Get all your news in one place.
100’s of premium titles.
One app.
Start reading
The Telegraph
The Telegraph
National
Lizzie Roberts

NHS mental health services failing to consider impact of the menopause on women, says watchdog

Woman takes Hormone Replacement Therapy - Getty
Woman takes Hormone Replacement Therapy - Getty

NHS mental health services do not consider the full impact of the menopause on women, patient safety investigators have found.

Women are frequently prescribed antidepressants when hormone replacement therapy (HRT) may be more appropriate, according to a new report. 

The Healthcare Safety Investigation Branch (HSIB) examined the suicide of a 56-year-old NHS worker who came into contact with mental health services multiple times between 2019 and 2020. 

The patient, known as Ms A, was diagnosed with psychotic depression. She was also prescribed an oestrogen hormone just before she died to help her with the menopause, but on the whole it was a "potentially unconsidered" factor among those treating her, according to investigators.

Her death prompted HSIB to launch a national investigation into treatment delivered via community mental health teams.

The report warned that mental health services are not taking the full effects of the menopause into account when assessing women, and are not looking at its potential impact on more severe mental health symptoms.

Staff not trained

It added that staff working in community mental health teams were not trained in this area, and menopause is not routinely considered as a contributing factor among women with low mood who need help.

The report noted that midlife is a point when mental health can deteriorate, leading to an increased risk of suicide.

Plus, women can be at increased risk of developing schizophrenia or other psychotic disorders at or around the menopause.

The report said experts in menopause care had suggested that the symptoms of the menopause and perimenopause "are often mistaken for depression, resulting in women being prescribed antidepressants rather than HRT".

Research has also found that many women suffering depression or a major depressive disorder at the time of menopause "may find relief of these symptoms and even the disorder by using HRT".

The report further warned that too many people are taking their own lives while being deemed as at low or moderate risk of suicide.

People left without the right care

Despite national guidance telling staff not to rank people as being at low, medium or high risk of suicide, too many NHS trusts still use the system, leaving people without the right care, investigators concluded.

The HSIB made a series of safety recommendations, including calling on the National Institute for Health and Care Excellence to evaluate the available research "relating to the risks associated with menopause on mental health and if appropriate, update existing guidance".

The Royal College of Psychiatrists should also form a working group to identify ways in which menopause can be considered during mental health assessments.

The HSIB noted that NHS England has written to all mental health trusts in England to highlight the importance of taking a person-centred approach and to "move away" from using tools to categorise people's risk of suicide and self-harm.

Sign up to read this article
Read news from 100’s of titles, curated specifically for you.
Already a member? Sign in here
Related Stories
Top stories on inkl right now
One subscription that gives you access to news from hundreds of sites
Already a member? Sign in here
Our Picks
Fourteen days free
Download the app
One app. One membership.
100+ trusted global sources.