Women’s Health, Menopause & Matt Bishop’s Event…

Women’s WellnessHormonesHormones Wellbeing & Holistic HealthCommunity & EventsPersonal ReflectionsAdvocacy & Maternity Reform

20 Sept

Written By Emma Gleave

Last night, I attended an event for women and girls at Speech House, hosted by Matt Bishop, MP for the Forest of Dean.

Firstly, I want to congratulate Matt and his team for bringing women together and creating space for these conversations. It was genuinely encouraging to hear how much he cares about the experiences of women and girls—and how the women working within his office have been able to share some of their own difficult experiences with him.

The problems facing women’s health are enormous and deeply systemic. They will not be solved by one MP or one event. But listening to women, bringing us together and opening these conversations publicly is a really positive place to begin.

Women are still being dismissed

Throughout the evening, we heard women’s stories of being utterly dismissed by the healthcare system.

Women spoke about being told that they could not address more than one health complaint at a time during a GP appointment, despite the fact that symptoms do not necessarily occur neatly in isolation.

One woman described her husband being brought into the conversation to give his permission for her hysterectomy. This was not a story from decades ago. It happened within the last three or four years.

We heard about women now being unable to access gynaecology appointments within the Forest of Dean and nurses having to travel across the county from Cheltenham. We also heard that, within the organisation of healthcare services, the Forest of Dean is not always treated as a distinct area with its own geography, population and needs.

Anyone living here knows that access cannot be understood simply by drawing a line on a map. Distance, rurality, limited public transport, travelling time and the availability of local services all affect whether healthcare is genuinely accessible.

These stories cannot be dismissed as a few unfortunate or isolated experiences. They reveal something much bigger.

The issues we have been witnessing within maternity care are whole-system issues. They affect services across women’s lives, and women and girls appear to be carrying a disproportionate share of the consequences.

The experience of early menopause

One particularly moving contribution came from a woman, who works in Matt’s office. She spoke about experiencing early menopause and the numerous ways in which she had been failed by health services.

Her story was a powerful example of why women need better information, better continuity and considerably more time than can usually be offered during a ten-minute GP appointment.

During the evening, one of the doctors spoke about the loss of oestrogen following menopause, describing it as “oestrogen-deficiency.”

She also discussed the benefits of local vaginal oestrogen for genital and urinary symptoms associated with menopause. These symptoms are collectively known as genitourinary syndrome of menopause, or GSM.

Local oestrogen can be enormously beneficial for women experiencing vaginal dryness, soreness, painful sex, urinary discomfort or recurrent urinary tract infections. It usually involves very low doses, with minimal absorption into the bloodstream.

However, I find myself questioning the language of “deficiency.”

Menopause is a natural and normal transition in a woman’s life. Are women being described as deficient because their hormone levels no longer resemble those of their reproductive years?

Aren’t our bodies just moving into a different phase, with different hormonal patterns and different needs?

Naturally occurring does not necessarily mean easy or harmless. Menopausal symptoms can be debilitating. Earlier-than-expected menopause can carry particular implications for bone, cardiovascular, sexual and emotional health. Women absolutely deserve access to effective medical treatments, including local oestrogen and systemic hormone replacement therapy.

But if menopause is presented primarily as a deficiency requiring pharmaceutical replacement, we risk turning a profound biological transition into another disorder of the female body.

What actually happens to oestrogen after menopause?

During the discussion, I raised something I had learned last year about the role of the adrenal glands in hormone production after menopause.

I was told that this did not happen and that the adrenal glands only produced testosterone.

I came home and looked at the research more closely.

The full picture is more nuanced.

The adrenal glands do not simply take over from the ovaries and begin producing large quantities of oestrogen. However, they produce hormones including DHEA, DHEAS and androstenedione. These act as precursors which can be converted into oestrogens within fat, skin, muscle, bone and other tissues.

After menopause, oestrone becomes the predominant form of oestrogen, rather than the ovarian oestradiol that predominates during the reproductive years.

The postmenopausal body therefore does not stop producing oestrogen altogether. The source, quantity and form of that oestrogen change. Some hormone production becomes localised within individual tissues, which means a blood test does not necessarily tell us everything taking place throughout the body.

“The adrenal glands take over oestrogen production” is too simplistic—but saying they play no part is also incorrect.

The key piece of information here is that the adrenal glands cannot be considered separately from the way a woman is living. When the body is under continual stress—not only emotional stress, but the physiological stress created by disrupted sleep, caffeine, alcohol, sugar, blood-sugar instability and constant exposure to hormone-disrupting substances—the whole endocrine system is affected.

These exposures can come from products we use every day, including cosmetics, cleaning products, plastics and microplastics, as well as contaminants within our food and water. When the body’s stress response is continually being activated, this can affect adrenal function and the wider hormonal pathways through which adrenal precursors are converted and used.

This is vital information. Before women are simply told that they are deficient and need pharmaceutical hormones, they deserve to understand the role of the adrenal glands, the interconnected nature of the endocrine system and the powerful ways that everyday lifestyle and environmental exposures may influence their hormonal health.

I will write another article soon about practical ways to support hormone balance and begin tuning into—and working with—our natural midlife transition.

Medication can be valuable without being the entire answer

This is not an argument for or against HRT or local oestrogen.

But there have been numerous times throughout medical history when treatments believed to be safe were later found to carry risks that had not initially been recognised. That does not mean we should refuse all medication. It means women deserve honest, evolving information about the benefits, uncertainties, limitations and possible risks of every option.

No medical treatment should be described as completely free of side effects. Local vaginal oestrogen has a strong safety profile so far, and very low systemic absorption, but it is still important to discuss a woman’s individual circumstances.

This is about informed choice—not telling women that medication is either entirely good or entirely bad.

Lifestyle means far more than “diet and exercise”

The importance of lifestyle was eventually acknowledged during the discussion - after I mentioned it.

There is an enormous body of practical knowledge that women deserve access to.

We can learn about the natural daily rhythms of cortisol and other hormones. Caffeine may work with the body’s natural cortisol rise earlier in the day, while consuming it later can disrupt sleep. Poor sleep can then affect mood, appetite, insulin sensitivity, stress tolerance and menopausal symptoms.

We can explore the importance of protein, particularly at breakfast; resistance exercise and weight-bearing movement; blood-sugar stability; adequate rest; time outdoors; alcohol consumption; nervous-system regulation; pelvic health and the health of the vaginal microbiome.

We also need to look beyond individual “healthy choices.”

Stress is not only something inside a woman’s mind. It can come from workload, financial insecurity, caring responsibilities, difficult relationships, unresolved trauma and being expected to hold everyone else together. It can also become embedded in habitual patterns within the body: how we breathe, brace, sleep, move and respond to pressure.

Women need opportunities to understand these connections—not so that they are blamed for their symptoms or told they can fix everything with yoga, but so they are not denied knowledge that may give them greater agency.

This cannot be covered in ten minutes

A ten-minute appointment may be enough to prescribe a treatment. It is rarely enough to understand the whole woman—particularly when she is told she may only discuss one concern, even though several symptoms may be connected.

That is why I became so interested in the conversation about community events.

Imagine local gatherings where women could learn about hormonal changes, menstrual health, fertility, pregnancy, birth, postnatal recovery, pelvic health, perimenopause and menopause before reaching a crisis point.

There could be clear information about HRT, local oestrogen and non-hormonal medical treatments, alongside conversations about nutrition, strength, sleep, stress, nervous-system health, pelvic health, relationships and the emotional and social experiences surrounding these transitions.

Women could hear the evidence, ask meaningful questions, share experiences and explore their individual options without being hurried towards one predetermined answer.

These events could be publicised through GP surgeries and developed collaboratively by doctors, nurses, midwives, bodyworkers, nutrition professionals, therapists and community educators.

Most importantly, they could bring women together.

When services are fragmented, appointments are unavailable and women are repeatedly dismissed, we need spaces in which women can share knowledge, witness one another’s experiences and offer practical support.

This should never be used as a substitute for properly funded, accessible healthcare. Women supporting one another cannot repair structural failures or replace qualified clinicians. But strong communities can reduce isolation, help women recognise when something is wrong and give them greater confidence to seek information, ask questions and advocate for themselves.

Medical knowledge is enormously valuable. So is the lived knowledge held by women and the wisdom that develops when women are given time to gather and speak honestly.

Last night demonstrated how much is waiting to be discussed.

Thank you to Matt Bishop and his team for beginning this conversation in the Forest of Dean.

I hope it becomes the start of something much larger: not simply better treatment for women, but a richer understanding of women’s bodies, choices and lives—and a stronger community of women able to stand alongside one another.