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New menopause drug approved for use by NHS in Scotland

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A new menopause drug has been approved for NHS use in Scotland, offering a non-hormonal option for women who cannot take HRT.

The Scottish Medicines Consortium has recommended that women can now be prescribed fezolinetant, also known as Veoza, for symptoms such as hot flushes and night sweats.

Some women cannot take HRT, leaving them with limited treatment options for symptoms that can be severe and long-lasting.

Dr Timir Patel, medical director of Astellas UK, said the company was “pleased that this important additional treatment option will be available to women in Scotland, helping to support more personalised care for those experiencing hot flushes and night sweats”.

Fezolinetant works by selectively blocking a neurotransmitter in the brain involved in triggering hot flushes.

Clinical trials have shown the drug can reduce both the frequency and severity of hot flushes and night sweats.

About 400,000 women in Scotland are said to be of menopausal age, with manufacturer Astellas Pharma Ltd saying up to 48,000 could benefit from the treatment.

Dr Rob Peel, chair of the Scottish Medicines Consortium, said: “We know that menopausal hot flushes and night sweats can substantially affect quality of life.

“For those who cannot take HRT, effective treatment options are limited. Fezolinetant provides a non-hormonal treatment option, and we know our decision will be welcomed.”

Dr Kay McAllister, consultant gynaecologist and clinical lead for menopause services at NHS Glasgow and Greater Clyde, said: “Today’s decision marks a positive development for the wellbeing of Scottish women.

“In clinical practice, I see how hot flushes and night sweats impact sleep and overall quality of life in my patients.

“The availability of this targeted treatment offers a welcome choice and further options for patients.”

Menopause

Quarter of women miss work due to menstual symptoms, survey finds

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Nearly a quarter of women often miss work because of menstrual symptoms, according to a survey examining hormonal health among women in full-time work in Ireland.

The survey looked at the impact of menstruation, fertility and motherhood, and perimenopause and menopause.

Research from The Menopause Hub found more than one in three women who had not disclosed a menstrual health issue at work said the lack of a clear workplace policy was the reason.

More than a quarter said they did not think their concerns would be taken seriously, while 22 per cent cited embarrassment and 18 per cent feared being judged.

Nearly half of respondents said better workplace support would have made them feel less stressed, while 40 per cent said it would have made them feel more valued. Some 36 per cent said they would have felt more comfortable speaking up.

Some 76 per cent of women surveyed said they experienced menstrual health issues, with 23 per cent of those often missing work because of symptoms.

Nearly half of respondents, 49 per cent, said they felt uncomfortable talking about menstruation at work.

One respondent said: “As a woman, we try to get through the day, sometimes in pain that can’t be seen. We feel emotionally and physically drained.”

The research also found that 62 per cent of those who experienced baby loss reported a moderate or significant impact on work attendance.

More than half of respondents who experienced depression during pregnancy also reported a moderate or significant impact on attendance.

Some 63 per cent of mothers said it was “difficult” to return to work after pregnancy, while nearly half said their maternity pay arrangement had negatively affected their financial wellbeing.

One respondent said: “I almost walked away. The only reason I stayed was because I had to provide for my family.”

The survey also found that nearly half of respondents said menopause had some impact on their attendance, while more than six in 10 reported an impact on their work performance.

Some 44 per cent of women said they were “uncomfortable” discussing perimenopause and menopause at work.

One person said they were “already terrified of losing my job at my age:

“I need to just struggle through this without support or acknowledgement. That’s basically workplace discrimination.”

The Menopause Hub chief executive Loretta Dignam said women’s hormonal health has been treated as a “private or personal issue” for too long, “when the reality is that it has a very real impact on women’s working lives”.

“The fundamental point is that women are not ‘mini men.’

“Our biology is different, and workplaces that were largely designed around a male model of health and working life need to evolve to recognise that.

“What is striking is how many women continue to show up, perform, push through and progress at work while managing significant physical and emotional symptoms, often without the policies, understanding or practical support they need,” Dignam said.

She added that because expectations are changing, Gen Z and Gen Alpha employees will be “far less willing than previous generations to accept workplaces that ignore their health and wellbeing”.

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Pregnant women told to avoid runny eggs amid salmonella outbreak

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Pregnant women are being advised to avoid runny or under-cooked eggs when eating out amid a developing salmonella outbreak.

The advice also applies to freshly made products that may contain uncooked eggs, including mayonnaise, soufflé and hollandaise sauce.

The FSA said well-cooked eggs served in restaurants, cafés and takeaways remain safe to eat.

The warning follows the UK Health Security Agency declaring a national outbreak of salmonella food poisoning after one person died and hundreds more fell ill.

Imported eggs or dishes containing them are thought to be behind the outbreak.

FSA chief scientific adviser Ian Young said: “If people are eating out or consuming eggs or egg-containing products from cafes and restaurants then for those people in particular who are young, elderly, pregnant or vulnerable, it’s important to make sure that any eggs or egg products that you consume in those settings have been very well cooked.”

He described the outbreak as “unusually large and rapidly increasing”, adding that “people need to be careful”.

The FSA said British eggs bought from supermarkets are not linked to the current outbreak because chickens bred in the UK are vaccinated against common strains of salmonella.

“There is no link to those eggs to this current outbreak,” Young said.

Mark Williams, chief executive of the British Egg Industry Council, said British eggs were safe to eat when runny, including for vulnerable people, and were widely available in restaurants and cafés.

“Customers who want to enjoy a runny egg should simply ask whether British Lion eggs are being used,” he said.

More than 200 cases in the UK have been linked to the outbreak, with the majority across England.

Genetic testing suggests the infections are part of the same outbreak and show similarities with previous outbreaks involving imported eggs.

Investigations into individual cases also suggest the eateries involved were buying eggs from abroad.

Salmonella are a family of bacteria that typically live harmlessly in the digestive systems of animals including cattle, pigs and chickens, which is why eggs and poultry are among foods commonly associated with infection.

People can become infected by eating contaminated food that has not been properly cooked, through cross-contamination between raw and cooked food or by coming into contact with infected animals.

Symptoms can include stomach cramps, diarrhoea, vomiting and fever.

Most people recover without further treatment, but older people, babies and people with weakened immune systems are at greatest risk of severe illness.

Hospital treatment with fluids and, in some cases, antibiotics may be needed for severe infections.

People who are concerned are being advised to contact their GP or out-of-hours service in the first instance.

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Insight

Study to tackle years-long delays in endometriosis diagnosis

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A study is examining where delays occur in diagnosing endometriosis  – a condition that can take seven to twelve years to diagnose.

Endometriosis affects an estimated 1.5 million women and people in the UK, but there is currently no consistent way of measuring where and why diagnostic delays happen.

The research aims to develop the first standardised framework for understanding the diagnostic journey and identifying points where interventions could improve care.

The international project involves researchers from the University of Sheffield, University of Liverpool, University of Oxford, Aarhus University in Denmark and the University of Edinburgh, alongside Endometriosis UK.

Dr Rebecca Mawson, NIHR clinical lecturer in primary care at the University of Sheffield, is part of the research team.

She said: “Our project asks: where exactly are people getting lost or let down on their journey to diagnosis, and how can we map those points in a systematic way to identify where interventions could make a real difference.”

The project is led by Dr Babu Karavadra, NIHR academic clinical fellow in general practice at the University of Liverpool, who has been awarded a World Endometriosis Society Early Career Investigator Award as lead principal investigator at the University of Liverpool.

Researchers will review existing evidence, gather experiences from people living with endometriosis and bring together an international panel to map the diagnostic pathway and agree common definitions for key points along the journey.

The work will focus particularly on people whose experiences are often missing from research, including Black women, people living in rural or deprived areas, LGBTQ+ communities and disabled people.

Primary care will also be central to the research because it is often where people first seek help with symptoms.

Mawson said: “Primary care needs to be at the heart of this work. Primary care is often where people first seek help with their symptoms, so it has a crucial role in understanding diagnostic delay.

“If we only look at what happens once someone reaches specialist gynaecology, we risk missing some of the barriers that shape the journey long before that point.”

Unlike cancer research, where internationally recognised standards exist for studying diagnostic delays, endometriosis research has been more fragmented, with studies measuring different parts of the diagnostic journey in different ways.

The researchers hope to create an ‘Endometriosis Diagnostic Pathway Framework’ to help identify where people are falling through the gaps and where healthcare could be improved.

They will also develop a ‘Snakes and Ladders’ style visual representation showing how systemic barriers, chance and individual experiences can influence whether someone reaches a diagnosis.

The project forms part of the PEARL network, Primary care Endometriosis and Adenomyosis Research and Learning, an international collaboration of primary care and community researchers and clinicians.

Mawson said: “Endometriosis diagnostic delay isn’t inevitable. If we can understand where and why people are experiencing barriers, we have a much better chance of designing interventions that actually make a difference.

“The scale of the problem demands that we look at the whole journey, listen to the people experiencing it and build an evidence base that can lead to real change.”

The framework could provide the foundations for future research, clinical guideline development, healthcare professional training and NHS service improvements, with potential applications to related conditions such as adenomyosis and chronic pelvic pain.

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