 The final item of business this evening is a member's business debate on motion 6225 in the name of Siobhan Brown on World Menopause Month. This debate will be concluded without any questions being put. I would invite members who wish to participate to press the request to speak buttons or place an RTS in the chat function if they are joining us remotely. I call on Siobhan Brown to open the debate for around seven minutes, Ms Brown. Thank you, Deputy Presiding Officer. Can I start by thanking everybody that supported this motion? This is such an important issue that affects so many and I'm really looking forward to hearing everybody's contributions today from across the Chamber. Menopause, the change of life being a woman of a certain age, just some of the terms to describe a time of life that happens to every woman regardless of race, colour, social status or background. 51% of Scotland's population are women who will go through this and some are lucky enough to breathe through it but others have some negative experiences. Generally happens between the ages of 45 to 55 when periods stop due to hormone levels dropping and the phase before that is called perimenopause. That's where you can have night sweats, hot flashes, joint pain, migraines and trouble sleeping and that's just some of the physical symptoms. Add to that the mental fog, anxiety, panic attacks and depression. Historically the menopause and indeed perimenopause has been rarely talked about. It was mentioned with embarrassment in hush tones and most certainly never discussed in public or around men. It was a taboo subject and it leaves women with questions and sometimes ones without answers like what are the symptoms, how do I know if I'm going to go through menopause, what help can I get and that is until now. The conversation has started and it's been branded the divina effect. Celebrities and those in the public eye like Divina McCall have been sharing their experiences of menopause symptoms and treatments and Divina and like those like her such as Penny Lancaster, Carol Vorderman and our own First Minister has become increasingly willing to share their stories and be part of the wider menopause movement down south, challenging the notion that women should not just shut up, pull up and carry on. The conversation for me starts on a very personal note as I've just recently started menopause treatment and to be honest I only investigated this after having discussions with colleagues. I'm 51 and I now believe I've been perimenopausal for several years without actually even knowing it. About four years ago I started to get pain in my lower back which would wake me up at night and every morning when I got up I was totally crippled. As the day got on things got better but the pain always returned at night so I went to the doctor, I even had an MRI scan and everything came back clear. So in the end I just put it down to getting older and just learn to live with the pain. I also didn't feel like myself. I wasn't the person I used to be, I didn't have the energy I once did and I felt sometimes I was always on this constant low. I put it down to age and I dismissed it as maybe being the stress of being in politics. I mean how stressful it can be being in politics at times. A few months ago I made an appointment at my local surgery to discuss treatment for menopause and I was lucky that my GP did recognise the symptoms straight away and the treatment plan was put in place. It's still really early days for me but the first thing I noticed after one night was my night pain improved instantly. When you wish I'd known more about the symptoms and asked for help sooner. And it's worth stressing that HRT isn't the answer for everybody. There is no one size fits all solution for menopause. And since the diagnosis I've heard from many women who've experienced the same as me, symptoms that are just put down to age they're never recorded and just pushed aside. Women who were struggling through each day who were miserable, anxious in pain thinking they had dementia or arthritis and who believed that, you know what, this is just my lot. Last weekend I was actually speaking at a local ladies event in Presswick and menopause was definitely a hot topic of the day. One local lady who's a local dentist told me that she'd gone to a doctor and was diagnosed with stress. And after perseverance it wasn't stress and she was put on HRT for menopause. But I have to highlight this because when she renewed her income protection insurance her premium went up because of this misdiagnosis of stress. So this should not be happening. And in August last year we welcomed the implementation of the women's health plan which outlined ambitious and bold plans to improve health and reduce inequalities for women in Scotland. This is great and it's so important. I'm going to tell you personally a really flippant remark from a doctor in Australia many years ago that haunted me for a long time. When I was 27 I was diagnosed with polycystic ovaries. I remember being told by the doctor that you're probably not going to have any kids in just a really dismissive way. And when I sort of questioned this I said, what do you mean I won't have any kids? And he said, well are you planning on having kids? Do you even have a boyfriend? And if not you better hurry up. So I did have a boyfriend at the time but this dismissive attitude had a huge impact on me for years afterwards thinking I was never going to have children. Thank God he was wrong and I went on to have my three children because it was always part of my plan. So that was a long time ago but it shows how important women's health issues were so misunderstood and just were not a priority. And in the women's health plan the priority for menopause was to ensure there is access to specialist services for advice and support on the diagnosis and the management of menopause. And in October last year the Scottish Government launched the NHS informed menopause information platform to burst miss highlight symptoms and treatment and that support is in place. And more than a year later in terms of menopause there is a specialist service in each mainland health board. It will be remiss of me to ignore the issue of menopause and the workplace as an employer since majority of my staff are women between the age of 45 to 55. 320,000 women in Scotland are that age and that's a working age for many. And I recently attended the launch of Let's Talk about Menopause which was hosted by NHS Ayrshire and Arran at Crosshouse Hospital. It's one of the largest employers in the area and it's actively putting in menopause support for its staff. Half of the staff of NHS Ayrshire and Arran are women over 45. And this is an age as we know that menopause symptoms manifest for the vast majority and they can last up to 12 years. And a final point I would urge women to act, seek help, seek advice, seek treatment. I want to remind employers to show compassion and understanding for those women. There's no one size fits all approach to menopause. What works for me may not work for you. My symptoms might not be the same as yours. That's why we have to have a meaningful dialogue and when menopause awareness month comes around discuss it and keep highlighting all these issues. The main message I hope you take from today is that it's good to talk about this to friends, to family in the workplace and to seek professional help. It is out there to help. The genie is out of the bottle and it's time we women of a certain age told our stories. Thank you, Ms Brown. I now call Karen Adam to be followed by Pam Goswell for around four minutes. First I want to thank my colleague Siobhan Brown for bringing this motion to the chamber. Social stigma and misogyny has resulted in the menopause being traditionally under discussed or marginalised despite the fact that affects almost all women at some point in their lives and impacts upon their health, economic and social equality. In recent years however there has been a greater focus on the issue, led by women of course, talking about their experiences with the resulting changes in policy, understanding and practice. But we must go much further. In the workplace and outside of it there should be a legal, moral and ethical responsibility upon organisations, whatever their nature, towards creating a menopause confident environment. The evidence suggests that those who do retain their talent. This is extremely important at the moment as we face a labour shortage in key sectors which are usually a majority of female staff. Responses to a recent survey included that one collated over 2,000 responses and they found that 31 per cent of respondents reported taking time off work due to menopause symptoms, which included problems with memory or concentration, anxiety, depression and headaches. Despite that, less than a third of respondents told anyone at work and just under 11 per cent requested adjustments in the workplace due to their symptoms. Those who did not request adjustments said that they were most likely not to do so as a result of stigma. With 26 per cent citing the reason was, I was worried about the reaction of others. The stigma is still very apparent. The Scottish Government published its women's health plan in August 2021. The plan addresses health inequalities for women and lists the menopause as a priority area with an objective to ensure that women need it. We will have access to specialist menopause services for advice and support on the diagnosis and management of menopause and that a menopause and menstrual health workplace policy is set as a goal. Many of us here will know only too well the limitations of their own social education at school or in the home. They were never really explicitly talked about it in school and many parents didn't talk about it out of shame or simply not thinking that it mattered. The advantage of young people learning about the menopause is that it can hopefully start a conversation at home and get parents thinking about what they might be about to go through themselves. It will open up conversations between mothers and daughters, grandmothers and aunts who will begin to share their own experiences openly with confidence. It is a part of many women's lives. Please teach us as girls. I have had meetings with engender who have previously reported that their own findings on the menopause stigma that just under 60 per cent of women suggested they did not feel supported even by medical professionals, which was higher than those who did not feel supported by their employers or friends and families, but the most common reason for a lack of support from friends and families included a lack of understanding. In conclusion, to speak to the women, we have a tendency to carry on through and, as my colleague Siobhan Brown said, to put up and shut up. It's time we gather, as we are here today in this chamber, and assure we are talking openly about our experiences, our symptoms and the consequences, much like my colleague Alina Whitham did earlier. We shouldn't be red-faced about this, unless it's a flush, of course. Thank you. Pam Gozel, to be followed by Evelyn Tood again, around four minutes. I am honoured to be speaking in this debate on behalf of the Scottish Conservatives today. I would like to thank the member Siobhan Brown for bringing forward this debate on such an important topic and sharing her experience. It's never easy to talk about something as personal as this, particularly something that can make you feel uncomfortable in your own skin. For some time, I was reluctant to speak about it myself. It's not always easy to speak about the symptoms of menopause. It's not very appealing to speak about the hot flushies, the sweats, the sudden onset of cramps, the body aches, the brain fog and much more. Naturally, it's far easier to avoid this topic, but I've heard the horror stories of women who have had a different experience to me. Women who have almost taken their own lives because the depression had affected their mental health so much. Nobody should feel like this. There is still a real reluctance to be frank and candid about what women go through with menopause. I am also very aware that in BAME communities speaking about menopause is a taboo. People are still very apprehensive. Elders in the Asian communities don't see it as something to share, but I think it's really important that we all share our experience if we are able to. Let me be open about how menopause has started to affect me, because you never know who out there needs to hear that someone else is going through it too. It will be okay even if the journey is tough. For me, this is menopause. It feels like being a stranger in your own body. I've looked in the mirror and I don't recognise myself. Everything is changing so fast. It's out of control. My biggest fear is how menopause will impact how I do my job here. What happens if I get a hot flush while I'm in the chamber speaking? What happens if my brain turns foggy during a debate? The lack of control can be difficult to accept and even more difficult to speak about. The changes in your personality and in your mood can be really unsettling and unpredictable. It leads to you wondering which part is the menopause and which part is really you. As a society, we need to be better at accepting and understanding menopause and improve the support offered to 400,000 women in Scotland who are menopausal, organisations such as Scottish Menopause Warriors, argue that there is still a postcode lottery for menopause care. There is a real inequality in the treatment available depending on where you stay. Many women are still waiting months and for much needed treatment. The appointment of a women health champion is long overdue and I hope that the Scottish Government will appoint one very soon. In conclusion, I hope that today's debate will spur the Government on to act more. I hope that it will mean that the inequality of menopause and perimenopause treatment is seriously examined. I sincerely hope that the stories and truths that we have shared today will help someone, even one person who is going through this and is struggling. To do so, we cry and not talk but action. Eveline Tweed is followed by Stephanie Callan in around four minutes. I thank Siobhan Brown for raising this debate and for sharing her experiences as others are tonight. At an event in the summer of 2018, my daughter said to me urgently, mum mum, you must stop fanning yourself, you look unhinged. I actually had no idea I was doing this but I was extremely hot and I actually felt that my head was on fire. And boom, the menopause had arrived. Over the next few months, the hot flushes, as these are known, got worse. I was anxious, jittery, unfocused, had insomnia and mood swings. The menopause usually occurs between the ages of 45 and 55 and symptoms like mine are common and can last for up to 10 years. But everyone is affected differently. I went to my GP for help early, but for some women this process is very difficult. Last year, Bupa found that just under half of those affected said that they had never visited their GP for help due to factors including a lack of awareness and embarrassment. Whilst menopausal women are the fastest growing demographic in UK workplaces, 900,000 women have left their jobs due to a lack of support. Research has found that women in better paid jobs are actually better supported through the menopause but there is little data available on the experience of women in low-paid or manual jobs, despite the fact that these women account for more than half of the all-working women in the UK. There is also a lack of research into how women of colour experience menopause and the barriers that they face both in the workplace and when accessing healthcare. This all contributes further to health inequality at a time when women living in the most deprived areas of Scotland experience 25 fewer years of good health than their counterparts in more affluent areas. Businesses cannot afford to lose experienced and talented women from the workforce at any level and more support is required if we are to achieve better health outcomes for all women in Scotland. Awareness raising has achieved a great deal in recent years with 500,000 more women like me now receiving HRT or hormone replacement therapy and I would say that it's not a panacea, not all the symptoms go away. This is in part due to open conversations from influential individuals such as Davina McCall and Nicola Sturgeon. However, it must be noted that whilst prescription rates have doubled in more affluent areas, poorer areas are lagging behind. After the menopause, estrogen levels drop, increasing the risk of osteoporosis and bone breakages. This is serious but it can be managed through HRT. There are generally no specialist menopause services with women being placed on extremely long gynaecology waiting lists. I therefore welcome the Scottish Government women's health plan. It sets out steps for menopause specific services and much needed advances in this area. Scotland again leads the way and is the first country in the UK to implement such an ambitious plan. The underpinning principles include addressing inequalities and responding to unjust and avoidable differences in people's health. I am pleased that this topic is generating such an open debate tonight and I look forward to the Scottish Government's goals for menopause being realised. I think I've just had a hot flush myself. Thank you. Thank you, Miss Tweet. I now call Stephanie Callaghan who joins us remotely. We'll be followed by Carol Mocken. Miss Callaghan, I think your microphone is on but you will maybe have to turn your camera on as well for around four minutes. I'm trying to turn my camera on. That's you coming through on audio and on video. Around four minutes please Ms Callaghan. Thank you, Presiding Officer. Thanks to my colleague Siobhan Brown for bringing womenopause to this chamber. I think that women make up for half of our population and we need to be open and bring ways to support them through this stage in their life. It's vital that we raise awareness for menopause and perimenopause too and we support options to improve the health and wellbeing for women across Scotland so that women's health plan is really well-come-progressed. In that same spirit of openness, I'm attending remotely today because yesterday I underwent a hospital procedure related to menopause and I readily admit that I'm not exactly feeling my best but, like most women, I came to work despite that and I have tried to do my best throughout the day. Talking to women in communities across Ardenstone, Baleshill, I've listened to their stories, shared my own experiences and the message that no two women's experiences of the menopause are the same comes through loud and clear every time. Today my message to women, like others today too, is that we should be open and speak out and that being aware of symptoms is the first step in managing them. Common symptoms can include, and I know this is repetition, but women do need to know and take this in. It can be brain fog and memory issues, difficulties sleeping, fatigue, hot flushes, joint aches, lost of sex drive, low moods, anxiety, migraine, night sweats, vaginal dryness or pain but a quick google lists a huge range of symptoms with some websites listing over 60 of them. So go look at it and know what you're dealing with. Recent findings show that although not completely risk free, HRT remains the most effective solution for helping with symptoms of menopause and it's also effective for the prevention of osteoporosis and possibly heart disease too. Here's some statistics to consider. Three in five women experiencing menopause say it negatively impacts their work but most feel unable to get proper support. The Faucet Society reports that one in ten women has left a job due to menopause symptoms. 41% of UK universities do not have mandatory menopause education in the curriculum that's training medical schools and a study by News and Health highlighted that 79% of women's surveys had visited the GP regarding clearly menopausal symptoms yet only 37% were given hormone treatment therapy and 23% were given antidepressants. Certainly things are improving in recent years but sadly the vast majority of women going through menopause reporting no employer support, no policies, no awareness and no training. I hope this debate really encourages more employers to think about introducing a menopause policy. Presiding Officer, HRT is seen as the gold standard replacing our hormones using symptoms and protecting our bodies. Thankfully HRT is increasingly available more widely and I urge all women to speak with their GP about whether HRT may help with their symptoms but for some women things are not straightforward. I spoke to a woman who reached perimenopause at 44 years old and was tested for a load of other conditions before menopause was even considered as a possibility. She said, The gynaecologist that examined me internally was really annoyed when I refused the coil and went for the HRT patches. Asked me several times if I was sure and made me feel really stupid for not agreeing with her. It was scary being tested for cancer before they even tested my hormone levels and delayed my treatment. Eventually that woman did get help from a male GP that she describes as brilliant. My own journey has been complicated too with a history of endometriosis and much scarring, but my experience has been better and I'm still hopeful that HRT will be a possibility for me. It's a bit scary to think it might not. I want to thank my GPs for their support. A few of them have all been incredibly helpful and incredibly knowledgeable. I want to thank my colleagues in this chamber for their understanding and thank my office team especially for the support they've given me. I also want to thank, last but not least, the four women involved in my procedure yesterday. They were absolutely amazing and nothing short of brilliant. In closing, every menopausal woman deserves our support at work, at play and at home. We as women need to speak out and we need employers and everyone else to listen. So no more taboo, no more stigma, no more suffering and silence. Please step up to support women through the menopause and know that we will really, really appreciate it. Thank you. Thank you very much, Ms Callaghan. Thank you also for being in the vanguard of using our new hybrid technology. I now call Carl Mocken to be followed by Eleanor Whitham again in around four minutes. Thank you, Deputy Presiding Officer. I also thank Colin Brown for bringing this important debate to the chamber. On behalf of Scottish Labour, I welcome the World Menopause Society designating October World Menopause Month, aiming to raise awareness of the menopause. I want to also, on behalf of Scottish Labour, reiterate we welcome the women's health plan and we have also pushed for action on women's health throughout this Parliament and indeed the last Parliament. It's of course very welcome that women's health and health issues such as menopause once avoided in public discussion is receiving some of the spotlight it deserves in the chamber tonight. I thank and admire the women who have shared their stories across the chamber this evening. We have heard that it's estimated that about 13 million women in the UK are either peri or menopausal at any one time, a massive number of women. Menopause is a major life event marking the end of the reproductive life cycle and for many women, as we have heard, experience very troublesome symptoms related to menopause and often for a number of years. This can have a detrimental impact on their quality of life, wellbeing and many also have a significant impact on personal relationships and as we've heard I'm very pleased to see a number of times in the workplace as well. Considering all the symptoms that have been raised by other members it is vital that people in my position and our positions speak up for those who are perhaps unable to do so. As Siobhan Brown mentioned, some of the celebrities have really come to the fore and put effort into making sure that we can discuss these issues more openly. I know from my constituents that the stigma surrounding menopause, menstrual and reproductive health are just a few of the ways in which women like the celebrities, like ourselves, feel that we can move forward and that considering them in a modern Scotland is very important. We have seen change but I think some women do report to me and it sounds like to other members that it can feel like a bit of a snail's pace. For the last few minutes of my time I'd like to concentrate my remarks on menopause in the workplace. Every single one of our female colleagues will go through menopause. Menopause we have heard is not a new issue but if we are absolutely honest with ourselves it's a relatively new issue discussed openly, particularly in relation to workplace matters. I think that's why a number of the women have already raised that issue this evening. The STUC's Women's Committee did some pioneering work in 2019. Women were asked a number of questions across the workforce and women responded to a number of questions and some of the results really highlighted the need to make menopause in the workplace a more visible issue. In summary women said that they often find managing their menopause symptoms in the workplace extremely challenging. Coping with symptoms in the workplace can be hard especially as many women find it so difficult to discuss. Some of the statistics that came out is that 99% of the respondents either didn't have or didn't know if their workplace had any menopausal policy and 63% said that menopause had been treated as a joke within their workplace. I think that it is important that we are talking about these issues and that it makes women more confident to speak out if that happens to them in the workplace. At today's 95th annual STUC Women's Conference trade union delegates highlighted women's health as a workplace issue. I'm sure the member will want to join me in supporting the STUC Women's Committee's call for the Scottish Government to increase monies used to investigate women's health including diseases such as endometriosis and would urge all members in the debate to do the same. Of course I would fully support the work of the STUC Women's Committee and the point made by the member. In concluding trade unions really are at the forefront of work to ensure policies in the workplace support employees at challenging times in their life and menopause support, menopause policy development and eliminating menopause discrimination are all part of that. I hope to work with the trade unions and the Government to make sure that we can make a difference to those women. I look forward to more discussions on that in the chamber. I thank the member again for the contributions. I now call Elena Whitham to be followed by Collette Stevenson for around four minutes. I thank my colleagues from Brown for bringing this to the chamber. We've had many conversations about menopause in our long journey back to Ayrshire every week. My name is Elena Whitham and I am menopausal. Being menopausal is not in any way the sum of my existence but some days it sure feels that way. Whether it's sweating bullets in this place and not from any opposition interventions but from some confounded internal combustion engine that arbitrarily decides to power up the flamethrowers as it did earlier in the debate we had or the ever-present brain fog that means I call my children the dog's name or I put the remote control in the freezer or sometimes it takes all of the women in my office for us to complete a sentence as we help each other out, as women do or the sudden panic as my haywire menstrual cycle decides its tsunami season and my moon cup literally runneth over. Or as I yell when my husband reaches out to hold my hand during a walk and my sore finger joints squeal under his embrace or yet again as I decide to close my ever-so-tired eyes on the train to Parliament only to be jolted awake by some fellow passenger rudely snoring without a care in the world only to realise it's myself and my exhaustion is further underlined with the retail of slivers that are escaping from my slack jaw. Sometimes it literally feels like I've lost myself somewhere between the ages of 46 and 48 and I'm wading through a trickle trying to figure out who I am as Pam Goswell says, right? Whilst I try to juggle work, a neurodivergent teenager and husband and needy Jack Russell, a 20-something-year-old son who sometimes just needs his mammy to make his work's peace all at a time where my multitasking skills have all but deserted me. Help my boba here, you all say, she needs to pit down. All I needed was a box of bioidentical HRT patches and I've got the battle scars to prove that. My menopause started during the pandemic and coincided with me getting a really nasty dose of the delta variant which led to questions about whether it was long Covid. I was diagnosed as well as having a vitamin B deficiency so some of those symptoms mirror the menopause and mirror long Covid. All it took for me was to keep battling, to get the hormone replacement that my body was so evidently crying out for and I think that all women should be very well aware of those symptoms and I think that we need to communicate that more often. Posters everywhere you go that says, if this has happened to you, this might be menopause. Then I bought a book by an amazing journalist, Kate Muir. There are other books on menopause available but that's everything you need to know about menopause but I'm afraid to ask, literally change my life. Whilst reading it in bed I kept exclaiming, it's just like me whilst poking my husband as he tried to read in bed beside me. I finally felt empowered and alive and equipped with the knowledge I needed to once again ask my GP for support. Please bear in mind, I was a young mum at the time of both the discredited MMR and HRT studies and I still bear the scars from them as well and I remember vowing that I would never take HRT. I would do it out. I wasn't going to put myself at risk. It's only natural, right? No, I was wrong. Each woman will experience their own version of menopause and all options should be available to each and every single one of us. HRT can protect against osteoporosis, dementia, heart disease and stroke, can give us wellbeing, can help us to protect our relationships and our jobs can be saved if we care enough to make sure women are supported as they move into the menopause. Heaven for Fenn, we should place importance on our sex lives and ask for testosterone gel which is currently woefully under-prescribed in Scotland. Funnily, doesn't have the same traction as we blew pills that help men with erectile dysfunction. Something more than half the world experiences should not be left to chance in GPs with scant training. Finally, I have a keen focus on social justice and, like many health concerns, there are clear health inequalities when it comes to menopause. Women in deprived areas tend to be prescribed less HRT and when they do get a prescription it tends to be the more dangerous oral variety that they will get which then will interact with comorbidities that they must face and lead to poor outcomes. That kind of must change and I would like to hear how the minister thinks the women's health plan will positively influence better outcomes for women who are not always able to navigate a system designed without them at its heart. Thank you. Thank you very much, Ms Whitham and I'm very grateful to Collette Stevenson for taking the lead on the appropriate facial expressions to have over the last four minutes and with that, I invite Collette Stevenson who will be followed by Monica Lennon for around four minutes. It's lovely to see people smiling and laughing in the chamber despite what we're talking about. Thank you, Presiding Officer and I also want to thank Siobhan Brown for bringing this debate forward today. I can relate as well as the menopausal women along with several others in the chamber. I had a brain fog last week where I took the lift at second floor and normally resided in the third floor in this building, walked straight up to what I thought was my office and I looked at the young boy standing there and I said, who are you? And he was like, I'm Jamie Greene's assistant and I was just like, oh my! By this point Edward Mountain and Jackson Carlaw were absolutely killing themselves laughing at me. So I quickly scurried away and I didn't join the other side. Sorry, totally digress in there. It's right that we recognise World Menopause Month and acknowledged women across the world who are going through or have gone through the menopause or at the perimenopausal stage. In the past, nothing really prepared women for this life-changing event. However, in recent years the Scottish Government's work to raise awareness and to support the setting up of specialist clinics and NHS informs on the menopause platform has been so important. I'm glad that we're having another debate on the menopause because it is vital that we have an open dialogue on this really important what is normally a taboo subject. Today I also want to focus on the impact on women in work. Research indicates and it's already been quoted as well that 900,000 women in the UK have lost their jobs from experiencing menopause related symptoms. It's actually an awful statistic and it shows that much still needs to be done. As the CIPD said, this could mean that women are leaving work at the peak of their experience which will impact productivity. So while menopause discrimination can be covered under the Equality Act, I believe that more specific legislation should be considered. I'm a champion of workplaces introducing a menopause policy to ensure women get the support and adjustments that they need. I was instrumental in campaigning for this within South Lanarkshire Council a few years ago and at the time this was groundbreaking. There are some great third sector groups out there including the menopause experts as well who I met with recently and the menopause friendly workplace accreditation scheme is also great and I know that there are some businesses in East Kilbride big and small that support it. Women should not be suffering in silence and having their needs ignored. We should all be embracing this topic and having menopositivity empowering, comfortable to say that they're struggling with symptoms rather than it being a barrier. As the motion says, different women have different symptoms and experiences of the menopause. So when women seek menopause and medical treatment they deserve to be heard as an individual with their own experience. The availability of hormone replacement therapy is increasing and I hope any woman who asks for it and where clinically appropriate will be given that opportunity. The Scottish Government's women's health plan and recent improvements in the NHS services are very welcome and there are many good employers out there supporting female colleagues experiencing the menopause. Let's continue in that vein with open conversations suitable healthcare options and social and employer support. I want to end my speech on what I consider to be the best three minutes of TV ever an extract from Fleabags Barstool on menopause. I've been longing to say this out loud. Women are born with pain built in. It's our physical destiny. Period pain, sore boobs, childbirth, you know we carry it with ourselves throughout our lives. Belinda says, men don't they have to invent things like gods and demons. They create wars so that they can feel things each other and we have all going on in a year inside we have a pain on a cycle for years. So to conclude, let's do everything to support women, experience the menopause and remove at least some of that pain. Thank you. Thank you Ms Stevenson. I'm not sure what the facial expression appropriate to that silhouette we was. I now call final speaker in the open debate. I want to call in him for around four minutes. Thank you, Presiding Officer. It really has been an enjoyable debate. Some difficult topics that have been covered but everyone who's been speaking already has brought a lot of insight and loved experience and a bit of humour as well. Thank you, Presiding Officer. I've given notice that I have to leave before the end so I apologize I can't stay for the minister's closing remarks but it would be good to hear about the great start with the women's health plan the first in the UK. There's a lot in there that's really positive as we've heard recently at the cross party group on women's health that I chair but we just need to keep going on that and I know there is that commitment across the chamber and that's why it is so important to know when we'll have a women's health champion because I'm sure there's plenty of able people who could do that role but I want to congratulate Siobhan Brown on securing the debate. It's really important that we don't just let these awareness months and days pass us by because we are having much more open conversations about the menopause and indeed perimenopause but just having that talk isn't enough we know there's a lot to do and we've heard about the importance of good quality time of GPs and primary care I know when I get a chance to speak to the Cabinet Secretary for Health and Social Care about medical misogyny and that's a phrase I think he really gets now and we all have to do work on that but it really is important that we as we continue to it's a bit like mental health when we ask people to come forward and get help early we have to make sure the resource is there to meet that expectation and that's about supporting the workforce as well and of course we've heard today that menopause is a workplace issue we've heard that from a number of colleagues including Carol Mockin and Mercedes Villalba with her intervention because it is timely we meet today I know Minister you've been at the STC Women's Committee conference really important we are so blessed in Scotland we have fantastic trade union women who are real champions in the workplace who bring us the information to come into these debates to speak in our CPGs and our committees and also I want to give a nod to the all-party parliamentary group in Westminster because the APPG on menopause they undertook an inquiry and it's a really good report and it's quite long so I won't go into it too much but they also make the important point that no colleagues here will agree is that the way that menopause can affect minority groups including those in the LGBTQ plus community is really important and I think it is important to make political differences but Pam Gosol is a role model on these issues and by sharing your experience because we know that many people will be afraid of the menopause some people have an easy experience and some don't and it's important that we break down those barriers so for all those colleagues who have shared their experience and of course to wish Stephanie Callaghan a good recovery but I think we have to remind our sisters it's okay to take a day off you know the life will carry on so again when we talk about good menopause policy in the workplace I think also it's about us showing that actually it's okay not to beat your work if I can in the few seconds that are remaining because colleagues have been really inclusive in the debate today but just to talk about early menopause for those women and people who menstruate whose period stopped before the age of 45 that can also be for reasons related to other health conditions it could be cancer linked to treatment or endometriosis because let's face it people are diagnosed with endometriosis on average far too late and that's an issue that I know the minister probably has sleepless nights about there is a really important commitment to bring that down from 8.5 years to 12 months by the end of this parliament and again it's another issue that we all need to work together on so I'll close there again thank you to Siobhan Brown for the debate and to all colleagues for their humour and insight Thank you very much indeed Ms Lennon and now I invite the minister to respond to the debate for around seven minutes Minister Thank you very much I want to start by thanking Siobhan Brown for moving this motion and for my colleagues important contributions today there was some brilliant contributions some humour some sharing though and I think we should all recognise that we are all of us who have spoken in this debate today women in powerful positions and it's really important that we use our positions to raise awareness of a subject that has been for too long suffering from being taboo and having a lot of stigma associated with it so I'm delighted that we have spoken and not just about our own experiences but our community experiences menopause is one of the top priorities of the women's health plan and I truly believe we can't talk about it enough but I'll try and stick to the seven minutes world menopause day and menopause awareness month provide us with a really valuable opportunity to highlight this important transition in women's lives but one that many women know little about women have told us and the evidence shows that when they are well informed about the menopause and know what to expect that experience can be more positive knowledge information and misbusting is powerful and I have to say that's one of the many aims of the women's health plan is to build on that knowledge is power theme and we've invested a great deal of effort in providing resources on the women's health platform on NHS inform in a whole variety of different forms so not just reading material material that's targeted at health professionals as well as that woman and misbusting films which I think is really powerful work being informed about the menopause means that we know what to expect in the future it can help us to manage the symptoms being experienced in the present and we can support other people in our lives with the experience of the menopause whether that's personally or family or friends or in the workplace this menopause awareness month the Scottish Government used the social media channels to raise awareness about menopause and to highlight the resources that are available on NHS inform we link with our partners Active Scotland during women and girls in sport week to highlight the positive impact that exercise can have on menopause symptoms and we also worked with our partners at health and social care alliance in the charity close the gap to create two new resource packs on the menopause and the workplace the alliance developed a pack for women and people who experienced menopause on menopause support in the workplace whilst close the gap created a resource for employers on creating a menopause aware workplace and both of those resources can be found online I wholeheartedly agree with the sentiment expressed in today's motion that we all benefit from an open conversation about menopause just last week the First Minister attended a menopause cafe in Perth a place where people come together to chat about menopause and over the summer the First Minister spoke with Kirsty Warke about her own experience of menopause at menopause cafes flushfest illustrating the impact that menopause can have on all women we want to continue this conversation throughout the year so that we can improve the support and end stigma the frustration and disappointment women express in relation to their experience of menopause consistent with feedback that we received from many women across Scotland when we were developing the women's health plan we listened to women and that's why menopause care and support is a top priority in our women's health plan women of all ages should know what to expect from menopause, what the symptoms are and what they can help what can help them so that they're not taken by surprise by any changes either physically or mentally in October 2021 we launched the menopause resource now part of the women's health platform on NHS Inform now as I said through that resource we are busting menopause myths we're highlighting menopause symptoms we're highlighting options for care and treatment and support and mental health and much more the range of treatments options which are available on the NHS in Scotland without any charge for prescription there is a huge range out there and there's a specialist menopause service now in every mainland health board with support in place for those island health boards that don't have their own service now women told us they don't always get the support they need when they're seeking help for menopause symptoms and that's why through the implementation of the women's health plan we're intending to build a basic understanding of menopause among all health professionals so that should include an awareness of symptoms of perimenopause and intermediate and long-term consequences of menopause knowing where to sign post-women for consistent advice and support now as I said on the women's health plan I'm really proud of the progress that we've made in the first year we've improved access to information as I said we've put together a bespoke training package for GPs on menopause and menstrual health but we're also working with the University of Glasgow on research on menopause and menstrual health in the workplace and a survey that was launched on world menopause day this year seeks the lived experience of those people who are working in NHS Scotland in relation to their personal experiences of menopause and menstrual health what we'll do with that information is build a really high quality workplace strategy for menopause in the NHS which we hope will be a leading light for other employers for private employers and for social care employers in terms of them I did actually start the day this morning at the STEC women's conference and I absolutely as you might imagine loved every minute of it I was delighted to be with them and to update them on the progress and implementation of the women's health plan but one of the issues that came up through their loud and clear is that being supported in the workplaces an absolutely essential part of action on menopause during menopause and women need to know that there is support in place to help me to work comfortably during menopause it's really difficult to talk about it for some women but it's really important to be able to speak openly in the workplace and the wider fair work approach we're going to work with employers and trade unions in all sectors where low pay and precarious work can be most prevalent to develop sectoral fair work agreements that deliver improved employment outcomes such as payment of the real living wage better security of work and wider fair work first standards and those standards include action to tackle the gender pay gap which as we all know have many drivers that restrict women's opportunity of progression in work such as health menopause Mercedes Villalba mentioned the issue of research I've mentioned already some of the research that's going on in the NHS workforce but we do have research into we've already committed a quarter of a million pounds as part of the women's health plan to research on endometriosis but we also have a longer term commitment to develop a women's health fund in areas and we know there are many where the understanding of women's health problems is poor and to target research there so I'm really pleased that we've started with endometriosis but there will be further work on menopause to come Certainly Can go son Thank you obviously for that information that you just said minister but can I ask a question that looks like mine that still think it's a taboo I know certainly when I started having these symptoms in perimenopausal I didn't know what they were and even there was so much information out there because nobody spoke about it in my house and nobody wants to speak about it round me either so how do you reach them Minister So that's a really good question and actually one of the things that we know really works with health inequalities and certain communities do face them find it harder to access healthcare information that makes those communities find the leaders in the communities like yourself and work with them to reach the community so that they can reach the information that they need also on the women's health platform that information that I talked about written information is available in many different languages so online there should be an availability of information that's accessible to all of our communities in Scotland If I can just very quickly touch on I was really pleased to hear Evelyn Tweed, Stephanie Callahan and others mentioning osteoporosis and heart disease Challenging myths and stigma is absolutely great I'm really glad that we're talking about treating symptoms of menopause but I fear sometimes that we are missing a public health opportunity for preventing quite severe illness further down the line and I wouldn't make I'm not going to advocate that everybody considers the HRT but I want women in Scotland to be able to make an informed decision weighing up all of the pros and cons busting many of the myths in the past which were perpetuated about HRT in order to make an informed decision about their future health so to sum up the women's health plan is really clear menopause is a priority in Scotland I'm determined that through the plan we continue to drive forward improvements in menopause support at all times listening to the voice of lived experience ensuring that informs everything that we do I extend my particular gratitude to the women who continue to inform this vital work and who to bring their voices and views to us we know that women aren't always getting the care and treatment and support that they need but working in partnership together we can improve menopause support we can end stigma and we can support women to more positively experience this important life transition thank you thank you very much minister that concludes the debate and I close this meeting apartment