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Wednesday, November 06, 2024

Mayo Clinic researchers recommend alternatives to hysterectomy for uterine fibroids, according to study

Mayo Clinic

ROCHESTER, Minn. — Uterine fibroids are a common condition that affects up to 80% of women in their lifetime. Nearly half of those women will experience symptoms that affect their quality of life and fertility, including severe pain and anemia. Uterine fibroids are the major reason for the removal of the uterus by hysterectomy. However, Mayo Clinic researchers recommend minimally invasive treatment alternatives to hysterectomy, in an invited clinical practice paper published in the New England Journal of Medicine.

"Less invasive treatments can help women recover faster and resume their normal activities more quickly. Additionally, many studies have now shown that there are health benefits to keeping the uterus and the ovaries," says Shannon Laughlin-Tommaso, M.D., Mayo Clinic OB-GYN and co-lead author of the paper.

Removing the uterus, even while sparing the ovaries, increases the risks of cardiovascular disease, depression, anxiety and higher mortality. These risks are higher for people who get their uteruses removed at a young age.

"Women contemplating a hysterectomy deserve counseling about these risks since there are other less invasive options for many women with fibroids," Dr. Laughlin-Tommaso says.

A recent study found that nearly 60% of women undergoing hysterectomy for fibroids had not received a less invasive treatment first. Having alternative options to hysterectomy allow women to maintain their uteruses for longer.

These alternatives include medical therapies, hormone-releasing IUDs, radiofrequency ablation, focused ultrasound ablation and uterine artery embolization.

Early detection is key. When fibroids are found early, they tend to be smaller and less extensive. As a result, treating them early is medically less complicated.

The incidence of fibroids increases with age until menopause and is higher among Black women. In addition, this population often presents with more severe fibroids.

"Earlier diagnosis and treatment of uterine fibroids can help reduce this health disparity among Black women," says Ebbie Stewart, M.D., co-lead author and Mayo Clinic gynecologist and reproductive endocrinologist. In survey-based studies, many Black patients preferred minimally invasive therapies over hysterectomies.

Diagnosing fibroids is straightforward with a pelvic ultrasound but determining who to screen is not, and screening usually occurs after the fibroids are large or the patients are symptomatic. Many women with symptomatic fibroids have reported psychological suffering, including depression, concern, anger and body image distress.

The researchers suggest that future studies should include screening younger women, particularly young Black women, and people with a strong family health history of fibroids to determine if early treatment reduces long-term risks.

Why a hysterectomy?

Hysterectomies have been the most common treatment for uterine fibroids for several reasons.

"Hysterectomy makes decision-making easier for medical providers and patients. For providers, they don't have to determine which fibroids to treat or remove. Hysterectomy is also universally available in OB-GYN practices," explains Dr. Laughlin-Tommaso.

Additionally, concerns about inadvertently missing a rare cancer that grows in the smooth muscle of the uterus, known as leiomyosarcoma, has led to an increased rate of hysterectomies over less invasive approaches.

Lastly, a major reason for hysterectomy is that fibroids can recur about 50% of the time within five years after they are removed. However, the researchers note that not all new fibroids will become symptomatic, especially among women entering menopause.

Review the paper for a complete list of authors, disclosures and funding.

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Additional Resources:
NIH award supports new center at Mayo Clinic for health disparities in uterine fibroid treatment

Journal

New England Journal of Medicine

Article Title

Uterine Fibroids

Article Publication Date

6-Nov-2024

Friday, October 18, 2024

Strengths and weaknesses of the UK Employment Rights Bill

Jeff Slee analyses the Government’s new legislation and outlines how the trade union movement should respond.

The Labour Government published its Employment Rights Bill on Thursday 10th October, within the 100 days they had promised. But many of the areas it covers are for consultation with unions, bosses and others, and will take the next two years to come into force.

Alongside the Bill, the Government published a briefing document Next steps to make work pay, which says what the Government is doing more widely on workers’ rights

The Bill and other government measures are to implement the commitments agreed between the Labour front bench and affiliated unions in May.

Some provisions of the Bill only apply to England, with the other UK nations making their own laws.

Trade unions have generally given the Bill a cautious welcome, but said that there is a lot still to play for as the Bill goes through Parliament, with some measures dependent on amendments the Government will bring forward during the parliamentary process. And much will also depend on the many consultations with unions, bosses and others, that the Government will hold. The Government says that it will take several years for all of the measures they have promised to be brought in, and many will only become definite depending on the outcomes of consultations and reviews.

Reservations have been expressed by Sharon Graham, Unite General Secretary, and Daniel Kebede, National Education Union General Secretary. Sharon Graham said: “The Bill still ties itself up in knots trying to avoid what was promised. Failure to end fire and rehire and zero-hours contracts once and for all will leave more holes than Swiss cheese that hostile employers will use. The Bill also fails to give workers the sort of meaningful rights to access a union for pay bargaining that would put more money in their pockets and, in turn, would aid growth.”

Daniel Kebede said: “It is disappointing, however, that the statutory reasons for refusing requests for flexible working have been retained.”

Here is my view of the Bill. I’m not a lawyer, and there is such a lot in the Bill and accompanying documents that I can’t cover it all.

Trade Union Rights

The Bill does not repeal the Trade Union Act 2016 in full, which Labour promised in May. But, as Keith Ewing and Lord John Hendy KC wrote, it does remove those parts of the 2016 Act which made it more difficult for unions to take industrial action – such as the thresholds of 50% turnout and 40% voting Yes in industrial action ballots, and unions having to appoint picket supervisors for picket lines.

The Bill also includes repeal of the Tories’ Strikes (Minimum Service Levels) Act 2023. So, unions are now back to the pre-2016 industrial action position. In the Government’s briefing, there is a promise to look further at “modernising” trade union laws. Which might be good news. Or might not. The restrictions placed on trade unions by Thatcher’s anti-union laws of the 1980s all remain in place.

The Bill will make it easier for unions to get recognition (the legal right to collective bargaining with an employer). They will need only a simple majority in a ballot of workers to get this; the requirement for 40% of workers having to vote for recognition as well as getting a majority will be scrapped. Employers now sometimes use this threshold to prevent recognition, by taking on more workers on short-term contracts just before a recognition ballot. There will still be methods that some employers will use to frustrate unions getting recognition, and the Government has merely committed to “seek views on how to strengthen provisions to prevent unfair practices during the trade union recognition process.”

The Bill also gives unions a new right of access to workplaces to speak to workers. But this will not be straightforward. Unions will have to apply to the employers and reach an agreement on access with them. If the employer won’t reach an agreement, unions can then refer the matter to the Central Arbitration Committee (CAC), a Government body which arbitrates between unions and employers on industrial relations matters, who will make a ruling. There will certainly be plenty of work for anti-union lawyers in advising employers on how to frustrate this right of access.

In May, Labour committed to giving unions the right to use electronic (online) balloting instead of postal balloting in industrial action ballots and union elections. This is now delayed, but hopefully not for too long. It will be referred to “a working group with stakeholders”, with full rollout implemented following Royal Assent of the Employment Rights Bill. There is no need for a long delay on this. Trade union postal ballots under the anti-union laws are often run by Electoral Reform Ballot Services, which is now part of a software company called Civica. Civica already run electronic balloting for unions on matters that do not come under the anti-union laws, and they are all set to run electronic balloting for statutory ballots once the law allows this.

The promise of secure workplace balloting, made in the New Deal in May, is nowhere in the Government legislation or accompanying documents.

The Bill does include welcome improvements on facility time and resources that employers must give workplace union reps, and extends these to union equality reps.

Workers’ Rights from Day One

This part of the Bill makes welcome improvements to workers’ rights – but not all of them straightaway. Workers will get the right to protection against unfair dismissal, by appeal to an Employment Tribunal, from day one, instead of after two years as now. But this reform will not come into effect any sooner than Autumn 2026. Until then, the current two-year qualifying period will continue to apply. This two-year wait is disappointing and unnecessary. I fear the Government has given way to bosses’ pressure on this.

The Government says this delay is to give time for consultation on how long probation periods should last, on probation procedures, and “to allow employers to prepare and adapt”. But there should be no reason – certainly for larger and established companies – why drawing up a procedure for probationary periods that will satisfy Employment Tribunals should be hard or time-consuming. ACAS could probably come up with a template probationary procedure in just a couple of days. And if there is to be a delay for consultation and preparing, a reduction of the qualifying period to the one year that applied under the last Labour government could be done quickly in the Bill.

It is welcome that the Bill will make paternity and parental leave a right from day one of employment. Workers will also be entitled to Statutory Sick Pay from day one. And there will be a new right to bereavement leave. The government will also start a more general review of parental and carer’s leave.

Family-Friendly Policies

More improvements are that large employers will be required to produce action plans on how to address their gender pay gaps and on how they will support employees through the menopause. The Government will also strengthen protections for pregnant workers, making it unlawful to dismiss them within six months of their return to work except for in specific circumstances. And there are new measures to prevent sexual harassment in the workplace.

Flexible Working

The right to flexible working will, the Bill says, become the default position. However, this may not in practice make it any easier for those workers who need flexible working for reasons such as childcare or other family care responsibilities. Because, as the Government says in its explanatory notes to the Bill, “an employer may only refuse a flexible working request if it considers that a specified ground or grounds applies and if it is reasonable to refuse the request on that ground or those grounds. The specified grounds remain the same as the current legislation.” (my italics)

Zero-hours contracts and Fire and Re-hire

The Bill bans what the government calls “exploitative” zero-hours contracts, by making employers offer workers guaranteed hours based on the “reference hours” that they have already actually been working. Some in the trade union movement, especially Sharon Graham, are sceptical of how far the Bill as proposed will actually put an end to bosses exploiting workers through zero-hour contracts.

The Bill makes “fire and re-hire” automatically an Unfair Dismissal, under the meaning of employment legislation. But there is a get-out for employers: fire and re-hire won’t necessarily be unfair if they can show that they did this because of financial difficulties which, at the time of the dismissal, were affecting the employer’s ability to carry on the business as a going concern.

Sectoral Collective Bargaining

Unions have long wanted to bring back sectoral collective bargaining, which was common in many industries until the 1980s. Sectoral collective bargaining is where unions and employers, across a whole sector of employment, collectively agree on minimum pay rates, conditions and standards for every company in the sector. The benefit to workers is that companies can’t then compete for business by undercutting others to do the job more cheaply, which encourages a “race to the bottom”. Without sectoral collective bargaining, bosses will often tell their workers and unions: “We’d like to offer higher pay and better conditions, but if we did, we would lose contracts and business to other companies who pay less.”

The Employment Rights Bill takes two steps towards bringing back sectoral collective bargaining. First, it sets up an Adult Social Care Negotiating Body which will set pay, terms and conditions for social care workers across this sector. Second, it re-establishes the School Support Staff Negotiating Body, which will set pay, terms and conditions of employment, training and career progression for school support staff.

Nicola Countouris, Keith Ewing and John Hendy have written fully on sectoral collective bargaining for the Institute of Employment Rights The Long Slow Death of Labour’s Plans for Sectoral Collective Bargaining? – IER.

Conclusion

In my view, the tasks facing the trade union movement following publication of the Bill and associated documents are as follows.

Firstly, to prepare to use the new rights that workers and unions will get to build unions’ membership and organisation in workplaces, and to improve workers’ pay and conditions – and to get into the many workplaces and companies where unions now don’t exist.

Secondly, to push – together with pro-union MPs and others – for improvements to the Bill through amendments as the Bill goes through Parliament.

Third, to prepare their input into the many consultations and reviews that the Government will hold, as it turns the vague promises in the Bill into the detail of laws, regulations, and codes of practice. In doing this, it will help if the TUC can get its constituent unions working together to press for policies in line with TUC policy as decided by its Annual Congresses.

Monday, October 07, 2024

Women’s pain in healthcare shouldn’t be normal

Columnists Opinion
Delyth Jewell

4 October, 2024
LEFT FOOT FORWARD

"Women make up half our population. Their suffering should not be treated as normal."

Delyth Jewell is a Member of the Senedd for South Wales East and deputy leader of Plaid Cymru

Most women, at some point in their lives, will hear the words “this might hurt” – and not from an aggressor, but from their doctor, or nurse. Because too many intimate procedures in women’s healthcare involve pain. Women are expected to tolerate that pain. And this isn’t the fault of individual doctors or nurses, it’s because not enough focus or resource has been given to challenging that expectation. The procedures we have, be they smear tests, coil fittings, hysteroscopies – they are painful, and they’re uncomfortable. And all too often, as a result, women put off getting the help they need. Because they are worried about that pain.

This week, in the Senedd, I led a debate about women’s healthcare that focused on the desperate need to end the normalisation of this pain. Because this isn’t the only way in which women are expected to put up with pain. The stubbornly grim statistics for gynaecological cancers can partly be put down to the fact that when women talk to their doctors about the pain they’re feeling, in those parts of the bodies it’s more awkward to talk about, they’re not believed.

Target Ovarian Centre research has found that one quarter of women in Wales report visiting their GP three or more times before being referred for tests and one third report waiting more than three months from their first appointment with their GP to receiving their diagnosis. Doctors either don’t have the training to recognise the symptoms of some cancers, or not enough research has been done into finding more accurate ways of interpreting those indistinct types of pain.

And then there are those debilitating conditions affecting women that we still don’t know enough about – because of a lack of research or understanding. Endometriosis is a condition that affects roughly 1 in 10 women, and occurs when the tissue inside the uterus begins to grow outside it, often leading to chronic pain. As the British Pregnancy Advisory Service points out, despite the prevalence of endometriosis, it remains underdiagnosed and too often misunderstood.

With this condition and so many others, women are too often either gaslit, and told to wait and see if things get worse, or they’re psychologised, asked whether they suffer with anxiety.

And all of that makes women, again, less likely to seek out help. Because their pain is – if not trivialised, then minimised. Played down. They are told not to trust their own gut instincts that something is wrong.

How many women’s lives are lost, or made miserable through pain, because they fall into a gap in our healthcare system, where their words aren’t trusted, their instincts dismissed? Where women are told that they don’t understand their own bodies and how they work?

In procedures, the pain that is inflicted on women is accepted as normal. And the pain women speak about, or seek help for, is also lessened.

Why should we have to put up with so much pain? Why is that normal?

I am not a medical professional, and what’s more I have the utmost respect for those who dedicate their professional lives to helping others. I am sure that the vast majority of doctors and nurses find this situation deeply concerning too. Again, this isn’t about individuals – it is about the systemic lack of research, of resource, of thought given over to lessening the need for pain in gynaecological procedures.

The absence of a dedicated women and girls’ health plan in Wales is unquestionably part of the problem. Other governments, like the Scottish Government, the Norwegian government, the Swedish government, and the Canadian Government, have all published versions of Women and Girls’ Health plans. They have allowed those countries to focus more on ensuring women’s voices are central to their healthcare. Wales is lagging behind.

Our First Minister has laudably spoken about tackling this issue, at long last. But it should not have taken so long. Again, how many women have been lost or have had to endure unacceptable levels of pain because of this delay?

The motion I presented to the Senedd (which was passed unanimously) called for there to be a legal requirement for healthcare providers to collect feedback from female patients about their experiences – especially about gynaecological appointments, midwifery and postnatal services, perinatal mental health and menopause. Too many women are left feeling isolated, violated and in pain after these appointments. It shouldn’t be normal. We have an obligation to ensure that it isn’t.

I also called for the Welsh Government to use its influence to change the curriculums of healthcare courses that are delivered and funded within Wales, to provide additional training in women’s healthcare, and to influence national regulatory bodies like the General Medical Council and the Royal College of General Practitioners to tailor aspects of their training standards to better address women’s health.

I called for them to support research into women’s health issues, particularly into pain-perception and gynaecological cancers. We should be learning from other parts of the world that have found innovative ways of tackling low and late diagnosis rates, like introducing mail-in testing kits for cervical cancer, as happens in Denmark.

The pain suffered by women in their healthcare can be both physical and psychological. It is unacceptable, and it is costing lives. I hope that, now my motion in the Senedd has passed, it will result in improved guidance, changes in procedures, and better training for health professionals. Women make up half our population. Their suffering should not be treated as normal.

This is a shortened, adapted version of a speech given by Delyth Jewell in the Senedd on 2 October

Friday, September 20, 2024

WOMENS HEALTH

The Menopause Society launches Making Menopause Work™ Initiative

THIS IS A UNION ISSUE

Unique educational and designation initiative based on new science-based Consensus Recommendations to help employers retain workers and recoup $1.8 billion in lost workdays by supporting menopausal women in the workplace

The Menopause Society

CHICAGO (Sept 13, 2024)—Menopause is a natural life transition occurring when many women are at the “top of their game.” Unsupported menopause symptoms drive up employer healthcare costs and cause roughly $1.8 billion in missed workdays. To help employers retain these valued workers and build cultures of well-being, The Menopause Society launched Making Menopause Work™ based on new science-based Consensus Recommendations. The Recommendations are published online in Menopause, the journal of The Menopause Society.

“More employers—from large corporations to small organizations—are supporting workers during menopause,” Dr. Stephanie Faubion, medical director of The Menopause Society and director of the Mayo Clinic Center for Women’s Health, said today at The Menopause Society’s Annual Meeting in Chicago.

“But more menopause-supportive workplaces are urgently needed,” Faubion continued. “Women ages 50 and older are the fastest-growing demographic group, making essential contributions to society, families, communities, and the paid and unpaid workforces. This is a moment of tremendous opportunity.”

The Menopause Society builds on its 35-year, science-based track record with the creation of Making Menopause Work. The program—which includes a free Employer Guide, an assessment, planning tools, and other resources, with an employer designation program to come—incorporates recommendations based on new scientific consensus recommendations from a multidisciplinary panel of leading medical, legal, and human resource experts.

“Employers need to take menopause symptoms seriously and also know that they’re manageable and temporary,” said Jill K. Bigler, labor attorney at Epstein Becker Green and a member of the advisory panel for the Consensus Recommendations. “Making Menopause Work is a smart, strategic move for employers. It safeguards workers’ opportunities for leadership and financial security. It retains workers and productivity. And it builds a multigenerational workplace where midlife employees hold institutional knowledge, bring calm under stress, and make wise decisions.”

Understanding menopause and creating menopause-responsive workplaces

Menopause, the end of menstrual periods, usually occurs between ages 45 and 55; although perimenopause can start as early as age 35. Symptoms are different for each person. For some, periods become irregular and then stop. Others may experience hot flashes, difficulty sleeping, memory problems, mood disturbances, vaginal dryness, or weight gain.

The Society’s Consensus Recommendations cite a survey by the Society for Women’s Health Research showing that two out of five people had considered looking for or had found a new job because of menopause symptoms. Not only do employers risk losing talent and revenues when they ignore menopause, they also face greater costs for healthcare as well as the cost of replacing and training workers.

Creating a supportive workplace culture is the first step in turning these numbers around. The Employer Guide supports employers, managers, and supervisors to do this, including opening conversations for those who want it, understanding how to hear and support people’s needs, and recognizing menopause as a normal part of life for half the population.

From there, the Employer Guide helps employers update policies, benefits, and environments, including offering the following:

Health insurance plans that include adequate and affordable coverage for menopause-related care
Access to adequate bathrooms and flexible breaks to use them—vital for people with heavy or unpredictable bleeding
Improved ventilation and updated uniforms with breathable, flexible fabrics—a game changer for people experiencing hot flashes
Quiet work environments and flexible deadlines, which improve focus for people experiencing insomnia, anxiety, or brain fog
Peer support networks, employee resource groups and employee assistance programs, which can help people know they’re not going through menopause alone

Employers or employees interested in learning more about this important initiative should visit menopause.org/workplace.

The Menopause Society (formerly The North American Menopause Society) is the leading nonprofit organization dedicated to empowering health care professionals to improve the health of women during the menopause transition and beyond. Employers who support Making Menopause Work become part of a movement that includes more than 2,000 health care professionals who have earned The Menopause Society’s Certified Practitioner (MSCP) credential, along with tens of thousands of people who rely on The Menopause Guidebook, the most complete consumer menopause resource available.

Not in the mood for sex after menopause?

A new study suggests that cognitive behavioral therapy could be key in improving sexual function in postmenopausal women

The Menopause Society

CLEVELAND, Ohio (Sept 10, 2024)—Many women report a decline in sexual function, including desire, when transitioning through menopause. Such problems can contribute to poor self-image and negatively affect physical and emotional well-being. A new study suggests that cognitive behavioral therapy may be a safe and effective treatment for mitigating sexual concerns during this period. Results of the study will be presented at the 2024 Annual Meeting of The Menopause Society in Chicago September 10-14.

Partially due to declining estrogen levels, 68% to 87% of peri- and postmenopausal women express sexual concerns. Despite such high prevalence and negative impacts, treatment options–particularly nonpharmacological ones–are quite limited. In response, researchers initiated a small study to evaluate the efficacy of a four-session individual cognitive behavioral therapy protocol for improving sexual functioning (eg, desire, arousal, pain, satisfaction). Secondary objectives included assessing body image, relationship satisfaction, menopause symptoms (such as hot flashes), depression, and anxiety during peri- and postmenopause.

The researchers found that participants in this study experienced a significant improvement in multiple areas of sexual functioning, body image and couple satisfaction, as well as a significant decrease in menopause symptoms, depression, and anxiety, and self-reported overall health. In addition, 100% of participants indicated they were very satisfied with the treatment and that it helped them cope with their symptoms more effectively.

“To our knowledge, this is the first study that has examined the efficacy of a cognitive behavioral therapy protocol specifically aimed to improve sexual concerns experienced during peri- and postmenopause,” says Dr. Sheryl Green, lead study author from McMaster University in Ontario, Canada. “Results suggest that this type of therapy leads to significant improvements across several important sexual concern domains, and we hope this study will provide the basis for larger randomized clinical trials in the future.”

More detailed results will be discussed at the 2024 Annual Meeting of The Menopause Society as part of the Top Scoring Abstract Session presentation titled “Cognitive behavioral therapy for sexual concerns during peri- and postmenopause, a clinical trial.”

“This study is important to women experiencing sexual health related issues and provides their healthcare professionals with another nonpharmacologic treatment option to discuss with their patients,” says Dr. Stephanie Faubion, medical director for The Menopause Society.

Both Drs. Green and Faubion are available for interviews prior to the Annual Meeting.

For more information about menopause and healthy aging, visit the newly redesigned www.menopause.org.

The Menopause Society (formerly The North American Menopause Society) is dedicated to empowering healthcare professionals and providing them with the tools and resources to improve the health of women during the menopause transition and beyond. As the leading authority on menopause since 1989, the nonprofit, multidisciplinary organization serves as the independent, evidence-based resource for healthcare professionals, researchers, the media, and the public and leads the conversation about improving women’s health and healthcare experiences. To learn more, visit menopause.org.

UK’s first menopause education and support network to trial two new courses

University College London

Details of two new courses to help individuals before and during the menopause have been published as part of the launch of the UK’s first menopause education and support programme, created by UCL researchers.

The United Kingdom’s National Menopause Education and Support Programme (InTune), is being developed by Professor Joyce Harper (UCL EGA Institute for Women’s Health), Dr Shema Tariq (UCL Institute for Global Health) and Dr Nicky Keay (UCL Division of Medicine).

The work has been undertaken in partnership with two charities, Wellbeing of Women and Sophia Forum. The programme also has the support of the Royal College of Obstetricians and Gynaecologists and British Menopause Society (BMS).

A core aim of the UCL team is to co-design InTune with a diverse range of women and people who are affected by the menopause, to ensure that it is relevant, accessible and inclusive.

Over the last 12 months, the team have conducted two workshops (involving academics, clinicians, charity representatives, activists and other professionals working in menopause), focus groups and a public consultation survey. Through this work, they have established the need for two separate but interrelated programmes: Be Prepared for Menopause and the Perimenopause Programme.

Professor Joyce Harper said: “Our previous research has highlighted an urgent need for accessible, evidence-based menopause education and support. We now wish to use our research expertise to respond to this.

“Our vision is of high quality, inclusive menopause awareness, education and support, for everyone. We will achieve this by developing and delivering a non-commercial programme of holistic support and education about menopause, co-designed with stakeholders and the public.”

Be Prepared for Menopause is a two-hour interactive session aimed at individuals under 40 who have not yet reached perimenopause, but anyone can attend. The session will cover what menopause is, symptoms, diagnosis, management (including lifestyle modification) and life post menopause. The UCL team are using a novel teaching style, including showing short videos by key experts in the field, followed by opportunities for course attendees to reflect and discuss the issues raised.

The first version of the course has already been developed and has started to be piloted across the UK.

The Perimenopause Programme will be for individuals who are already experiencing menopause-related symptoms to ensure they have peer support and learn more about the perimenopause.

The perimenopause usually occurs around three to five years before the onset of menopause. During this stage women’s oestrogen and progesterone levels begin to fluctuate, causing them to experience mood changes, irregular menstrual cycles and other menopausal symptoms.

This stage of the menopause continues until one year after a woman’s last period and can often last for between four and eight years in total.

Inspired by antenatal classes, the Perimenopause Programme will be between six and eight weeks long and delivered in a group setting. The team hope that eventually the course will be available through employers and in communities, fusing education with coaching and peer support.

The team will ensure that both courses will be available online and in-person, and that the content will be adapted for a diverse range of target audiences, including people who are neurodivergent, racially or sexually minoritised, and those living with an existing health condition.

Dr Nicky Keay added: “We believe that the time is right for InTune, a national programme that will allow people to be in tune with menopause, in tune with their bodies and in tune with each other.”

Plans for the programme were first announced last year* following research led by Professor Harper, that showed that more than 90% of women were never educated about the menopause at school and over 60% only started looking for information about it once they began experiencing menopausal symptoms**.

New details published in Women’s Health reveal how InTune can help address this lack of information and ensure that people reaching menopause have a greater understanding of what is happening to their bodies.

Dr Shema Tariq said: “InTune recognises that with the right information and support, delivered to the right people, at the right time, we can empower communities to manage their health and wellbeing through this key life shift.”

The team recently showcased InTune at a House of Commons event - chaired by Carolyn Harris MP, who is Chair of the All-Party Parliamentary Group on Menopause, and Professor Dame Lesley Regan, the Women’s Health Ambassador for England - where they discussed the need to provide education and support for menopause***.

The team are now hoping to secure further funding to ensure the programme is refined and robustly evaluated.

*https://www.ucl.ac.uk/news/2023/aug/plans-uks-first-menopause-education-programme-launched-ucl-academics

** https://www.ucl.ac.uk/news/2023/apr/nine-ten-women-were-never-educated-about-menopause

*** https://www.ucl.ac.uk/news/2024/may/details-uks-first-menopause-education-and-support-network-announced-parliament