Dr Deborah Lee, Specialist in Sexual & Reproductive Healthcare and Menopause, Dr Fox Online Pharmacy, discusses how the menopause may be affecting you at work
A must-read for all women currently employed and aged over 45 years
Are you in denial about your menopause?
Are you over 45, female and currently in employment? If so, you have now unknowingly, become a member of a high-risk group – women who find going through the menopause is affecting their work.
The average age of menopause is age 51. However, as you pass through the transition towards the final menstrual period, the physiological effects which take place at this time, increase the likelihood of experiencing health-related difficulties at work.
Quite often, neither you, your manager or work colleagues will be aware of this secret, ticking time-bomb.
Did you know?
- Around half the British workforce are now female, and this proportion is increasing?
- There are 4.4 million women at work in the UK aged between 50 – 64;
- 8 out of 10 women going through menopause – are working;
- 3 out of 4 women going through menopause – are suffering menopausal symptoms, and for 1 in 4 these are severe.
What do women say about menopausal symptoms and work?
- 72% experience hot flushes and night sweats;
- 65% inability to concentrate;
- 58% they feel more stress;
- 52% they felt less patient with their customers and colleagues;
- 30% have taken time off due to menopausal symptoms but less than 25% told their manager the real reason why.
Other common symptoms are difficulty sleeping, anxiety, depression, mood swings and memory problems. (CIPD) 2020.
If these symptoms go unnoticed, they can lead to exhaustion, depersonalisation, stress, and burnout. Some women end up leaving the workforce prematurely.
Yet there is plenty that can be done to help you and to avoid this end-result.
Could this be happening to you?
You may not even realise that you are suffering from menopausal symptoms as these come on in a slowly and insidiously. The menopause tends to creep up on you!
Estrogen levels peak in your early reproductive life, fall from around the age of 30 onwards, with a steeper decline age 35, then again over 40, and with a very steep drop in the few years before the last menstrual period. Like a car running on a half-empty tank of petrol, your body starts to notice the relative shortage of estrogen.
The average age of menopause is aged 51, but women often begin to notice symptoms due to lowered estrogen levels much earlier – often in their 40’s.
It’s hard accepting you are ageing and that the menopause is happening to you. We all think we are invincible. It’s easy to be in denial. So, if you are a woman aged 40 plus, ask yourself, could you be suffering from the effects of your oncoming menopause?
Have you had work issues which may be at least partly down to tiredness, irritability, anxiety, or uncharacteristic lack of efficiency or underperformance for some reason due to unusual symptoms?
You are indeed mortal – and the menopause may be taking it’s a toll on you too!
How do you know your symptoms are due to menopause?
Clinical diagnosis of menopause
Good question! Diagnosing the perimenopause depends largely on your age and your symptoms. There are long list of possible menopausal symptoms. You need to discuss how you are feeling with your doctor. This will help build up a clinical picture and you can discuss the next steps.
Blood tests to diagnose menopause
Blood tests are unreliable at menopause and are generally not recommended to make the diagnosis. This is because, if the blood result is normal, this does not rule out the fact you are perimenopausal.
However, if the blood test suggests you are peri-menopausal, this may be reassuring, as this supports the perimenopause/menopause as a likely diagnosis.
A blood test for menopause is called a hormone profile (estradiol and FSH level).
- If you are not on hormonal contraception the test should be taken day 1-5 of your cycle.
- If you are using hormonal contraception, this will affect the results, and your doctor will advise you.
Premature ovarian insufficiency – 1% of women go through early menopause before the age of 40 – premature ovarian insufficiency (POI). It’s important not to miss this. Do seek help at any age, if you think this could be happening to you.
Hysterectomy with ovarian conservation – Women who have had a hysterectomy but still have their ovaries are at higher risk of premature menopause. Because you have lost your uterus (womb) you are not having periods, and have lost your marker of menopause. An annual blood test (FSH level) is advised.
What can be done to help?
Your working rights
Leading authorities, including the British Menopause Society (BMS), and the Advisory, Conciliation and Arbitration Service (ACAS) now recognize the impact of menopause in the workplace. Menopause is a physiological event which occurs in every woman’s life, and you are protected by law.
You cannot be discriminated against because you are older, or have any medical condition which is disabling (Equality Act 2010). Your manager has a duty to make reasonable adjustments to support you to fulfil your role (The Health and Safety at Work Act 1974).
Failure to comply with these legal stipulations could result in an employment tribunal.
Managers are now being trained to understand the menopause, to encourage discussion within the workforce, and to create a culture and an environment in the workplace where colleagues are aware of the issue and the atmosphere is supportive.
Discuss with your manager
Go and discuss how you are feeling with your manager. You will find them a lot more sympathetic than you may have imagined.
Practical steps they can put in place include –
- Moving your desk next to the window
- Installing fans, keeping the room cool
- Ensuring a supply of cool drinking water
- Offering regular rest breaks
- Allowing time off for doctor’s appointments
- Being flexible for example agreeing some days working from home
- Discussing any other options such as change of role, or specific responsibilities. Offering part-time options if practicable and acceptable.
Manage your menopause
Get support for your menopause early on. Information is power. There is a lot of help, for example, Women’s Health Concern produces excellent information leaflets on menopause, and menopause treatments, both HRT, nonhormonal and complementary therapies and cognitive behavioural therapy (CBT).
There is also a lot of information, including a decision-making tree, and online forum at menopausematters.co.uk
Once you feel ready, find a specialist and make an appointment.
Where to get help for menopause
- Your GP – There may be a GP or a practice nurse at your practice with a special interest in Menopause. Make an appointment. If there isn’t, you can see another GP in your area as a temporary resident if you prefer.
- NHS Sexual Health clinics often have specialist menopause service
- Menopause Specialists. Some Gynaecologists or Sexual Health Consultants /specialists have special skills in Menopause care. You can ask for an NHS referral or see them privately.
- Specialist NHS Menopause Clinics are few and far between, but you can ask for a GP referral.
- Don’t be afraid. You are completely right to acknowledge the problem and ask for help. It’s better to do this early and avoid a crisis.
- You are important. You have rights and your employer is on your side.
- Don’t be frightened of HRT. There has been so much negative publicity about HRT you may feel scared and confused. However, most of these headlining claims were falsified and untrue.
- HRT is a low dose of natural estrogen, chemically identical to the estrogen your ovaries have been producing since you went through puberty as a teenager. It is very different for example to the estrogen in the combined contraceptive pill.
- The British Menopause Society have clearly stated ‘HRT is safe after all!’
The National Institute for Health and Care Excellence (NICE) 2015 HRT Guidelines endorsed the use of HRT, and said, “women with menopausal symptoms should not suffer in silence.”
- HRT is the most effective way of controlling hot flushes and has positive effects on your cardiovascular system and your bone health.
- To get the best benefits from HRT it needs to be started early in the perimenopausal period and taken for 5-10 years before the age of 60. This is called the window of opportunity. Don’t miss yours!
- The menopausal transition takes several years. There is no quick fix. This is a marathon, not a sprint. You need to think about all aspects of your health, including adopting a healthy lifestyle, for best results.