The menopause is a natural part of getting older for women and the majority of us at some point will go through it. Despite this, there is still limited understanding of what the menopause actually is and the associated symptoms – not just amongst men but amongst women as well. It’s not something that enters into regular conversation, except amongst like-minded females and medical professionals. It’s generally not a top consideration for workplace wellbeing, but it’s actually something that employers should think a little more about. More women are in work than ever before – a record-breaking 14 million now have jobs, and approximately 77% of UK women between the ages of 47 and 55 are now in employment. On average, the menopause occurs at 51 years of age in the UK, although it can vary between 40 and 58 years of age and it is slightly earlier among smokers. These are not figures that can be easily dismissed.
So, what is the menopause? The menopause is actually caused by a change in the balance of the body’s sex hormones. It literally means the last menstrual period. Sometimes it can be difficult to define precisely when the menopause occurs, especially if a woman begins to take hormone replacement therapy (HRT). In the lead-up to the menopause, oestrogen levels decrease, causing the ovaries to stop ovulating. Oestrogen is the female sex hormone that regulates a woman’s periods. The reduction in oestrogen causes physical and emotional symptoms, including hot flushes, night sweats, mood swings and vaginal dryness. Menopause can also be prompted when the ovaries become damaged or when the ovaries are removed, usually at the time of a hysterectomy.
HRT still creates debate around the potential long term effects. However, new statistics suggest that if a woman is experiencing symptoms from the menopause, adding in HRT, in a low dose and for the shortest time required, can improve quality of life. Despite the controversies surrounding the risks and benefits, hormone replacement therapy (HRT) is the mainstay of treatment in this condition. Alternative therapies to HRT in the management of symptoms of menopause, include:
- lifestyle measures, including regular aerobic exercise such as swimming or running, and avoidance or reduction of alcohol and caffeine intake
- diet and supplements, such as calcium, calcitonins, vitamin D supplements
- complementary therapies, such as evening primrose/starflower oil (a rich source of gamolenic acid), which is used for breast tenderness and mood swings
- psychological support – the marked placebo effect in several studies point to the value of psychological support and a sympathetic ear. The menopause frequently coincides with other stresses, such as children leaving home, which may exacerbate the biologic changes associated with this time of life.
The physical symptons of menopause can be easier to identify and treat that the psychological aspect that is inevitably part of this life-changing package. Menopause highlights that the biological clock has ticked and stopped and this emphasises a women’s age and the entering into a new time of life – sometimes this can be positive, but unfortunately, more often than not, it is negative. The physiological changes also cause mood and thought disturbance – women often tell me in my clinic that they just don’t feel like themselves and that all they want is to feel normal again. Memory is something else can also be affected, as well as increased perceived stress and reduced self-esteem. This can lead to presenteeism issues in the workplace, reduced productivity and absence.
Of course, not all women will get symptoms, but in my experience most do and therefore, if it is normal to have these symptoms at menopause, it needs to be normal to accept them and talk about them. If employers are keen to support their older female workforce through this change in their lives and maintain productivity, they should consider the common symptoms: hot flushes, tiredness, mood changes and hot sweats.
These are some useful questions HR managers can ask in order to determine whether a working environment is appropriate:
- Does each workplace have temperature control and windows that can be opened?
- Do uniforms stop women from being able to remove clothing and cool down and are women able to change clothes during the day if they have numerous hot sweats?
- Are regular breaks allowed for toilet breaks (periods can become very heavy)?
- Is there an EAP or similar programme where women can turn for help? If you have a large force should you consider a peer support group?
- Do women have female senior peers they can turn to? No female wants to discuss periods with a male boss
Article by Dr Davina Deniszczyc, Wellbeing Medical Director, Nuffield Health
Menopause: This is a sensitive subject as most ladies I have talked to think that a mention of menopause is like pointing out a weakness that will negatively affect their position in employment and may be used to judge them wrongly.This stigma thus causes more conflict then resolution at the work place bringing out personal biases especially if they ladies are in leadership position.
this can be overcome via behaviour change communication is emphasized so that men can fully understand the biology of women and for women who feel intomidated to conceptualise this as a normal part of growth that brings out challenges that are hormonally generated but can be manged well if also well understood.
Most of us do not have the emotional resielence that can drive harmony especially when men make comments that seem to portray the other gender as weaker and women fail to see it as ignorance which did exist at puberty-boys misunderstand girls alot as they do not appreciate the difference being accentuated by hormones.
May be we need more learning.
Dr Davina’s post is probably well-intentioned. However, it inhumanely strips away from women the dignity that can be found in privacy. The way the article describes “the psychological part of this life changing package” is alarmist and suggests that, at a certain age women lose their sense and reason as well as their hormones. Women are used to dealing with changes privately and rationally before and after age 51.
Ultimately it is a woman’s personal choice whether she talk’s about her perimenopause &/or menopausal symptoms. For some women they breeze through this stage of life for many other’s it is hugely impactful can & does lead to suicide thought the lack of support whether that be in the workplace amongst medical professional’s or simply a woman not feeling able to seek help & support.
I am so pleased that in 2019 Menopause is being less of a taboo subject, for those women who breeze through menopause I’d ask that they are less dismissive & instead more supportive of those women who are impacted negatively during menopause we should be empowering & supportive of each other it really can be life saving as I have recently found via my work Co Leading a workplace menopause support group.
We set up our group late 2013, produced a Menopause Discussion Pack which aims to raise awareness, educate & start what can be a difficult conversation in which to seek workplace support & we have 2 online Yammer Support groups an open group & a closed group offering those who prefer more privacy, in October 2017, we won a Civil Service Award, Diversity & Inclusion for our groups work. We are a small group of likeminded women based in different locations across the UK so our work has been achieved via regular teleconference calls & emails. It was at the award ceremony we realised we were front runners in the workplace, people were engaged and this led to the setting up of a cross government menopause group, this continues to grow in numbers with all organisations sharing & supporting this area of work. Our work is voluntary in addition to our main ‘day job’ roles though our line managers support us in allowing limited time to continue this work. Many hours of our own time has been spent on this work, by choice because we are passionate about supporting others and raising awareness.
This years webinar to mark Wold Menopause Day included personal case studies from 3 women, I read out one of them as the writer wished to remain anonymous, it was a very hard hitting powerful story which started with the writer saying if they’d not been interrupted by someone putting a light on upstairs in the early hours she wouldn’t be around to tell her story, years of dealing with terrible periods since the age of 13 & menopausal symptoms affected her so badly that she had lined up several tramadol tablets & was about to take her own life – a hard hitting true story of how deeply this stage of life can affect some women.