Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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The current provision of the Free HRT Arrangement, legislated for under the Health Insurance (Amendment) and Health (Provision of Menopause Products) Act 2024, limits eligibility to those whose healthcare provider has prescribed HRT to alleviate the symptoms of menopause.

The legislation includes the following definitions which limits the arrangement to the treatment of the symptoms of all stages of menopause:

• “‘menopause’ means, in relation to a woman, the various stages related to menopause and includes perimenopause, post menopause, early menopause, premature menopause and medically induced menopause;
• ‘menopause products’ means hormone replacement therapy drugs, medicines and surgical and medical appliances used to alleviate the symptoms of menopause, which are for the time being on the Reimbursement List.”

Menopause is the permanent cessation of menstruation. Perimenopause is the time leading up to a woman’s final period – it covers the transition from reproductive age through to menopause. It begins at the first clinical, biological and endocrinological features of menopause – e.g. menopause symptoms, menstrual irregularities – and ends 12 months after the last menstrual period.

Menopause is a natural part of ageing for women. Not all women need treatment to relieve the symptoms of the stages of menopause, but treatments are available if a woman finds her symptoms particularly difficult. Therefore, clinicians treat the symptoms of menopause rather than menopause itself.

HRT is the most common, and shown to be the most effective treatment for the symptoms associated with menopause.

In relation to the use of the phrase "symptoms of menopause" in the legislation, the symptoms associated with all stages of menopause are wide-ranging and vary with each woman's experience. Some of the associated symptoms can impact on mental health (low mood, brain fog, etc.) and some on physical health (fatigue, hot flushes, vaginal discomfort or pain, etc.). The phrase "symptoms of menopause" is used, therefore, to encompass the wide-ranging symptoms of menopause.

Any woman experiencing such symptoms should speak to her healthcare provider about menopause and the correct course of treatment for her. More information about menopause, its symptoms, and treatment can be found on HSE.ie/menopause.