Scotland's New Women's Health Plan Listens to Girls and Older Women—Here's What They're Getting

Scotland is overhauling its approach to women's health by centering the voices of girls as young as 12 and women in their 90s—groups historically left out of health planning. The country's Women's Health Plan Phase Two (2026-2029) emerged from focus groups that engaged across the entire female lifespan, revealing critical gaps in education and support that the new plan directly addresses.

Why Are Girls and Older Women Getting More Attention Now?

For years, women's health planning has focused on working-age women, leaving younger girls confused about their bodies and older women struggling without adequate support. Scotland's new plan changes that by deliberately including underrepresented voices. The Young Women's Movement and Age Scotland facilitated focus groups to ensure girls and older women could share their real experiences and needs.

Girls and young women consistently asked for one thing: better education about menstrual health. They wanted to understand what's normal, when to seek help, and where to access support. In response, Scotland is reviewing and updating women's health content on RSHP.scot and developing new, detailed educational resources specifically about menstrual health and periods.

For older women, the focus is equally urgent. Phase Two includes a greater emphasis on the health challenges that disproportionately affect women as they age, including bone health, brain health, and pelvic floor health.

What Health Challenges Are Older Women Facing in Scotland?

The numbers tell a sobering story. In Scotland, approximately 359,313 women are of menopausal age, between 45 to 54 years old, with the average age of menopause at 51. Women live longer than men—with a life expectancy of 80.8 years compared to 76.8 for men—but they spend more of those extra years in poor health.

One of the most pressing issues is bone health. Hip fractures among people aged 50 and older have surged by just over 25% between 2017 and 2023, and women account for the majority of these cases in Scotland. The disparity is striking: more than twice as many women are admitted to hospitals for hip fractures than men. Even more troubling, socioeconomically deprived women suffer hip fractures 5.6 years earlier than the least deprived, which can impact overall life expectancy.

Women also face higher risks for conditions like osteoporosis and dementia. Alzheimer's disease and dementia are the leading causes of death in women in Scotland, making brain health and bone health central priorities for the new plan.

How Is Scotland Addressing the Broader Women's Health Crisis?

Beyond menstrual education and aging support, Scotland is tackling systemic barriers in women's health services. Gynaecology waiting lists have grown by 193% since the pandemic began in February 2020, creating dangerous delays for women with conditions like endometriosis. Approximately 10% of women and girls of reproductive age worldwide are affected by endometriosis, making it a significant public health concern.

The economic impact is staggering. A 2024 report by the NHS Confederation found that absenteeism due to gynaecological conditions costs nearly £11 billion annually. The same report estimated that for every £1 invested in obstetrics and gynaecology services per woman in England, there is a return on investment of £11.31. These findings are relevant to Scotland's situation, suggesting that investing in women's gynaecological health pays dividends for the economy and workforce.

The plan also recognizes that women face disproportionate caregiving burdens. In 2023-24, 73% of all carers were female, and 80% of working-age carers were women. Women typically begin caregiving responsibilities at age 45—12 years earlier than men—which can impact their own health and work participation.

Key areas the plan addresses include:

• Menstrual Health Education: New resources on RSHP.scot to help girls and young women understand their periods and know where to access help.
• Bone and Brain Health Support: Specific interventions for older women to manage osteoporosis risk and dementia prevention through pelvic floor health and preventative care.
• Gynaecology Service Transformation: Efforts to reduce waiting lists and improve access to care for conditions like endometriosis and other reproductive health issues.
• Holistic Health Touchpoints: Using routine appointments like smear tests to promote preventative health and help women optimize their long-term wellbeing.
• Accessibility for Disabled Women: Ensuring disabled women can access cervical screening and gynaecology services without facing structural barriers.

The plan also acknowledges that disabled women face unique barriers. Disabled women make up 20% of women of reproductive age in the UK, yet there is limited data on their experiences in Scotland. Women with learning disabilities have a life expectancy 23 years shorter than the general population, highlighting the urgent need for inclusive health services.

Over a third of Scotland's female workforce is over 50 years old, making it essential for employers and the health system to support women's wellbeing during menopause and beyond. By listening to girls and older women, Scotland's new plan aims to fill decades-old gaps in women's health care and ensure that every woman—regardless of age—has the support and information she needs to thrive.