Menopause gap: some women face worse symptoms and less care

Reports show menopause experiences and access to care vary by ethnicity and culture, with up to 80% of women developing symptoms and average symptom durations around seven years; the NHS will start asking women aged 40 to 74 about menopausal symptoms during health checks.

Menopause is a biological transition that is also shaped by culture, ethnicity and access to healthcare. Experiences differ in age of onset, symptom patterns and how openly symptoms are discussed. Up to 80 percent of women develop symptoms linked to falling sex hormones, and symptoms can last an average of seven years. The NHS will for the first time ask women aged 40 to 74 about menopausal symptoms during routine health checks. Known differences: - Symptom patterns vary by ethnicity: research and specialist bodies report more severe vasomotor symptoms among African and Caribbean women, earlier average menopause among many South Asian women (around 46–47), and fewer hot flushes but different symptom profiles among some East Asian groups. - Biological effects of falling oestrogen are linked to longer-term risks such as osteoporosis, heart disease and mood disorders, and researchers have identified more than 40 possible menopausal symptoms. - Practical and cultural barriers are frequent: language differences, limited representation in educational materials, stigma about discussing sexual and reproductive health, lower health literacy and socioeconomic inequalities affect recognition and access to care. - The NHS change aims to normalise discussion and improve diagnosis, but evidence shows some ethnically minoritised groups are less likely to attend health checks, so benefits may not be evenly distributed. Summary: Embedding questions about menopause into NHS health checks is intended to broaden diagnosis and support, while reporting shows symptom experience and care access already vary across communities. How effectively this policy reaches women who face the greatest barriers is undetermined at this time.