David Cullinane (Waterford, Sinn Fein)
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103. To ask the Minister for Health his plans to expand awareness, access and affordability of menopause supports and treatments; and if he will make a statement on the matter. [26381/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Government recognises that menopause is a key health issue for women in Ireland today. Work is underway to drive progress in this area which is being driven by the Women’s Health Taskforce. The Taskforce was convened in September 2019, to improve health outcomes and health experiences for women and girls.

Awareness of menopause and its symptoms has been emphasised through the nationwide “Radical Listening” exercise carried out by the Women’s Health Taskforce. This exercise enabled women across the country to share their views and experiences of the health sector and health services. This was a large-scale consultation process intended to maximise the participation of women across all life stages from 18 years upwards, including minority and disadvantaged women.

278 women participated in open interviews and workshops, where menopause was a recurring theme. Through this process, the taboo around discussing menopause, and a lack of trusted information, were consistently raised as key issues for women experiencing menopause. I published a report on the findings of the ‘Radical listening’ exercise in September 2021.

The first-of-its-kind ICGP post of Clinical Lead for Women’s Health in General Practice has been established. In March 2022, Dr. Ciara McCarthy took up post as the Women's Health Clinical Lead. Her role will enable the development of a comprehensive life-course approach to women’s health in general practice, where the vast majority of advice and services for women at all stages in their health journey is available. Dr McCarthy’s appointment comes soon after the successful roll-out of the comprehensive new Certificate course in Community Gynaecology for GPs, which provides GPs with up-to-date training in a range of gynaecological presentations in general practice, with evidence-based learning on best practice, from contraception, sexual health, fertility, HRT and the menopause.

Additionally, the Women’s Health Taskforce engaged in discussions on menopause through the ‘Women’s Health Weekly’ presentation series in which key stakeholders presented to Taskforce members on important topics in women’s health. In November 2019, the topic of ‘Perimenopause and Menopause’ was presented, the video of this presentation is available on gov.ie and YouTube. 

The HSE has developed a dedicated landing page - hse.ie/menopause - to improve user experience and accessibility to relevant information.

While the majority of women who seek support for their menopause can be effectively supported within primary care by their GP, approximately 25% of symptomatic women will require specialist medical expertise in menopause. Specifically, this cohort of women will fall within four broad categories:

1. Treatment does not improve their menopausal symptoms;
2. They have on-going troublesome side effects e.g. bleeding;
3. They have contra-indications to HRT; and
4. There is uncertainty about the most suitable treatment option for their menopausal symptoms e.g. complex medical history.

In September 2021, I announced my commitment to establish dedicated specialist menopause clinics across Ireland. The Women’s Health Action Plan 2022-23 committed to developing 4 specialist menopause clinics nationally in 2022. In April, I announced further investment to support 2 additional specialist Menopause Clinics, bringing a total of 6 such clinics nationwide for women who require complex, specialist care. These clinics will form a core part of a new approach to menopause care for women in Ireland and will be supported by enhanced community and primary care supports as well as the publication of targeted and trusted sources of information for women experiencing menopause.

Specialist menopause clinics will be provided in Dublin, Limerick, Galway and Cork working to complement the menopause support available to women in their community.

The first specialist menopause clinic in the National Maternity Hospital opened in December 2021. The clinic is multidisciplinary, supported by GPs with a certified special interest in the area of menopause and by clinical nurse/midwife specialists. In addition to seeing women who meet the clinical criteria for referral to the service, the clinical team also provides advice and guidance to GPs in the community to support the effective management of menopausal symptoms for women closer to home within primary care.  

Additional activity underway and planned in the area of menopause includes:

- ‎GP training is a key aspect of women receiving the best care through menopause. The Irish College of GPs are active members of the Women's Health Taskforce and continue to be engaged on how women's health can be better considered within the primary care setting. Relevant activity includes the collaboration between ICGP and the British Menopause Society to develop training in menopause management, which is currently in place; an ICGP Women’s Health Webinar on menopause and endometriosis which was held in June 2021 and had 1567 attendees; and a GP Education course which was established in September 2021 in the area of Community Gynaecology which includes menopause as a topic. Funding has been provided through the Women's Health Fund to develop a 'quick reference guide' for GPs on the menopause, to support primary care provision in this area.

- ‎‎A number of health topics relating to women's health, including menopause, have recently been updated and are now live on the HSE A-Z webpage. This information is an important first step towards delivering enhanced information and education on menopause. A public information webinar on the menopause was held on November 29th, 2021.  

- A civil service webinar on 'Menopause at work' was held on October 18^th2021, and further HR training to better understand the challenges and solutions for supporting women in their menopause journey within the civil service was held on November 30^th2021.

In addition to the activity outlined above, menopause will continue to be a priority for my department and this Government for 2022 through targeted funding for menopause projects via the Women’s Health Fund and implementation of the Women’s Health Action Plan 2022-2023.