UK Medicine Policy Series Roundtable Two

Not Just Menopause: Pharmacy’s Role in Women’s Health Inequalities Across the Life Course

Women’s Health Inequalities in the UK: From Policy Ambition to Better Frontline Care

On 9 May 2026, the roundtable ‘Not Just Menopause: Pharmacy’s Role in Women’s Health Inequalities Across the Life Course’, convened by Global Policy Network, brought together perspectives from pharmacy, education, and women’s health to examine a pressing policy question: how can the community pharmacy respond more effectively to women’s health needs across the life course, rather than addressing them through isolated conditions or stages of life.

Women’s health in the UK is entering a period of greater policy attention. The Women’s Health Strategy for England and the development of Women’s Health Hubs have placed women’s health more firmly on the policy agenda, with increasing emphasis on prevention, earlier intervention, and care across the life course. Yet the pressures facing women remain familiar: delayed diagnosis, fragmented pathways, limited access to appropriate care, and the persistent normalisation of symptoms that should not be accepted as inevitable.

Within this changing landscape, one issue stands out. Women’s pain continues to be under-recognised and undertreated across a range of conditions beyond reproductive issues, including endometriosis, fibroids, menstrual and contraceptive-related pain, as well as cardiovascular and metabolic conditions. Focusing solely on reproductive health risks reinforces the same siloed approach that contributes to these inequalities: women’s symptoms can be overlooked or misinterpreted across the healthcare system more broadly, contributing to delayed diagnosis and missed opportunities for earlier intervention. The problem is not that women experience pain. It is that pain has historically been treated as something they are expected to tolerate. This can shape how women interpret their own symptoms, how professionals respond to them, and how quickly they move through the healthcare system.

The roundtable highlighted a growing tension at the heart of this debate: expectations for women to recognise, manage, and advocate for their health are outpacing the capacity of health services to respond consistently and appropriately.

When Pain Becomes Normal

Pain is not always treated as a clinical problem when it occurs in women. Menstrual pain, pelvic pain, symptoms associated with endometriosis, and pain related to long-acting reversible contraception can be interpreted as expected aspects of female biology rather than symptoms requiring investigation or active management.

This normalisation has consequences. Women may delay seeking help because they have internalised the expectation that pain is something they should endure. Clinicians may also interpet symptoms through the same cultural lens, particularly when they are complex or difficult to attribute to a single condition.

The result can be a cycle of delayed recognition, repeated consultations, inadequate symptom management, and declining trust.

Participants highlighted this particularly clearly in relation to long-acting reversible contraceptive procedures. As one pharmacist observed, while women in some countries may be offered analgesia and sedation, women in the UK can still be advised to “just have it in your lunch hour and take two paracetamol”.

The issue extends beyond pain relief. When symptoms are repeatedly normalised, underlying conditions can remain undiagnosed and untreated. Women’s health inequalities are therefore not simply a problem of awareness or help-seeking; they are also embedded in how symptoms are interpreted and valued within healthcare.

A Fragmented System?

The NHS is often described as an integrated health system, yet women can experience it as a series of disconnected services. Conditions are frequently organised around individual specialties and pathways, while women’s experiences are often more complex.

A woman may experience pain, fatigue, mental health difficulties, reproductive symptoms, or metabolic risk simultaneously, but services can still address these concerns separately. This creates particular difficulties for women with multimorbidity, who may move between general practice, pharmacy, specialist services, and self-management without a clear point of continuity.

Participants also highlighted the risk of relying too heavily on awareness-driven approaches. Encouraging women to seek help is important, but it does not guarantee timely diagnosis or appropriate treatment. If increased awareness generates additional demand without strengthening service capacity, the result can be longer waits, repeated consultations, and further pressure on an already stretched system.

The direction of travel therefore needs to shift from awareness alone towards earlier recognition, coordinated care, and system capacity to respond.

Community Pharmacy: An Untapped Opportunity

Community pharmacy is already embedded within local communities and provides one of the most accessible points of contact with the health system. Pharmacists see women repeatedly through contraception services, blood pressure checks, medicines consultations, and routine prescription collection.

This creates opportunities that are not always available elsewhere. Repeated contact can help pharmacists recognise emerging concerns, identify patterns in symptoms over time, provide appropriate symptom management, and encourage women to seek further assessment when needed.

The opportunity extends beyond reproductive health. Community pharmacy can contribute to women’s health across the life course, including menopause, chronic pain, cardiovascular risk, mental health, pregnancy, breastfeeding, and metabolic conditions.

The role is therefore not to replace general practice or specialist services. It is to strengthen the frontline between self-management and formal care: a place where women can be listened to, their symptoms taken seriously, and appropriate action initiated earlier.

Capability Must Match Responsibility

The potential of community pharmacy, however, depends on whether professionals are equipped and enabled to use it.

Participants highlighted uncertainty around scope of practice, with one education professional stating. Women’s health consultations can involve sensitive conversations, multimorbidity, prescribing decisions across pregnancy and breastfeeding, and symptoms that do not fit neatly within one clinical pathway. Pharmacists therefore need more than condition-specific knowledge. They need confidence in consultation, symptom recognition, pain management, risk assessment, and referral.

This requires stronger education and clinical guidance across the pharmacy workforce. Participants also highlighted the need for resources that allow clinicians to make more informed decisions across the life course, rather than relying on guidance that simply advises “avoid” without explaining the circumstances in which a treatment may be appropriate.

But capability is also constrained by capacity. Pharmacy teams have increasingly less time for the relational and problem-solving work that underpins good care. Expanding pharmacy’s role without addressing time, funding, consultation space, and infrastructure risks creating another set of expectations without the capacity to deliver them.

From Accessibility to Integration

Community pharmacy is accessible, but accessibility alone does not create integration.

For pharmacy to contribute meaningfully to reducing women’s health inequalities, it needs stronger connections with general practice, Women’s Health Hubs, and specialist services. Referral pathways need to be clear, digital systems need to support information sharing, and private consultation environments need to enable women to discuss sensitive issues safely.

The same principle applies to public awareness. Women need to know what support pharmacies can offer, but communication should not simply shift responsibility onto women to navigate the system themselves. Awareness must be matched by a system capable of listening and responding.

This is particularly important for pain. Pharmacy should not become another place where women are simply advised to manage symptoms themselves. It should help shift the conversation from “this is normal” to “this is worth understanding.”

Key Recommendations

• Embed community pharmacy within national women’s health pathways, with clearer roles, competencies, referral routes, and responsibilities across the life course.

• Strengthen women’s health education across the pharmacy workforce, including pain recognition, multimorbidity, consultation skills, cultural competence, and recognition of gender-related bias in symptom assessment.

• Develop accessible clinical decision-support resources for women’s health, including evidence-based guidance on prescribing and symptom management across reproductive health, pregnancy, breastfeeding, menopause, and chronic conditions.

• Invest in the infrastructure required for high-quality pharmacy care, including private consultation spaces, sufficient consultation time, interoperable referral systems, and sustainable commissioning.

• Improve public communication about women’s health and pain, ensuring women understand when symptoms warrant professional assessment and what support community pharmacy can provide.

• Measure the contribution of community pharmacy to reducing inequalities, including earlier recognition, referral quality, patient experience, symptom management, and outcomes among underserved groups.

  
  

Looking Ahead

Women’s health does not lack policy ambition; it lacks the capacity and consistency to translate that ambition into better care. The normalisation of women’s pain illustrates the challenge clearly: encouraging women to seek help is only meaningful if the system is equipped to recognise their symptoms, take them seriously, and respond appropriately. 

Community pharmacy can strengthen this frontline response, but only if pharmacists have clear responsibilities, appropriate training, clinical guidance, sufficient time and infrastructure, and effective integration with the wider health system. The next phase of women’s health policy should therefore focus not only on whether women seek help, but on what happens when they do, ensuring earlier recognition, appropriate support, and equitable access to care across the life course. 

GPN’s work on women’s health will continue to bring together frontline and policy perspectives to explore how community pharmacy can contribute to more equitable, responsive, and integrated care for women.