Menopause

Menopause in the Workplace

Menopause

The menopause is a natural part of the aging process of a woman. It refers to the time in every woman’s life when her periods stop and her ovaries lose their reproductive function. This commonly occurs around 45-55 years of age, but can be earlier or up to the mid-60s. The menopause is influenced by a change in hormone levels causing many women to suffer with symptoms that can be distressing.

Some women breeze through menopause with few problems, other women can suffer with both physical and psychological symptoms such as hot flushes, night sweats, sleep disruption, fatigue, difficulty concentrating, poor memory, anxiety and mood disturbances. Not all women experience significant symptoms, but if you do they can adversely affect a woman’s personal and working life. In the workplace, the symptoms can cause both embarrassment and stress.

Some women find menopausal symptoms affect their wellbeing and capacity to work. It is important to remember that the menopause is a natural and temporary stage in a woman’s life and simple supportive steps by family, friends and colleagues in the workplace can be hugely helpful to women who find they are struggling to cope with the symptoms. Medical help may also be required.

The menopause is a personal experience, not just a medical condition and one that many women have few problems with. However, if you are unfortunate and do suffer with problems, this website may offer some advice that you will find helpful.

Menopause

What is the Menopause?

The menopause is characterised by a change in hormone levels. During a woman’s fertile years, an egg is produced each month with the release of three reproductive hormones collectively known as oestrogen, mainly produced by the ovaries. The egg is released each month and if fertilised by male sperm, becomes implanted in the uterus. If the egg is not fertilised, the lining of the uterus is shed and the woman has a period. 

As women get older, the store of eggs in the ovary decreases and the ability to conceive diminishes. At the same time, less oestrogen is produced. Oestrogen takes several years to stop being produced completely and during this time symptoms can gradually arise. This is known as the peri-menopause. 

At around 50-55, the monthly cycle stops completely, no more ovulations, no more periods and therefore no more pregnancies. This is the menopause.

For the majority of women perimenopause symptoms end at menopause, however for some the symptoms continue.

It is not always easy to confirm that the menopause has actually happened. Irregular periods and the occasional hot flush are often a sign changes are taking place. Most doctors will assess a woman’s symptoms to evaluate menopausal status. NICE guidance does not recommend a blood test for diagnosis in most women.   

Some women may have had a hysterectomy by the age of 50 and at the same time had their ovaries removed. The removal of the ovaries will cause an immediate menopause and the symptoms associated with natural menopause will apply to these women. This is also the case for those women whose ovaries produce insufficient hormones or lose their function at an early age.

Guidance for women dealing with symptoms

Find out about the menopause, understand what is happening to your body. Many women suffer symptoms during the menopause that cause them difficulty, embarrassment and frustration. By being aware of the changes happening to you, you can apply self-help strategies or seek advice from your GP. Symptoms vary hugely in duration, severity and impact.

Common symptoms include:

 Hot flushes  Night sweats  Irregular periods  Heavy bleeding  Vaginal dryness
 Itchy skin  Anxiety  Low mood  Mood swings  Weight gain
 Difficulty concentrating  Memory lapses  Dizziness  Bloating  Irregular heartbeat
 Headaches  Breast pain  Joint pain  Urinary frequency  Urinary tract infections
Guidance for women dealing with symptoms
 

What can you do to help yourself:

Talk about your symptoms with others, especially those also experiencing symptoms. It helps to find out that you are often not alone in suffering. Use humour to deflect embarrassment if it helps. Discuss your needs with your manager. Your manager may not realise that you require some assistance and may require educating. Women are being encouraged to raise awareness at work to reduce the stigma of the menopause. Point colleagues to this site for more information if they don’t know much about it.

Hot flushes: Common triggers are drinking alcohol, caffeine, hot and spicy foods, stress, tight clothing, cigarette smoke, bending over. Try and avoid these triggers, especially before presentations or meetings. If you feel a hot flush coming on at work, try sipping ice water. Avoid wearing wool, silk and most synthetic fabrics. These materials trap heat and can increase body temperature. Clothes made of cotton, linen or rayon breathe better, release heat and help to keep you cooler. Try to wear layers, that way you can remove layers to cool yourself down and can then put back on if you have a cold chill following the hot flush.  At night, wear cotton night clothes. Ask your line manager for a small fan to put on your desk at work. Eating hot foods increase body temperature and can exacerbate hot flashes. Try eating salads and cold foods at work. Try not to rush around, give yourself plenty of time to get to work and to meetings. This will help keep your body temperature stable and reduce the frequency of a hot flush.

Insomnia: Night sweats can often lead to insomnia and not getting a restful night’s sleep when you are working can be difficult especially if it happens regularly. This may result in you feeling fatigued at work and not being able to concentrate fully. Make sure your room is dark, quiet and safe, try to keep it as cool as possible. Don’t drink alcohol and smoke tobacco before sleeping.  Keep a face flannel wrapped in an ice block in a container near your bed so you can cool yourself quickly. Exercise, relaxation and meditation can be helpful, especially yoga and shiatsu. If you are really troubled by insomnia, then HRT (hormone replacement therapy) can be considered. Let your manager know that you are having difficulty sleeping and it maybe that temporary flexible working hours can be put in place to help you. Have a look at the Sleepio to help build a sleep programme.

Coping with Memory Loss: The brain contains oestrogen receptors responsive to the oestrogen hormone. When levels of oestrogen hormones drop, you can suffer unexpected lapses in memory. These lapses in memory should not last. Once you are through the menopause, you should be able to recall information more effectively again.

There are certain self help strategies one can do to help memory recall:

  • Drink plenty of water – water hydrates the body and brain keeping them healthy

  • Exercise – regular exercise will help to keep a rich blood flow around the brain

  • Mind games – such as suduko and crosswords help to keep the brain active

  • Eat a well balanced diet including fish, soy products, fruit and vegetables

  • Vitamin B complex & Omega 3 fish oils – can aid memory function

  • Write lists or use your phone and computer to help you remember things

  • Sleep well at night & relax – both these helps to improve mental function and concentration

Coping with anxiety: Menopause anxiety is very common and often one of the trickiest symptom to cope with during the menopause. Many women suddenly feel unable to deal with situations that were never a problem before and can become overwhelmed by simple aspects of day to day living and working. This leads to a build up of anxiety and the feeling of “going mad”. To help alleviate this pressure, try to vent the anxiety – talk to friends, develop an exercise plan and focus on breathing. When you feel overwhelmed, take a few minutes to calm your breathing. Breathe in for the count of 7, and breathe out counting to 11.  After a few deep relaxing breaths, your body and mind will hopefully slow down and your thoughts become much clearer. Develop “me-time”, take time out for yourself to relax. Consider relaxation techniques such as mindfulness and other potentially helpful techniques such as cognitive behavioural therapy and meditation. These can all help to reduce the impact of anxiety and a range of symptoms attributed to the menopause. Try cutting back on caffeine to see if that triggers your anxiety or nervousness. Consider your alcohol intake. Alcohol is a depressant and we can often use it as a crutch to help reduce feelings of anxiety, thereby exacerbating the issue. Try to keep stress to a minimum as it can make symptoms worse.

Coping with Mood Swings: one of the most commonly experienced symptom of the menopause. As the oestrogen levels decline so does the level of serotonin and mood changes can be fairly sudden and dramatic. Often women feel that they are on an emotional pendulum; up one minute and down the next. Most women report reacting to things in a far stronger way than the situation merits, with irritability and less tolerance and patience than normal. This if often very frustrating and can appear as though you are out of control. It can seem to the woman as though no-one understands what she is going through. This can be difficult for women in the workplace and lifestyle changes should be considered such as weight reduction, smoking cessation and exercise.

Eat a healthy diet. The fall in oestrogen levels can increase the risk of heart disease and osteoporosis, so eat a low saturated fat and low salt diet to help reduce blood pressure, and a diet rich in calcium and vitamin D to strengthen bones. A healthy diet will also help with weight gain.

Stop smoking – smoking has been linked to early menopause and can trigger hot flushes.

Counselling: Some women feel emotional at the loss of reproductive ability and may benefit from counselling. The College offers counselling via Confidential Care, details are on the Health & Wellbeing website.

It is important to maintain a perspective, try not to let the symptoms control you, try to maintain a sense of positive wellbeing.  Some women see it as a new chapter in their lives, an opportunity to develop new interests and get fit and healthy. Getting through the menopause for some women is not always easy, but by communication, sharing of information and experiences with other women, colleagues and health professionals, a woman can feel supported and better informed as she passes through this temporary phase of her life.

Guidance for Managers

These practical guidelines aim to help Managers support female colleagues that may be experiencing troublesome menopausal symptoms. Although rarely discussed at work, the menopause is a natural stage of life that millions of women workers are either going through now or will experience. The menopause can lead to changes in a woman’s health and emotional changes can affect how a woman does her work and her relationship with other colleagues. It is important for Managers to understand the issues, then offer support where appropriate. Where women have taken time off to deal with symptoms, often the real reason for absence is not disclosed to their line managers.

  • Be aware of the symptoms of the menopause and the difficulties that it can cause for a woman.

  • Managers may find it useful to read this guidance from the Faculty of Occupational Medicine.
  • Have regular informal conversations to help identify if support is required, but be aware that some women may be uncomfortable discussing their symptoms with a younger manager or a male, so a referral to OH may be more appropriate.

  • Manage workload, try to reduce stress and pressure as this can increase menopausal symptoms.

  • Offer solutions if workplace temperature and ventilation a problem, such as a desktop fan or location of a workstation near to an opening window or away from a heat source.

  • Heavy and painful periods, fatigue, mood disturbance and poor concentration can pose significant and embarrassing problems for some women, resulting in lowered confidence.

  • Consider flexible working or shift changes if sleep is being disturbed or if they need help dealing with their symptoms.

  • Offer regular breaks.

  • Provide access to cold drinking water if possible.

  • Ensure convenient access to washroom and toilet facilities.

  • Use of technology where appropriate for note taking and reminders if memory problems an issue.

  • Advise to see GP to discuss concerns.

  • Provide time off to attend medical appointments if necessary.

  • Refer to OH for further support, advice and possible work adjustments.

Complimentary Therapies and HRT

Complementary and Alternative Therapies

Limited scientific research has been done to support the safety of taking these or their effect. However, they have become popular with women and can help with troublesome symptoms.

  • Popular herbal products include: Black cohosh, red clover Dong quai, Evening Primrose Oil, Soy, but you must check with your doctor for advice before taking any of these, as there are interactions with medications such as blood thinners eg warfarin, psychiatric medications and other conditions.

  • Some of the treatments that women have reported as being helpful are: acupuncture, aromatherapy, herbal treatments, homeopathy, hypnotherapy, yoga, reflexology, tai chi and guided breathing.

Hormone Replacement Therapy (HRT)

  • This is the most widely used and most effective treatment for menopausal symptoms.

  • It can be taken by pill, through a vaginal cream or gel or via a patch and is a simple way of replacing the hormone oestrogen that is lost during the menopause.

  • HRT aims to reduce symptoms such as hot flushes, osteoporosis, vaginal dryness, sleep and mood disturbances. Some women do experience side effects when taking it for the first time such as breast tenderness, leg cramps, nausea, bloatedness. If these haven’t resolved after a few months, it may be necessary to try another type, dosage or route of HRT.

  • See your GP for advice if you think this may help you.