Working through the menopause…with Dr Louise Newson
The number of women aged between 50-64 in employment has risen by over 50 per cent in the last 30 years.[i] The average age of women going through the menopause is 51 so it stands to reason more of us are likely to be experiencing symptoms whilst at work. One in four women report these to be so debilitating their home and work life is severely affected and around 10 % say they have seriously considered giving up work because of them [ii]. Obviously this is not an option for most of us and supporting women through their symptoms and creating a more menopause-friendly work environment is one of the challenges of our time. As a GP with a particular interest in the menopause, I work closely with women listening to what their particular problems are, providing them with information about the impact symptoms can have on their working day and, crucially, how to manage them.
What women want
The reason this is such a big issue is that menopausal symptoms can last between four and eight years – a not insignificant amount of time – and include hot flushes, night sweats, interrupted sleep, vaginal dryness, memory problems, brain fog, mood swings, anxiety and anger. Of these, probably the most common complaint I hear from the patients in my menopause clinic is how they can’t get a good night’s sleep: they wake up feeling exhausted and drag themselves through the next day. Many also suffer serious brain fog and struggle to absorb information. This can be such a concern they worry they have dementia because they are constantly forgetting stuff. It can be really distressing. Obviously, if you’re not sleeping, your brain feels like it is made of bubble wrap, you can’t concentrate and/or you are on edge or teary, you are unlikely to be on top of your game at work. Sadly, many employers tend to be oblivious to the potential impact the menopause can have on their employees and there are some frankly shocking statistics revealing just how alone women feel at this time: nine out of 10 say they don’t feel able to talk to their managers about their symptoms. [iii]
The change is coming
Encouragingly, things are changing and evolving slowly. I have been working with West Midlands Police Force and also West Midlands Fire Service and we’ve been pushing hard to challenge the taboo. In many ways, I see this as how being open about mental health issues or pregnancy was treated 10 years ago and we have seen how this has changed dramatically for the better. But these things take time and the situation is not made any easier by the fact many women often put symptoms like low mood, feeling unmotivated, irritability and lack of energy down to natural signs of ageing and/or stress rather than realising these symptoms are due to their changing hormone levels. In addition, many doctors are still wrongly diagnosing women presenting with menopausal symptoms as suffering from depression. The classic image of the menopausal woman pouring with sweat and standing in front of an open fridge or fan possibly doesn’t help: my patients say it is the psychological and emotional symptoms – the ones that aren’t visible – that are the hardest to cope with. Feeling overwhelmingly anxious, irritated or weepy and/or angry are emotions that are hard enough to handle in the comfort of your own home let alone somewhere where your livelihood is at stake. So how do you work with them?
Look after yourself first and foremost. Eat a healthy, balanced Mediterranean style diet [iv], cut down on alcohol and try to get some regular exercise. Taking a walk in your lunch hour will not only help keep your weight down, research shows it can significantly reduce feelings of anxiety, stress and depression during menopause.[v] Do whatever you can to improve the quality of your life at home and work – take muscle-relaxing Epsom salt baths to help you sleep; invest in bedding more likely to keep you cool; carry a portable fan for your commute; try a product like Regelle if you are affected by vaginal dryness and itching; download relaxation or mindfulness apps on to your phone and listen to them when you are feeling overwhelmed. Take your time when responding to someone or an e-mail or text that has made you angry – if you are feeling anxious, irritable and tired then you are more likely to be reactive not responsive. But I would say the most effective treatment for improving symptoms for most women is hormone replacement therapy (HRT). The female hormones oestrogen and testosterone need to be balanced for women to function well physically and they play an important role in cognition and memory. Significantly, those women taking it generally report their performance at work improves dramatically.
Airing the problems
There are other practical considerations that can help. I have seen policewomen who haven’t been allowed to have fans on their desks when it may not be possible to turn up the air conditioning or open a window. All this needs to change. But it is not as simple as buying a few desk fans and thinking this is the situation dealt with. What is needed is a climate where employees feel able to talk about it. The training organisation Laughology, [vi] who I have been working with, are trying to do just this. There has been a menopause support group set up at West Midlands Police which is very popular. I’ve seen great strides forward in the last year – so much so that similar initiatives are being set up by other police forces and companies. There are also Facebook groups emerging to give women a safe space to discuss their symptoms and get support from an online community. This, in itself, can be a huge help.
Negotiate your way through it
In 2016 the Faculty of Occupational Medicine also introduced new guidelines for women, their colleagues and managers to help them navigate their way through menopause more seamlessly.[vii] There is also ongoing research at King’s College London in collaboration with the University of Nottingham looking at how flexible working hours could help menopausal women. They are suggesting, for example, the possibility of having a later start to your day if you have had a bad night’s sleep or coming in a bit later to avoid a hot, sweaty commute. Or possibly doing a shorter working week. There are also helpful in-work menopause workshops available: Lynda Bailey set up the menopause unit at West Midlands Police and is the co-founder of www.talkingmenopause.co.uk with Sarah Davies. Ruth Devlin from Let’s Talk Menopause – letstalkmenopause.co.uk – has helped implement awareness raising events in a range of workplaces – which have not just helped women going through it but significantly many younger women, and men, who say they have helped them to understand what may be happening to their mum/partner/colleague/boss. By raising awareness of the problems, listening to suggestions from women going through them and implementing practical changes we should start to make a better job of working through the menopause.