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