March 2023 • PharmaTimes Magazine • 14-15
// WOMEN'S HEALTH //
Pause for thought
Pharmacy’s central role in women’s health – including the menopause – must reflect a more modern, tailored approach
An estimated 13 million women in the UK are currently menopausal or postmenopausal, which is the equivalent of a third of the entire UK female population.
The menopause affects all women at some point in their lives, and with 50% of the population affected, updated research and education is needed to ensure women can find information and receive support. This represents a critical element of the government’s Women’s Health Strategy (WHS) as it focused on its ten-year ambitions.
The WHS was published by the government in August last year and included a spotlight on improving the menopause experience – from adding the menopause to the education curriculum to reducing stigma in future generations. It also focused on ensuring vital support for women experiencing the menopause in the workplace.
Clear and present
The WHS declared the menopause as a clear priority. In January however, the government rejected several recommendations from the Women and Equalities Committee report on menopause and the workplace, which some view as a step backwards.
Beyond the government’s strategy there has also been a clear increase in the number of women campaigning for better menopause care and awareness, and there is no doubt these campaigns have been pivotal in ensuring governmental and societal change.
Before such a movement existed, it was deemed normal for women to suffer in silence, but as a society we are now progressing to the point where the menopause is discussed more openly, on television and in the media. Women can now access support for the aspects of menopause that affect them most.
While some symptoms of the menopause are well known for their significant impact on women, such as hot sweats, disrupted sleep and forgetfulness or ‘brain fog’, there are also lesser-known intimate symptoms that few women want to talk about, such as vaginal dryness and discomfort, caused by the condition vaginal atrophy. Vaginal atrophy affects one in two postmenopausal women, yet 80% of women admit they know nothing about it.
Intimate symptoms can often be difficult for people to talk about, with nearly half of women feeling uncomfortable talking to their GP about them despite the fact over a quarter of women admitted it affected their ability to relax. However, with the launch of an over-the-counter treatment these conversations are now being approached in pharmacy.
Counter action
The treatment, Gina, launched in September 2022 and is a local oestrogen treatment for vaginal atrophy in postmenopausal women over the age of 50 who haven’t had a period in one year.
As the first local hormone replacement therapy (HRT) available over the counter, it can be supplied without a prescription following a consultation with a pharmacist. Vaginal atrophy is a condition that can present as several symptoms including vaginal dryness, itching, soreness, burning and uncomfortable sex and although many symptoms of the menopause, such as hot flushes or mood swings, reduce and over time eventually disappear, vaginal symptoms may not.
Vaginal atrophy is both chronic and progressive meaning that without treatment the symptoms are likely to only get worse. As highlighted in the WHS, however, having Gina available over the counter means women have a more accessible treatment for vaginal atrophy that they can use without having to go to their GP.
‘Intimate symptoms can often be difficult for people to talk about, with nearly half of women feeling uncomfortable talking to their GP’
As this is the first local HRT available to buy in pharmacy, pharmacies were thoroughly prepared beforehand and sent training to ensure staff were not only aware of the product but also expertly trained to advise and support any women asking about Gina.
A comprehensive pharmacy team training programme was provided, including support materials to assess the suitability of Gina via a checklist and guidelines for when women should be referred to their GP.
Following on from the product launch, a study surveying over 200 pharmacy staff showed that pharmacies are seeing on average 25 patients per month seeking advice about vaginal dryness treatments.
This is in sharp contrast to previous data showing only 7% of women felt comfortable talking to their pharmacists about the vaginal symptoms of the menopause. Clearly, increasing accessibility to treatments and driving awareness of the condition can help people feel confident enough to approach these conversations.
Access all areas
Accessibility has never been so relevant. In the wake of the pandemic there are seven million people waiting for elective care in the NHS and only 60% of healthcare services currently meet the 18-week referral to treatment timescale set out in the NHS Constitution.
With the increasing pressure on the NHS, it is now more important than ever that individuals feel empowered to visit their local pharmacies where they can receive care and advice and be appropriately signposted if necessary.
Pharmacists and pharmacy staff are uniquely positioned and qualified healthcare professionals available on nearly every high street, providing the public with support and expert advice on medicines daily. As public-facing establishments they may see different people on a day-to-day basis, or members of the local community to dispense prescriptions, take on medication queries and sell appropriate products to patients.
With many offering health check-up services such as blood pressure monitoring and blood glucose checks, alongside vaccines and medications required for travel, pharmacies are a part of many people’s routines. Therefore, having the ability to access medication over the counter, which would previously require a GP appointment, increases accessibility, and allows for patient choice.
The menopause is one section of the wider picture of women’s health, as pharmacies provide one solution to the wider issue of patient accessibility. When we talk about accessibility, we don’t only need to consider physical accessibility but also enable a society that openly talks about women’s healthcare needs and empowers their well-being.
By taking steps to ensure that women are supported and given the help and advice they need by their local pharmacies, not only during the menopause, but across all aspects of life, we can help to create an environment and culture in which women feel supported and empowered to ask for help. With each pharmacy consultation one woman becomes that bit more empowered and I look forward to more women taking charge of the conversation around their vaginal health.
The menopause can be a huge part of a woman’s life, but the uncomfortable symptoms of vaginal atrophy don’t have to be.
Sanjay Verghese, Commercial Vice President at Novo Nordisk UK.
Go to novonordisk.co.uk
PharmaTimes
PharmaTimes is the UK’s leading pharmaceutical magazine, tracking the trends and issues that affect the industry here in the UK, in Europe and across the world. We deliver independent, authoritative and trustworthy content through impartial, balanced and informed opinion and analysis.