Norwegian health authorities are evaluating whether to expand state-subsidized hormone therapy for women experiencing menopause. The Directorate for Medical Products will deliver its assessment this week on health benefits and costs of making treatment more accessible.
Current criteria for receiving hormone therapy through the 'blue prescription' system are too restrictive according to women's health advocates. Only women who experienced menopause before age 40 automatically qualify for subsidized treatment.
"Today's criteria for getting hormones on blue prescription are far too narrow," said Liv Bjørnhaug Johansen, senior advisor for women's health at Norway's largest voluntary women's organization. "We know that one third of all women have significant health problems during menopause. But very few of them are covered by today's criteria."
Last year, nearly 300,000 women over 35 received hormone treatment for menopause symptoms. Only about 4 percent received it through the subsidized system. The rest paid out of pocket.
"The treatment can become expensive, and if the woman has symptoms that affect quality of life and functioning, it feels unfair that finances should determine how she experiences this period," said Marianne Natvik, a specialist in general medicine.
Current guidelines require women to have more than six hot flashes daily, with at least one lasting over 15 minutes, to qualify for subsidized treatment. Natvik notes hot flashes rarely last 15 minutes but can still significantly impact quality of life even with fewer episodes.
The criteria also don't account for other debilitating symptoms like cognitive challenges, mood changes, and sleep disturbances that affect women's ability to work and function.
The Labor Party promised during elections to implement new guidelines during this government period. The final decision and new criteria will depend on the directorate's assessment, due by Saturday, November 1.
Johansen expressed satisfaction that the government started the process but would have preferred changes in next year's budget. "We know there's broad political support from all parties to ensure women get this treatment on blue prescription," she said.
The main challenge is cost—all women go through menopause, and subsidizing treatment for all who need it would be expensive.
"We believe everyone who has so many problems that it's difficult to function at work and in life should be included in the scheme," Johansen said. "We know menopause is a phase where many women drop out of working life. If politicians are serious about women's employment and reducing sick leave, they must allocate the necessary funds."
Natvik thinks some regulation of hormone treatment is reasonable but hopes for updated criteria that better reflect women's actual symptom burden.
The debate highlights the tension between healthcare costs and women's health needs during a natural life transition that affects half the population.