DR MAX PEMBERTON: I know the reason why so many women are off sick

Night sweats, mood swings, sleep problems, weight gain, hot flushes, headaches, palpitations and joint symptoms. These are just some of the debilitating symptoms women experience when going through the menopause.

You'd think they might be enough to get a doctor's attention and mobilise them into taking action. Sadly, that's often not the case.

Latest data has revealed the full, devastating impact the menopause can have – not just on the women affected, but on society and the economy as a whole.

According to research by the NHS Confederation, 60,000 women are off work with long-term symptoms, with these absences costing the economy £1.5billion a year.

The report found that those suffering severe mental or physical issues are less likely to be in employment compared with the rest of the population, and twice as likely to be economically inactive due to their health problems.

Yet, despite this, menopausal women up and down the country are being ignored or fobbed off when they see the doctor and ask for help. While the rich and famous can always pay for private treatment, the rest face an uphill struggle to get even basic care.

Even though 13million women are going through the menopause it is estimated that one in four have to visit their GP at least three times before getting appropriate treatment, such as HRT. Is it any wonder so many feel let down and desperate?

Worse still, when they finally do get treatment, it's often the wrong kind. Campaigners say that common menopausal symptoms such as anxiety, low mood or palpitations are dismissed as being psychological and patients are sent packing with antidepressants.

I've seen this several times in my clinics where women have been told they are 'just' depressed. Yet when I spend time talking and listening to them, it becomes clear their troubles are the result of the menopause.

One patient had been given antidepressants, a beta-blocker to deal with palpitations which were put down to stress, and a highly addictive anti-anxiety medication to treat symptoms that had only developed with the onset of menopause. 

Her GP had refused to prescribe HRT when she requested it. In desperation she sourced it privately and, after a few months, her depression and anxiety vanished enabling her to stop all the other tablets.

Of course, it's perfectly possible to be both menopausal and depressed.

It's why docors need to pay much more attention to women going through the change of life with careful, detailed assessments to find out where the root of their problems lie. 

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Regular readers will know that I am a passionate advocate for the NHS, which is why it pains me to say that women are being let down by the health service. Why are they having to fight for treatment? When did accessing HRT turn into such a battle?

I'm not suggesting every woman should take HRT. Some are lucky enough to sail through the menopause with no major issues, others can get by by using mindfulness and meditation techniques to help with hot flushes.

The menopause is a natural phenomenon, it's not an illness or the body going wrong in some way. While we hear lots about the health risks associated with the menopause, such as osteoporosis (thinning bones), we know from large-scale studies that it's complex and that there are actually some health benefits too.

Women no longer risk pregnancy, for example, and many say their sex lives benefit.

Others gain confidence, once symptoms recede, and love the fact they're not dealing with monthly menses.

Mostly though, western women are increasingly being told that the menopause is something to be feared and loathed. It is presented in terms of the body giving up or failing, rather than moving into its next phase.

It's heartbreaking to think of all the women who have previously never experienced anxiety or depression finding themselves felled by this, barely able to get up in the morning, finding no enjoyment or excitement in life, and going through each day numb and like an automaton.

How can we expect people to hold down a job in this state?

It beggars belief that there are treatments and medication that can alleviate women's suffering and distress and yet accessing it is so difficult that tens of thousands have to be signed off on sick leave.

Researchers have urged struggling new dads to seek specialist mental health support in the weeks following the birth of their child, in a bid to ward off 'post-natal depression in men'. 

Some men can struggle to adjust to their new life as a dad, however, this is akin to any difficulty adjusting to a big event in life. It's wrong to compare their experience to new mothers going through huge hormonal shifts that don't affect men.

Shirley is right on Strictly row 

Strictly judge Shirley Ballas broke her silence on the findings of the BBC bullying probe last week, saying 'I don't condone bullying…if things aren't right or need addressing I feel for the person who wants them addressed.'

Then she added: 'But now the investigation is over and everybody can move on.'

Bravo, Shirley. In particular, I do think Amanda Abbington, for her own sanity and everyone else's, needs to step away from the whole affair. I suspect it's not really in her best interests to keep dragging the row on, with interviews and threats of legal action.

I've had patients who have found it very hard to get over something traumatic that has happened to them. They have a tendency to focus on one big, cathartic event in the hope this will in some way resolve everything, as perhaps Amanda has done with the BBC report.

They spend their life savings taking people to court, give interviews to TV and press, write books, demand inquiries. All of these are done with the best intentions but once it ends, it often leaves the person feeling hollow and desperate because they realise that nothing has really changed. 

As a therapist said to me once, often the only way to deal with awful things that have happened in the past and cannot be changed is to remember the words of the Disney song Frozen: Let it go.

The proportion of GP appointments conducted online has hit a record high despite concerns over patient safety, official figures reveal. This news fills me with dread. Can patient-centred and clinically accurate care really be delivered via the internet? Certainly for some things, especially minor ailments, virtual appointments might be fine. 

But for some time I've been unconvinced that a virtual appointment can replace seeing a doctor face to face. I've had online consultations myself and the experience has been revealing. Several times the diagnosis has been wrong and the treatment prescribed incorrect for the condition I really had because the GP couldn't properly examine me.

Personal contact is also lost – that human connection that is so important in the doctor/patient relationship and near-impossible to replicate via a screen.

Dr Max Prescribes: Anna Richardson: Love, Loss and Dementia

In her truly moving Ch4 documentary Anna explores the issues facing those with dementia and the challenges of those caring for them. It's all the better for being a deeply personal film, detailing her father's battles with vascular dementia.