If your answer to menopause is HRT, you don’t understand the question

It should have been hailed as a major move forward. This week, the House of Commons’ Women and Equalities Committee called for government action on menopause, saying it should become a protected characteristic under the Equality Act.

What that would mean is you could not be discriminated against or harassed because of menopause. It means your employer would have a legal duty to make reasonable adjustments to allow you to continue working. It means menopause would be given the same status as pregnancy, with the same protections.

There’s a great video explaining it here:

Now I don’t know about you, but I would have thought that was pretty significant. So imagine my disappointment when I saw some leading campaigners complaining because the report’s emphasis wasn’t on HRT. One even said there would be no need for workplace considerations if all menopausal women were on HRT.

Well, that’s one way to deal with those pesky women demanding equality, isn’t it?

This niggled at me for a few days (I know, you’re surprised, right?) but it was only last night, as I was switching off Stranger Things and settling down to sleep with hopes of dreams of Joseph Quinn, that it hit me why this was bugging me so much.

And it’s because: if your answer is HRT, you don’t understand menopause.

Let me explain.

HRT is not right for everyone

First of all, cards on the table – I am on HRT. I am an advocate for HRT. I get calls and messages almost every day from women worried or anxious and I share my experience and we talk it through.

However, it’s taken me nearly four years to find the right HRT and even then, I’m not 100% “cured”*. I still have the odd day when my anxiety goes through the roof and the black dog is howling and I feel my life – life in general – is pointless.

There are still days when I’ve had next-to-no sleep and I struggle into work. My employers are great. My bosses understand menopause. But without any security in law, I feel I cannot take time off. It’ll go down on that pesky Bradford Score and when the menopause anxiety hits, the last thing I need is to worry about any impact on my attendance rate. So I go in to work.

Yes, I can hear them all shouting now: “But that problem is YOU!” And I understand why they’d say that because we have a pledge at work, but I still go in to work on days I’m struggling.

Because a pledge is not legally binding and while I trust my employer, I know that when menopause depression and anxiety hits I don’t even trust myself.

Which is why I, like many other women, struggle in each day because the alternative is crying in a corner thinking you’re going to be sacked because you’ve taken a menopause sick day.

It is a menopause mindset that needs to change and the way to do that is to have menopause recognised in law as a protected characteristic. HRT isn’t going to do that because HRT doesn’t work for everyone.

Some communities need protection

In addition, the work that I’ve been doing with Pausitivity, taking menopause awareness into deprived and vulnerable areas of society, has opened up my eyes so much to how privileged I am when it comes to seeking medical help.

I’ve been meeting and working with women who have no relationship with any form of healthcare provider. Some of them are asylum seekers and refugees, new to this country and unsure about officialdom. Corruption in their own countries has often made them cynical about what support and help is on offer – even from healthcare providers.

Others are women from the same type of estates I grew up on – again, wary of anything bureaucratic and living in a culture where their own needs are bottom of the list.

Shockingly, many are working two and even three jobs, part-time and sometimes temporary. These are some of the most vulnerable women in the workplace – the pandemic showed us that, with numbers of women employed dropping – and they need protections in law.

When they don’t have to worry about losing their job because they’re menopausal, then they can relax and seek help.

Scare tactics aren’t helping

My last niggle is the negative impact shouting “HRT is the only answer” has. Some women can’t take HRT for various reasons, including the fact it may be a risk to them (and until there are major long-term studies or research to show otherwise, that has to be taken as a fact).

Also, some women struggle with HRT and take months if not years – hello! – to get relief. And some women just don’t like taking long-term medication. That is their choice and that should be respected.

The answer isn’t to scare them into thinking there is no other option or with what could happen (and again, with very little scientific proof that HRT would prevent it). It is to find more ways to support them in the choices they make, whether that choice is theirs or the medical establishment’s or, as in the vulnerable communities, the societal pressures they are under.

Why I’ve changed…

When I first began writing about menopause, my focus was on the established healthcare system: the need for greater medical training and easier (and free) access to HRT. That hasn’t changed. I am still a proponent of all that and the first thing I say to a woman when she says she’s having problems is: “Have you thought about HRT?”

And on 18 October, World Menopause Day I’ll be outside parliament – as I was last year (by myself) – raising awareness again, whether there’s a promised rally or not.

So what has changed is that I now view menopause as more than just a health issue. Menopause healthcare is wrapped up and part of how society views midlife women in general: past it, dried up, invisible. Viewing HRT as the elixir of youth, which will keep our bodies as strong and supple and moist (yuk) as in our menstruating days, merely adds to this.

Age discrimination is on the rise and yes, it’s hitting women harder than men. These are menopausal women on the whole, hit because their body is doing what Mother Nature intended it to do. Putting the emphasis on HRT is giving employers (and society) a get-out-of-jail-free card.

“Well, she wouldn’t go on HRT so what did she expect?”

We need a holistic view that views menopause as it is – a lifestage, like puberty and like pregnancy. And like those, it has an impact on a woman’s life that drugs can’t do anything about.

I am mentally and physically different now to the woman I was pre-perimenopause.

HRT hasn’t and can’t change that. And that is why, if your answer to the problem of menopause is HRT, you don’t understand the question.

Main image: me taking the menopause message to Westminster, with Trisha Goddard, Michelle Heaton, Carolyn Harris MP and former HELLO! editor-in-chief Rosie Nixon