Understanding perimenopause and menopause treatment in women with intellectual disability: a retrospective cohort study

Purpose This study aims to explore how menopause is recognised, recorded and treated in women with intellectual disability receiving care from community learning disability services. It sought to identify gaps in diagnosis, treatment provision and access to routine health checks, as well as regional disparities across a NHS Trust in the Northwest of England. Design/methodology/approach A retrospective cohort study was conducted using routinely collected clinical data from 555 women aged 40–60 with intellectual disability, obtained from electronic health records across multiple community learning disability teams. Descriptive and comparative analyses were performed to examine menopause diagnosis rates, treatment patterns and annual health check (AHC) participation. Findings Only 4% of women had a recorded diagnosis of menopause or perimenopause. However, a greater proportion received menopause-related interventions, indicating a potential gap in formal recognition. The use of Hormone Replacement Therapy varied significantly across regions, with less than half of eligible women having had an AHC. Practical implications Findings support the need for accessible screening tools, workforce education and equitable service commissioning. Originality/value To the best of the authors’ knowledge, this is one of the first studies to audit menopause care for women with intellectual disability at scale using data from electronic patient records. The findings highlight systemic under-recognition, inconsistent documentation and inequities in access to care, calling for improved screening, professional training and inclusive policy responses.