France expands menopause care by empowering midwives with hormone therapy prescriptions, aiming to cut 2.3 billion euros in annual costs through prevention.
Health minister seeks midwife involvement in menopause care
During the Menopause Congress in Paris on October 15, 2026, Minister of Health Stéphanie Rist announced plans to request the High Authority for Health (HAS) to consider expanding the prescription of hormone therapy (HT) to midwives. This would allow midwives to prescribe certain treatments, a role currently reserved for doctors.Current midwife role in menopause management
The principle of long menopause consultations by midwives is already recognized by the ministry. Minister Rist noted that midwives already provide gynecological care during perimenopause and menopause and encounter these situations regularly. She emphasized that midwives could take on this role in the future, provided they do not deal with high-risk cases.Government measures to support menopausal women
The French government has outlined four measures to support the 17 million women undergoing menopause. These aim to reduce an estimated annual economic cost of 2.3 billion euros, including increased sick leave, lower productivity, and unnecessary hospitalizations. A study found that 25% of menopausal women experience a significant decline in quality of life, often due to hot flashes or sleep issues.Economic impact of fragmented care
The lack of a structured care pathway leads to women consulting an average of 3.4 professionals before receiving proper care. The Social Security Fund spends 320 million euros annually on related costs, with 40% of that potentially avoidable through preventive support. Hospitalizations for cardiovascular and osteoporosis complications add an additional 450 million euros in costs each year.Preventive assessments as a key measure
The My Prevention Assessment program, aimed at women aged 45 to 50, is a central part of the government’s plan. This free assessment, launched in 2024, is expected to reach 2.5 million women by 2028. The program costs 180 million euros over three years but aims to yield 4.2 euros in savings for every euro invested by preventing hospitalizations and detecting health risks early.Midwives to lead long-term consultations
After unsuccessful talks with doctors, the government is turning to midwives for long-term menopause consultations. Negotiations with the Social Security Fund will soon begin, with a planned fee of 60 to 80 euros per consultation. The goal is to conduct 800,000 consultations annually by 2028, at a cost of 48 to 64 million euros per year.Potential savings from midwife prescriptions
Allowing midwives to prescribe hormone therapy could save up to 120 million euros annually. Currently, only doctors can prescribe these treatments, leading to higher costs. However, concerns remain about the risk of fragmented care and inappropriate prescriptions, especially after a 2002 study linked HT to a higher breast cancer risk.National awareness campaign planned
In January 2027, Santé publique France will launch a 12-million-euro national campaign to raise awareness about menopause. The World Health Organization notes that menopause is rarely discussed in families or communities. A similar campaign in the UK reduced emergency menopause-related consultations by 18%, saving 85 million pounds.Uncertainty about long-term success
The evaluation of these measures is scheduled for October 2027, after the presidential election, raising questions about their sustainability. The HAS’s recommendations, expected in mid-2027, will be crucial for implementation. The government aims to transform 2.3 billion euros in indirect costs into 260 million euros of preventive investment, but success will depend on healthcare professionals and equitable access across the country.
