Women and Menopause

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Supporting women going through the menopause

The media is full of ‘miracle cures’ for menopausal symptoms, so how can women know which products best suit them, asks Victoria Goldman...

Updated NICE guidance on the menopause, published in November 2024, recommends hormone replacement therapy (HRT) as a first-line treatment for troublesome symptoms such as hot flushes and night sweats. It also clarifies that cognitive behavioural therapy (CBT) should be an ‘add-on’ treatment rather than a primary approach.

NICE encourages GPs to have informed discussions with women, keeping in mind:

Age
Individual circumstances
Potential risk factors. 

While hot flushes and night sweats affect around 70% of women, other symptoms – like mood swings, vaginal dryness and joint pain – are also common.

Not all women can or want to use HRT though. Other options include non-hormonal medications, pharmacy products and lifestyle measures, with many women preferring a combination of approaches. However, with the media constantly promoting ‘miracle cures’ often with conflicting advice, how can women identify the most effective and reputable products?

💬 “As pharmacists, we’re in a unique position to break down taboos and help women navigate this transformative time,” says Laura Dowling, a community pharmacist in Dublin.

Pharmacists are in a unique position to support menopause by:

Offering a mix of evidence-based products, supplements and lifestyle advice
Ensuring recommendations are clinically proven rather than driven by trends
Listening and providing tailored guidance.

HRT options: what women need to know

When discussing menopause management, healthcare professionals should clearly explain the benefits and risks of different types and forms of HRT.

📈 Demand is increasing: In October 2024, NHS Business Services Authority data revealed HRT prescriptions went up by a fifth in 2023/24.

For vaginal dryness, irritation or painful sex, vaginal oestrogen is available in various forms – including creams, gels, tablets, pessaries or rings – and can be used on its own or in combination with non-hormonal moisturisers or lubricants.

💬 “The majority of HRT is only available on prescription,” explains Jacquie Lee, Numark’s medication safety officer and information pharmacist. “But there are some vaginal oestradiol pessaries and creams that can be purchased over the counter if, after questioning, it is clinically appropriate.”

Pharmacists, in this scenario, can play a pivotal role by:

✅ Offering advice and information
✅ Signposting patients to GPs or specialist clinics for HRT prescriptions
✅ Explaining how HRT works – its different types and potential benefits and risks.

Product choice: navigating herbal & dietary supplements

While some herbal products and dietary supplements may help ease menopausal symptoms and improve overall health, they are not a quick fix, may cause side effects and often have contraindications.

According to NICE guidance, there is some evidence that:

Isoflavones or black cohosh may help relieve hot flushes and night sweats but vary in effectiveness and safety
St John’s Wort could also help alleviate symptoms, but its correct dosage and safety profile remain unclear.

*For women with a personal history of breast cancer or high risk, caution is advised when considering St John’s Wort.

💬 “In general, it’s important for community pharmacists to recommend brands that adhere to high standards, using scientifically selected, premium-quality ingredients offering innovative formulas that have an optimum nutrient delivery to support everyday life,” says Thorrun Govind – pharmacist, lawyer and TV health expert.

She advises pharmacists and patients to:

Look closely for key ingredients
Ensure they are provided at sufficient levels
Be aware of potential interactions with other medications.

MTick: a universal symbol for menopause-friendly products

To help consumers navigate the overwhelming number of menopause-related products, GenM has introduced the MTick – a universal shopping symbol and certification for menopause-friendly items. According to them:

Over 700 products have been certified with the MTick symbol on their packaging and website
94% of menopausal women want to shop for clearly labelled, menopause-friendly brands
However, 66% can’t readily find what they need due to poor signposting.

💬 “Pharmacists can support their customers by directing them to MTick-labelled products,” says Jen Julian, Chief Operating Officer at GenM.

The MTick ensures that products have been assessed against a strict set of criteria, including:

Providing scientific evidence
And in the case of food supplements, products need to include at least 50% of the NRV (Nutrient Reference Value) of active ingredients.

"With the help of the MTick and GenM’s online education hub, healthcare professionals can easily identify and recommend reliable, menopause-friendly products."

Lifestyle advice: managing menopause

Healthy lifestyle changes can significantly improve menopausal symptoms and women’s general health. For example:

Exercise & stress management

Supports weight management and healthy bones
Boosts mood and energy levels
Improves sleep and mood swings with relaxation techniques and mindfulness.

If women are prone to hot flushes & night sweats, pharmacy teams can recommend:

Wearing breathable layers – opt for natural fibres like cotton and silk
Staying cool – with cold showers, cold drinks and using a fan
Sleeping in a cool bedroom – with cotton sheets and wearing lightweight nightwear.

Diet & nutrition tips for menopause support include:

A diet rich in calcium, vitamin D and whole foods
Phytoestrogens like soy and flaxseeds to help with hormonal balance
Reducing alcohol, caffeine and spicy foods to help relieve hot flushes.

Keeping up to date

The menopause is a dynamic category with regular media coverage, so it’s important that pharmacists are aware of new health information or product trends.

💬 “Staying informed is key. Keeping up with NICE guidance and reputable journals ensures pharmacists are always providing accurate advice,” says Dowling.

Key ways for pharmacists to stay ahead:

✅ Follow NICE guidance and reputable journals
✅ Join menopause organisations like the British Menopause Society or the Menopause Society of Ireland to access updated evidence-based resources like CPD courses, webinars and menopause-specific training
✅ Collaborate with local GPs and menopause specialists.

These steps help ensure pharmacists are confident when addressing customers' concerns and recommending effective menopause management options.

In summary...

Menopause care is evolving. By offering trusted medical advice, a mix of HRT, non-hormonal treatments and lifestyle strategies, as well as clear product guidance with evidence-based recommendations, pharmacists can empower people make informed choices about their health.