Menopause & Advocacy in the Workplace

How to Advocate for Yourself with Your Employer: Menopause, Anxiety, and Work Performance”

Why does menopause continue to be problematic in the workplace?

Women in the workplace have always been expected to integrate with existing male frameworks. Menstrual health and peri/menopause were – and continue to be – taboo and stigmatising topics, despite some attitudinal changes in the last 5-8 years. The ongoing lack of a body of evidence-based data about treatments, care, and support reflects the historical under-investment into research about women’s health. In sharp contrast, there is ample data indicating that adverse work environments exacerbate the severity of menopause symptoms.

Nowadays, there is a wider recognition that peri/menopause is a natural midlife transition that typically occurs between the ages of 45-55. There is little awareness, however, that premature peri/menopause (possibly medically or surgically induced, or as a result of an autoimmune disorder) may start in a woman’s 40s or even 30s. Employers – and society in general – remain largely ignorant about sociocultural, ethnic or genetic variations; even less is known about the menopause experiences of individuals who do not identify as cisgender or are autistic. The complexities of menopause (with at least 30 known symptoms) highlight that we cannot make assumptions about an individual’s encounter with the menopause as it personal to them.

In the UK (which includes the devolved nations,) there are almost 4 million women in the workplace in the 45-55, age range, with those 50s representing the fastest growing sector. So the onset of the peri/menopause often coincides with the time when we reach the peak of our careers, occupying senior and leadership roles and entering the C-suite. With 25% of peri/menopausal women reporting severe

physiological, physical and psychological challenges and a further 50% reporting some symptoms, the need for companies to have clear menopause policies cannot be overstated. Menopause charities, not-for-profit companies and podcasts about women’s health, are all focused on raising awareness about the experience of menopause in the workplace. The work of Helen Tomlinson, the UK’s first Menopause Employment Champion, has helped start a cultural shift in the way we discuss the menopause, empowering women to have more open conversations with managers about the support they need and highlighting the critical knowledge gaps displayed by employers (as well as many healthcare professionals). In a less helpful move, the cross-party Women and Equalities Committee’s call for ‘menopause’ to be a protected term under the Disability Act was rejected by the then Conservative government in 2023. Today, only one quarter of the UK’s companies have a menopause policy.

The impact of peri/menopause on working women

The physical symptoms of the loss of oestrogen in the ovaries and brain may include insomnia, night sweats, hot flushes, weight gain, palpitations, panic attacks, dry skin, thinning hair, osteoporosis, and an increased risk of cardiovascular disease. The less visible symptoms relate to poor memory, ‘brain fog’, anxiety, reduced confidence, mood swings, and depression. Whilst all these signs and symptoms are transient – and many can be treated – they can be deeply embarrassing, and anxiety-provoking.

A subjective sense of lost efficiency or productivity may lead us to take time off or even to quit our jobs; others of us, fearful of losing our jobs or because of a misguided sense of shame, may choose to suffer silently.

With a potential 10-20 years of work ahead of us women are losing the sense of worth that work can provide, together with our independence and our financial stability. For those of us contemplating a return to work (following redundancy or a career break), employers’ lack of support and managers’ lack of understanding for menopause may present as an insurmountable barrier.

The impact of peri/menopause on employers

At present, employers’ responsibility is limited to the provisions of the Equality Act (2010). The inadequacy of this legislation is reflected in the millions of women who leave the work force, go off sick (absenteeism), show up but are unable to work (presenteeism), neglect career development or decline promotion. Companies are losing their most talented and skilled employees, whilst also failing to recruit others with similar skills sets. This attrition results in lower economic growth both for the individual company and for the UK as a whole: it is calculated that 14 million work days are lost each year due to peri/menopausal symptoms. Employers may also face claims for constructive dismissal or breaches of the Health and Safety at Work Act (1974).

What can you do?

If you are in the 40% of the workforce employed in a large company, it is possible that your organization has a Menopause policy. Do you feel that it is well implemented? Does your company have a Menopause champion who advocates for further training for management? Do you have an ally with whom you can discuss your personal challenges – whether internally or in another company?

Do you feel able to have a unrushed conversation with your line manager – not just 5 minutes by the water cooler – about the specific support that you need? Practical support may include flexible working arrangements or even a cooler office. In terms of your emotional and psychological welfare, is there menopause-specific counselling available? Have you been able to negotiate a long-term career plan, rather than simply focusing on your perception of your short-term efficiency or productivity deficits.

If you work for a SME (small and medium enterprise), you may not even have a HR department. You may be amongst the 1 in 4 women who have reported that they have considered leaving the workplace because of a lack of support from management. If your mood changes have been censured as simply bad behaviour or your manager squirms at the idea of open discussion about the menopause, you need to take action and find a way to start a conversation.

The best place to start is with the guidance and advisory recommendations contained in the British Standards Institution’s publication, ‘Menstruation, menstrual health, and menopause in the workplace (BSI 30416). This document helps employers and senior leaders design, create and implement an inclusive culture where menopause is a normative concern that affects each individual differently. Importantly, it includes ways to assess and evaluate the impact of the changes it introduces. You can also helpfully ask your employer to access the free Government hub, ‘Help to Grow:

Menopause and the Workplace’ (https://helptogrow.campaign.gov.uk/menopause-and-the-workplace/) which offers sector-specific advice, as well as listing training opportunities for companies. These resources are free.

Finally, you have to educate yourself about the care and available treatments. Whilst Hormone Replacement Therapy (HRT) is widely held to be a powerful boost to good health during the menopause, over 80% of us in the peri/menopause cohort are not taking it. This may represent a preference to pursue another option, whether talking therapy (CBT) or the newer Estradiol preparations. It is more likely, however, to indicate a lack of awareness about its benefits either on our part or on that of the health professionals treating us. Further, find out about the national allyship programme and how you can secure empathic and confidential support.

Menopause is a woman’s issue and each of us needs to be aware of the ways in which we can best navigate this transitional phase of our lives – and flourish.

Dr. Nikki Scheiner
November 2024