Menopause care for diverse communities: a qualitative study of GP clinician experiences

Background In the UK, there is increasing public awareness of menopause. However, there remain inequalities in its treatment, with lower hormone replacement therapy (HRT) prescribing in socially-deprived areas. Little is known about how health care professionals (HCPs) view and understand this. Aim To explore barriers and facilitators to the provision of menopause care in diverse communities through qualitative interviews with primary healthcare professionals involved in delivering care. Method We purposively sampled 15 HCPs working in patient-facing roles in areas of high deprivation in England (Midlands). 11 individual interviews and 1 focus group were conducted and subject to team-based iterative thematic analysis. Results Three key themes emerged; the context of contemporary primary care, delivering menopause care, and limitations of the current approach to menopause care. HCPs reported experiencing increasing awareness of menopause and request for HRT by women. Cultural and ethnic differences were perceived as impacting on whether women seek menopause care and/or HRT from their GP. HCPs believe women have high expectations of HRT and that discussions around expectations were important. HCPs emphasised the difficulty of remaining up-to-date on menopause care, limited ability to refer to specialists and the impact of patient requests for testosterone. Conclusion HCPs believe that differences in levels of menopause care across diverse populations experiencing health inequalities reflect differing demands from communities and a lack of time and funding to provide targeted community-based education on menopause and its treatment. Future work should include culturally sensitive and targeted health education for patients and HCPs.