New study highlights equity gap in accessing menopause care

Warwick Medical School research has explored how women experience menopause and access care within the NHS, focusing on inequalities shaped by ethnicity, socioeconomic status, and cultural norms.

In recent years, menopause has gained significant visibility in mainstream media and public discourse, but the benefits of this awareness are not being felt equally across the UK, with Black and Asian women about 80% less likely to get hormone replacement therapy (HRT).

To provide answers and recommendation, The MenopauseGAP study – carried out at Warwick Medical School (WMS) - has published its findings in two studies in the British Journal of General Practice.

These qualitative studies involved in-depth interviews and focus groups to explore a range of people’s experiences of menopause and menopause care. In one study, a diverse sample of forty women, aged 40-60, and in the other 15 healthcare professional, were interviewed to examine a diverse range of experiences in accessing and providing primary care.

Dr Claire Mann, Research Associate in WMS at University of Warwick, said: “Our findings show that menopause care is not reaching all women equally, for a variety of factors. Future work to improve menopause care within the NHS should include targeted and intersectional health education for both patients and clinicians; especially for women who may want holistic treatment but cannot access this due to the limitations of current consultation frameworks.”

The first study identified three overarching themes in women’s experiences:

1. Context of care: Modern life’s pressures often amplify menopause symptoms. Many women expressed frustration at the commercialisation of menopause treatments and confusion about reliable sources of information.

2. Experience of care: Consultations were often emotionally charged, with women feeling they had to advocate strongly for HRT or adjust their behaviour to avoid stereotypes.

3. Social and cultural influences: Cultural norms in many Black and South Asian communities discourage open discussion about menopause, leaving women without relatable information or representation in healthcare materials.

The second study saw healthcare professionals interviewed for the study reported similar challenges:

1. Uneven awareness: Rising public attention has encouraged more women to seek HRT, but cultural stigma and limited education still prevent many from accessing care.

2. Clinical challenges: Diagnosing menopause can be difficult, with symptoms overlapping with mental health disorders and growing demand for unlicensed HRT and testosterone treatments.

3. Systemic barriers: Language gaps, underfunded interpretation services, and time-limited consultations hinder communication — leaving disadvantaged women less likely to seek or receive support.

Dr Sarah Hillman, Clinical Associate Professor of Women’s Health and Primary Care, University of Birmingham (formerly at WMS), said: “We must recognise that menopause care is not one-size-fits-all. Cultural sensitivity, representation, and clear information are key to ensuring all women receive the support they need.

“GPs should not assume that all women will advocate for themselves. Our findings show that initiating sensitive conversations about menopause and its management options, especially with women from underrepresented groups, can make a real difference in patient outcomes and satisfaction.”

The team worked closely with community leaders and organisations including Cysters and Black Women in Menopause, who contributed to recruitment, terminology, and interpretation of findings.

Nina Kuypers, PPIE and founder of Black women in Menopause, added: “It's clear that current care provisions are failing to capture a whole range of experiences and voices of those experiencing the menopause, resulting in multiple demographics of people – especially those within Black and South Asian communities - being left behind to struggle in silence or excluded from conversations.

“We need to redefine how the menopause is being represented; everyone deserves a personalised, ‘menopause-centric medicine’ approach to their care. Moving forwards, I hope studies like the MenopauseGAP can make people aware of the diversity of menopause experiences within different ethnic groups.”

Recommendations for change

Funded by the National Institute for Health and Care Research (NIHR), the MenopauseGAP study calls for urgent action to address these inequalities, including:

• Culturally tailored education for both patients and healthcare professionals.  
• Specialist menopause training for GPs and practice staff, with a focus on diverse communities.  
• Community outreach programmes to raise awareness and support among underrepresented groups.  
• Accessible resources in multiple languages and formats, including video and audio.  
• Improved funding and time allocation for menopause consultations in primary care.  
• Better integration with secondary care services to support complex cases.  

ENDS

Notes to Editors

For more information please contact:

Matt Higgs | Media & Communications Officer (Press Office)

Email: Matt.Higgs@warwick.ac.uk | Phone: +44(0)7880 175403

Additional Quotes:

Dr Abi Eccles, Senior Researcher, University of Oxford (formerly WMS), added: “Menopause is a natural process, but for many it can be profoundly disruptive; this is often compounded by contemporary problems and expectations of modern women, such as higher workloads alongside caring responsibilities.

“Our study shows that while awareness of menopause has increased in recent years, access to care is not equitable. Having a system where it is assumed that women will advocate for access to treatment, means some do not access equitable care. Our findings show how women from South Asian and Black communities may be less likely to discuss menopause within their communities or consider menopause a problem to seek healthcare for. This appears to be reinforced by a lack of representation, some mistrust of medical institutions, as well as preferences for more holistic approaches”

About the University of Warwick

Founded in 1965, the University of Warwick is a world-leading institution known for its commitment to era-defining innovation across research and education. A connected ecosystem of staff, students and alumni, the University fosters transformative learning, interdisciplinary collaboration, and bold industry partnerships across state-of-the-art facilities in the UK and global satellite hubs. Here, spirited thinkers push boundaries, experiments, and challenge conventions to create a better world.

The MenopauseGAP

This project, The MenopauseGAP, is funded by the National Institute for Health and Care Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number NIHR 204354). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

It proposes a range of recommendations to ensure equitable access to menopause support and hormone replacement therapy (HRT). It comprises of two papers, which can be accessed online via the British Journal of General Practice:

• A qualitative study of GP clinician experiences
• A qualitative study of Women’s experiences

 About the University of Birmingham

The University of Birmingham is ranked amongst the world’s top 100 institutions. Its work brings people from across the world to Birmingham, including researchers, educators and more than 40,000 students from over 150 countries.

England’s first civic university, the University of Birmingham is proud to be rooted in of one of the most dynamic and diverse cities in the country. A member of the Russell Group and a founding member of the Universitas 21 global network of research universities, the University of Birmingham has been changing the way the world works for more than a century.

About the University of Oxford

Oxford University has been placed number one in the Times Higher Education World University Rankings for the ninth-year running, and number 3 in the QS World Rankings 2024. At the heart of this success are the twin pillars of our ground-breaking research and innovation and our distinctive educational offer.

Oxford is world-famous for research and teaching excellence and home to some of the most talented people from across the globe. Our work helps the lives of millions, solving real-world problems through a huge network of partnerships and collaborations. The breadth and interdisciplinary nature of our research, alongside our personalised approach to teaching, sparks imaginative and inventive insights and solutions.

About the National Institute for Health and Care Research

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

• Funding high quality, timely research that benefits the NHS, public health, and social care
• Investing in world-class expertise, facilities, and a skilled delivery workforce to translate discoveries into improved treatments and services
• Partnering with patients, service users, carers, and communities, improving the relevance, quality, and impact of our research
• Attracting, training, and supporting the best researchers to tackle complex health and social care challenges
• Collaborating with other public funders, charities, and industry to help shape a cohesive and globally competitive research system
• Funding applied global health research and training to meet the needs of the poorest people in low- and middle-income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low- and middle-income countries is principally funded through UK international development funding from the UK government.

22 October 2025