Menopause: A Family, Social and Healthcare Issue Hiding in Plain Sight

By Dr Lucy Steed GP with Specialist Interest in Menopause, Lifestyle Medicine Advocate

As parents, we want to be inspiring, dependable, and emotionally present—an anchor for our children. But when menopause enters the equation, especially during the already demanding years of raising a family, that ideal can begin to unravel.

This is a scenario I witness frequently in my role as a GP and menopause specialist. Increasingly, women are having children later in life, which means many are navigating school runs, sleepless toddlers, or teenagers while also entering perimenopause. And it’s not just the women who are affected—the impact spills over into the whole family, not least children.

The Hidden Casualties of Menopause at Home

Low mood, anxiety, irritability, and exhaustion are symptoms I see every week in the women I care for. When left unsupported, they affect not only how a woman feels—but how she shows up in her relationships. Many women speak of a deep sense of guilt: for snapping at their children, for lacking the energy to engage, or for simply feeling absent from moments they used to enjoy. In many cases, children are left to navigate an emotional storm without a map.

It’s also important to say—this isn’t only about hormones. For many women, this life stage collides with a cascade of competing pressures: demanding jobs, caring for children and ageing parents, financial strain, and more. Women are often stretched thin long before perimenopausal symptoms even begin.

My Personal Stake in the Conversation

My own childhood was shaped by my mother’s complex mental health journey. She experienced her first manic episode in her early 40s and went on to be diagnosed with bipolar affective disorder. I clearly remember that hormones were briefly considered at the time, but the idea was quickly dismissed after a single blood test.

It wasn’t until some years after I had qualified as a GP, and when I began learning properly about menopause, that the pieces came together. I now have a deep conviction that her hormones played a much larger role than anyone acknowledged at the time—and that her suffering, and ours, could have been eased had the system understood more.

Today, I’m a widowed parent raising two young boys, and I know that my own perimenopause is not far off. Given my family history, the thought of going through it can sometimes feel frightening. But unlike my mum, I have access to knowledge, support, and options. I’m in many ways in a privileged position—and I’m acutely aware that many women are not. That weighs heavily on me.

A Voice for the Women Who Can’t Pay Their Way

I was educated at a comprehensive state school, and then trained in Birmingham, an ethnically and economically diverse city which deepened my understanding of health inequality and the importance of accessible care. I have now worked as a doctor in the NHS for more than 15 years, but over the past three years working in private menopause care has shown me how fragmented and inconsistent menopause support can be—particularly for those without the means to go private. I’ve always felt most driven to serve those who cannot afford to go private or pay for help.

I know what it’s like to sit opposite a woman in tears who’s tried everything—diet, exercise, stress reduction—but still feels like she’s losing herself, and yet she can’t access the HRT she needs because her GP lacks the training or confidence to prescribe it.

I also know how deeply socioeconomic factors influence health. Women in deprived communities are more likely to be misdiagnosed, more likely to go without treatment, and less likely to have the time, flexibility, or support to research their symptoms—let alone advocate for themselves.

That’s why the postcode lottery around menopause care is not just unfortunate—it’s unjust. And it’s why I’m such a vocal supporter of initiatives like the Menopause Mandate campaign to include menopause in the NHS 40+ Health Check. Because this is one of the few tangible opportunities we have to catch women early, particularly those who might otherwise be left behind.

Lifestyle Medicine Isn’t a Luxury

I’m a strong believer in the power of lifestyle medicine—nutrition, movement, sleep, social connection and stress reduction—to ease symptoms and build resilience. But we have to be realistic: these tools cannot replace HRT, nor should they be used to gatekeep care.

What lifestyle medicine can do is help create calmer, healthier family environments. When women sleep better, move more, eat well, and feel connected, they parent more steadily and with greater emotional bandwidth. That’s good for children—and it’s good for public health.

But again, access is everything. Lifestyle medicine must be delivered in an inclusive, culturally sensitive way that doesn’t assume time, money, or a personal trainer. Otherwise, it’s just another inaccessible fix.

We Need a National Menopause Service in Primary Care

We need a standardised, fully funded menopause service across NHS primary care, led by trained and confident professionals. Thankfully, with increased awareness and campaigns in recent years, there is now a growing number of GPs with the knowledge and expertise to deliver high-quality menopause care. But many still struggle to find a place for this work within the NHS in a meaningful or supported way—resulting in a steady drift toward the private sector, where time and resources are more accessible.

Beyond the emotional and social impact, menopause also carries significant medical risks that are too often overlooked. Falling oestrogen levels increase a woman’s long-term risk of cardiovascular disease, osteoporosis, and metabolic conditions. These are not abstract threats—they are leading causes of disability and death in women. Addressing menopause proactively isn’t just about quality of life; it’s about prevention, early intervention, and protecting women’s long-term physical health.

This isn’t just about women’s wellbeing—it’s about the emotional stability of families, the security of our children, the sustainability of our workforce, and the long-term health of our communities. If the NHS is to uphold its promise of equitable care, it must treat menopause as a critical and integrated part of the healthcare landscape—not a side concern or afterthought.

Children Must Be Part of This Conversation

Parents often ask how to talk to their children about menopause. The best advice is: be honest, be simple. Tell them your body is going through changes, that it can make you tired or grumpy, but it’s not their fault—and that you still love them just the same.

We also need to equip schools, teachers, and early years workers with basic knowledge of perimenopause and menopause—not only to support the colleagues, families and children they work with, but also to recognise and manage these changes in themselves, as members of a workforce that forms the very foundation of our society. If we’re serious about early childhood wellbeing then menopause support must be part of the package. Because a parent in crisis can’t always meet their child’s needs, no matter how much love is in the room.

Conclusion: For Women, For Families, For the Future

We’ve made progress in awareness—but awareness isn’t enough. Now is the time for decisive action: standardised training, equitable access to support, and a proactive model of care embedded in primary practice.

Menopause is a defining life stage—one that carries implications not just for individual women, but for families, workforces, and public health as a whole. It deserves a national response: whether through inclusion in the NHS 40+ Health Check, or through a dedicated menopause education and care strategy built into the core of the NHS.

Let’s make sure every woman—regardless of postcode or income—is seen, supported, and empowered at this critical stage in life.