Having worked as a clinician in the field of workplace wellbeing within large government agencies and the NHS for over 20 years, I’ve gained experience and insight into how life events, physical and mental health all impact upon our day-to-day working lives and our ability to remain in work.
A trend we have identified is the increasing number of calls to Employee Assistance Programmes (EAPs) from women in the workplace, with what feels to them like ‘non-specific anxiety’ or other workplace difficulties.
Further exploration often reveals that they are struggling at work and/or at home. They will often acknowledge a range of other symptoms but just feel they are not coping and are struggling to understand why.
As a female within that ‘menopausal’ age bracket, and as a clinician, it can still feel like a tender subject to broach with another female.
The ‘have you thought or considered this may be menopause/perimenopausal related’ is often met with ‘I still have periods’ or dismissal as the issues seem unrelated. And while it may or may not be relevant, it’s often not considered or is often overlooked, as women expect, and are expected, to ‘just get on with it’.
There is stigma in relation to mental health, we acknowledge that, and many workplaces are working hard to overcome this with training and acknowledgement. This means we are now in a very different place compared to 10 years ago. The high-profile work of the Royals, the excellent work of MIND, as well as the services of EAPs and other organisations, have all made a massive difference.
So why then is menopause still difficult to talk about? And why, in workplaces, do we need to bother to address this issue?
What is the menopause and perimenopause?
It’s a natural stage where a woman’s oestrogen levels decline and she stops having periods. Symptoms are typically experienced over a period of years, so is best described as a ‘transition’ rather than one off event and generally occurs between the ages of 45 and 55.
Perimenopause is the stage leading up to menopause where a woman’s hormones start to change. Some women may experience this as early as their late 20’s while for others, this may not start until their late 40’s. Research shows that the average menopause age is 51 but that 1 in 100 women experience this before they are 40. 
What are the symptoms?
The Royal College of Nursing  highlights the following key symptoms which can be experienced in varying degrees by women going through the menopause:
· Psychological – loss of confidence, reduced concentration, anxiety, depression, panic attacks, palpitations
· Hot flushes and night sweats which can lead to sleep disturbance and tiredness
· Muscle and joint pain or stiffness
· Irregular periods – heavy or lighter than normal and increases in urinary tract infections and cystitis
· Headaches and memory loss
· Weight gain and changes to skin condition
· Reduction in sex drive
The range of symptoms and age presentation is wide, so it is understandable that calls come through to EAP helplines from women who just can’t understand why they feel as they do.
Research has found that 6 in 10 menopausal women report their symptoms have had a negative impact upon their work, with 3 in 4 women experiencing symptoms and 1 in 4 of those being serious.
Why is menopause a workplace concern?
As people are working longer, we have an aging population with 1 in 3 of the workforce soon to be over the age of 50. According to the Office for National Statistics, there are around 4.4 million women aged 40-64 within the workplace.
Menopausal aged women are also the fastest growing workplace demographic. The Faculty of Occupational Medicine (FOM) reporting that nearly 8 out of 10 menopausal women are in work.
A study into the menopause and work, led by Professor Amanda Griffiths at the University of Nottingham (2010) found that women experienced poor concentration, tiredness, poor memory and feeling low or depressed.
The study of 896 women from UK organisations reported that hot flushes, in particular, were described as a major cause of discomfort and embarrassment for women. The majority of those surveyed revealed that they were unwilling to disclose menopause-related health issues to their line managers, most of whom were men or younger than them.
In addition, research from the CIPD suggests that 50% of women are likely to find it difficult to cope with work during the menopause.
These women are often highly skilled and at the peak of their careers so finding ways to better support these women at work and ensure this senior talent is not lost is crucial.
Employers also have a duty of care as the menopause is covered by the Equality Act 2010. Whilst not considered to be a disability in itself, menopause symptoms can give rise to a section 6 Equality Act disability if the symptoms have a long-term and substantial adverse effect on normal day to day activities.
The first successful employment tribunal was brought under the Equality Act in 2012 (Merchant vs BT), and the successful Davies vs Scottish Courts and Tribunal Service SCTS in 2018 was won on the grounds of disability.
So, whilst there are duty of care and legislative drivers to investing time and resources in supporting menopausal women within the workplace, when you also consider that the cost of replacing talented employees can be in excess of £39,000 (The Cost of Brain Drain, Oxford Economics, 2014), the retention and engagement of these skilled women makes good business sense.
How can employers help?
Employers can provide training for managers and employees so that they understand more about the menopause and its effect. All women will go through it. Helping to normalise and break the taboo surrounding menopause, so that both male and female line managers have a better understanding of the issues, is a really important first step.
Employers should also review organisational policies and ensure that their workplace wellbeing policy specifically recognises and addresses menopause.
Typically, we find that where policy and guidance are written down and well-publicised, it makes it clear for employees and line managers and promotes more open conversations.
As a Line manager how can I help?
Line managers are often the first point of contact. Any health condition, both physical and mental, can be hard for employees or line managers to talk about.
Organisations can provide training and coaching for line managers to ensure they understand the policy and guidance documents and help build knowledge around specific issues, such as menopause, that are relevant to their direct reports.
Having regular and informal 1-2-1’s with staff members is key. When you ask: ‘how are you?’ really listen. Get to know your employees and use this time for discussion on any health conditions or concerns.
Just as many EAP providers will train line managers in mental health awareness so that they can spot the signs and symptoms and be able to have conversations with their team members, it’s the same for menopause.
Utilise the support options in place for line managers by exploring the training and coaching available through your EAP service. As well as providing services to employees, EAP’s are often also used to support managers who may be finding a conversation or situation difficult.
Trained experts can provide guidance and ongoing coaching for line managers so that they understand how to use open questions, how to listen properly and how to signpost employees to further help or support. EAP providers will also have a wealth of information and resources available on their website that line managers can tap into.
Finally, look at the workplace setting and make ‘reasonable adjustment’ where possible to help alleviate some of the symptoms. This may be as simple as moving a desk nearer to a window or air conditioning unit, or alteration of working hours to assist with sleep disturbance.
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