Eleanor's Letter: A special interview

Meet Carolyn Harris MP, Queenager supreme and menopause warrior

Dear Queenagers,

Hope you’ve all had a great week! It’s been busy here at Noon – it was World Menopause Day last Tuesday and we hosted a Noon panel with a fantastic line-up of women. If you missed it, it’s really worth a watch. The contributions from the women of colour on the panel were particularly touching about the damage the lack of a conversation, or language, with which to talk about the subject has done. Did you know there is no word for menopause in many south Asian languages, only “barren”? Or that global majority women tend to get menopause earlier, suffer worse symptoms and are way less likely to get HRT? Yasmin Alibhai Brown (brilliant writer and Noon Advisory Board member) talked about how her aunties went from joyous and vibrant to depressed as the change hit them and no-one talked about why! I also learnt that suicide in women peaks during the menopause years – and that divorce rates spike. By opening up this conversation – and our Noon campaign is to make it more truly inclusive – we really will save lives and families. If you would like to do that do please sign our Parliamentary Petition to make Menopause a QOF (more about what that is later but am putting this in high up for anyone in a hurry).

I was particularly thrilled this week to interview Carolyn Harris MP – the UK Parliament’s menopause warrior and a true Queenager herself. (Some of you newer subscribers won’t know but I spent the last 25 years as an Editor at The Sunday Times where I started as the paper’s main interviewer. Over the years I’ve interrogated everyone from Mikhail Gorbachev to the Dalai Lama, Sheryl Sandberg to Theresa May and Dawn French – so I love getting out my Dictaphone and asking the questions.. ).

So here is a Noon exclusive: my interview with Carolyn…

Carolyn Harris MP pops up on my Zoom screen a picture of vitality: her pink hair matching her pink wallpaper. A true Queenager, Harris is living proof of our Noon motto: “So Much More to come! It is never too late and you are never too old!” 

Carolyn was 54 when she became an MP in 2015. “I had my first son Martin [who died tragically as an infant] when I was 21 and worked as a school dinner lady and as a bar maid to fit in around child care before getting restless and going back into education in my late thirties. I knew I had more to give.”

These days she is Parliament’s unofficial menopause champion, and has led a super-successful one-woman crusade to put menopause on the political map. On World Menopause Day this year – October 18th – she launched an APPG report into menopause in the work place, a book of menopause journeys, and led a rally in Parliament Square (as well as heading up Noon’s Inclusive Menopause panel).

She is also the MP behind the private members bill which will make HRT free – or much cheaper at any rate; thanks to Carolyn’s campaign women in England will now only have to pay one prescription charge for a year’s supply, a huge improvement on the expensive multiple bills women had to pay before.

But that’s not all: today we launch a campaign, supported by Carolyn, and a Parliamentary Petition to incorporate menopause into the Quality and Outcomes Framework (QOF) for GPs. That would mean that just as all women are called in by their GP for a breast cancer screening when they hit 50, or have to go for cervical smears (and doctors are financially rewarded for ensuring that they do), this same kind of mass call-out would happen for all women when they hit menopause.

“The biggest problem of all currently,” says Carolyn, “is the lack of training amongst GPs about menopause. That is being addressed by the new Women’s Health Strategy which sets out that from now on, all GP training courses will include menopause. But it’s seven years before doctors being trained that way will qualify. So between now and then, there’s not enough knowledge amongst the medical profession, to identify menopause. There’s also not enough confidence within the medical profession to prescribe HRT, if that’s what the person wants. Of course if you have had breast cancer you have to be careful but it can be possible even then. A lot of women are missing out because of doctor’s lack of confidence and lack of knowledge. So including menopause in the QOF would definitely help with that.”

Carolyn’s warmth and enthusiasm shines through the screen as she speaks at great speed in her broad Swansea accent. She is adamant that HRT prescribing doesn’t have to be done by a GP.  “It can be a GP pharmacist, it can be a women’s health nurse, as long as they’re able to prescribe. I don’t see why we can’t have menopause clinics in every doctor cluster. But if menopause is in the QOF all women – particularly the poorest ones – will get access to quality medication, support and resource, because at the moment they really haven’t.”

Carolyn is passionate about making the menopause conversation more inclusive. “I was talking to a group of shop workers the other day and one of them said: “Aren’t you posh having a menopause!” That’s why we need menopause included in the QOF – so all women get the care that they need, not just the ones who can access private medical care. I worry about the women on low incomes, they are working all day and they don’t have access to the right information. They have all these symptoms and they don’t know that there is an answer, they just think it is to do with their age. They end up on anti-depressants, really suffering. It is really sad and unfair. That lower income demographic of women, they are the ones that we really need to reach. ”

She is right. The latest data from the NHS Business Services Authority on Hormone Replacement Therapy (HRT) – which can be prescribed to relieve menopause symptoms – shows that there were 7.8 million HRT prescriptions in England last year, a 35% increase on 2020/21 (it’s been dubbed the Davina Effect after Davina McAll’s Channel 4 Documentaries). But scandalously, “areas of greater deprivation had the lowest number of identified patients being prescribed HRT” Indeed, twice as many people are being prescribed HRT in the most affluent areas of the country compared to those in the most deprived areas. There is also a massive discrepancy in the treatment received by BAME women. As Dr Nighat Arif, a women’s health expert explains; “In my community there is no word for menopause, it is just barren”. Too many women are being left out of the conversation.

This blatant inequality in information and access to health care has to stop. That is why Noon, along with Carolyn Harris MP, Netmums, The Menopause Charity, Vira Health, Theramex and Henpicked are launching this Parliamentary Petition. If we get to 10k signatures Parliament has to act. So please share this newsletter and the petition far and wide.

One of the big problems affecting how HRT is prescribed is what is known as the local formulary. Essentially, each local authority area has a board which decides what doctors in that area can prescribe and what the local Health Authority will fund in terms of prescriptions. This leads to local black spots where HRT isn’t available – often not because there isn’t any, but because that authority hasn’t approved different varieties and the ones that are authorised have run out.

“What we need is a National Formalry,” insists Carolyn. “A list of nationally approved HRT products. Currently, every Health Board has a local formalry. The stuff that they haven’t got on their local formalry doesn’t cost any more, and it’s just as good quality, but because the meeting of the local board hasn’t happened – and many are so far behind –  perfectly good products take forever to get passed. This means there are lots of good HRT products in pharmaceutical warehouses which go out of date because they are not on local formalry, so they are not being prescribed in a particular area.”

The backlog in the system means that having a National Formalry, or list of approved products and providers for medications, would be helpful in increasing supply and preventing the black spots for HRT which are all too common. This is one of the recommendations which has been put forward by the Equalities Committee chaired by Caroline Nokes MP in the wake of the HRT shortages earlier this year. There was an outcry last summer when HRT dried up – we had many anguished messages to Noon from women who couldn’t get hold of their precious gels. I was on a whatsapp group with women anxious to get hold of their medicine. Many were desperate. As one Noon woman wrote: “I need that oestrogel, without it I can’t sleep, I get hot flushes, I feel terrible. This is not a joke!”

Carolyn nods when I tell her about this. “It’s stupid. The boards aren’t meeting regularly enough. It’s just a mess and it needs to be fixed.” There is also a problem with recruiting doctors to work in deprived areas. A vicious circle is in place. Poorer women have less access to doctors because of the shortages, so are even less likely to get the care they need.

Carolyn first started talking about menopause publicly in 2018, long before Davina, Penny Lancaster and others did. Why? “Menopause is the biggest problem for women when it comes to health inequalities. Women have been having the menopause forever but until now no-one has campaigned to equalise the health system. Did you know that a man with erectile problems can get free Viagra if they say their mental health is being affected? (otherwise is by paid-for prescription)  Yet only 14% of women are getting treated for menopause. I first started talking about menopause in 2018, when I was completely unaware that I was menopausal. But then I began listening to the experts and I realised my extreme tiredness wasn’t just me getting on, it was menopause! I find that all the time. I talk to educated women and it is not till they hear a list of the symptoms that the penny drops.”

Thanks to Carolyn, menopause is becoming part of the national conversation. “It was in 2021 when I introduced my private members bill that it began to really take off. I’ve discovered the great thing about being an MP is that it gives you a platform, if you start talking about something and people listen.”  

If ever there was an example of a Queenager changing the world this has got to be one. Carolyn is also walking proof of the importance of having representation from all walks of society in our parliament– an older, working class Welsh woman is still not a common sight in the hallowed halls of Westminster. If there were more MPs like her maybe women’s issues wouldn’t be such a neglected area!

When I thank her for all she has done for women, Carolyn bats it off. But she really has made a difference. Eventually she accepts the compliment. “I mean, you’re right, it’s really changed. Menopause used to be one of those taboo subjects. But I find the more you say the words vaginal dryness, the less shocking they get. I don’t even flinch now!”

She is particularly pleased that men are now part of the conversation. In her constituency she invites women to bring their bosses to her menopause sessions. “We get men to wear the Menovests which mimic a hot flush, we talk about the best diets for menopause, we tell people all the symptoms of menopause, many of which are psychological it’s not just about hot flushes and periods stopping. One in four women can become so depressed they feel suicidal. One in ten leave their jobs.Yet until now so many women have suffered in silence. And large swathes of the population, particularly those who are disadvantaged to begin with, are still suffering. Making menopause a QOF would mean equal access to the treatment all women need. I want every woman to be able to talk about this and to have access to the best care.”

To help ALL women have a better menopause experience and to force the NHS into providing it signing our petition is a concrete step you can take today which will really make a difference! Please do it.

Many of you will know that what we are doing at Noon.org.uk (the platform I founded, home of the Queenager) is about changing the narrative about the later stages of women’s lives, challenging gendered ageism and being more positive about all that we are. I know that 78% of you don’t want to be branded ‘menopausal’ – just as my daughters wouldn’t want to be branded ‘menstrual’ or middle aged blokes wouldn’t want to be told they are in their Viagra years (“welcome to the limp dick club”). BUT we DEFINITELY want to fix the real health inequalities that are out there. And you lovely Queenagers can really make a difference to less fortunate Queenagers out there with one simple click!

Ok, I promise I won’t go on about this anymore!

For those of you who fancy a bit of light relief here is an interview I did as part of a campaign called Courage is Contagious on Queenagers with Meta’s Sophie Neary - all about why Queenagers deserve joy, fun, purpose all the good stuff!

And don’t forget about our October Noon Book Club – with the brilliant Mary Ann Sieghart – brilliant woman and author of The Authority Gap which is all about why women’s voices don’t get heard. We’re going to do this on Linked In on October 31st at 12.30pm – here is the link

Have a great week.

Eleanor