Why Menopause Awareness Matters in Care Homes
Care homes are places where women’s health intersects with complex care needs, and menopause — something every woman will go through — and its implications need to form a key part of our discussions, assessments and care planning. Many female residents live with the long-term consequences of menopause, while many staff and family carers are navigating it right now.
As a dementia care manager, my own experience of perimenopause and menopause has profoundly shaped my understanding of how hormonal changes influence cognition, mood, sleep, and overall wellbeing, in midlife and across our lifespans. Recognising menopause as a key factor in women’s health allows us to deliver more compassionate, informed and holistic care to the women living in our homes, and better support the women working within them.
What is Menopause?
Menopause is reached when menstrual periods have stopped for a full year, either through the natural ageing process or due to surgery, medications, or treatments such as chemotherapy. In the UK, the average age of natural menopause is 51. The years leading up to this transition are known as perimenopause, which can last between 4 and 12 years, followed by post‑menopause, the stage beyond the final period.
Although menopause is universal, the experience is highly individual — and its impact extends throughout a woman’s life.
Why Is It Important That We Talk About Perimenopause and Menopause?
My interest in menopause stems from both personal experience and professional reflection. Before it began for me, I assumed menopause would arrive quietly in my 50s, bring a few hot flushes, and then pass. I thought it would be relatively simple, perhaps even a relief.
But when perimenopause arrived, nothing about it felt simple. I struggled with symptoms that affected my wellbeing, confidence, and even my cognitive clarity. Yet I didn’t have the language at first to recognise what was happening.
A turning point came when I joined The Latte Lounge, a Facebook group where women shared stories that sounded just like mine. Around the same time, public awareness grew, fuelled by voices like TV presenter Davina McCall’s. Suddenly menopause was being talked about openly.
When I sought specialist advice and began HRT, it significantly improved my quality of life. HRT isn’t the right choice for everyone, but it is one of many options. What matters most is that women understand what they are experiencing and feel empowered to seek support.
Symptoms of menopause can be physical, emotional, cognitive, or behavioural. Some women experience few, while others experience many. For women who do experience symptoms, the impact can be profound, influencing work, relationships, daily functioning, and emotional wellbeing. This makes it essential that we talk about menopause in care settings, where staff and residents may both be affected.
Menopause and Young Onset Dementia
Going through perimenopause myself gave me a new lens through which to view my work. Earlier in my career, I rarely included menopause in conversations with younger women worried about cognitive decline, because menopause simply wasn’t spoken about.
During my time as a Consultant Admiral Nurse for young onset dementia at Dementia UK, this realisation inspired collaborative work with The Menopause Charity and with women living with both young onset dementia and menopause. Together, we created accessible resources to help women, families, and professionals recognise overlapping symptoms and improve holistic assessment.
Hormonal changes can affect memory, concentration, mood, sleep, and emotional resilience. Without awareness of menopause, these can easily be misinterpreted as depression, stress, or dementia progression. That’s why understanding menopause is vital for accurate assessment and compassionate care.
How Does Menopause Impact Care Home Residents?
Many assume that because most women in care homes are post‑menopausal, menopause is no longer relevant. In reality, ongoing low oestrogen continues to significantly affect health and wellbeing.
Low oestrogen can contribute to:
- Cognitive vulnerability
- Reduced bone density and osteoporosis
- Genitourinary issues such as urgency, incontinence, UTIs, and vaginal dryness
- Sleep disturbance
- Mood changes
For women living with dementia, these can present as:
- Increased falls
- Agitation or distress
- Night‑time restlessness
- Apparent confusion
- Behaviour that challenges
While my anecdotal experience is that very few women are prescribed HRT in care homes, there are no available statistics. I have come across many women under the age of 65 who are prescribed HRT, but no older women.
I have spoken to older women in care homes about their experiences of HRT and many were prescribed HRT earlier in their lives at the time of menopause, but because of the purported cancer scare in the 2000s, most had their HRT stopped. Now there are no thoughts to restart it, as they view themselves ‘too old’.
One area where I have encouraged care home staff to think about is genitourinary issues such as urgency, incontinence, UTIs, and vaginal dryness. GPs are usually very happy to prescribe topical oestrogen, as it acts locally, and is considered a safe option for most women. This can have a life changing effect as it reduces dryness (and associated pain) improves bladder function and reduces stress incontinence, and overall there are a reduction in urinary tract infections.
Should we, as a society, be considering the benefits of HRT for the older women? I believe we certainly should. As yet, the depth of research we need isn’t available in terms of benefits and risks, but we should be encouraging conversation with our peers so that we can make informed decisions.
More broadly, if more women choose to remain on HRT later in life, care homes must ensure staff understand how to support those choices and liaise appropriately with GPs and specialists.
Menopause is not just a midlife issue, it is a lifelong women’s health consideration.
Case Study: Elizabeth and Her Daughter Clare
This composite case draws on my experience supporting women with dementia and their families.
Clare, aged 50, had been living in a care home for a year after a diagnosis of young onset Alzheimer’s disease. Before moving into the care home, her mother Elizabeth had been her main carer at home. Clare was diagnosed with Alzheimer’s disease 3 years ago, but she has had symptoms for at least the past 5 years.
Elizabeth was very distressed about her daughter needing the support of a care home, as she had hoped that she would be able to manage Clare at home. Clare transitioned into the care home as she was no longer able to maintain her safety at home and she needed 24-hour support. Initially Clare settled well - she built some good relationships with staff, and she had worked as a nurse so the routines of the care home felt familiar to her. Over time though her mood declined, she struggled to sleep, and she appeared increasingly distressed at night. Despite normal blood tests, she was prescribed antidepressants, which offered little improvement.
During a review, the dementia care manager explored whether hormonal changes might be contributing. Although Clare no longer had periods due to medication, further conversation revealed she was experiencing night sweats and recurrent UTIs.
These symptoms prompted a GP review, and Clare began HRT alongside vaginal oestrogen.
Over the following weeks:
- Her sleep improved
- Night sweats resolved
- Her UTIs stopped
- Her mood lifted
- Antidepressants were discontinued
Elizabeth also reported positive changes in her daughter. Clare had re‑engaged with meaningful activities and her speech had improved, further supporting improvements to her overall quality of life.
This case demonstrates how taking a holistic approach is so important and why women’s health awareness is essential in care homes.
The Future
Our understanding of menopause is growing, and research into its long-term impact continues to evolve. What remains clear is that awareness benefits everyone in a care home environment: residents, relatives, and the largely female workforce supporting them.
As a dementia care manager, my own menopause journey has strengthened my empathy and shaped the way I support residents and my colleagues, and advocate for women’s health. By building menopause knowledge into everyday practice, we can offer more dignified, holistic, and person-centred care.
Resources and information
Menopause Symptom Checker - The Menopause Charity
Welcome to The Latte Lounge - The Latte Lounge
WHC factsheets and other helpful resources - Women's Health Concern