Experience and severity of menopause symptoms and effects on health-seeking behaviours: a cross-sectional online survey of community dwelling adults in the United Kingdom

(2023) 23:373 Huang et al. BMC Women’s Health https://doi.org/10.1186/s12905-023-02506-w BMC Women’s Health Open Access RESEARCH Experience and severity of menopause symptoms and effects on health‑seeking behaviours: a cross‑sectional online survey of community dwelling adults in the United Kingdom David Roy Huang1* , Abigail Goodship1 , Iman Webber1 , Aos Alaa1 , Eva Riboli Sasco1 , Benedict Hayhoe1   and Austen El‑Osta1    Abstract Background Almost all women will experience menopause, and the symptoms can have a severely detrimental impact on their quality of life. However, there is limited research exploring health-seeking behaviours and alternative service design or consultation formats. Group consultations have been successfully deployed in perinatal and diabetic care, improving accessibility and outcomes. This cross-sectional online survey was conducted to explore women’s personal experiences of menopause, including perspectives on group consultations. Methods An online survey investigated the experiences of individuals at all stages of menopause and their receptiveness towards group consultations for menopause. Respondents were categorised by menopause stage according to the STRAW + 10 staging system. Associations between menopause stage, acceptability of group consultations and participant demographics were assessed using logistic regression. Results Respondents experienced an average of 10.7 menopausal symptoms, but only 47% of respondents felt they had the knowledge and tools to manage their symptoms. Advice on menopause was sought from a healthcare professional (HCP) by 61% of respondents, the largest trigger for this being severity of symptoms and the main barrier for this was the perception that menopause wasn’t a valid enough reason to seek help. Of the respondents seeking advice from HCPs, 32% were prescribed transdermal HRT, 29% received oral HRT, 19% were offered antidepressants, 18% received local oestrogen and 6% were prescribed testosterone. Over three quarters (77%) of respondents indi‑ cated that they would join a group consultation for menopause and would be comfortable sharing their experiences with others (75%). Logistic regression indicated premenopausal respondents were 2.84 times more likely than postmenopausal women to be interested in a group consultation where they can meet or learn from others’ experiences. Conclusions This study highlighted a strong willingness of women aged 35–70 to participate in group consulta‑ tions for menopause, with motivation being strongest amongst premenopausal women. Low awareness of selfmanagement and lifestyle interventions to manage the symptoms of menopause highlight the need for greater *Correspondence: David Roy Huang Full list of author information is available at the end of the article © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Huang et al. BMC Women’s Health (2023) 23:373 Page 2 of 10 outreach, research and interventions to build knowledge and confidence in the general population at scale. Future studies should focus on investigating the effectiveness and economic impact of menopause group consultations and the lived experience of individuals participating in group consultations. Keywords Menopause, Patient acceptance of health care, Delivery of health care, Group consultation, Shared medical appointment, Self-care Introduction Menopause is defined as the permanent cessation of menstruation, resulting from a decline in ovarian follicular activity [1]. It is preceded by the menopausal transition, a period of menstrual cycle irregularity, which usually begins in the mid 40s, and is followed by the postmenopausal period [2]. By 2025, the number of postmenopausal women worldwide is expected to exceed 1 billion [3]. Despite the ubiquity of menopause, women in the menopausal transition report considerably lower levels of health-related quality of life and higher levels of work impairment [4]. Vasomotor menopausal symptoms are often considered the cardinal symptoms of menopause, and over three quarters of women describe their menopause symptoms as moderately or extremely problematic at work, while 44% have taken undisclosed sickness absence due to their symptoms [5]. An American study found that $27.6 m was lost in work productivity in women with untreated vasomotor symptoms [6]. A study by the UK Department for Work and Pensions estimated that if 600,000 more post-menopausal women continued to work full or part-time, this would add £20bn and £9bn to GDP respectively [7]. The Women’s Health Strategy survey conducted by the Department of Health and Social care found that only 9% of respondents felt that they had enough information on menopause, and considered menopause to be one of top health conditions causing them the highest concern [8]. Hormone replacement therapy (HRT) is the most effective treatment option for menopausal symptoms, yet it is widely under-prescribed by healthcare professionals (HCP). Menopause should also ideally be managed holistically, using positive health behaviours in combination with hormonal or non-hormonal treatments. However, approximately two thirds of menopausal women are unable to access adequate care for their symptoms highlighting the demand for more accessible, up-to-date information around menopause [9]. Awareness of menopause and positive attitudes can influence the severity of symptoms and quality of life. Psychological aspects such as perceived control and self-compassion are more strongly linked to wellbeing than physiological symptoms such as the frequency of hot flushes experienced [10]. Surveys from the Royal College of Obstetricians and Gynaecologists demonstrate 58% percent of women are unable to access menopause services locally, suggesting there is an urgent need to increase access [11]. Primary care providers are responsible for managing the majority of the NHS’ caseload, yet only half of GPs receive menopause training [12 (...truncated)