Table 1.

Barriers for Women to Seek Help and Access Support

Barriers to Seeking Help	Barriers to Accessing/Accepting Treatment and Support
Lack of knowledge of the full range of menopausal symptoms beyond vasomotor symptoms and how long they might last	Limited information exchange with GPs making it more difficult to diagnose, especially when follicle stimulating hormone (FSH) investigations are “normal”
Misattribution of symptoms to another cause	Perceptions of HRT based on beliefs about risk of breast cancer
Normalisation of symptoms	Beliefs surrounding HRT versus delaying symptoms
Stigma, embarrassment, identity (not wanting to associate with everything the menopause represents) meaning symptoms are not discussed	Limited or no information supporting the decision to use HRT: how to take it, how long for, long-term safety, long-term benefits, concerns not addressed (some HRT prescriptions were not filled because concerns had not been addressed)
Cultural norms around the menopause and symptoms in different ethnic groups	Language of HRT: sometimes described as an additional treatment instead of restoring reduced hormones