Menopause in incarceration is a social and policy campaigning issue in which people work to raise awareness of the gender specific impact

menopause Menopause, also known as the climacteric, is the time in women's lives when menstrual periods stop permanently, and they are no longer able to bear children. Menopause usually occurs between the age of 47 and 54. Medical professionals often d ...

symptoms can have on people in

prison A prison, also known as a jail, gaol (dated, standard English, Australian, and historically in Canada), penitentiary (American English and Canadian English), detention center (or detention centre outside the US), correction center, correc ...

. Although women are a minority of those incarcerated, the age of women in the prison system is increasing across the world. As this happens it becomes necessary for inmates to be assessed for menopausal symptoms and offered the gender and age-specific services and support they need. Researchers have identified this as a gap in

prison healthcare Prison healthcare is the medical specialty in which healthcare providers care for people in prisons and jails. Prison healthcare is a relatively new specialty that developed alongside the adaption of prisons into modern disciplinary institutions ...

which leaves the needs of many people unmet.

Background

Menopausal women experience a range of medical and health issues whether or not they are in prison. Particular aspects of incarceration, however, may exacerbate the experience of

and these are the responsibility of organisations making health policy. In the US, a third of older women prisoners say they are concerned about it. Menopause is an inter-sectional issue in women's health as it combines gender and age. Incarceration brings a complex combination of inequality factors for women's needs in terms of

menstruation Menstruation (also known as a period, among other colloquial terms) is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. The menstrual cycle is characterized by the rise and fall of hor ...

pregnancy Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but ca ...

contraception Birth control, also known as contraception, anticonception, and fertility control, is the use of methods or devices to prevent unwanted pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth contr ...

post-natal The postpartum (or postnatal) period begins after childbirth and is typically considered to end within 6 weeks as the mother's body, including hormone levels and uterus size, returns to a non-pregnant state. The terms puerperium, puerperal perio ...

health, mental health and menopause. In countries where prisons are privatized, women's heatlh needs may be seen as low priority. In prisons access to hygiene and medical supplies are restricted, and it is difficult to regulate the temperature of rooms. Peri-menopause leads to erratic periods and many women experience frequent hot-flashes. Many facilities do not provide access to locally controlled air conditioning or fans which are needed to regulate and relieve

hot flashes Hot flashes (also known as hot flushes) are a form of flushing, often caused by the changing hormone levels that are characteristic of menopause. They are typically experienced as a feeling of intense heat with sweating and rapid heartbeat, and ...

, which are a common symptom of menopause. Additional layers of clothing may be needed for increased comfort during hot flashes and night sweating. The symptoms of menopause may also include mental health issues such as feelings of shame, embarrassment, short-temper, loneliness and depression which are challenging to manage for well-being in prison. In the UK, 65% of women in prison suffer from depression. Shame and embarrassment results from physical changes but also from societal norms in which menopause continues to be a 'taboo subject'. Women inmates in prisons report that their concerns were often dismissed. There are additional physical complications as menopause often brings

osteoporosis Osteoporosis is a systemic skeletal disorder characterized by low bone mass, micro-architectural deterioration of bone tissue leading to bone fragility, and consequent increase in fracture risk. It is the most common reason for a broken bone ...

and in prisons the weight-bearing exercises and extra support may not be available to help in treatment. In the UK the health of older prisoners is seen to be worse than that of the wider community and many have additional disabilities or long-standing illness.

International perspectives

In the USA the fastest-growing segment of the prison population is women but health systems which have been designed for men fail to meet their needs. The

National Commission on Correctional Health Care The National Commission on Correctional Health Care (NCCHC) is an independent, non-profit organization dedicated to improving the standard of care in the field of correctional health care in the United States. With support from the major national ...

recognize the need for standards in care in jails and prisons. The

UK Government ga, Rialtas a Shoilse gd, Riaghaltas a Mhòrachd , image = HM Government logo.svg , image_size = 220px , image2 = Royal Coat of Arms of the United Kingdom (HM Government).svg , image_size2 = 180px , caption = Royal Arms , date_es ...

has set standards for care of women in prison which includes appropriate treatment and support for transition through the menopause and access to the similar standards of care as they would have in the community. Women are offered access to

hormone replacement therapy Hormone replacement therapy (HRT), also known as menopausal hormone therapy or postmenopausal hormone therapy, is a form of hormone therapy used to treat symptoms associated with female menopause. These symptoms can include hot flashes, vaginal ...

and the option to change their sheets frequently if they suffer from night sweats. In 2009 the

Kyiv Kyiv, also spelled Kiev, is the capital and most populous city of Ukraine. It is in north-central Ukraine along the Dnieper, Dnieper River. As of 1 January 2021, its population was 2,962,180, making Kyiv the List of European cities by populat ...

Declaration on Women's Health in Prison reviewed issues affecting women's health in the criminal justice system. The Declaration raises awareness of the differences in health needs between men and women prisoners. The

World Health Organisation The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...

considers that prison health services contribute to the social well-being of all of society and suggests that prisons should have written policies showing the practices that are sensitive to women. The United Nations 2010 Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders are known as ' The Bangkok Rules'.The 70 Rules give guidance to cover healthcare and humane treatment .{{Cite journal , last=UNODC , date=2011 , title=THE BANGKOK RULES , url=https://www.unodc.org/documents/justice-and-prison-reform/Bangkok_Rules_ENG_22032015.pdf , journal=

References

Women's health Menopause Prison healthcare Health activism Middle age Nursing Equality rights Imprisonment and detention of women Criminal justice Health policy