I just put it down to getting older, and I learned to live with the pain.

I also did not feel like myself. I was not the person that I used to be and did not have the energy that I once had; I felt that I was always in a constant low. I put it down to age and dismissed it as perhaps being down to the stress of being in politics—we all know how stressful it can be, at times. A few months ago, however, I made an appointment at my local surgery to discuss treatment for menopause. I was lucky that my general practitioner recognised the symptoms straight away, and a treatment plan was put in place. It is still early days for me, but the first thing that I noticed, after one night, was that my night pain had improved instantly. I only wish that I had known more about the symptoms and had asked for help sooner.

It is worth stressing that hormone replacement therapy is not the answer for everybody—-there is no one-size-fits-all solution for menopause. Since that diagnosis, I have heard from many women who have experienced the same symptoms as I did. Such symptoms are often never recorded—they are simply put down to age and are pushed aside. Those women were struggling through each day—miserable, anxious and in pain, thinking that they had dementia or arthritis. They believed “This is just my lot.”

Last weekend, I spoke at a local ladies event in Prestwick, where menopause was definitely a hot topic of the day. One lady, who is a local dentist, told me that she had gone to a doctor and was “diagnosed” with “stress”. After persevering, she found out that it was not stress, and she was put on HRT for menopause. However, I highlight her story because when she renewed her income protection insurance, her premium went up because of the misdiagnosis of her symptoms as being a result of stress. That should not be happening.

In August last year, we welcomed the publication of “Women’s Health Plan: A plan for 2021-2024”, which outlined ambitious and bold plans to improve health and reduce inequalities for women in Scotland. That is great, and the plan is so important.

I will tell members a personal story about a flippant remark that I heard many years ago from a doctor in Australia, and which haunted me for a long time. When I was 27, I was diagnosed with polycystic ovaries. I remember being told by the doctor, in a really dismissive way, “You’re probably not going to have any kids.” I questioned that—I said, “What do you mean, I won’t have any kids?” He said, “Well, are you planning on having kids? Do you even have a boyfriend? If not, you’d better hurry up.” I did have a boyfriend at the time, but that dismissive attitude had a huge impact on me for years afterwards, because I thought that I was never going to have children. Thank God the diagnosis was wrong, and I went on to have my three children, which was always part of my plan.

That happened a long time ago, but it shows how such important women’s health issues were so misunderstood and were just not seen as a priority. In the “Women’s Health Plan”, a priority for menopause is to ensure that there is

“access to specialist ... services for advice and support on the diagnosis and management of menopause”.

In October last year, the Scottish Government launched the NHS Inform menopause information platform to bust myths and highlight symptoms and the treatment and support that are in place. More than a year later, there is a specialist service for menopause in each mainland health board.

It would be remiss of me, as an employer, to ignore the issue of menopause in the workplace, especially given that the majority of my staff are women between the ages of 45 and 55. Around 320,000 women in Scotland are of that age, which is working age for many of them. I recently attended the launch event of “Let’s talk about menopause”, which was hosted by NHS Ayrshire and Arran at University hospital Crosshouse. The board is one of the largest employers in the area, and is actively putting in place menopause support for its staff. Half the board’s staff are women over 45. As we know, that is the age at which, for the vast majority of women, menopause symptoms manifest themselves and can last for up to 12 years.

Finally, I urge women to act—to seek help, advice and treatment. I also remind employers to show compassion and understanding towards those women. There is no one-size-fits-all approach to menopause—what works for me might not work for someone else, and my symptoms might not be like theirs. That is why we need a meaningful dialogue, and when menopause awareness month comes around, we can discuss, and keep on highlighting, all the issues.

The main message that I hope members take from the debate is that it is good to talk about menopause to friends and family and in the workplace, and it is good to seek professional help, because help is out there. The genie is out of the bottle, and it is time that we women of a certain age told our stories.

17:27  

I thank my colleague Siobhian Brown for bringing the debate to the chamber. Social stigma and misogyny have resulted in the menopause traditionally being underdiscussed or marginalised, despite the fact that it affects almost all women at some point in their lives and impacts on their health and on their economic and social equality. In recent years, however, there has been greater focus on the issue—led by women, of course, who have been talking about their experiences—which has led to changes in policy, understanding and practice. However, we must go much further.

In the workplace and outside it, there should be a legal, moral and ethical responsibility on organisations, whatever their nature, to create a menopause-confident environment. The evidence suggests that those that do so retain their talent. That is currently extremely important, as we face a labour shortage in key sectors that usually employ a majority of female staff.

A recent survey collated more than 2,000 responses. It found that 31 per cent of respondents reported taking time off work due to menopause symptoms, including problems with memory or concentration, anxiety, depression and headaches. The survey reported that, in spite of that,

“less than a third of respondents told anyone at work”,

and

“Just under 11% ... requested adjustments”

in the workplace

“due to their symptoms.”

Those who did not request adjustments said that they were most likely not to do so as a result of stigma, with 26 per cent citing as the reason:

“I was worried about the reaction of others”.

The stigma is still very apparent.

The Scottish Government published its “Women’s Health Plan” in August 2021. The plan addresses health inequalities for women and lists menopause as a priority area, with an objective to

“ensure women who need it have access to specialist menopause services for advice and support on the diagnosis and management of menopause”.

The development of

“a menopause and menstrual health workplace policy”

is also set out as a goal.

Many of us in the chamber know only too well the limitations of our own social education at school or in the home. We were never explicitly taught about the subject in school, and many parents did not talk about it, either out of shame or simply because they did not think that it mattered.

The advantage of young people learning about the menopause is that it will, we hope, start a conversation at home and get parents thinking about what they might be about to go through themselves. It will open up conversations between mothers, daughters, grandmothers and aunts, who will begin to share their experiences openly and with confidence. Menopause is a part of many women’s lives: please teach us about it as girls.

I have met Engender, which has previously reported its findings on menopause stigma. It found that

“Just under 60% of women suggested they did not feel supported by medical professionals, which was higher than those who did not feel supported by their employers or friends and families.”

It also found that

“The most common reasons for a lack of support from friends and families included ... lack of understanding”.

In conclusion, I say that I speak to women: we have a tendency to carry on through and—as my colleague, Siobhian Brown, said—to put up and shut up. It is time that we gather together, as we are doing today in the chamber, and ensure that we talk openly about our experiences, our symptoms and the consequences, as my colleague Elena Whitham will do. We should not be red-faced about the issue—unless we are experiencing a flush, of course.

17:31  

I am honoured to speak in the debate on behalf of the Scottish Conservatives. I thank Siobhian Brown for bringing to the chamber a debate on such an important topic, and for sharing her experience.

It is never easy to talk about something so personal—in particular, something that can make a person feel uncomfortable in their own skin. I was, for some time, reluctant to speak about it, myself. It is not always easy to speak about the symptoms of menopause; it is not very appealing to speak about the hot flushes, the sweats, the sudden onset of cramps, the body aches, the brain fog and much more. Naturally, therefore, it is far easier to avoid the topic.

However, I have heard the horror stories of women who have had a different experience from mine. There are women who have almost taken their own lives because depression was affecting their mental health so much. Nobody should feel like that.

There is still real reluctance to be frank and candid about what women go through during menopause. I am also very aware that speaking about menopause is taboo in some black and minority ethnic communities. People are still very apprehensive about it. Elders in the Asian community do not see the experience as being something to share.

However, I think that it is really important that we all share our experiences, if we are able to do so. I will be open about how menopause has started to affect me, because we never know who, out there, needs to hear that someone else is going through it too, and that it will be okay, even if the journey is tough.

For me, this is menopause: it feels like being a stranger in my own body. I have looked in the mirror and I do not recognise myself: everything is changing so fast, and it is out of control. My biggest fear is how menopause will impact how I do my job in Parliament. What happens if I get a hot flush while I am speaking in the chamber? What happens if my brain turns foggy during a debate? The lack of control can be difficult to accept, and even more difficult to speak about. The changes in personality and mood can be really unsettling and unpredictable and can lead a person to wondering which part is the menopause and which part is really them.

As a society, we need to be better at accepting and understanding menopause, and we need to improve the support that is offered to the 400,000 women in Scotland who are menopausal. Organisations such as Menopause Warriors Scotland argue that there is still a postcode lottery in menopause care. There is real inequality in terms of the treatment that is available, which depends on where someone stays. Many women are still waiting months for much-needed treatment.

The appointment of a women’s health champion is long overdue, so I hope that the Scottish Government will make that appointment very soon. I hope that today’s debate will spur the Government on to act further and that it will mean that the inequality in menopause and perimenopause treatment is seriously examined. I sincerely hope that the stories and truths that we have shared today will help someone—even one person—who is going through menopause and is struggling. However, to do so requires not just talk, but action.

17:35  

I thank Siobhian Brown for the debate and for sharing her experiences, as other members are doing tonight.

At an event in summer 2018, my daughter said to me, urgently, “Mum! Mum! You must stop fanning yourself! You look unhinged!” I had no idea that I was doing it; however, I was extremely hot. In fact, I felt that my head was on fire. Boom! The menopause had arrived.

Over the next few months, the hot flushes, as they are known, got worse. I was anxious, jittery and unfocused, and I had insomnia and mood swings. The menopause usually occurs between the ages of 45 and 55, and symptoms such as the ones that I had are common and can last for up to 10 years.

However, everyone is affected differently. I went to my general practitioner for help early on, but for some women, the process is very difficult. Last year, Bupa Ltd found that just under half of women who were affected said that they had never visited their GP for help due to factors including lack of awareness and embarrassment.

Menopausal women are the fastest-growing demographic in United Kingdom workplaces, but the fact is that 900,000 women have left their jobs because of a lack of support. Research has found that women in better-paid jobs are actually better supported through the menopause, but little data is available on the experience of women in low-paid or manual jobs, despite the fact that those women account for more than half of all working women in the UK. There is also a lack of research into how women of colour experience menopause, and into the barriers that they face both in the workplace and in accessing healthcare.

All of that contributes to there being more health inequality at a time when women who live in the most deprived areas of Scotland experience 25 fewer years of good health than their counterparts in more affluent areas. Businesses cannot afford to lose experienced and talented women from the workforce at any level, and more support is required if we are to achieve better health outcomes for all women in Scotland.

Awareness raising has achieved a great deal in recent years, with 500,000 more women like me now receiving HRT—which I should point out is not a panacea, because not all the symptoms go away. The fact that women are accessing such therapy is due partly to the open conversations that influential individuals such as Davina McCall and Nicola Sturgeon have been having, but it must be noted that, although prescription rates have doubled in more affluent areas, poorer areas are lagging behind.

After the menopause, oestrogen levels drop, which increases the risk of osteoporosis and bone breakages. That is serious, but it can be managed with HRT. I must also point out that there are, in general, no specialist menopause services, with women instead being placed on extremely long gynaecology waiting lists.

I therefore welcome the Scottish Government’s “Women’s Health Plan”, which sets out steps for menopause-specific services and much-needed advances in that area. Scotland, again, is leading the way, as the first country in the UK to implement such an ambitious plan, the underpinning principles of which include addressing inequalities and responding to unjust and avoidable differences in people’s health.

I am pleased that this topic is generating such an open debate tonight, and I look forward to the Scottish Government’s goals for menopause being realised.

I think that I have just had a hot flush myself. [Laughter.] Thank you.

I call Stephanie Callaghan, who joins us remotely. Ms Callaghan, your microphone is on but you might have to turn your camera on, too.

17:39  

I am trying to turn my camera on—

That is you coming through on audio and visual now, Ms Callaghan.

Thank you, Presiding Officer.

I thank Siobhian Brown for bringing this debate on menopause month to the chamber. Women make up half the population, and we need to be open about the issue and find ways to support them during this stage of their lives.

It is vital that there is awareness of menopause and perimenopause. We support options to improve the health and wellbeing of women throughout Scotland, so the women’s health plan represents welcome progress.

In the spirit of openness, I will say that I am appearing remotely today because yesterday I underwent a hospital procedure that is related to menopause. I readily admit that I am not exactly feeling my best, but, despite that, I came to work—as most women do in such circumstances—and I have tried my best throughout the day.

I have talked to women in communities across Uddingston and Bellshill. I have listened to their stories and shared my experiences, and the message that no two women’s experiences of menopause are the same comes through loud and clear every time. My message to women today, like that of other members, is that we should be open and we should speak out.

Awareness of symptoms is the first step towards managing them. I know that I am repeating what other members said, but women need to know this and take it in: common symptoms include brain fog and memory issues, difficulties sleeping, fatigue, hot flushes, joint aches, loss of sex drive, low mood, anxiety, migraine, night sweats and vaginal dryness and pain. A quick google will bring up a huge range of symptoms—some websites list more than 60—so I encourage women to have a look so that they know what they are dealing with.

There are recent findings that HRT, although it is not completely risk free, remains the most effective solution in helping with the symptoms of menopause. It is also effective for the prevention of osteoporosis and perhaps heart disease, too.

Here are some statistics to consider: three in five women who are experiencing menopause say that it negatively impacts their work but most feel unable to get proper support; the Fawcett Society reports that one in 10 women have left their job due to menopause symptoms; 41 per cent of United Kingdom university medical schools do not have mandatory menopause education on the curriculum; and a study by Newson Health found that 79 per cent of the women who were surveyed had visited their general practitioner with menopausal symptoms but only 37 per cent were given HRT, with 23 per cent having been given antidepressants.

Things have improved in recent years, but, sadly, the vast majority of women who go through menopause report no employer support, no policies, no awareness and no training. I hope that this debate encourages more employers to think about introducing a menopause policy.

HRT is regarded as the gold standard when it comes to replacing hormones, easing symptoms and protecting our bodies. I am thankful that, increasingly, HRT is more widely available, and I urge all women to speak to their GPs about whether it might help with their symptoms.

For some women, things are not straightforward. I spoke to a woman who reached perimenopause when she was 44 years old. She was tested for a load of other conditions before the menopause was even considered as a possibility. She said:

“The gynaecologist that examined me internally was really annoyed when I refused the coil and went for HRT patches, asked me several times if I was sure and made me feel really stupid for not agreeing with her. It was scary being tested for cancer before they even tested my hormone levels and it delayed my treatment.”

Eventually, that women got help from a male GP whom she describes as “brilliant”.

My journey has been complicated, too, involving a history of endometriosis and much scarring, but my experience has been better and I still hope that HRT will be a possibility for me—it is a bit scary to think that it might not be. I thank my GPs for their support; a few of them have been incredibly helpful and knowledgeable. I thank my colleagues in the Parliament for their understanding, and I especially thank my office team for the support that they have given me. Last but not least, I thank the four women who were involved in my procedure yesterday. They were absolutely amazing—nothing short of brilliant.

Every menopausal woman deserves our support at work, at play and at home. We, as women, need to speak out, and we need employers and everyone else to listen. There should be no more taboo, no more stigma and no more suffering in silence. Please step up to support women through the menopause and know that we will really appreciate that.

I thank Ms Callaghan for being in the vanguard of using our new hybrid technology.

17:45  

I, too, thank Siobhian Brown for bringing this important debate to the chamber.

On behalf of Scottish Labour, I welcome the World Health Organization and the International Menopause Society designating October as world menopause month to raise awareness of the menopause, and I reiterate that we welcome the women’s health plan. We have pushed for action on women’s health throughout this parliamentary session and, indeed, the previous one. It is, of course, welcome that women’s health and health issues, such as the menopause, which was once avoided in public discussion, are receiving some of the spotlight that they deserve in the chamber.

I thank and admire the women across the chamber who have shared their stories this evening.

We have heard that it has been estimated that around 13 million women in the UK are either perimenopausal or menopausal at any one time. That is a massive number of women. Menopause is a major life event that marks the end of the reproductive lifecycle. As we have heard, many women experience very troublesome symptoms related to it, often for a number of years, and that can have a detrimental impact on their quality of life and wellbeing. For many, it can also have a significant impact on their personal relationships and in the workplace—I am pleased to say that we have heard that a number of times.

Considering all the symptoms that other members have raised, it is vital that people in our position speak up for those who are perhaps unable to do so. As Siobhian Brown mentioned, some celebrities have really come to the fore and put effort into ensuring that we can discuss such issues more openly. I know from my constituents about the stigma surrounding the menopause and menstrual and reproductive health. Women such as those celebrities and ourselves feel that we can move forward and that considering those issues is very important in a modern Scotland. We have seen change, but some women have reported to me—and, it seems, to other members—that it can feel that that change is at a snail’s pace.

In my last few minutes, I would like to concentrate my remarks on menopause in the workplace. Every single one of our female colleagues will go through the menopause. As we have heard, it is not a new issue, but, if we are being absolutely honest with ourselves, it is relatively new that is discussed openly, particularly in relation to workplace matters. I think that that is why a number of women have raised that issue this evening.

In 2019, the Scottish Trades Union Congress women’s committee did some pioneering work. Women across the workforce were asked and responded to a number of questions. Some of the results really highlighted the need to make menopause in the workplace a more visible issue. In summary, women said that they often found managing their menopause symptoms in the workplace to be extremely challenging.

Coping with menopause symptoms in the workplace can be hard, especially as many women find it so difficult to discuss them. Ninety-nine per cent of the respondents either did not have a workplace menopausal policy or did not know whether their workplace had one, and 63 per cent said that the menopause had been treated as a joke in their workplace. It is important that we talk about those issues, as that makes women more confident about speaking out if that happens in the workplace.

At the 95th annual STUC women’s conference, trade union delegates highlighted women’s health as a workplace issue. I am sure that Carol Mochan will want to join me in supporting the STUC women’s committee’s call for the Scottish Government to increase the moneys used to investigate women’s health, including diseases such as endometriosis, and that she would urge all members to do the same.

I fully support the work of the STUC women’s committee and the point that the member has made.

Trade unions are at the forefront of work to ensure that policies in the workplace support employees at challenging times of their lives, and menopause support, menopause policy development and eliminating menopause discrimination are all part of that.

I hope to work with the trade unions and the Government to ensure that we can make a difference for those women. I look forward to more discussions on the issue in the chamber, and I thank members for their contributions.

17:50  

I thank my colleague Siobhian Brown for bringing the debate to the chamber. We have had many conversations about the menopause during our long journeys back to Ayrshire every week.

My name is Elena Whitham and I am menopausal. Being menopausal is not in any way the sum of my existence, but some days it sure feels that way. It could be sweating bullets in the chamber—not from any Opposition interventions, but from some confounded internal combustion engine that arbitrarily decides to power up the flame-throwers, as it did during the earlier debate—or the ever-present brain fog that means that I call my children by the dog’s name or put the remote control in the freezer. Sometimes, it takes all of the women in my office to complete a sentence—we help one another out, as women do—or there is a sudden panic as my haywire menstrual cycle decides it is tsunami season and my Mooncup literally runneth over.

Whether it is when I yelp when my husband reaches out to hold my hand during a walk and my sore finger joints squeal under his embrace, or, yet again, as I decide to close my ever-so-tired eyes on the train to Parliament, only to be jolted awake by some fellow passenger who is rudely snoring without a care in the world, and then realising that it is me—with my exhaustion being further underlined by the wee trail of slavers that are escaping from my slack jaw—sometimes it literally feels like I have lost myself somewhere between the ages of 46 and 48. It feels like I am wading through treacle trying to figure out who I am—as Pam Gosal talked about—while trying to juggle work, a neurodivergent teenager and husband, a needy Jack Russell and a 20-something-year-old son who sometimes just needs his mammy to make his work’s piece, all at a time when my multitasking skills have all but deserted me.

“Help ma boab,” I hear members say, “she needs pit doon.” Nah—all I needed was a box of bioidentical HRT patches, and I have the battle scars to prove it.

My menopause started during the pandemic and it coincided with my getting a really heavy dose of the delta variant, which led to questions over whether it was long Covid. I was also diagnosed with a vitamin B deficiency, some of the symptoms of which mirror the menopause and long Covid. I had to keep battling to get the hormone replacement that my body was so evidently crying out for.

All women should be well aware of those symptoms. We need to communicate them more widely, with posters everywhere that say, “If this is happening to you, it might be the menopause.”

I bought a book by the amazing journalist Kate Muir, “Everything You Need to Know About Menopause (But Were Too Afraid to Ask)”—other books on menopause are available—and it literally changed my life. While reading it in bed, I kept exclaiming, “That’s just like me,” while poking my husband as he tried to read beside me. I finally felt empowered, alive and equipped with the knowledge that I needed to once again ask my GP for support.

Please bear in mind that I was a young mum at the time of the discredited measles, mumps and rubella and HRT studies, and I still bear the scars from them. I remember vowing that I would never take HRT; I would dure it out. I was not going to put myself at risk. It is only natural, right? No—I was wrong. Each woman will experience their own version of menopause and all options should be available to each and every one of us.

HRT can protect against osteoporosis, dementia, heart disease and stroke. If we care enough to make sure that women are supported as they move into the menopause, HRT can protect our wellbeing and relationships, and our jobs can be saved. Heaven forfend that we should place importance on our sex lives and ask for testosterone gel, which is currently woefully underprescribed in Scotland. It is funny that it does not have the same traction as those wee blue pills that help men with erectile dysfunction. Something that more than half of the world’s population experiences should not be left to chance and GPs with scant training.

I have a keen focus on social justice, and, as is the case with many health concerns, there are clear health inequalities when it comes to menopause. Women in deprived areas tend to be prescribed less HRT, and, when they get a prescription, they tend to get the more dangerous oral variety, which will interact with comorbidities that they must face, leading to poorer outcomes. That can and must change, and I would like to hear how the minister thinks that the women’s health plan will positively influence better outcomes for women who are not always able to navigate a system that is designed without them at its heart.

Thank you very much, Ms Whitham. I am very grateful to Collette Stevenson for taking the lead on the appropriate facial expressions to show during the previous four-minute speech. With that, I invite Ms Stevenson to speak, to be followed by Monica Lennon. You have around four minutes, please.

17:54  

Thank you, Presiding Officer. It is lovely to get people smiling and laughing in the chamber, despite what we are talking about.

I, too, thank Siobhian Brown for bringing the debate to the chamber. Like several other women in the chamber, I am a menopausal woman and I can relate to what is being said. Last week, I had a bit of brain fog and took a lift to the second floor and not to the third floor, where I normally reside. I walked straight up to what I thought was my office. I looked at the young boy standing there and asked, “Who are you?” When he told me that he was Jamie Greene’s assistant, I said, “Oh, my!” At that point, Edward Mountain and Jackson Carlaw were absolutely killing themselves laughing at me. I quickly scurried away—no, I did not join the other side. [Laughter.]

I digress. It is right that we recognise world menopause month and acknowledge women across the world who are going through or have gone through the menopause or who are at the perimenopausal stage.

In the past, nothing really prepared women for this life-changing event. However, in recent years, the Scottish Government’s work to raise awareness and to support the setting up of specialist clinics and NHS Inform’s menopause platform has been so important.

I am glad that we are having another debate on the menopause, because it is vital that we have an open dialogue on this important taboo subject. Today, I want to focus on the impact on women in work. As has been cited, research indicates that 900,000 women in the UK have lost their jobs from experiencing menopause-related symptoms. That is an awful statistic, and it shows that much still needs to be done.

As the Chartered Institute of Personnel and Development said, that could mean that women are leaving businesses

“at the peak of their experience”,

which will

“impact productivity”.

Although menopause discrimination can be covered under the Equality Act 2010, I believe that more specific legislation should be considered.

I am a champion of workplaces introducing a menopause policy to ensure that women get the support and adjustments that they need. I was instrumental in campaigning for that in South Lanarkshire Council a few years ago. At the time, that approach was groundbreaking.

There are great third sector groups out there, including Menopause Experts, which I met recently. The menopause friendly workplace accreditation scheme is also great and I know that businesses—big and small—in East Kilbride support that.

Women should not be suffering in silence, and their needs should not be ignored. We should all be embracing this topic and having menopositivity. We should be empowered, with woman feeling comfortable to say that they are struggling with symptoms, rather than that being a barrier.

As the motion says, different women have different symptoms and experiences of the menopause. Therefore, when women seek medical treatment, they deserve to be heard as individuals with their own experience.

The availability of hormone replacement therapy is increasing. I would hope that any woman who asks for that treatment will be given the opportunity to have it, where that is clinically appropriate.

The Scottish Government’s women’s health plan and recent improvements in NHS services are very welcome. In addition, there are many good employers supporting female colleagues experiencing the menopause. Let us continue in that vein, with open conversations, suitable healthcare options and social and employer support.

I will end my speech by highlighting what I consider to be the best-ever three minutes of television. This is an extract from “Fleabag”, in which Belinda delivers a barstool soliloquy on menopause. She says:

“I’ve been longing to say this out loud—women are born with pain built in, it’s our physical destiny—period pain, sore boobs, childbirth, you know. We carry it with ourselves throughout our lives ... Men don’t. They have to invent things like gods and demons ... they create wars so they can feel things and touch each other… and we have it all going on in here. Inside, we have pain on a cycle for years.”

Let us do everything that we can to support women experiencing the menopause and to remove at least some of that pain.

Thank you, Ms Stevenson. I am not sure what facial expression was appropriate to that soliloquy.

I call Monica Lennon, who is the final speaker in the open debate.

18:00  

It really has been an enjoyable debate. Some difficult topics have been covered, but everyone who has spoken has brought a lot of insight and lived experience, and a bit of humour as well. I have given notice that I have to leave before the end of the debate and thank you, Presiding Officer, for allowing that. I apologise that I cannot stay for the minister’s closing remarks, which it would be good to hear.

We have made a good start with the women’s health plan—the first in the UK. There is a lot in there that is positive, as we heard recently at the cross-party group on women’s health, which I chair. We need to keep going on that, and I know that there is commitment to that across the chamber. That is why it is so important to know when we will have a women’s health champion. I am sure that there are plenty of able people who could fill that role.

I congratulate Siobhian Brown on securing the debate. It is important that we do not just let these awareness months and days pass us by. We are having much more open conversations about the menopause and, indeed, the perimenopause. However, just having that talk is not enough.

We know that there is a lot to do, and we have heard about the importance of good-quality time with GPs and in primary care. When I get the chance to speak to the Cabinet Secretary for Health and Social Care, we talk about medical misogyny. He really gets that phrase now and I think that we all have to work on that. Menopause is a bit like mental health, in that, when we ask people to come forward to get help early, we have to make sure that the resource is there to meet that expectation. That is about supporting the workforce, as well.

As we have heard today, menopause is a workplace issue. We have heard that from a number of colleagues including Carol Mochan, and Mercedes Villalba with her intervention. It is timely that we meet today, because I know that the minister has been at the STUC women’s committee conference, which is important. We are so blessed in Scotland in having fantastic trade union women who are champions in the workplace and who bring us the information so that we can speak in these debates and in our CPGs and committees.

I also give a nod to the all-party parliamentary group on menopause in Westminster. It undertook an inquiry and produced a very good report. It is quite long, so I will not go into it too much, but it makes an important point that I know that colleagues here will agree with, which is that the way in which menopause can affect minority groups including people in the LGBTQ+ community is important. We might have our political differences, but Pam Gosal is an important role model on these issues, by sharing her experience, because we know that many people will be afraid of the menopause. Some people have an easy experience and some do not, and it is important that we break down those barriers.

I thank all colleagues who have shared their experience and, of course, I wish Stephanie Callaghan a good recovery. I think that we have to remind our sisters to take a day off. Life will carry on, so, again, when we talk about good menopause policy in the workplace, it is also about us showing that, actually, it is okay not to be at your work.

Colleagues have been really inclusive in the debate, but in the few seconds that remain I just want to talk about early menopause for those women and people who menstruate whose periods stop before the age of 45. That can also be for reasons that relate to other health conditions. It could be cancer, linked to treatment, or endometriosis. Let’s face it: people are diagnosed with endometriosis far too late on average. That is an issue that I know the minister probably has sleepless nights about, but there is an important commitment to bring that time down from eight and a half years to 12 months by the end of this session of Parliament. That is another issue that we all need to work together on.

I thank Siobhian Brown again for the debate, and I thank all colleagues for their humour and insight.

I invite the minister to respond to the debate.

18:04  

I thank Siobhian Brown for her motion, and I thank my colleagues for their brilliant and important contributions. There was some humour and some sharing. We should recognise that all of us who have spoken in the debate are women in powerful positions, and it is important that we use our positions to raise awareness of a subject that has, for too long, suffered from being taboo and having a lot of stigma associated with it. I am delighted that we have spoken about not only our own experiences but our community experiences.

Menopause is one of the top priorities in the women’s health plan, and I truly believe that we cannot talk about it enough, but I will try to stick to my seven minutes.

World menopause day and menopause awareness month provide us with a valuable opportunity to highlight this important transition in women’s lives, but it is one that many women know little about. Women have told us, and the evidence shows, that when they are well informed about the menopause, and know what to expect, their experience can be more positive. Knowledge, information and myth busting are powerful. One of the many aims of the women’s health plan is to build on the “knowledge is power” theme, and we have invested a great deal of effort in providing resources on the NHS Inform women’s health platform in a variety of forms. We have provided not only reading materials but material that is targeted at health professionals as well as at women, and myth-busting films. That work is very powerful.

Being informed about the menopause means that we know what to expect in the future. It can help us to manage the symptoms being experienced in the present, and we can support other people in our lives with experience of the menopause, whether that be in our personal lives—our family and friends—or in the workplace.

During menopause awareness month, the Scottish Government used its social media channels to raise awareness about the menopause and to highlight the resources that are available on NHS Inform. During women and girls in sport week, we linked with our partners, our active Scotland team, to highlight the positive impact that exercise can have on menopause symptoms.

We also worked with our partners at the Health and Social Care Alliance Scotland and with the charity Close the Gap to create two new resource packs on menopause for the workplace. The alliance developed a pack for women and people who experience menopause on menopause support in the workplace, while Close the Gap created a resource for employers on creating a menopause-aware workplace. Both resources can be found online.

I whole-heartedly agree with the sentiment expressed in today’s motion that we all benefit from an open conversation about menopause. Just last week, the First Minister attended a menopause cafe in Perth—a place where people come together to chat about the menopause. Over the summer, the?First Minister also spoke with Kirsty Wark about her experience of menopause?at Menopause Cafe’s “Flush Fest” to illustrate the impact that menopause can have on all women. We want to continue that conversation throughout the year so that we can improve support and end stigma.

The frustration and disappointment that women express about their experience of menopause is consistent with the feedback that we received from many women across Scotland when developing the women’s health plan. We listened to women, which is why menopause care and support is a top priority in that plan. Women of all ages should know what to expect from menopause, what the symptoms are and what can help them, so that they are not taken by surprise by any changes, either physically or mentally.

In October 2021, we launched the menopause resource, which is now part of the women’s health platform on NHS Inform. As I said, through that resource, we are busting menopause myths and highlighting menopause symptoms and options for care, treatment, support, mental health and much more. A huge range of treatment options are available on the NHS in Scotland without any charge for prescription, and every mainland health board now has a specialist menopause service, with support in place for island health boards that do not have their own service.

Women told us that they do not always get the support that they need when seeking help for menopause symptoms. That is why, through implementation of the women’s health plan, we intend to build a basic understanding of menopause among all healthcare professionals. That should include awareness of the symptoms of perimenopause and menopause, the intermediate and long-term consequences of menopause, and knowing where to signpost women for consistent advice and support.

As I said, I am proud of the progress that we have made in the first year of the women’s health plan. We have improved access to information and put together a bespoke training package for GPs on menopause and menstrual health. We are also working with the University of Glasgow on research on menopause and menstrual health in the workplace.

A survey launched on world menopause day this year seeks to learn about the personal lived experience of menopause and the menstrual health of those people who are working in NHS Scotland. We will use that information to build a high-quality workplace strategy for menopause in the NHS, which we hope will act as a leading light for private and social care employers.

I started my day at the Scottish Trades Union Congress women’s conference and, as members might imagine, I loved every minute of it. I was delighted to be with them and to update them on the progress of the women’s health plan. One of the issues that came up loud and clear was that being supported in the workplace is an essential part of action on menopause. Women need to know that there is support in place to help them to work comfortably during menopause. It is difficult for some women to talk about it. However, it is important to be able to speak openly in the workplace.

As part of our fair work approach, we will work with employers and trade unions from all sectors where low pay and precarious work can be most prevalent to develop sectoral fair work agreements that deliver improved employment outcomes, such as payment of the real living wage, better security of work and wider fair work first standards. Those standards include action to tackle the gender pay gap; as we all know, there are many drivers that restrict women’s opportunity for progression in work, such as health and menopause.

Mercedes Villalba mentioned research. I have already mentioned some of the research in the NHS workforce. We have already committed £250,000 as part of the women’s health plan to research on endometriosis. We also have a longer-term commitment to develop a women’s health fund to look at those areas where the understanding of women’s health problems is poor—we know that there are many of those areas—and target research there. I am pleased that we have started with endometriosis. However, further work on menopause is to come.

I thank the minister for that information. How do we reach communities such as mine that still think that the menopause is taboo? When I started having perimenopausal symptoms, I did not know what they were even though there is so much information out there, because no one in my house spoke about it—and no one wants to speak about it around me either. How do you reach those people?

That is a really good question. Something that we know that works in certain communities that face health inequalities and find it harder to access healthcare information is to get right in among those communities, find the leaders—like Pam Gosal—and work with them to reach the communities so that they can get the information that they need. Written information on the women’s health platform is available in many different languages; there should be information online that is available and accessible to all our communities in Scotland.

I was pleased to hear Evelyn Tweed, Stephanie Callaghan and others mention osteoporosis and heart disease. Challenging myths and stigma is great. I am glad that we are talking about treating the symptoms of menopause. However, sometimes I fear that we are missing a public health opportunity to prevent quite severe illness further down the line. I do not suggest that everyone should consider HRT, but I want to bust many of the myths about HRT that were perpetuated in the past and for women in Scotland to be able to weigh up all the pros and cons in order to make informed decisions about their future health.

The women’s health plan is very clear: menopause is a priority in Scotland. I am determined that, through the plan, we continue to drive forward improvements in menopause support, listening at all times to the voices of lived experience and ensuring that those voices inform everything that we do. I would like to extend my particular gratitude to the women who continue to inform this vital work and who bring their voices and views to us.

We know that women are not always getting the menopause care, treatment and support that they need. However, through working in partnership, together we can improve menopause support, end stigma and support women to more positively experience this important life transition.

That concludes the debate.

Meeting closed at 18:15.