 Felly, can I remind members of the Covid-related measures that are in place, and that face covering should be worn when moving around the chamber and across the Holyrood campus? The final item of business is a member's business debate on motion 1534, in the name of Collette Stevenson, on improving support and ending the stigma of the menopause. This debate will be concluded without any questions being put, and I would ask those members who wish to speak in the debate to please press the request to speak buttons now, and I call on Collette Stevenson to open the debate—about seven minutes, please, Ms Stevenson. Thank you, Presiding Officer, and thanks to colleagues for signing my motion so that we can debate this important topic. We have come a long way here in Scotland to improve support and end the stigma of the menopause, but we still have much to do. Starting conversations and ending stigma around the menopause is something that I am passionate about, and I look forward to the upcoming campaign to remove the stigma and raise awareness of symptoms. Presiding Officer, I want to thank my friend, the Equalities Minister, Christina McKelvie, for delivering the first-ever Government debate on the menopause in 2019, and for all the work that she has been doing to advance women's equality. There are around 400,000 women of menopausal age in Scotland. The average age of women reaches a menopause is 51. However, some women experienced permenopause 10 years earlier, which can include heavy or infrequent periods, night sweats and hot flushes. Earlier this year, the Scottish Government published its very welcome women's health plan. One of the priorities is ensuring that women can get access to specialist services for advice and support on the diagnosis and management of menopause. All too often, we are giving leaflets from our GP to read over, but we need options and better advice. There are over 30 symptoms of the menopause, and women deserve tailored support for their own symptoms. Hormone replacement therapy is a well-known treatment, and thankfully it is free at the point of need here in Scotland. However, HRT is not for everyone, and I would like to see more treatment options available. I want to urge our Government to offer more holistic approaches to tackle the varying degrees of symptoms associated with menopause. Many women do not speak to their doctor about the menopause as they worry that they are wasting NHS time. NHS informs that the new menopause website is a welcome development, but I encourage any women struggling with menopause symptoms to speak to a GP or other healthcare worker to make sure that they get the support that they need and deserve. Another important aim is to continue the women's lived experience group, which will inform policy and improve services. During the development of the plan, they talked about the need for choice and flexibility and educating everyone about women's health issues. I absolutely agree, but most importantly and shockingly, but not surprisingly, they found that women wanted to be taken seriously. We need more research, more support but ultimately more education on the menopause. Current events highlight the need to improve support, end the stigma of the menopause and ensure that women can get a break when needed. Wearing masks when a hot flush hits you is the equivalent of a towering infernal. As someone who has experienced menopause symptoms, I know how challenging this has been. Whilst many women experience hot flushes and sweats, want to down tools and run a mile, there are so many women in the medical, nursing and caring professions who have had to look after us during the pandemic, kitted out in full PPE and battling menopause symptoms. I want to applaud those women who overcome their own challenges to protect the lives of others. In terms of the workplace, 45 per cent of women told a survey that menopausal symptoms had a negative impact on their work, and 40 per cent of those who took a day off work for that could not tell their employer the real reason. Furthermore, in gender's research found most women think that workplaces should have a menopause policy, but only 3.7 per cent were aware of that in their own workplace. Many workplaces have improved in recent years. I was instrumental in launching South Lanarkshire Council's groundbreaking menopause in the workplace policy, having campaigned for many years as a trade union rep to make that happen. NHS Lanarkshire also implemented a policy this time last year. It is good to see those two large employers ahead of the curve. I hope that other workplaces follow suit. I have an open door for any East Kilbride businesses who want to discuss the best way to support women colleagues. I want to acknowledge Gillian Martin's great work on that matter, and I am looking forward to her contribution in today's debate. I hope that today we will help to raise awareness and encourage employers to do all they can to help colleagues to go through the menopause and to ensure that women know that they deserve support. Let's empower our young women and girls through high-quality education on menstrual health, but let's also pay attention to our attitudes and behaviours. There is still a stigma there, and we need to reach out to men and women alike to tackle it. We all have a part to play in ensuring that conversations continue, that this natural process in a women's reproductive cycle stays visible. Women's health should be a subject that we can broach without fear or flux. The support available continues to improve, but the stigma must end. I now call Gillian Martin to be followed by Rachel Hamilton up to four minutes. I want to thank Collette Stevenson for bringing this debate, which is so important to women in Scotland. I thank you for name checking me in your speech. I am delighted. I know that Ms Stevenson has campaigned for many years on better menopause services and workplace policy. In fact, in that debate that she mentioned, that Christina McKelvie brought to the chamber, I spoke in that debate and I mentioned the work that she had done in making South Lanarkshire Council the first local authority in Scotland to introduce a menopause policy. It is those campaigns and those of positivity and 50 cents and all the menopause cafes and events. They are the things that have really prompted change, and change that has happened in the last few years—it has really been incredible—not least in making discussions about the menopause more open, more frequent and more normal. In large part, there are conversations and campaigns that have led to the Scottish Government's women's health plan, a plan that includes the development of menopause and menstrual health workplace policies and ensuring that we have GPs that are menopause experts and access to specialist menopause clinics across Scotland. I would also like to mention the importance of Mr Todd holding the first-ever ministerial post that has women's health in the title. That is significant progress and I can think of no better women to have that responsibility. Put bluntly, stigma around the menopause is a barrier to women getting the help that they need. Menopause is a normal stage of life as a female. If we use that fact as our baseline, then perhaps we can start to normalise conversations around it. If we normalise conversations around it, then maybe we can start to make more progress on the treatment of its often debilitating effects. Stigma is one thing, but there is a lot more clinically that needs to be done in the menopause sphere. More menopause training for GPs needs to happen. It should not be a chance that you get to speak to someone with that interest or expertise. Often a five-minute appointment is not enough to diagnose menopause. It might even be the wrong day to diagnose your menopause if your hormones are playing up. Women should not have to go privately to see a menopause specialist. We need to make sure that this is equal for women access to menopause specialists. Referals should be happening more from GPs to NHS services. I note that the women's health plan addresses those points. I am pleased to see a commitment to more research into women's health more generally and the menopause specifically. I have been researching the role testosterone plays in women. We think that menopause is a bit estrogen, and yes, that is largely true, but we lose testosterone as well. That can lead to memory, sleep and energy loss, and complete loss of libido. If the stigma around male erectile dysfunction is rightly being diminished and you can get medication to counteract that easily, then let's start talking about the loss of hormones that can end a woman's sex life in the same frank, compassionate, serious and solution-focused way. Marriages and relationships break down because of this. Women's mental health suffers because of this, and it is high time that we took this seriously. There is no available female testosterone replacement available in this country. If a GP prescribes it, it is the male and regel variety, and dozing it is a bit of a shot in the dark when it comes to women. That has been addressed in Australia, who has just approved androfem, a metered female testosterone replacement, and I believe that NICE are looking into approving it in the UK. As the menopause specialist Dr Louise Neuson says, these are hormones we've lost and we want them back. Every cell in the female body has estrogen and testosterone in it. Is it any wonder when these decline we start to feel ill and miserable? Dr Neuson says, all we want is our hormones back. Talking about this openly, as we will be today, combined with the seriousness that the Scottish Government is placing on menopause policy, getting us access to the right menopause care gives me hope for a better life for women going through this entirely normal stage of their lives. I now call on Rachel Hamilton, who is joining us remotely, to be followed by Rona Mackay. Up to four minutes please, Ms Hamilton. I want to firstly thank Collette Stevenson for bringing forward this very important motion for members' business this evening. Ending the stigma and misinformation around menopause should be at the heart of taking forward any future women's health policy. In my very short time today, I want to make three key points about stigma, the workplace and the action being taken across the UK to make a difference. First, ending the stigma is the first building block in tackling the systemic issues around the treatment of women. It is extremely important that we teach not only young women and girls about it but also young men and boys too. We simply cannot expect the stigma of menopause to disappear unless we educate everyone about it. Today is that first step. Secondly, we must do more to support women in the workplace during menopause, and there are significant issues around a complete lack of understanding from employers towards their employees. I want to thank Dr Louise Neuson, a menopause doctor who runs not-for-profit Neuson health research and education for her new research. Her survey found 99 per cent of women felt that their menopause or menopause symptoms had a negative impact on their careers. Overall, more than one in five women passed on the chance to go for a promotion they would have otherwise considered, and 19 per cent reduced their hours and 12 per cent resigned. Those figures are quite outstanding. I am glad too that leading broadcasters, celebrities and other public figures have recently spoken of their experiences. DJ Joe Wiley revealed that she was struggling with menopause symptoms. At the same time, her radio to show with Simon Mayo was being criticised. Joe Wiley felt that she couldn't continue on drive time because of her experience. No woman should ever be held back from pursuing her career or doing her job well because of the stigma. I learned recently that, in Scotland, only 10 cases of alleged discrimination against women affected by the menopause have been heard by industrial tribunals in Scotland over the past five years, with three this year alone. As the Deputy Convener of the Women's Health Cpg, along with a number of women that are speaking in this debate tonight, our discussion about our forthcoming work will certainly look into how we can further support women in the workplace to avoid those exact scenarios. Back in 2019, we welcomed Christina McKelvie's promise that the Scottish Government were encouraging all employers, including other public bodies, to update or provide menopause awareness training and guidance for their managers. I would be grateful if the minister in closing could provide an update on the progress of this work. Thirdly, and on a positive note, right across the UK, there is fantastic work being done to tackle these issues. In July, the UK Women and Equalities Committee launched an inquiry into menopause in the workplace, and since then they have collected evidence for a wide range of sources about the impact that menopause can have on women and their occupations. Further to this work, I welcome the new menopause bill in the House of Commons, which has been really interesting to follow. The announcement by the health minister, Maria Caulfield, said that the menopause will become a priority in the UK Government's upcoming women's health strategy, which is due to be published very shortly. We can all keep an eye on that. Here in Scotland, I also welcome the work involved with the women's health plan, which outlines improvement and changes in areas including menopause, heart health, mental health, endometriosis and sexual health. Right across the UK, it is clear that there is momentum to finally address the personal, social and professional impact of the menopause on the lives of women across the UK. In closing, I very much welcome the Scottish Government's commitment to launch a public campaign to raise awareness of the symptoms of menopause alongside the women's health plan. There is much more work to do. If we continue like this in a collegiate manner, we will make some progress and seek to end the stigma and improve support for women. I now call Rona Mackay to be followed by Kara Mocken. Up to four minutes, please, Ms Mackay. I am pleased to be speaking in this debate, and I thank my colleague Collette Stevenson for bringing it to the chamber. I echo her comments about the great work done by her colleagues Christina McKelvie and Gillian Martin. The days when the menopause has always been viewed as a bit of a joke are thankfully coming to an end and not before time. Around 400,000 women in Scotland are of menopausal age and more than half suffer a variety of distressing symptoms such as memory loss, insomnia, anxiety, palpitations, hot flushes, joint pain and much, much more. Mugs, napkins, aprons, car stickers and other rubbish, all emblazoned with so-called slogans about the change, aren't really funny at all. That is why I welcome the Scottish Government's women's health plan, which aims to reduce stigma, raise awareness and get people talking about an issue that affects more than half of our population and is, of course, perfectly normal. Sadly, women's health issues have been taboo subjects in society for as long as I can remember. Menstruation, endometriosis, thyroid conditions and IVS treatment are often swept under the carpet when it comes to talking and being open about them, particularly in the workplace. The menopause exacerbates gender inequality in the workplace. We know that there are increasing numbers of older women in employment and many more will experience the menopause whilst at work. Some will sail through it, some will not, others will not. That is why I am glad to see that we are at last making some headway. I really welcome the Scottish Government's women's health plan, which aims to alleviate women's health inequalities and ensure that women access specialist menopause services. Praise should go to South Lanarkshire Council, the first local authority to implement a menopause policy to support women in the workplace. Other employers, public and private, must have buy-in, too. A menopause policy will give peace of mind to women that they will be understood, their symptoms will be recognised and support and flexibility will be offered if they need it. It really is not too much to ask in a civilised society. It is not acceptable for employers to jeopardise a women's career by showing a lack of understanding or respect about the perfectly natural process. In the summer of 2019, the excellent feminist charity Engender undertook a survey as part of a research project seeking to understand how current Scottish policy meets the needs of women going through the menopause, and it found that most women still felt inadequately supported. It also found that many women simply did not know where to go for information. 40 per cent reported not feeling informed about the menopause, with an additional 10 per cent unsure as to whether they were informed or not, and only 15 per cent were aware of the existence of specialist menopause services. We must do better. In response to the question, what would help you to manage your menopause symptoms at work? The most common responses include access to fans and temperature control, breaks in work days and flexible working and greater mental health and wellbeing support generally. The good news is that not all women felt negative stigma around the menopause, and several indicated that they perceive it as either a neutral or positive transition. For example, one respondent described that the menopause is liberation, fun, wellbeing, joy and being happy. Let's get rid of the stigma, increase support and collect and utilise further data, especially for underrepresented groups. Do more medical research, raise awareness, scale up specialist services and make them equally available across health boards for women needing support. Women of future generations must not endure the same stigma, misinformation and, frankly, indifference to the perfectly natural process in women's lives. With the correct support, let them embrace their newfound freedom to enrich their lives. I now call Carol Mocken to be followed by Julian Mackay up to four minutes. Thank you, Deputy Presiding Officer. I thank Stephen Snow for bringing this important issue to the chamber. On behalf of Scottish Labour, I would like to start by welcoming World Menopause Day, which was marked on 18 October. It is vital that we take time to recognise the importance of raising awareness of the menopause. How it can impact women's health and indeed their day-to-day life and crucially highlight what we can do to tackle the stigma that to this day still surrounds the menopause. Around 400,000 women in Scotland today are of menopausal age, as the motion states, most of them will experience symptoms that are wide ranging and often distressing. It is our role in the Scottish Parliament to ensure that the experiences are not stigmatised but rather spoken about openly and freely and to ensure adequate support is put in place to support them in all aspects of society, at home, in public places and in the workplace. My call for such support to be put in place, however, is not just for councils or the Scottish Government or places where support can be offered to women with relative ease, but welcome those such interventions have been and we have heard tonight of the excellent policy brought forward by Collec, which is very welcome. I am calling for support for every woman up and down the country who experiences menopause symptoms. Women who work in industries with a path to securing such protections may not be as clear and those who do not feel comfortable going to an employer to discuss such concerns. I consider it important that I discuss Scotland's significant health inequalities in this debate and how they do and will continue to link to women's experiences of the menopause. The motion states, in my view, correctly that employers should be flexible with women who feel that their ability to work is being impacted by symptoms linked to the menopause and, as such, they should be treated with dignity and respect in the workplace. That must mean a minimal expectation of allowing flexible and homeworking and of giving time off where necessary. We have made significant progress in proving provision for matters relating to women's health in Scotland's workplaces in recent years, as we have heard, but we can still go further. That includes being more open in our discussions about the menopause and offering greater levels of protection than those that exist already. In Scotland, in 2021, we must accept that we fall way below the standard when it comes to addressing health inequalities. Time and again, it is the poorest in our communities. Those with low incomes, debt and those who, at this time of year, have to make the incredibly difficult choices between feeding themselves and their families or heating their homes who may suffer from the consequences of inaction. I consider that health inequalities in our country to be one of the greatest challenges. Women in low-paid precarious employment may want to take time to attend their GP or primary care service related to the menopause, but they simply cannot afford to do so. Those perhaps working in very male-dominated sectors may want to explain their difficulties to employers but do not feel comfortable doing so. In the worst cases, those with the most severe symptoms may want to take time off work but either cannot afford to do so or do not feel that there is adequate support to do so. Decisively resolving those issues are in the powers of the Scottish Parliament. Inequality in health and, in particular, employment practices more widely do not reflect the Scotland that we want to live in but absolutely the Scotland that ordinary people struggle and live through. We must do all that we can to bring health solutions closer to home so that those who need them most, such as women experiencing menopausal symptoms, can get relief and support without having to visit a hospital or go to their GP continuously. That starts by addressing stigmas about women's health and tackling health inequalities more widely and ensuring that workplaces are suitable for the needs of those women. We must push on with increased purpose, creating a just and compassionate society that recognises for generations that women have largely been left to struggle needlessly, and that has to change. Thank you. I now call Julian Mackay to be followed by Emma Harper up to four minutes please, Ms Mackay. Thank you Deputy Presiding Officer. I welcome this debate on the stigmas surrounding the menopause and I would like to thank Collette Stevenson for bringing it to the chamber. For too long people going through the menopause have had their experiences and symptoms ignored and underplayed. It's often the bus of the joke or dismissed as women's issues. That's why it's so important that we make time to talk about it in Parliament and raise awareness of how much of an impact menopause can have on women and people who menstruate. As the motion states, there is still much stigma surrounding the menopause, which is part of a wider culture that discourages people from talking about their menstrual health. That causes real harm. It prevents women from asking for support from employers or accessing healthcare. It causes shame and embarrassment, which causes unnecessary distress and can prevent people from getting the help that they need. Workplaces can absolutely do more. A survey conducted by Engender in 2019 revealed that only 3.7 per cent of respondents were aware of their workplace having a menopause policy, and 21.7 per cent were unsure if their workplace had one. A 2019 UK survey conducted by Bupa and the Chartered Institute for Personnel and Development found that three in five menopausal women were negatively affected at work and almost 900,000 left their jobs because of menopausal symptoms. It's scandalous that so many workplaces are either unable or unwilling to make adaptions to allow for the fact that most women will go through the menopause at some point. Surely it's in their interests to make adjustments and implement policies that will allow them to retain their staff. Also, how can we hope to tackle the gender pay gap when women are being driven out of employment by symptoms that a significant proportion of them will experience? Stigma surrounding menopause marginalises and disadvantages women and is a driver of inequality. How do we tackle that? As I said earlier in my speech, debates such as this today can help to address stigma. Engender's survey found that there has been an increase in public conversation around the menopause, its impacts and women's needs, although most respondents still felt inadequately supported. Conversations about the menopause should not be left to women. Everyone should be educated about menopausal symptoms. We teach children about puberty in school as part of their personal and social education, but there is no corresponding educational tool for menopause, despite it being one of the major transitions in many people's lives. We need to see robust workplace policies around health and safety, sickness absence and flexible working, and a workplace culture that is understanding of the ways in which menopausal symptoms can impact employees. We also need healthcare that addresses the needs of those experiencing menopause, and I am pleased to see commitments in the women's health plan, by ensuring that women who need access to specialist menopause services for advice and support on the diagnosis and management of menopause. The availability of specialist services recognises the impact that menopause can have on people's health and wellbeing, and that it warrants dedicated support. Menopause stigma is born out of sexism and ageism, and we must recognise how it can intersect with other forms of discrimination. We know, for example, that black women in the UK experience significant inequalities when accessing healthcare. For example, a report published in 2019 found that black women still have more than five times the risk of dying in pregnancy or up to six weeks postpartum compared with white women. Black women may face barriers when accessing healthcare or find it difficult to have their symptoms taken seriously. I would like to see more research and data on how black women in Scotland are impacted by the menopause and their experiences of accessing both medical and workplace support. On that and wider women's health issues, I look forward to working with both the minister and colleagues on that. Emma Harper will be the last speaker before I call on the minister to respond to the debate up to four minutes. I welcome the opportunity to speak in this important debate and congratulate colleague Collette Stevenson in securing menopause matters. I agree that menopause has always been at best stigmatised, ignored or treated as a joke. Rona Mackay is right, and at worst, menopause is used as a way to degrade women. Just as women are not a homogeneous group, the impact of menopause can be very different, and it is certainly not a one-size-fits-all. Indeed, menopause treatment can also vary significantly, and it is a complex area with new observations and medical advances continually being made. I welcome that this Parliament was the first across the whole of the UK to hold a Government debate on the menopause. That was led by Christina McKelvie, which colleagues have also highlighted. That was in 2019, and the SNP-led Government was the first Government to rightly put national attention on reducing menopause stigma and improving treatment. Some women will experience menopause at a significantly younger age, either naturally or because of surgical or medical intervention, for example, as a result of an ufherectomy as part of cancer treatment. For many women, around 10 per cent, according to research from Manchester University, the negative impact of the menopause is life-changing. Gillian Mackay has rightly said that it even prevents women from attending work. Research, which informed the Scottish Government's women's health plan, sets out action to tackle menopause stigma and to support women going through the process. Research highlighted that women and girls are unprepared for the changes caused by menopause, so they often experience menopause in silence. I welcome that the Scottish Government's work is now beginning to make a difference through making menopause the subject of national debate, just as we are doing right here right now. Collette Stevenson and Gillian Martin and Rona Mackay said that we need more research, so I would like to highlight some research by Dr Lisa Mosconi, neuroscientist from New York University, who specialises in the study of women's brains and on the impact of menopause. Dr Mosconi's research presents the relationship between menopause and Alzheimer's disease. Her research shows that women's brains age differently to men due to the brain's interaction with hormones. For example, men on the whole have a lifetime supply of testosterone, whereas women's supply of estrogen reduces at around 50-years-old, although that age specification is not set in stone. The key side effects of the menopause, as described by colleagues, night sweats, hot flushes, memory lapses and anxiety and insomnia, do not start in the ovaries to start in the brain. Estrogen increases cerebral blood flow, so without estrogen, which aids in the provision of glucose to the brain, the neurons can start to slow down and age more rapidly. In some cases, this can lead to the development of amyloid plaques, a key indicator of Alzheimer's disease. As an example of that, the plaques may affect the brain's hypothalamus, which controls the body's temperature, causing the hot flushes, etc. I find Dr Mosconi's research very interesting, and she said herself that more research needs to be done. The complexity of menopause and how much of an impact it can have on some women and not on others needs to continue to have a focus. Menopause is a medical process, and that has been outlined by colleagues as well. It is normal, and we need to discuss it as it is a normal fact of life. I welcome the Scottish Government's women's plan that it commits the Government to ensuring that women who need it have access to specialised menopause services for advice and support on the diagnosis and management of menopause. I also welcome that the Scottish Government is working on a national public health campaign, and NHS Dumfries and Galloway has picked that up through their programme, which is called Menopause Matters. Just in closing, menopause covers more than just physical transition. There are mental health implications also. It impacts every aspect of our lives as women, both individually and collectively, and we must act to do all we can to see the stigma-reduced and treatment-improved menopause matters. It should be discussed, Presiding Officer. I now call on Minister Marie Todd to respond to the debate up to seven minutes, please, Minister. Thank you, Deputy Presiding Officer. I want to begin by thanking Collette Stevenson for raising this motion and for all of my colleagues' important contributions today. Menopause is one of the top priorities of the women's health plan, and I truly believe that we cannot talk about menopause enough. I am grateful that Collette Stevenson mentioned my colleague, and she is absolutely right to credit Christina McKelvie with her groundbreaking work and efforts on the front, and I look forward to working together with her as we bring forward more ideas on how to make progress in this area. World Menopause Day provides us with a valuable opportunity to highlight this important transition in women's lives, but one that many know little about. We want to continue this conversation throughout the year so that we can improve support and end stigma. Women have told us and evidence shows that when they are well informed about the menopause and know what to expect, their experience can be more positive. Knowledge, information and misbusting are powerful. Knowledge is power. Women of all ages, including those who do not identify as women, should know what to expect from menopause, what the symptoms are and what can help them so that they are not taken by surprise by any changes, either physically or mentally. It is essential that everybody gets the support that they need, when they need it and for as long as they need it. We want women to be provided with consistent information and care when they seek help with menopause symptoms, however they access their support. Being informed about the menopause means that we know what to expect in the future and it can help us to manage the symptoms being experienced in the present and we can support those in our lives, in their experience of menopause, whether that be personally, our partners, our family, our friends or in the workplace. The frustration and disappointment that women are expressing in relation to their experience of menopause is consistent with feedback that we have received from many women across Scotland. We have listened to women and that is why we are taking action through the health plan. There are 10 specific actions to menopause for the short, medium and long term that we will be driving forward so that we can make a real difference to experience of menopause, including timely access to menopause care and support, but we want to make a difference right now. The short term actions in the plan will be delivered within the next year and we hope that those actions and the ones that follow will make a real difference for women in Scotland. On 11 October, we launched a new menopause platform on NHS Inform, which includes comprehensive information on menopause from signs and symptoms to mental health treatment and support in the workplace. Remember, knowledge is power. We will also be taking forward work that ensures that supports available to women who can or prefer not to access information online. We have established a national menopause specialist network, which is meeting regularly online to provide consistent advice and peer support to healthcare professionals. The network provides and supports primary care teams by providing access to a menopause specialist for consistent advice, support and onward referral and leadership and training. Gillian Martin raised the issue of reduced libido, and there are lots of reasons why women might not want to have sex during the menopause, but loss of libido can be one of the most difficult symptoms to experience and to talk about. I am grateful for her to raise the subject. For women who no longer feel sexual desire or no longer want to have sex, that can be really upsetting and we can't underestimate that. The NHS Inform platform tackles that, and we are keen that we would specifically address that topic. We have included a whole page of information on sexual wellbeing and intimacy during and after menopause, as well as a short video that busts the myth that menopause means that your sex life is over. In relation to testosterone, it is important that women can access the treatment that they need. I am interested to hear that that is being prescribed in Australia, but for a medicine to be routinely prescribed in Scotland, it needs first to receive a licence from the MHRA, which is the licensing body for the UK, and it then needs to be accepted by the SNC, which provides advice to NHS Scotland about the value for patients in newly licensed medicines. I am keen to consider further issues around access to medication, so that our specific constituency cases that Gillian Martin would like to raise with me, I am keen to hear those. Rachel Hamilton raised the issue of menopause in the workplace. In fact, several of my colleagues did and collect students and has done outstanding work on this and has rightly been credited during this debate. A recent survey undertaken by the British Menopause Society found that 45 per cent of women felt that menopausal symptoms had an impact on their work. Being supported in the workplace is an essential part of action on menopause. Women need to know that there is support in place for them to work comfortably during menopause. It can be really difficult to talk about, but it is really important that we are able to openly talk about menopause at work so that we can provide support and help employers to recognise what they might need. Women who contributed to the women's health plan said that what they wanted most from employers was flexibility to manage their own symptoms such as being able to work from home or change their hours if needed. In response to Rachel Hamilton's specific ask, we have absolutely a whole suite of specific Scottish Government actions that are on course. The women's health plan obviously highlights the impact of menopause in the workplace and commits to developing a menopause and menstrual health workplace policy for NHS Scotland. In line with the action in the older people's framework action plan, we continue to work with women's organisations and trade unions to gain a clearer picture of the issues that are faced by women going through the menopause to identify other areas where action might need to be taken. Our gender pay gap action plan recognises the need for gaining a clearer picture of issues faced by women transitioning through the menopause and the need for improving workplace practices to support women. Our women returners programme also supports women to build confidence and skills and work experience and networks that need to ease the transition back to work. We have a women's equality fund that seeks to remove labour market barriers for certain priority groups, including women, so there is a whole suite of work going on in that. In terms of tackling the stigma, access to good information on menopause is really important. It is important that menopause is part of our education offering in Scotland, and menstrual health, including menopause, is included in the Scottish curriculum. We have made resources available online for young people, for teachers, for parents and for carers that are tailored to the different age groups, and we have strengthened the inclusion of menopause in an activity at the senior phase of relationship, sexual health and parent-hood education in the Scottish curriculum to ensure that meaningful learning is delivered about this important topic. In conclusion, the women's health plan is clear that menopause is a priority in Scotland. I agree with my colleague Collette Stevenson that we have come a long way in Scotland, but we still have much to do. I am absolutely determined that through the plan we will drive through forward improvements in menopause support at all times, listening to the voices of lived experience, ensuring that that informs everything that we do. We know that women are not always getting the menopause care treatment and support that they need, but through working in partnership together we can improve menopause support in stigma and support women to more positively experience this important life transition.