Carolyn Broom leads research on how we can better recognise menopausal symptoms

Our first response service team manager (west) Carolyn Broom is leading new research to improve how services identify and respond to menopausal symptoms – helping ensure women receive more tailored and effective care.

Menopause and menopausal symptoms also affect cisgender women, trans men, and non-binary individuals differently based on their natural aging, surgeries, and hormone therapy.

Carolyn, who has worked in the NHS since 1999, is carrying out the project as part of an internship with the National Institute for Health and Care Research (NIHR), drawing on her experience in crisis and home treatment services.

With a longstanding interest in women’s hormonal health, Carolyn says the research project was prompted by patterns she has seen in practice and statistics about women’s health and functioning.

The menopause can have a significant impact on women's health, wellbeing and working lives. This stage of life is associated with the highest rates of suicide among women, increased antidepressant prescribing, and around one in 10 women leaving the workforce.

It is also particularly relevant to the NHS, where around half of all female colleagues, approximately 600,000 people, are within the typical menopause age range.

“We started seeing a pattern of escalation of symptoms in people who had pre-existing mental health conditions, and people who were newly referred to the service, typically between the ages of 35 and 55,” she says.

“They were presenting with symptoms that could have mimicked mental health symptoms, or been linked to, hormonal change at that point in their lives.”

Carolyn’s work focuses on whether menopausal or perimenopausal symptoms are being routinely considered and documented when women are assessed by mental health services.

Looking at referrals to the home treatment team between 2024 and 2025, she reviewed around 900 referrals made to the service, including 555 individual women.

She found that menopause-related factors were recorded in just a small proportion of cases. “My project involved looking to see if we had either asked the question or whether we’d documented anything around menopause or perimenopause, and it was only documented 6% of the time,” she says.

“If we’re asking the question then we’re not documenting it, but the reality is we’re not consistently or effectively asking it.”

Carolyn believes that improving awareness and assessment of hormonal health could help ensure women receive safer effective and timely support and signposting to relevant care pathways.

“It’s not to say that all women should have the same treatment, but we want people to have an informed choice, get it in a timely way, and have their treatment effectively optimised,” she says.

“My work also highlights the need for greater knowledge and confidence among professionals when exploring the link between hormonal changes and mental health.

“Lots of women don’t have the knowledge of their own hormones and if we, as professionals, don’t have the knowledge to be curious then we’re missing a significant part of the puzzle.”

As part of the next phase of the project, Carolyn is developing training and practical tools to support colleagues, including prompts to help teams routinely consider menopausal symptoms during assessment and triage.

“As a home treatment service, we can look at how we can add it as a prompt during our assessments and provide training across the county,” she says.

Carolyn has also been working with colleagues across the trust and beyond to explore how the work could be embedded more widely across services.

She says the project reflects a broader ambition to improve understanding of women’s health and reduce inequalities.

“We know there’s no one-size-fits-all approach, and we need to make sure women are getting the right support at the right time,” she says.

“It’s about making sure we’re asking the right questions and giving people the opportunity to understand what’s happening to them.

“The internship has provided valuable time and space to explore the issue in more depth and contribute to improvements in care – it has been an opportunity to step back and evaluate what we’re doing.

“If we can build that into everyday practice, then we can make care more effective for the people we support.”