Department of Health of Ireland

09/10/2021 | Press release | Distributed by Public on 09/10/2021 09:41

Minister for Health announces a new approach to menopause care for women in Ireland

Minister for Health, Stephen Donnelly TD, today announced his commitment to establish dedicated specialist menopause clinics across Ireland. These clinics will form a core part of a new approach to menopause care for women in Ireland and will be supported by enhanced community and primary care supports as well as the publication of targeted and trusted sources of information for women experiencing menopause. The development follows the advice of the Women's Health Taskforce and ring-fenced investment through the Women's Health Fund.

The first phase of change will include the development of a dedicated specialist clinic, in the National Maternity Hospital, Holles Street this year. The clinic will be multidisciplinary supported by GPs with a certified special interest in the area of menopause and clinical nurse/midwife specialists. In addition to seeing women who meet the clinical criteria for referral to the service, the clinical team will also provide advice and guidance to GPs in the community to support the effective management of menopausal symptoms for women closer to home within primary care.

Minister Donnelly said:

'Our first priority in the Women's Health Taskforce has been to listen to women. Through that process women across the country have shared their experiences of menopause and have asked us clearly to change our approach to supporting them. I am making menopause a priority within our women's health programme and I am proud to announce my commitment to fund this first dedicated specialist menopause clinic within public health system this year. This is as an important part of an integrated solution to delivering better health experiences for women before, during and after the menopause.'

It is intended that the clinic will begin to see patients in the course of 2021 and will be supported by the development of additional regional clinics in the course of 2022.

Dr. Peter McKenna the Clinical Director of the National Women & Infants Health Programme in the HSE has today warmly welcomed this development:

'Once operational, this clinic will significantly increase the support available to women going through the menopause. It will deliver benefits to primary care practitioners as women's main health partners through the menopause in terms of providing guidance and advice to them, and will provide specialist support for a number of women who require additional care, thereby helping to look after women throughout their lifecourse.'

The National Women's Council of Ireland who have been key partners with the department in leading the Women's Health Taskforce also celebrated the initiative:

'The menopause is a critical phase in women's lives and NWC members have continuously highlighted the need for a greater supports and treatments as women transition through menopause. The establishment of dedicated menopause clinics is a very welcome measure in recognising and addressing women's health needs and advances our health services towards the development of a comprehensive model of reproductive healthcare in Ireland.'

A 2022 plan for women's health is in development informed by engagement with women across the country, key stakeholders, clinicians, and advocates for women's health through the Women's Health Taskforce. It is intended the plan will be brought to Government and published later this year.


Women's Health Taskforce

Women's Health is a priority for this government as outlined in the Programme for Government's commitments to 'Promoting Women's Health'. A Women's Health Taskforce was established by the Department of Health to improve women's health outcomes and experiences of healthcare in September 2019 and following a recommendation from the Scoping Inquiry into the Cervical Check Screening Programme that women's health issues be given more consistent, expert and committed attention by this department.

Operating on a phased and prioritised basis, the Taskforce is looking at a range of issues impacting women's health. Based on the evidence and informed by women's perspectives and views, the Taskforce identified 4 initial priorities within its initial 2-year action programme:

  • improve gynaecological health
  • improve supports for menopause
  • improve physical activity
  • improve mental health among women and girls

The Women's Health Fund was put in place to support a programme of priority actions in these areas, based on evidence and extensive engagement with the HSE. To date it has supported:

  • two community-based Ambulatory Gynaecology Services governed by two acute hospitals (Tallaght University Hospital, and University Maternity Hospital Limerick, though located in Nenagh General Hospital). This project, with an associated cost of €1.415m, will see the establishment of one-stop 'see and treat' gynaecology clinics in the community in which women can be seen and assessed, following referral by their GP to the hospital's general gynaecology services. This service will address a clear and identified need, as gynaecology services are acknowledged and recognised as being a service area that continues to be under significant and growing pressure. These one-stop-see-and-treat clinics will play a significant role to improve access to gynaecology, reducing waiting times and improving clinical outcomes for women
  • the expansion of the endometriosis service at Tallaght University Hospital (TUH), with an associated cost of €641k, will deliver a specialist endometriosis centre for the management and treatment of all forms of endometriosis, with particular focus on advanced and complex cases for which there is no ready access in Ireland. Endometriosis is estimated to affect 1 in 10 women and represents one of the top four categories of symptoms that comprise approximately 80% of gynaecology referrals. The provision of a secure, supported, expanded and specialist service in Tallaght University Hospital will help to improve both clinical outcomes and overall care experience for women suffering from this debilitating condition

The Department of Health and our Taskforce partners the European Institute for Women's Health, the HSE including the National Women and Infants' Health Programme, The National Women's Council of Ireland, The Irish College of General Practitioners, The Institute of Public Health, and the Department of Children, Equality, Disability, Integration and Youth will continue to listen to women and girls and work with them in the design and delivery of health and social care, and to promote a coherent, holistic approach to improving health outcomes and experiences for women and girls.

Maternity and Gynaecology Service Developments

The government is committed to promoting and improving women's health outcomes, as highlighted in the Programme for Government and underlined by the commitment, under Budget 2021, to provide €12m in funding for new developments in maternity and gynaecology services. This significant investment will help ensure a renewed impetus to the implementation of the National Maternity Strategy and help improve gynaecology services, for example, by accelerating the roll out of the Ambulatory Gynaecology Model of Care through the establishment of additional clinics in 2021.

Details of the Clinic

Funding of €157,000 has been allocated for the provision of specialist menopause care for women, supported by the Women's Health Fund under the Women's Health Taskforce.

This dedicated specialist clinic, to be established in the National Maternity Hospital, will be the first of its kind within the public hospital system, and will accept GP referrals from within the catchment region of the National Maternity Hospital. This clinic, which will be delivered by general practitioners with a certified special interest in the area of menopause, will also provide advice and guidance to general practitioners regarding the management of menopausal symptoms within primary care.

The specialist GPs working under the governance of the National Maternity Hospital will also have direct access to escalation pathways for women who require additional investigations and management from other healthcare professionals including consultant gynaecologists, ultrasonographers, and pelvic floor specialists.

While the majority of women who seek support for their menopause can be effectively supported within primary care by their general practitioner, approximately 25% of symptomatic women will require specialist medical expertise in menopause. Specifically, this cohort of women will fall within four broad categories:

  • treatment does not improve their menopausal symptoms
  • they have ongoing troublesome side effects, for example: bleeding
  • they have contra-indications to HRT; and
  • there is uncertainty about the most suitable treatment option for their menopausal symptoms, for example: complex medical history

This clinic will accept referrals from GPs based on the four criteria identified above, with a view to this cohort of women being provided with specialist medical advice and management regarding their menopausal management.