Menopause questions to be added to NHS Health Checks

Millions of women will be asked about the menopause as part of NHS Health Checks at GP practices, the Government has announced.

The specific questions that will be included in the NHS Health Checks – offered to eligible adults aged 40-74 every five years – have yet to be decided and will be developed over the coming months with advice from health experts, the Government confirmed.  

Asking about the menopause as a matter of routine will raise awareness of symptoms and give women the confidence to seek help, health secretary Wes Streeting said.

Screening women for menopause within the NHS health check was first proposed in 2023 under the previous Government.

Announcing the changes, Mr Streeting said the addition of questions about perimenopausal or menopausal symptoms would ensure women get the right information and support as well as helping them to recognise the signs and seek help sooner if needed.

The Government estimated almost five million women would benefit from the questions and advice.

Mr Streeting said: ‘Women have been suffering in silence for far too long and haven’t been encouraged to open up about the symptoms they’re experiencing.

‘This oftens means they’re left to navigate menopause alone, with very little support – all because of an outdated health system that fails to acknowledge how serious it can be.  

‘No one should have to grit their teeth and just get on with what can be debilitating symptoms or be told that it’s simply part of life.’  

NHS Health Checks, aimed at identifying people with health risks including cardiovascular disease, stroke, kidney disease, type 2 diabetes and dementia, have come under scrutiny in recent years after a report from the National Audit Office said the system was not working effectively.  

Pulse exclusively revealed earlier this year that several local authorities were limiting the checks GPs can carry out due to budget constraints.

In 2023/24, 3.6 million people were invited to attend an NHS Health Check – the highest ever level but of these 2.1 million did not take up the offer.

Digital health checks are being rolled out and councils have also been expanding to offer them in pharmacies and through the voluntary sector but most are still offered through general practice.

RCGP chair Professor Kamila Hawthorne said that while college members had raised valid concerns around the evidence base for the NHS Health Check programme, when they happen, it makes sense to use them as an opportunity, if appropriate, to check in on a patient about menopause and perimenopause and discuss any support or health interventions available that could be beneficial. 

She said: ‘GPs understand that menopause can have a significant impact on health and wellbeing, so it’s vital that women feel comfortable discussing their symptoms with their GP.

‘The college recognises the importance of improved care for women during the menopause and has worked closely with partners, including the British Menopause Society, the Royal College of Obstetricians and Gynaecologists and NHS England, to develop resources to support GPs and our teams to deliver the best possible care for women.’

NICE has said more than three quarters of women experience symptoms – from physical changes like joint pain, weight gain and hot flushes to cognitive effects such as memory issues and brain fog – which can last an average of seven years and significantly impact daily life.

But fewer than one in ten respondents to the Government’s Women’s Health Strategy call for evidence felt they had enough information on the menopause.

Professor Azeem Majeed, a GP and head of the department of Primary Care and Public Health at Imperial College London, told Pulse the change represents a ‘broadening’ of the check’s original aim and that there is a risk that including additional topics ‘could dilute’ their focus.

He said: ‘NHS Health Checks aim to identify and manage risk factors for cardiovascular disease, type 2 diabetes, kidney disease and stroke.

‘They have a clear and evidence-based focus on reducing morbidity and mortality from these major conditions. Adding questions about the menopause could be a positive step if it helps normalise conversations about women’s health and ensures timely support and advice.

‘However, it also represents a broadening of the Health Check’s original aims. There is a risk that including additional topics could dilute its focus and effectiveness and set a precedent for including other important – but non-cardiometabolic – conditions in the future.

‘While the menopause has important implications for health and overall wellbeing, it may be more appropriate to address it through QOF or through enhanced primary care pathways for women’s health.

‘This would allow a more structured and sustained approach to improving care, rather than trying to expand the scope of the NHS Health Check programme beyond its original remit.’

NHS England national clinical director in women’s health Dr Sue Mann said: ‘Far too often we still hear women say their concerns aren’t listened to or that they aren’t getting enough support for the debilitating symptoms that can come with the menopause, many of which can have a big impact on their lives and can be invisible to others. 

‘By tailoring NHS Health Checks to include questions around menopause, we hope more women will get the support they need to manage their symptoms – and this is testament to our ongoing commitment to improving treatment, care and quality of life for women.’