Time to start catering for women experiencing menopause at work

There are no workplace provisions to protect women during the menopause. It’s time to break the silence, says Áilín Quinlan.

CAUGHT between sky-high mortgages and rock-bottom pensions, women are staying in the workforce longer than ever.

At a time when many are at the height of their careers, the onset of menopause can be distressing and debilitating.

Most silently slog through the hot flushes, sleepless nights, and brain fog, afraid to draw attention to their menopausal symptoms — a 2013 study of nearly 900 women in Britain found that having hot flushes at work was seen as stressful and embarrassing.

The research, published in the journal Maturitas, found that women were reluctant to divulge their menopausal status at work, because of fear of “stigmatisation and ridicule”.

In fact, only about a quarter of those studied had discussed menopause with their line manager, according to Menopause and work: An electronic survey of employees’ attitudes in the UK. Discussion about the menopause at work was not only “widely perceived as taboo”, researchers learned, but that there had been little consideration of what employers could do to provide support.

In a 2014 study, Women, Work, and the Menopause, women made it clear they did not want to formally discuss their menopausal bodies with their bosses or feel “managed through menopause” in any way by their workplace. 

However, the inference was if the organisation took a proactive approach and the cultural perception of menopause and growing older in general shifted, it would significantly affect their work and career opportunities.

Informal conversations around menopause already existed in some workplace environments, according to the report. 

And those affected all cited difficulty in managing symptoms at certain times, thus affecting work performance. Women generally expressed relief at being able to discuss private matters with female colleagues and superiors and were more inclined to discuss menopausal issues with other women.

There were two reasons for this; another woman was more likely to have a personal knowledge of the issue and men were less likely to understand hormonal issues and more likely to perceive it as a sign of female fragility.

Menopause and the workplace are inextricably linked, the report found, even more so because of the silence and stigmatisation it receives.

Menopause on average occurs in women aged around 51 and can result in a variety of symptoms ranging from night-sweat, tiredness, and mood swings to anxiety and loss of confidence.

Between 20% and 30% of women experience symptoms which are severe enough to have an impact on their quality of life — the menopause can last anything from a few years to a decade.

Given that so many women are staying on longer in the workforce, and that up to 20% of the workforce potentially consists of women in menopause suffering from insufficient sleep and other symptoms, according to the American Congress of Obstetricians and Gynaecologists, isn’t it time for employers to be actively aware of the condition — and responding positively?

Providing a “supportive” workplace, where there’s an awareness of menopause, and where the subject is not taboo is something employers should aim for, believes Dr Cliona Loughnane, women’s health co-ordinator at the National Women’s Council of Ireland. She believes that practical supports can often be quite small and cost-effective. 

This could include flexible start and end times to support women fatigued by insomnia, the provision of a staff changing area, and a recognition of the need for regular toilet breaks for people in certain jobs such as on assembly lines or in call-centres.

“Managers need to be trained in women’s health needs to understand the supports women need,” she says.

“However, it’s also about supporting managers to have open conversations with staff.” Dr Loughnane also finds that women are reluctant to discuss menopause with management because of fears there will be an assumption by the boss that symptoms will affect their work performance.

However, given that approximately half the population will experience some form of menopause, she says, there should be an awareness of the need for support around it.

“We have policies in place, for example, on absenteeism and sickness, so menopause could be integrated into these policies,” she says.

Currently, there are no provisions in the Safety, Health, and Welfare at Work Act or any associated regulations dealing with responsibilities of employers in respect of women experiencing the menopause, according to the Department of Business, Enterprise, and Innovation.

According to lawyer Brian Gill, who specialises in employment law, there needs to be strong momentum of public opinion on the issue — or even a test case in the courts — to effect real change in the attitude to menopause in the workplace.

“I think that generally, employers would be receptive to it, but there’s probably not the level of impetus and awareness in relation to this particular issue,” says Gill, a partner with Callan Tansey Solicitors.

The issue of menopause in the workplace has not so far really “raised its head” in the public consciousness, he says.

“With issues like this there generally needs to be some form of momentum — either as a test case in the courts or public discourse, to push it up the news agenda,” he says, pointing to other headline workplace issues such as bullying, zero-hour contracts, and equal pay.

If there was to be a test case, says Gill, the relevant area of law would be the Employment Equality Acts and, in terms of the potential grounds for discrimination, it would probably be in the area of disability.

However, with so many women reluctant to discuss menopause in the workplace, how can employers ever expect to tackle it?

Is the great obstacle to progress women’s own reluctance to discuss menopause, because they’re afraid of seeming less than effective in their job?

Menopause was a deeply sensitive subject for Cathy*, a successful business executive, who began to experience severe symptoms in her late 40s.

She suffered through constant hot flushes, never disclosing her discomfort to her employer.

“There was such a change in my body. I started having hot flushes night and day. I’d hold a lot of meetings and I’d have a lot of dealings with staff. I seemed to get a hot flush every hour, and I’m fair-skinned so the red face was a constant.

“I’d get quite anxious and if I knew a flush was coming I’d get even more anxious.” Even the thought of sitting around the table for the meeting was unpleasant.

“You felt you were losing credibility because you’re flushing and embarrassed. You’d actually do nearly anything to avoid going to a meeting,” she says, adding that her concentration was affected and she sometimes found herself grappling for words or being unusually snappy with colleagues.

However, she didn’t want to highlight the issue to senior managers.

“It’s very personal and the jibes are still out there. Bringing it out in the open or making a thing of it in the workplace would not be helpful.” Menopause isn’t like pregnancy, says Cathy, now aged 54, adding that a stressful corporate environment discouraged possible disclosures.

“You don’t necessarily want to go in and say to your employer, ‘Oh, I’m menopausal and I cannot cope with my job’.

“This is why women just quietly go off and get treatment for the symptoms.” After a miserable year of very invasive symptoms, she recalls, she went on HRT, which she found successful.

Cathy’s attitude strongly reflects the findings of the Maturitas report, which found that the majority of women surveyed were unwilling to disclose menopause-related health problems to line managers — most of whom, in their cases, were men or younger than them.

However, there is a growing body of opinion which holds that employers should start being more aware of the menopause in the workplace, similar to the way pregnancy is treated.

Dr Myra Hunter, emeritus professor of clinical health psychology at King’s College, London who recently published a major report into menopause in the workplace, believes that advice and support should be provided for women in the workplace, and that it should be combined with staff training.

A study published last year by Hunter and her team of researchers from King’s College showed that a self-help booklet with information on how to use cognitive behavioural therapy (CBT) to help manage menopausal symptoms such as hot flushes and night sweats had a significantly beneficial impact on their working lives.

Hunter and her team are working on an as yet unpublished study on how to train managers to increase awareness of menopause in the workplace.

She believes practical changes such as more flexible working hours and more control over the temperature in the workplace can help.

More thought could also be given by employers as to the kind of fabric used in uniforms, she suggests, pointing out that the self-help tips in the booklet —Managing Hot Flushes and Night Sweats, co-authored by Hunter and Smith and published by Routledge — had proven helpful to the women in the study.

There is interest in the topic, she reports, and goodwill on the part of employers, but she believes a general awareness of the situation has “just not filtered down yet”.

“A lot of managers wanted to be able to be helpful but were not sure how to do it. I think everyone is a bit awkward about menopause and it does reflect something personal — women are afraid of being viewed as ‘past it’,” says Hunter, adding that this perception needs to be challenged.

Women in menopause do not want to be treated as ill or less able at work, she emphasises, adding that research showed that only between a quarter and a third of women actually experienced “troublesome symptoms”, and that currently there is no strong evidence that menopause impacted on women’s performance at work.

“They want the message to be that most women do not have problems as a result of menopause, but that if you do, the employer is ready to do some things that may be helpful.” A “lightness of touch” when approaching the matter would be helpful, she says. 

“There should be awareness of it as there is about pregnancy.” 

None of this comes as a surprise to businesswoman and past president of Network Cork, Ciara Wilson, 42, who runs a successful hair and beauty company in the city.

“If you have a broken arm you can see a cast. If it’s menopause, you cannot see the symptoms but that doesn’t mean it is not an issue in the workplace,” she says.

“The taboo around menopause needs to be lifted. Nobody talks about menopause, which is a huge thing.”

Education is required because, she believes, women will often be embarrassed to talk to a manager about it, particularly in the case of a male manager who has no real insight into the condition.

Wilson, who has been self-employed for 20 years, recalls how at one stage she worked in a business overseeing a team of more than 50 employees.

“There were older women on the team and although menopause never surfaced as an issue, I see in hindsight that women came to me with different issues which I now believe may have been linked to the menopause,” she says.

“There needs to be more awareness in the workplace so people understand. If it’s brought in at ground level in HR training it will become the norm.” * Not her real name


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