Menopause Index Reveals the Best Countries in Europe For Women

Menopause is an extremely challenging period in every woman’s life. Adapting to a wave of new symptoms, including hot flushes, mood swings, and fatigue can make maintaining work and social lives a real challenge.

However, for menopausal women, some countries are easier to live in than others. Across Europe, healthcare standards differ and certain countries offer more support through clinics, workplace policies, treatments and access to HRT (hormone replacement therapy).

With World Menopause Month taking place throughout October, we at The Independent Pharmacy have created the first-ever European Menopause Index to examine the best countries to live in during menopause.

European Menopause Country Index

To develop our index and find the best European country for menopausal women, we evaluated several key factors across European countries: access to HRT, the number of menopause clinics, non-hormonal treatments, mental health support, workplace support, climate control in public transport, and average temperature.

Each country was then given a score based on the significance of these factors in the daily lives of menopausal women and ranked accordingly. Now, without further ado, let’s explore the top ten destinations!

1. Switzerland

Switzerland is ranked as the best country in Europe for menopausal women, scoring an impressive 35.3 points. Throughout the country, HRT is available by prescription, helping ease symptoms and improve quality of life. Four menopause clinics are also dotted across the country, offering additional support on aspects such as diet and lifestyle.

With an average annual temperature of 8.3 degrees Celsius and air conditioning on public transport, hot flushes can be easier to manage in comparison to warmer cities around the continent.

Switzerland also ranked high for non-hormonal menopause treatments, with easy access to lifestyle advice, phytotherapy, and dietary advice.

2. United Kingdom

The United Kingdom lands the silver medal, scoring 34.7 points. Here in the UK, we’re home to the largest number of menopause clinics in Europe, with 59 in total. HRT is also widely integrated into healthcare, with the treatments - such as Gina 10mcg Vaginal Tablets - available by prescription across the UK alongside psychological services to assist women with their body’s transition.

Additionally, since 2011, UK brands such as Tesco and the Royal Mail have committed to ‘The Menopause Work Pledge’, recognising it as a workplace issue and promoting the open discussion of experiences with menopause.

The UK is a fairly cold place to live, with an average temperature of 12.3 degrees Celsius. During warmer months, menopausal women can enjoy air conditioning on some public transport to remain cool when symptoms persist in the heat.

3. Netherlands

Placing third, scoring 33.8 points, is the Netherlands. With access to both HRT and non-hormonal treatments, there’s plenty of support for menopausal women. Although currently, there’s only one menopause clinic in the country helping women transition into menopause with lifestyle and dietary advice.

They do however provide extensive access to psychological services, with registered psychologists and menopause specialists on hand to provide physical and mental health support.

While workplace policies are not a legal requirement, some businesses prioritise training staff and offer policies that allow women to access advice and support. The average temperature in the Netherlands throughout the year is 9.3 degrees Celsius - making hot flushes more manageable.

4. Germany

Next, Germany ranked in fourth place, scoring 33.3 points. Women in Germany have access to HRT with a prescription, helping to improve sleep, relieve night sweats, and ease symptoms generally, although this is not a legal requirement for businesses.

Menopause clinics are also available in Germany - with two in the country - where psychological support and advice on lifestyle amendments are easily accessible to women.

An average temperature of 9.2 degrees Celsius and climate control on public transport can make it easier for women to manage menopause symptoms, avoiding exacerbating hot flushes.

5. Spain

Spain is in fifth place, halfway through the ranking, with a score of 32.6. The country is home to 20 menopause clinics, on hand to offer support and non-hormonal treatments. Furthermore, air conditioning on public transport makes managing the warm climate slightly easier.

While Spain doesn’t have any legally binding menopause policies in the workplace, in 2023, it became the first country in Europe to introduce menstrual leave in the workplace. This allows suffering women to take up to five paid days off, should their period symptoms become unmanageable at work.

With a large number of menopause clinics and access to both hormonal and non-hormonal support, Spain can be a great location for women when their body begins to transition.

6. Italy

Italy ranks next, in sixth place with 32.3 points. The country has 3 menopause clinics for women, making advice easily accessible, and also offers both HRT and non-hormonal treatments. This includes extensive access to therapy with psychologists and lifestyle advice to help reduce the intensity of symptoms.

Currently, Italy has no Government-backed legislation forcing businesses to include menopause policies. Perhaps, unfortunately, the country decided against menstrual leave after considering its introduction back in 2016.

On a more positive side, public transport is fitted with air conditioning, making travel a much more comfortable experience for menopausal women. The average temperature in Italy throughout the year is 16.7 degrees Celsius.

7. Belgium

Belgium placed seventh in the ranking with a score of 31.3 points. Women in the country can access HRT by prescription. There’s also one menopause clinic available where people can receive advice and more tailored treatment, including non-hormonal treatments such as therapy.

Workplace policies have not yet been strictly enforced in Belgium, but flexible working, menopause leave, and the ability to take time off for appointments would all prove extremely beneficial to women, creating a more relaxed environment for sufferers.

The average annual temperature in Belgium is 10.4 degrees Celsius and public transport is fitted with air conditioning, aiding menopausal women travelling in the warmer months.

8. Austria

Austria is in eighth place, with a score of 29.8. HRT is available for menopausal women throughout the country via prescription, and there’s one registered menopause clinic available to offer further advice and support for women. In addition, there’s a range of non-hormonal treatments available, including complementary medicines and systemic coaching.

In the workplace, menopause support is not required by businesses. Despite this, businesses continue to promote open discussion, training and other supportive policies for menopausal women.

Air conditioning on public transport and an average temperature of 9.5 degrees Celsius can make day-to-day life more comfortable for women suffering symptoms of menopause.

9. Denmark

Approaching the end of the ranking, Denmark placed ninth, scoring 28.8 points. Despite Denmark offering HRT as a treatment for menopausal women, there are no registered menopause clinics. There are, however, a range of psychologists throughout the country who can provide mental health support and advice.

Additionally, no workplace legislation currently exists for Danish businesses, meaning workplace policies differ from company to company.

The country has a relatively cold climate, with an average temperature of 8.5 degrees Celsius and there is air conditioning available on public transport.

10. Finland

Finally, the tenth country in the ranking, placing joint-ninth, is another Scandinavian country, Finland, which scored 28.8 points. Similarly, there are no registered menopause clinics in Finland, but women do have access to HRT through prescription and a range of psychology facilities for support.

While there are limited workplace policies for menopausal women, it’s illegal for businesses to discriminate when hiring or employing an individual going through menopause.

Overall, from discrimination laws to easy access to HRT and therapy, Finland can be a great place to live when enduring menopause symptoms. Public transport is also equipped with air conditioning, and the country, as you’d expect, has a lower-than-average temperature of 4.9 degrees Celsius.

The Worst Countries for Menopausal Women

We also examined the opposite end of the scale, uncovering the worst countries to live in while experiencing menopause. The same factors were taken into consideration before each location was given a score out of 28.

1. Serbia

Ranking as one of the worst countries in Europe for menopausal women is Serbia. The Eastern European country scored 11.7, placing joint bottom in the ranking. Despite women having access to HRT, the limited mental health support and lack of workplace policies place Serbia joint last on our index, with other European countries offering more support.

2. Macedonia

Also receiving a score of 11.7 is Macedonia, ranking as another challenging location for menopausal women. In Macedonia, there are 0 registered menopause clinics and non-hormonal treatments are available, but less commonly used. With limited workplace and mental health support, Macedonia joins Serbia, Belarus and Armenia in joint last on our index.

3. Belarus

Belarus is next in the ranking, scoring 11.7 points. HRT is attainable by prescription, but access to the treatment can be limited. Similar to other destinations on this list, there’s a lack of substantial support for women in work and when discussing mental health.

4. Armenia

Next is Armenia, which also scored 11.7 points in the ranking. This is largely due to a lack of support for women, with an absence of workplace policies and limited access to non-hormonal treatments. There is, however, air conditioning on public transport, and access to HRT.

5. Moldova

Finally, ranking as the fifth-worst European country for women going through menopause is Moldova, which scored 12.7 points. The destination offers access to HRT and non-hormonal treatments, although the latter are somewhat limited. Additionally, there are no current workplace policies in place and the average temperature is 9.2 degrees Celsius.

There’s a variety of over-the-counter medications that can help ease symptoms of menopause. You can find further information, including expert guides, here.

Methodology

The Menopause Support Index, created by The Independent Pharmacy, assesses how well European countries support women experiencing menopause.

We looked at seven key areas: availability of Hormone Replacement Therapy (HRT), access to menopause clinics, non-hormonal treatments, mental health support, workplace support, climate control in public transport, and average temperature. To gather data, we used reliable sources like healthcare reports and government statistics.

Each of these areas was scored on a scale from 1 to 4, with higher scores indicating better support. We then applied different weights to each factor based on its importance:

• Access to HRT: Weight 2x (crucial for alleviating menopause symptoms)
• Workplace Support: Weight 2x (important for daily life and long-term well-being)
• Access to Menopause Clinics: Weight 1.5x (valuable but not as critical as HRT)
• Access to Non-Hormonal Treatments: Weight 1.2x (useful for those who cannot or prefer not to use HRT)
• Menopause Mental Health Support: Weight 1.2x (important, though it may overlap with clinic access)
• Climate Control in Public Transport: Weight 0.8x (comfort-related but less critical)
• Average Temperature: Weight 0.5x (less important but still relevant for managing hot flushes)

We then calculated each country’s overall score using these weighted metrics, ranking them to show how well they support menopausal women.