J Appl Res Intellect Disabil. 2026 Mar;39(2):e70192. doi: 10.1111/jar.70192.
ABSTRACT
BACKGROUND: People with intellectual disabilities who menstruate are underrepresented in menopause research and care.
METHODS: A mixed-methods service evaluation was conducted in one NHS Trust. In Phase 1, prescribing data from electronic health records for women aged 40-79 with intellectual disabilities (n = 149) was extracted and statistically compared to estimates for the general population. Phase 2 comprised a focus group with psychiatrists (n = 6) and an interview with a GP (n = 1); data were analysed using framework analysis.
FINDINGS: HRT was prescribed to 3.3% of people with intellectual disabilities, versus 17.2% in the general population, indicating significantly lower prescribing (p < 0.0001). Qualitative themes highlighted low clinician awareness, diagnostic overshadowing, concerns about monitoring and system-level issues. Facilitators included psychiatrist advocacy, proactive carers and clearer primary-to-secondary care collaboration.
CONCLUSIONS: Women with LD were substantially less likely to receive HRT, suggesting a marked inequity in menopause care. Recommendations are made to improve recognition, treatment access and outcomes.
PMID:41805101 | DOI:10.1111/jar.70192
