Meeting of the Parliament (Hybrid)

Meeting date: Tuesday, November 2, 2021

Official Report 899KB pdf

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Menopause

Before we begin the final item of business, I remind members of the Covid-related measures that are in place and that face coverings should be worn when moving around the chamber and across the Holyrood campus.

The final item of business is a members’ business debate on motion S6M-01534, in the name of Collette Stevenson, on improving support and ending the stigma of the menopause. The debate will be concluded without any question being put.

Motion debated,

That the Parliament recognises that World Menopause Day is held every year on 18 October; understands that around 400,000 women in Scotland are of menopausal age; acknowledges that most women will experience menopausal symptoms and in a variety of ways, which, for some, may be severe and have a large impact on their lives; notes that these symptoms can include memory loss, insomnia, anxiety, palpitations, hot flushes and pain; further notes the encouragement given to women to access the support and advice to which they are entitled, such as through their GP and primary care team; welcomes the Scottish Government’s Women’s Health Plan which aims to alleviate women’s health inequalities and ensure that women can access specialist menopause services; notes the view that many women could benefit from flexibility from employers to manage menopausal symptoms and that employers should consider introducing a menopause policy to best support women in the workplace; understands that South Lanarkshire Council was the first local authority in Scotland to implement such a policy; acknowledges that there continues to be a taboo and stigma surrounding the menopause; welcomes the Scottish Government’s commitment to launch a public campaign to remove this and raise awareness of the symptoms of the menopause; notes the calls for young women and girls to be empowered through high-quality education on menstrual health, and further notes the view that awareness-raising of the menopause will help its impact be better understood and addressed.

17:12  

I thank colleagues for signing my motion so that we can debate this important topic.

In Scotland, we have come a long way towards improving support for, and ending the stigma of, the menopause, but we still have much to do. I am passionate about starting conversations and ending the stigma around the menopause, and I look forward to the upcoming campaign to remove the stigma and raise awareness of symptoms. I thank my friend Christina McKelvie, the Minister for Equalities and Older People, for leading the first ever Government debate on the menopause in 2019, and for all the work that she has been doing to advance women’s equality.

There are around 400,000 women of menopausal age in Scotland. The average age at which a woman reaches the menopause is 51; however, some women experience perimenopause 10 years earlier, which can include heavy or infrequent periods, night sweats and hot flushes. Earlier this year, the Scottish Government published its very welcome “Women’s Health Plan”. One of the plan’s priorities is to ensure that women can get

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

All too often, we are given leaflets from our general practitioner to read over, but we need options and better advice. There are more than 30 symptoms of the menopause, and women deserve support that is tailored to their own symptoms. Hormone replacement therapy is a well-known treatment, and thankfully it is free at the point of need in Scotland. However, HRT is not for everyone, and I would like to see more treatment options available. I urge our Government to offer more holistic approaches to tackle the varying degrees of symptoms that are associated with the menopause.

Many women do not speak to their doctor about their menopause, as they worry that they are wasting national health service time. NHS Inform’s new menopause website is a welcome development, but I encourage any woman who is struggling with menopause symptoms to speak to her GP or other healthcare worker to ensure that she gets the support that she needs and deserves.

Another important aim of the plan is to continue the women’s lived experience group, which will inform policy and improve services. During the development of the plan, the group talked about the need for choice and flexibility, and to educate everyone about women’s health issues, and I absolutely agree. However, most importantly—and shockingly, but not surprisingly—the group found that women wanted to be taken seriously. We need not only more research and support, but ultimately more education, on the menopause.

Current events highlight the need to improve support, end the stigma of the menopause and ensure that women can get a break when they need it. Wearing masks when a hot flush hits you is the equivalent of a towering inferno. As someone who is experiencing menopause symptoms, I know how challenging that has been. While many women who experience hot flushes and sweats want to down tools and run a mile, there are so many women in the medical, nursing and caring professions who have had to look after us during the pandemic while kitted out in full personal protective equipment and battling menopause symptoms. I applaud those women, who have overcome their own challenges to protect the lives of others.

With regard to the workplace, 45 per cent of women told a survey that menopausal symptoms had had a negative impact on their work, and 40 per cent of those who took a day off work for that could not tell their employer the real reason. Furthermore, Engender’s research found that, although most women think that workplaces should have a menopause policy, only 3.7 per cent were aware of such a policy in their own workplaces.

Many workplaces have improved in recent years. I was instrumental in launching South Lanarkshire Council’s groundbreaking menopause in the workplace policy, having campaigned for many years, as a trade union representative, to make that happen. NHS Lanarkshire also implemented a policy this time last year. It is good to see that those two large employers are ahead of the curve, and I hope that other workplaces will follow suit. I have an open door to any East Kilbride businesses that want to discuss the best way to support women and colleagues. I acknowledge Gillian Martin’s great work on the matter, and I look forward to her contribution to the debate.

I hope that the debate today will raise awareness and encourage employers to do all that they can to help colleagues who are going through the menopause, and to ensure that women know that they deserve support. Let us empower our young women and girls through high-quality education on menstrual health, but let us also pay attention to our attitudes and behaviours. There is still a stigma there, and we need to reach out to men and women alike in order to tackle it. We all have a part to play in ensuring that the conversations continue, and that this natural process in a woman’s reproductive cycle stays visible. Women’s health should be a subject that we can broach without fear or flux. The support that is available continues to improve, but the stigma must end.

17:18  

I thank Collette Stevenson for bringing to the chamber this debate, which is so important to women in Scotland. I also thank her for name-checking me in her speech—I am delighted. I know that Ms Stevenson has campaigned for many years for better menopause services and workplace policies. In fact, I spoke in the 2019 debate that she mentioned, which was led by Christina McKelvie, when I mentioned the work that she had done in making South Lanarkshire Council the first local authority in Scotland to introduce a menopause policy.

It is that campaigning, including the Pausitivity campaign, 50Sense and all the Menopause Cafe events, that has really prompted change. The change that has happened in the past few years has been incredible, not least in making discussions about the menopause more open, frequent and normal. In large part, it is those conversations and campaigns that have led to the Scottish Government’s “Women’s Health Plan”, which includes the development of menopause and menstrual health workplace policies, and the need to ensure that we have GPs who are menopause experts and access to specialist menopause clinics across Scotland.

I also mention the importance of Ms Todd holding the first ever ministerial post that has “women’s health” in the title. That is significant progress and I can think of no better woman to have that responsibility. Put bluntly, stigma around menopause is a barrier to women getting the help they need, but here is the thing: menopause is a normal stage of life as a female. If we use that fact as our baseline, perhaps we can then start to normalise conversations around the menopause and, if we can do that, perhaps we can make more progress on the treatment of its often debilitating effects.

Stigma is one thing, but a lot more needs to be done clinically in the menopause sphere. More menopause training is needed for GPs. It should not be left to chance whether you get to speak to someone with that interest or expertise, and a five-minute appointment is often not long enough to diagnose menopause. It may even be the wrong day to diagnose menopause, if your hormones are playing up. Also, women should not have to go private to see a menopause specialist; we need to make sure that access to menopause specialists is equal for all women. There should be more referrals from GPs to NHS services. I note that the women’s health plan addresses those points.

I am pleased to see a commitment to more research into women’s health more generally and menopause specifically. I have been researching the role that testosterone plays in women. We think that menopause is about oestrogen, which is largely true, but we lose testosterone, as well. That can lead to memory, sleep and energy loss, and complete loss of libido. If the stigma around male erectile dysfunction is, rightly, being diminished and men can easily get medication to counteract that, let us start talking about the loss of hormones that can end a woman’s sex life in the same frank, compassionate, serious and solution-focused way.

Marriages and relationships break down because of that hormone loss and women’s mental health suffers; it is high time that we took it seriously. There is no available female testosterone replacement available in this country. If a GP prescribes testosterone, it is the male AndroGel variety and the dosing of that for women is a shot in the dark. That issue is being addressed in Australia, which has just approved Androfeme, a metered female testosterone replacement. I believe that the National Institute for Health and Care Excellence is looking into approving it in the United Kingdom.

As the menopause specialist Dr Louise Newson says, these are hormones that we have lost and we want them back. Every cell in a female body has oestrogen and testosterone in it, so is it any wonder that when those decline we start to feel ill and miserable? Dr Newson says that all we want is our hormones back. Talking about the issue as openly as we will be today, combined with the seriousness that the Scottish Government is placing on menopause policy and getting us access to the right menopause care, gives me hope for a better life for women when they are going through this entirely normal stage of their lives.

17:23  

I thank Collette Stevenson for bringing this important motion to the chamber for members’ business. Ending the stigma and misinformation around menopause should be at the heart of any future women’s health policy. In the short time that I have, I will make three key points—about stigma, the workplace and the action being taken across the UK to make a difference.

Ending the stigma is the first building block in tackling the systemic issues around the treatment of women. It is extremely important that we teach not only young women and girls about menopause, but young men and boys, too. We cannot expect the stigma of menopause to disappear unless we educate everyone about it. Today is that first step.

Secondly, we must do more to support women in the workplace during menopause. There are significant issues around a complete lack of understanding from employers towards their employees. I thank Dr Louise Newson, a menopause doctor who runs the not-for-profit company Newson Health Research and Education, for her new research. Her survey found that 99 per cent of women felt that their perimenopausal or menopausal symptoms had a negative impact on their careers. Overall, more than one in five women passed on the chance to go for a promotion that they would otherwise have considered, 19 per cent reduced their hours and 12 per cent resigned.

 

Those figures are quite outstanding. I am glad, too, that leading broadcasters, celebrities and other public figures have recently spoken of their experiences. DJ Jo Whiley revealed that she was struggling with menopause symptoms at the same time that her Radio 2 show with Simon Mayo was being criticised. Jo Whiley felt that she could not continue on “Drivetime” due to her experience. No woman should ever be held back from pursuing her career or doing her job well because of such stigma.

Recently, I learned that only 10 cases of alleged discrimination against women affected by menopause have been heard by industrial tribunals in Scotland over the past five years, with three this year alone. I am the deputy convener of the cross-party group on women’s health, which includes a number of women who are speaking in this debate, and our discussion on forthcoming work will certainly include how we can further support women in the workplace to avoid those exact scenarios.

Back in 2019, we welcomed Christina McKelvie’s promise that the Scottish Government was encouraging all employers, including other public bodies, to update or provide menopause awareness training and guidance for their managers. I would be grateful if, in closing, the minister could provide an update on the progress of that work.

On a positive note, right across the UK, fantastic work is being done to tackle the issue. In July, the UK Women and Equalities Committee launched an inquiry into menopause in the workplace, and since then, it has collected evidence from a wide range of sources about the impact that menopause can have on women and their occupations. Further to that work, I welcome the new Menopause (Support and Services) Bill in the House of Commons, which has been interesting to follow, and the announcement by the health minister, Maria Caulfield, that menopause will become a priority in the UK Government’s upcoming women’s health strategy, which is due to be published shortly—we can all keep an eye out for that.

In Scotland, I welcome the work involved with the women’s health plan, which outlines improvement and changes in areas including menopause, heart health, menstrual health, endometriosis and sexual health. Right across the UK, it is clear that there is momentum to finally address the personal, social and professional impact of menopause on the lives of women.

I welcome the Scottish Government’s commitment to launch a public campaign to raise awareness of the symptoms of menopause alongside the women’s health plan. There is much more work to do, but if we continue to work in a collegiate manner, we will make progress in seeking to end the stigma and improving support for women.

17:27  

I am pleased to be speaking in the debate, and I thank my colleague Collette Stevenson for bringing it to the chamber. I echo her comments about the great work that has been done by our colleagues, Christina McKelvie and Gillian Martin.

Thankfully, the days of the menopause being viewed as a bit of a joke are coming to an end, and not before time. Around 400,000 women in Scotland are of menopausal age, and more than half suffer a variety of distressing symptoms, such as memory loss, insomnia, anxiety, palpitations, hot flushes, joint pain and much more. Therefore, mugs, napkins, aprons, car stickers and other rubbish, all emblazoned with so-called slogans about the change are not really funny at all. That is why I welcome the Scottish Government’s women’s health plan, which aims to reduce stigma, raise awareness and get people talking about an issue that affects more than half of our population and is perfectly normal.

Sadly, women’s health issues have been taboo subjects in society for as long as I can remember. When it comes to talking and being open about such issues, subjects such as menstruation, endometriosis, thyroid conditions and in vitro fertilisation treatment are often swept under the carpet, particularly in the workplace.

The menopause exacerbates gender inequality in the workplace. We know that there are increasing numbers of older women in employment and that many more women than previously will experience the menopause while at work. Some will sail through it, but others will not. That is why I am glad to see that we are at last making some headway. I welcome the Scottish Government’s women’s health plan, which aims to alleviate women’s health inequalities and ensure that women have access to specialist menopause services.

Praise should go to South Lanarkshire Council, which is the first local authority to implement a menopause policy to support women in the workplace. Other employers, both public and private, must have buy-in, too. A menopause policy will give women peace of mind and reassurance that they will be understood, their symptoms recognised, and support and flexibility will be offered if they need it. That is really not too much to ask in a civilised society. It is not acceptable for employers to jeopardise a woman’s career by showing a lack of understanding and respect around this perfectly natural process.

In the summer of 2019, the excellent feminist charity Engender undertook a survey as part of a research project seeking to understand how current Scottish policy meets the needs of women going through the menopause. It found that most women still felt inadequately supported and that many women simply did not know where to go for information: 40 per cent reported not feeling informed about the menopause, an additional 10 per cent reported that they were unsure whether they were informed and only 15 per cent reported being aware of the existence of specialist menopause services.

We must do better. In response to the question, “What would help you manage your menopause symptoms while you are at work?”, the most common responses included access to fans and temperature control, breaks in work days, flexible working, and greater mental health and wellbeing support generally.

The good news is that not all women felt negative about the menopause. Several indicated that they perceived it as either a neutral or a positive transition. For example, one respondent used these words to describe the menopause:

“Liberation, fun, wellbeing, joy, happy”.

Let us get rid of the stigma, increase support, collect and utilise further data—especially from underrepresented groups—do more medical research, raise awareness, and scale up specialist services and make them equally available across health boards for women needing support.

Women of future generations must not endure the same stigma, misinformation and, frankly, indifference to this perfectly natural process in women’s lives. Let us ensure that, with the correct support, women can embrace their newfound freedom to enrich their lives.

17:31  

I thank Collette Stevenson for bringing this important issue to the chamber.

On behalf of Scottish Labour, I welcome world menopause day, which was marked on 18 October. It is vital that we take time to recognise the importance of raising awareness of the menopause and how it can impact women’s health and their day-to-day life, and—crucially—to highlight what we can do to tackle the stigma that still surrounds the menopause.

As the motion states, around 400,000 women in Scotland today are of menopausal age, and most of them will experience symptoms that are wide ranging and often distressing. Our role in the Scottish Parliament is to ensure that their experiences are not stigmatised, but are spoken about openly and freely, and that adequate support is put in place to support them in all aspects of society—at home, in public places and in the workplace.

My call for such support to be put in place is addressed not only to councils, the Scottish Government and places where support can be offered to women with relative ease. Although interventions such as the excellent policy brought forward by Collette Stevenson that we heard about earlier, are very welcome, I also call for support for every woman up and down the country who experiences menopause symptoms, including women who work in industries where a path to securing such protections may not be clear and for those who do not feel comfortable going to their employer to discuss such concerns.

It is important to discuss Scotland’s significant health inequalities and how they link, and will continue to link, to women’s experiences of the menopause. The motion states—correctly—that employers should be flexible with women who feel that their ability to work has been impacted by symptoms linked to the menopause, and that they should be treated with dignity and respect in the workplace. That must mean a minimal expectation of allowing flexible and/or home working and of giving time off where necessary.

As we have heard, in recent years, we have made significant progress in improving provision relating to women’s health in Scotland’s workplaces. However, we can still go further, including by being more open in our discussions about the menopause and offering greater levels of protection than already exist.

In Scotland in 2021, we must accept that we fall way below the standards when it comes to addressing health inequalities. Time and again, it is the poorest in our communities who suffer the consequences of inaction—those with low incomes and debt and those who, at this time of year, have to make the incredibly difficult choice between feeding themselves and their families or heating their homes.

The health inequalities in our country are one of our greatest challenges. Women in low-paid and precarious employment may want to take time to attend their GP or a primary care service relating to the menopause, but they simply cannot afford to do so. Those who are working in male-dominated sectors might want to explain their difficulties to employers, but do not feel comfortable doing so. In the worst cases, those who have the most severe symptoms might want to take time off work but either cannot afford to do so or do not feel that there is adequate support to do so.

Decisively resolving those issues is within the power of the Scottish Parliament. Inequalities in health, particularly in employment practices more widely, do not reflect the Scotland that we want to live in. However, that is the Scotland in which ordinary people struggle through and live. We must do all that we can to bring health solutions closer to home so that those who need them most, such as women who are experiencing menopausal symptoms, can get relief and support without having to visit a hospital or go to the GP continuously. That starts with addressing stigma about women’s health, tackling health inequalities more widely, and ensuring that workplaces are suitable for the needs of such women.

We must push on with increased purpose to create a just and compassionate society that recognises that, for generations, women have largely been left to struggle needlessly, and that that must change. As we have heard tonight, it has to change now.

17:35  

I welcome this debate on the stigma surrounding menopause, and I thank Collette Stevenson for bringing it to the chamber.

For too long, people going through the menopause have had their experiences and symptoms ignored and underplayed. They are often the butt of the joke and their symptoms are dismissed as women’s issues. That is why it is so important that we make time to talk about it in Parliament and raise awareness of how much impact menopause can have on women and people who menstruate.

As the motion states, much stigma still surrounds the menopause, and it is part of a wider culture that discourages people from talking about their menstrual health. That causes real harm. It prevents women from asking for support from employers or accessing healthcare. It causes shame and embarrassment, which causes unnecessary distress and can prevent people from getting the help that they need.

Workplaces can do more. A survey conducted by Engender in 2019 revealed that only 3.7 per cent of respondents were aware of their workplace having a menopause policy, and 21.7 per cent were unsure whether their workplace had one. A 2019 UK survey conducted by BUPA and the Chartered Institute for Personnel and Development found that three in five menopausal women were negatively affected at work, and almost 900,000 had left their jobs because of menopausal symptoms.

It is scandalous that so many workplaces are either unable or unwilling to make adaptations to allow for the fact that most women will go through the menopause at some point. Surely it is in their interests to make adjustments and implement policies that will allow them to retain their staff. Also, how can we hope to tackle the gender pay gap when some women are being driven out of employment by symptoms that a significant proportion of women will experience? The stigma surrounding the menopause marginalises and disadvantages women and is a driver of inequality.

How do we tackle that? As I said earlier, debates like this can help to address stigma. The Engender survey found that there has been an increase in the amount of public conversation about the menopause, its impacts, and women’s needs, although most respondents still felt that they were inadequately supported.

Conversations about the menopause should not be left to women. Everyone should be educated about menopausal symptoms. We teach children in school about puberty as part of their personal and social education, but there is no corresponding educational tool for menopause, despite it being one of the major transitions in many people’s lives.

We need robust workplace policies on health and safety, sickness absence, and flexible working, and a workplace culture that is understanding of the ways in which menopausal symptoms can impact on employees. We also need healthcare that addresses the needs of those who are experiencing menopause, and I am pleased to see that the commitments in the women’s health plan include ensuring that women receive access to specialist services for advice and support on the diagnosis and management of menopause. The availability of specialist services recognises the impact that menopause can have on people’s health and wellbeing, and that it warrants dedicated support.

Menopause stigma is born out of sexism and ageism, and we must recognise how it can intersect with other forms of discrimination. For example, we know that black women in the UK experience significant inequalities when accessing healthcare. A report published in 2019 found that black women still have more than five times the risk of dying in pregnancy or up to six weeks postpartum compared with white women. Black women might face barriers to accessing healthcare or find it difficult to have their symptoms taken seriously. I would like more research and data on how black women in Scotland are impacted by the menopause and their experiences of accessing medical and workplace support. I look forward to working with the minister and colleagues on that, and on wider women’s health issues.

17:40  

I welcome the opportunity to speak in this important debate and I congratulate my colleague Collette Stevenson on securing it.

Menopause matters. I agree that menopause has always been, at best, stigmatised, ignored or treated as a joke—aye, Rona Mackay is right—and, at worst, used as a way to degrade women.

Women are not a homogeneous group, and the impact of the menopause can be very different—there is certainly no one-size-fits-all experience. Menopause treatment, too, can vary significantly; it is a complex area, with new observations and medical advances continually being made.

I welcome that the Scottish Parliament was the first Parliament in the UK to hold a Government debate on the menopause. That debate, in 2019, was led by Christina McKelvie, as members said. I also welcome that a Scottish National Party Government was the first Government to direct national attention to reducing menopause stigma and improving treatment. It was right to do so.

Some women experience menopause at a significantly younger age, either naturally or because of surgical or medical intervention, for example as a result of an oophorectomy as part of cancer treatment. For many women—around 10 per cent, according to research from the University of Manchester—the negative impact of the menopause is life changing. As Gillian Mackay rightly said, it can even prevent women from attending work.

Research that informed the Scottish Government’s women’s health plan, which sets out action to tackle menopause stigma and support women who are going through the process, highlighted that women and girls are unprepared for the changes that menopause causes and often experience menopause in silence. I welcome that the Scottish Government’s work is beginning to make a difference by making menopause the subject of national debate—just as we are doing here, right now.

Collette Stevenson, Gillian Martin and Rona Mackay said that we need more research. I highlight the work of Dr Lisa Mosconi, a neuroscientist at New York University who specialises in the study of women’s brains and the impact of the menopause. Dr Mosconi’s research presents the relationship between menopause and Alzheimer’s disease and shows that women’s brains age differently from those of men, due to the brain’s interaction with hormones. For example, men have a lifetime’s supply of testosterone, on the whole, whereas a woman’s supply of oestrogen reduces at around 50 years old—although that age is not set in stone.

The key side effects of the menopause, which members described—night sweats, hot flushes, memory lapses, anxiety and insomnia—start not in the ovaries but in the brain. Oestrogen increases cerebral blood flow and aids in the provision of glucose to the brain, so without it the neurons can start to slow down and age more rapidly. In some cases, that can lead to the development of amyloid plaques, which are a key indicator of Alzheimer’s disease. Plaques might affect the brain’s hypothalamus, which controls the body’s temperature, thereby causing hot flushes and so on.

I find Dr Mosconi’s research very interesting. She has said that more research needs to be done. There should be a continued focus on the complexity of menopause and its impact on some women and not others.

Menopause is a medical process, as members said. It is a normal fact of life and we need to discuss it. I welcome the Scottish Government’s women’s health plan, which commits the Government to ensuring that women have access to specialist menopause services for advice and support if they need such services in the context of menopause diagnosis and management. I also welcome that the Scottish Government is working on a national public health campaign, which NHS Dumfries and Galloway has picked up through its menopause matters programme.

Menopause covers much more than just a physical transition; there are mental health implications. It impacts every aspect of our lives as women, individually and collectively, and we must do all that we can to reduce the stigma and improve treatment. Menopause matters and should be discussed.

17:44  

I thank Collette Stevenson for lodging the motion, and I thank colleagues for their important contributions to the debate.

Menopause is one of the top priorities of the women’s health plan, and I truly believe that we cannot talk about menopause enough. I am grateful to Collette Stevenson for mentioning Christina McKelvie. She was absolutely right to credit her for her groundbreaking work and efforts on that front. I look forward to working with her as we bring forward more ideas on how to make progress in this area.

World menopause day provides us with a valuable opportunity to highlight an important transition in women’s lives, but one that many know little about. We want to continue that conversation throughout the year so that we can improve support and end stigma. Women have told us, and 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. Knowledge is power.

Women of all ages, including those who do not identify as women, 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, physical or mental. It is essential that everybody gets the support that they need, when they need it and for as long as they need it. We want women to be provided with consistent information and care when they seek help with menopause symptoms, however they access such support. Being informed about the menopause means that we know what to expect in the future. It can also help us to manage symptoms that are being experienced in the present and to support those in our lives in their experience of menopause, whether on a personal level, if a partner, family member or friend is going through it, or in the workplace.

The frustration and disappointment that women are expressing in relation to their experience of menopause is consistent with feedback that we have received from many women across Scotland. We have listened to women, which is why we are taking action through the health plan. There are 10 specific actions on menopause for the short, the medium and the long term, which we will drive forward so that we can make a real difference to women’s experience of menopause, including the provision of timely access to menopause care and support. We want to make a difference right now, and the short-term actions in the plan will be delivered within the next year. We hope that those actions and the ones that follow will make a real difference for women in Scotland.

On 11 October, we launched a new menopause platform on NHS Inform, which includes comprehensive information on menopause, from signs and symptoms to mental health treatment and support in the workplace. Remember: knowledge is power. We will also progress work to ensure that support is available to women who cannot or prefer not to access information online. In addition, we have established a national menopause specialist network, which has regular online meetings, to provide consistent advice and peer support to healthcare professionals. The network supports primary care teams by providing access to a menopause specialist for consistent advice, support and onward referral, as well as leadership and training.

Gillian Martin raised the issue of reduced libido. There are lots of reasons why women might not want to have sex during the menopause, but loss of libido can be one of the most difficult symptoms to experience and to talk about. Therefore, I am grateful to Gillian Martin for raising the subject. For women who no longer feel sexual desire or no longer want to have sex, that can be really upsetting. We cannot underestimate the effect of that. The platform on NHS Inform tackles that specific topic, because we were keen to address it. We have included a whole page of information on sexual wellbeing and intimacy during and after menopause, as well as a short video that busts the myth that menopause means that a woman’s sex life is over.

In relation to testosterone, it is important that women can access the treatment that they need. I am interested to hear that that is being prescribed in Australia. However, for a medicine to be routinely prescribed in Scotland, it must first receive a licence from the Medicines and Healthcare products Regulatory Agency, which is the licensing body for the UK, and it must then be accepted by the Scottish Medicines Consortium, which provides advice to NHS Scotland about the value for patients of newly licensed medicines. I am keen to consider further issues around access to medication, so if there are specific constituency cases that Gillian Martin would like to raise with me, I would be keen to hear about those.

Several colleagues, including Rachael Hamilton, raised the issue of menopause in the workplace. Collette Stevenson has done outstanding work on that, for which she has rightly been credited during the debate. In a recent survey, the British Menopause Society found that 45 per cent of women felt that menopausal symptoms had had an impact on their work. Being supported in the workplace is an essential part of action on menopause. Women need to know that support is in place for them to work comfortably during menopause.

Menopause can be really difficult to talk about, but it is important to talk openly about it at work, so that support is provided and employers recognise what people might need. Women who contributed to the women’s health plan said that what they wanted most from employers was flexibility to manage their symptoms through, for example, working from home or changing their hours, if that was needed.

To respond to Rachael Hamilton’s specific ask, we absolutely have a suite of Scottish Government actions that are on course. The women’s health plan highlights the impact of menopause in the workplace and commits to developing a menopause and menstrual health workplace policy for NHS Scotland.

In line with the action in the older people’s framework action plan, we continue to work with women’s organisations and trade unions to gain a clearer picture of the issues that are faced by women who are going through the menopause, to identify other areas where action might need to be taken. Our gender pay gap action plan recognises the need to gain a clearer picture of the issues that are faced by women who are transitioning through the menopause and the need to improve workplace practices to support women. Our women returners programme supports women to build the confidence, skills, work experience and networks that they need to ease the transition back to work. We also have a workplace equality fund, which seeks to remove labour market barriers for priority groups, including women. A suite of work is going on.

To tackle stigma, access to good information on menopause is important. Menopause information must be part of our education offering, and menstrual health, including menopause, is included in the Scottish curriculum. We have made available online for young people, teachers, parents and carers resources that are tailored to different age groups. We have strengthened the inclusion of menopause in an activity at the senior phase of relationships, sexual health and parenthood education in the Scottish curriculum to deliver meaningful learning about this important topic.

The women’s health plan makes it clear that menopause is a priority in Scotland. I agree with my colleague Collette Stevenson that we in Scotland have come a long way, but we still have much to do. I am determined that, through the plan, we will drive forward improvements in menopause support. At all times, we will listen to the voices of lived experience and ensure that they inform everything that we do.

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

Meeting closed at 17:52.