Understanding and responding to the Menopause

Women tend to be less active workforce participants than men, largely because of their child-rearing duties and historical patterns of earlier retirement. Nonetheless, they have been approaching numerical equality.

Nonetheless, there is evidence that in some cases women going through the menopause find that “the change” makes for one more problem which has to be overcome. Going through the menopause may thus become an “age barrier.” For a woman of menopausal age who may be encountering multiple problems in the workplace or in the home environment, it can all become too much, contribute to mental ill-health and tip her into premature exit from work.

Women in the economy and workplace

Women play contribute vitally to the economies of all countries. While they tend to work fewer hours, work in lower-paying sectors, and occupy lower-ranking positions than men (resulting in considerable gender pay and earnings gaps) women’s contributions to the productive, creative and economic success of their countries and enterprises is enormous. Because we rarely talk about the menopause and the impact it may have on women, they tend to struggle on alone and without help from their employer.  The result may be that valuable members of the workforce are lost.

Women who become unemployed through redundancy or other reasons, may find that job searching whilst they are experiencing the menopause, is problematic. In this way, perfectly good people who could be earning and contributing to their own and society’s well-being by remaining in employment, may be forced to drop out, perhaps retire early or move into a less demanding job.

Labour market participation differences between men and women are to some extent due to deep-rooted traditional gender roles, economic incentives and differences in the health and care giving experiences which women and men respectively undergo. Increasing women’s participation in the labour-force and raising their employment rate are important if the EU is to meet its target of 75% of the population aged 20-64 to be employed by 2020. Understanding the menopause may make an important contribution to achievement of this target.

What is the menopause?

Menopause means the ‘last menstrual period’. However, many women say they are ‘going through the menopause’ when talking about the time leading up to their final period when they notice changes in their menstrual cycle and the onset of symptoms such as hot flushes and sweats. Women are said to have reached the menopause when they haven’t had a period for one year. In the UK the average age at which women reach the menopause is around 51, however, some women can go through the menopause earlier or later. A menopause before the age of 45 is an ‘early’ or ‘premature’ menopause

What happens to women’s bodies in the menopause?

Changes in periods occur resulting from declining levels of oestrogen and progesterone, the two hormones produced by the ovaries which control the menstrual cycle. This is usually the first sign that the menopause is near. A woman’s menstrual periods change during the menopause, which in turn can have a big impact on their everyday lives including feeling very different, with “hot flushes” and heavy bleeding. Some women experience almost no symptoms, but around 80% do experience noticeable changes and of these, 45% find their symptoms difficult to deal with. The most common symptoms are hot flushes, night sweats and irritability.

Medical help and treatment

Without treatment, most menopausal symptoms gradually stop naturally. Most women with symptoms have at least two or three years of ‘hormonal chaos’ as their oestrogen levels decline before the last period, although for some this can go on for five or more years. This is called the perimenopause. During this time menstrual periods become less frequent, the odd period is missed and then they stop altogether. Women are said to be postmenopausal any time after their last period. However, a small minority still have hot flushes in their eighties. Every woman’s experience of the menopause will be different

Moods and feelings

Oestrogen helps to support certain types of brain functioning, such as cognition. When oestrogen levels change, a woman’s mood may change too.  She may experience anxiety about aging and stress about the future, which can cause upset and mood swings. Not all women have mood swings during menopause however.

Researchers have investigated these impacts and found that women experience concerns and worries of different kinds on the onset of the menopause. Younger women who enter the menopause early, may believe they may be pregnant. The erratic nature and unpredictability of periods can be annoying, and at times embarrassing and debilitating. Women have spoken about the uncertainty they face not knowing when to expect a period, or whether it would be heavy or light. On the other hand, for many women, the end of the menopause brings with it a sense of freedom from the unpredictability and inconvenience of periods and the fear of getting pregnant.

Impact of Menopause in the workplace

Workplaces and working practices are not designed with menopausal women in mind. Heavy and painful periods, hot flushes, mood disturbance, fatigue and poor concentration pose significant and embarrassing problems for some women, resulting in lowered confidence. Women are often uncomfortable disclosing their difficulties to their managers, particularly if those managers are younger than them or male. Researchers found that where women had taken time off work to deal with their symptoms, only half of them disclosed the real reason for absence to their line managers. Some women told researchers they had worked extremely hard to overcome their perceived shortcomings due to menopause. Others considered working part-time, although they were concerned about the impact on their career if they did so, or had even thought about leaving the labour force altogether.

How women say they cope with menopause

In 2011 the British Occupational Health Research Foundation (BOHRF) published research by the University of Nottingham exploring the experience of working through the menopause.

• Half of the women felt that it would be useful to have information or advice regarding the menopause and how to cope with work from their employer.
• Temperature in the workplace was an issue for many women and nearly half of the sample reported not having temperature control in their usual working environment. Some could not open windows, or experienced interpersonal difficulties doing so in shared workspaces.
• The research also showed that many women had developed strategies for coping with problematic menopausal symptoms at work, such as obtaining fans or opening windows, adjusting their working hours or routine, active coping strategies (like requesting formal adjustments, trying to control emotions, using positive reinterpretations and humour), taking precautionary measures such as wearing layers of clothes, and having a change of clothes at work.
• Some women use hormone replacement therapy (HRT) to cope with the more troublesome symptoms at work, although the majority surveyed by BOHRF did not use it. Nearly three quarters of the women who had tried HRT reported that work was one of the main reasons they had decided to try it, and 91% of these said it had helped.
• Many women adopted more general strategies such as altering their diet, trying to sleep longer at weekends, doing more exercise, wearing layers of clothing, seeking out more information about the menopause, maintaining a sense of humour, making time for themselves, and making changes to their appearance to counteract an increasingly negative self-image.

What can employers do?

Women who are experiencing the menopause need support from line management. Work can affect women working through the menopause in various ways, especially if they cannot make healthy choices at work.

• Every workplace is different; in some workplaces it is not possible to open windows or improve ventilation. These issues need to be considered in a supportive way.
• Women may have to wear a uniform and may be unable to change the type of clothing they are wearing when they are having flushes or sweating. Management should consider how they can exercise flexibility to deal with such issues.
• Employers should ensure that all line managers have been trained to be aware of how the menopause can affect their workers and what adjustments may be necessary to support women who are experiencing the menopause.
• Employers can ensure that, as part of a wider occupational health awareness campaign, issues such as the menopause are highlighted so all staff know that the employer has a positive attitude to the issue, and it is not something that women should feel embarrassed about.

Guidance on how to deal with the menopause should be freely available in the workplace. All women should be given information of how they can get support for any issues that arise as a result of the menopause. Because of the way that society treats the menopause, many women will feel uncomfortable going to their line manager, especially if he is a man, and other options should be available. This may be through human resources, or a welfare officer. Many employers have employer assistance programmes that can act as a go-between.

Lifelong learning