Menopause: Policy engagement through lived experience

Nicole Dron, the Clinical Skills Facilitator at the Edinburgh Medical School, shares how her personal experiences with menopause shaped her strategies around policy engagement, and how we too can use our lived experiences to enable positive change.

Advocacy is not criticism, it is about system improvement. With a nursing background, one of my key strengths is being an advocate for my patients. Yet perhaps the joke was on me.

I had always been told I had an old head on my shoulders, and to be honest I’m not past a nice early bedtime with bourbon biscuits, cosy pyjamas and a good book. However, when I started experiencing symptoms of menopause in my twenties (cue the hot flushes, night sweats, weight gain, mood changes to name a few), I thought - surely not.

So did the healthcare professionals I went to for advice. ”Don’t be so stupid.” were their first exact words before leading onto the usual spiel I am sure others have heard many times before: “Of course it’s not menopause, have you ever thought you could just be anxious? Just stop worrying, or how about just sleeping better? Wait in fact you know what will help - a good cup of tea…”

To begin with, I didn’t feel stupid. But I was leaving so many appointments feeling unheard, unsupported and constantly facing barriers to the point where I thought – maybe I am the stupid one. I felt even more stupid having a career in healthcare. Surely, that would be an advantage?! Yet I was coming against a wall each time, and I was floundering.

Menopause is not a niche or invisible issue. It is, after all, a known life transition or consequence of treatment that affects more than half of Scotland’s entire population. Yet historically, as like most women’s health concerns, it has been massively under discussed, under researched and poorly managed. Despite working in the healthcare system, I found myself battling against it; navigating through inconsistent advice, limited speciality access and no support. In fact, I was continually dismissed until they could not dismiss me any longer. The facts were there, the evidence was indisputable – menopause.

It had taken years of emotional and physical war but at 30 I had finally got a diagnosis.

Don’t forget I was the ‘stupid’ one for suggesting it years earlier.

The switch had flipped, I was no longer just a nurse advocating for my patient – I was the patient, and I was an angry ball of emotions going to do something, anything about improving healthcare so that folk do not have to fight for as long and weary as I did.

Previously I had not considered independent policy changemaking, but like I said, I was angry, and instead of sitting stewing, I took my frustrations and wanted to be productive. However, despite my want to make impactful change, I had no idea where, how or who to start with. This was not some QR code or group email tick box exercise, this needed to be bigger.

So why not take it to the head and work backwards?

I began raising concerns directly with Scottish Parliament: reaching out to the Parliamentary Presiding Officer, the Minister for Public and Women’s Health as well as relevant MSPs and cross-party groups, grounding my recommendations not only in lived experiences or from a healthcare professional’s perspective but also in actual evidence. Over email, phone and in person I highlighted how unmanaged menopausal and menstrual symptoms significantly impact educational and workforce participation, mental health, and long-term wellbeing. There were no curriculum considerations about this topic, never mind the fact that the stop-gap for menopausal education for healthcare professionals is an optional TURAS module online.

Following on from this, engagement with NHS Lothian became a key step in translating concern into constructive dialogue and action. I sought clarity on clinical pathways, prescribing practices, and the availability of specialist services before probing change and suggestions into existing measures and making simple recommendations for future practice.

Policy change requires alignment between lived experience, clinical evidence, and institutional willingness and I was proud to present three achievable and (in my opinion) cost-effective policy changes. However, I learned that pushing for change involves patience, and a lot of it.

The process was long and more complex that I had first considered – and odd because of course making political change is political, but I had not quite appreciated how ‘political’ it was to be heard, so I would take every opportunity given to make my voice LOUD. Don’t forget, I work in the NHS, and I still found this whole process daunting. But it was exactly this perspective that encouraged me to keep championing for those who are less able to have their voice heard.

Conversation and action around women’s health is thankfully now shifting. The Women’s Health Plan: Phase Two (2026-2029), follows the arguably narrow sighted first public policy for women’s health in Scotland (2021-2024) with more robust and considered recommendations. For the first time in a long time menopause, menstruation and transitional care is being discussed and appreciated by employers and educational institutions.

More opportunity is arising; the Scottish Women’s Health Fund (deadline 22^nd April 2026), is calling for applicants who are keen to investigate research into menstrual, menopausal, pelvic floor health and healthy ageing, primarily from the findings and development of Phase Two of the Women’s Health Plan 2026-2029, with the aim to continue developing this important public health issue.

My involvement may be miniscule, yet no matter how small a part I may have played in this process, I am proud to have been involved in some way and will continue to champion for positive change and strive to ensure that others do not struggle in silence. Despite the difficulties of grasping how to influence public policy, I would encourage more people to advocate for change - just remember to be patient.

After all, lived experience matters in making impactful policy changes.

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