All women are born (un)equal: menopause, HRT and women’s well-being

This project will investigate the impacts of menopause and Hormone Replacement Therapy (HRT) on various aspects of women’s lives.

Why this project is important

Menopause marks a significant transition in a woman’s life and is often accompanied by physical and psychological symptoms that can have major implications for her economic and social wellbeing, for example by reducing participation in the labour force. Awareness of the challenges experienced by women in the period surrounding menopause has increased significantly, but their consequences have not been properly quantified and costed.

At the same time, the prescription and uptake of Hormone Replacement Therapy (HRT) to potentially alleviate menopausal symptoms has grown markedly in recent years. An estimated 2.3 million individuals were prescribed HRT items in 2022/23, a 29 per cent increase from 2021/22.  However, little systematic research evidence exists on the impact of menopause, the extent to which HRT is beneficial, who gets access and who benefits, and if ethnic, economic and age inequalities play out.

What it will involve

The research team aims to address this gap by analysing large-scale datasets following women over time to demonstrate causal impacts of menopause and of HRT on multiple dimensions of women’s lives.

The 1970 British Cohort Study, English Longitudinal Study of Ageing, Million Women Study, and UK Biobank will be used to:

1. Estimate the impact of menopause on a wide range of women’s outcomes.
2. Examine differences in HRT take-up, and the influence of education and information provision, drug availability, prices, and access to specialist services on HRT usage.
3. Estimate the causal impact of HRT on women’s outcomes and assess whether women who are less likely to use HRT are more likely to benefit from it.
4. Study heterogeneity in the effects of menopause and HRT on a range of outcomes, by race, education, deprivation, and other indicators of disadvantage.

Diane Danzebrink, founder of Menopause Support, will contribute her expertise and ensure the inclusion of women with lived experience. The team will undertake up to 30 interviews with a diverse group of women to give valuable context to the findings.

How it will make a difference

The findings will inform the design of targeted interventions to support women’s well-being. Ultimately, this project has the potential to contribute to breaking down barriers to menopause care and improving the lives of women across different socioeconomic backgrounds.