Menopause at work

Overview
Managing the impact of the menopause at work is important for both workers and employers.
For the worker experiencing symptoms:
it can be a difficult and stressful time
a very sensitive and personal matter
For their employer:
it is a worker health and wellbeing concern
a matter needing particularly careful handling
Impact of the menopause on a worker:
What is the menopause?
The menopause is a natural stage of life for women, usually in their late forties/early fifties. It can also happen earlier or later. For many women symptoms last about four years, but in some cases can last longer - up to 12 years.
Part of the process includes what is termed the 'perimenopause' when a woman's body is starting to change in the build up to the menopause. The perimenopause usually starts in the mid-forties, but can start earlier or later and last several years. The perimenopause is not the same as an early menopause.
Perimenopausal and menopausal symptoms already affect a substantial number of workers. That number is expected to grow considerably, with more older workers forecast to stay in or go back to work.
Also, employers should be aware that certain surgery, rather than natural ageing, will trigger the menopause in a woman.
In addition, employers should be aware that a trans man - someone who proposes to go through, is going through or has gone through a process, or part of a process, to change their gender from woman to man - may go through perimenopausal and menopausal symptoms.
What can be the symptoms?
The number of symptoms can vary from person to person, and range from very mild to severe.
Some symptoms of perimenopause and menopause can be the same. They include:
difficulty sleeping and night sweats
feeling tired and lacking energy
mood swings
feeling anxious and panic attacks
hot flushes
struggling to remember things, concentrate and focus
taking longer to recover from illness
irregular periods which can become heavier
aches and pains including muscle and joint stiffness
urinary problems
headaches including migraines
putting on weight
noticeable heartbeats
skin irritation
dry eyes
If a worker does not get the help and support, they need, it is increasingly likely that the effects of the menopause can, for example, lead to them:
feeling ill
losing confidence to do their job
suffering from mental health conditions such as stress, anxiety and depression
leaving their job

The early menopause
As many as one in 20 women may go through an early menopause. It may happen for various reasons, including if a woman has had certain medical conditions and health treatment.
Employers, managers, supervisors and team leaders need to be aware that medically this can be a complicated area, and they should take this into account in supporting a worker through the menopause.
To find out more about early menopause, go to the National Health Service at www.nhs.uk/conditions/early-menopause and/or charity the Daisy Network at www.daisynetwork.org.
Surgical menopause
Surgical menopause is triggered by the removal of a woman's ovaries, even if she is young.
Menopause symptoms will start straight away after the surgery if the woman has had both ovaries removed. If the woman has lost only one ovary, there is a chance the symptoms will start within five years of the surgery. Ovaries are part of a woman's reproductive system.
Surgical menopause can increase the risks of cancer, heart disease, weaker bones, depression and anxiety.
To find out more about surgical menopause, go to the National Health Service at www.nhs.uk/conditions/hysterectomy/considerations/.
Why many workers do not reveal their menopause symptoms
Currently, many workers do not disclose their menopausal symptoms at work. In addition, many who take time off work because of the menopause do not tell their employer the real reasons for their absence.
For example, this can be because the worker feels:
their symptoms are a private and/or personal matter
their symptoms might be embarrassing for them and/or the person they would be confiding in
they do not know their line manager well enough
wary because their line manager is a man, or younger or unsympathetic
Other worries include that:
their symptoms will not be taken seriously
if they do talk, their symptoms will become widely known at work
they will be thought to be less capable
their job security and/or chances of promotion will be harmed

Supporting a worker through the menopause
Helpful steps for an employer include:
Make sure health and safety checks are suitable
An employer must minimise, reduce or where possible remove workplace health and safety risks for workers.
This includes:
ensuring menopausal symptoms are not made worse by the workplace and/or its work practices
making changes to help a worker manage their symptoms when doing their job
An employer must generally assess health and safety risks for workers. Regarding the perimenopause and menopause, an assessment should, for example, include:
the temperature and ventilation in the workplace
the materials used in an organisation's uniform, if there is one, and whether the uniform might make a worker going through the perimenopause or menopause feel too hot or worsen skin irritation
somewhere suitable for the worker to rest
whether toilet and washroom facilities are easily available
whether cold drinking water is easily available
To find out how to carry out a health and safety risk assessment, go to the Health and Safety Executive at www.hse.gov.uk/risk.
Develop a policy and train managers
It is advisable for an employer to develop a policy and train all managers, supervisors and team leaders to make sure they understand:
how to have a conversation with a worker raising a perimenopause or menopause concern
how the perimenopause and menopause can affect a worker
what support and/or changes for the worker might be appropriate
the law relating to the menopause
A worker knowing their organisation's managers are open and trained to talk and listen sensitively about the effects of the perimenopause and menopause, and consider support, should give them the confidence to approach their manager.
Also, it is advisable for an employer to raise awareness among all staff that it will handle menopause in the workplace sensitively, and with dignity and respect.
Give a worker the option of talking initially to someone other than their manager
If a worker feels unable to broach the subject with their line manager - for example, because they feel their symptoms are too personal - the worker could be given the option of talking initially to someone else with the necessary knowledge and training. For example, options might include:
a member of the human resources team, if the organisation has such a department
a trade union representative, if there is one in the workplace
a counsellor from the employer's employee assistance programme, if it has one
a menopause or wellbeing champion, if the organisation has one.
Carefully manage sickness absence or a dip in job performance
Managing absence from work should be handled sympathetically because the menopause is a long-term and fluctuating health change.
Further, employer and worker should be prepared to make changes to help the worker continue to work, and minimise, reduce or remove any dips in their job performance because of symptoms.
A worker should also be given a reasonable amount of time to adjust to changes.
In an employment tribunal, menopause symptoms have been accepted to be a disability. Consequently, it is advisable, as well as being good practice, for an employer to consider making changes for a worker experiencing perimenopausal or menopausal symptoms.
If a worker is off sick because of the menopause or perimenopause, the employer should record these absences in a way that can be distinguished from other absences. This is because there may be times when it could be unfair or discriminatory to measure menopause-related absence as part of the worker's overall attendance record.
There are risks of disability discrimination and/or sex discrimination, and/or age discrimination if a worker is mismanaged because of their menopause or perimenopause symptoms.
Consider having a menopause or wellbeing champion in your workplace
This person could be a point of contact for both workers and managers who need advice, or initially someone to talk to. The champion, maybe working with human resources and/or occupational health, might also help:
run workshops in their organisation to raise awareness among workers and managers
let all staff know, through steps such as posters, that the employer will try to support workers having difficulties because of symptoms
check that health and safety risk assessments are suitable regarding the perimenopause and menopause
set up a support network for staff
tell workers and managers where they can find more information
How the employer and worker together can find solutions
Know how to talk about the menopause...
Both the employer and worker may find the menopause and perimenopause difficult topics to discuss as they are sensitive and personal.
It is likely to be particularly difficult if the manager has not been trained how to have such a conversation. Also, the manager needs to aware not to be discriminatory.
The conversation should be confidential, friendly, honest, in private, and where both manager and worker feel as relaxed as they can in the circumstances, and where they will not be disturbed.
As a manager, you should find it easier to talk with a worker, if you:
know them because you already have regular one-to-one contact with them in the course of their work, and trust and respect one another
have been trained to understand what the range of menopause and perimenopause symptoms can be and their effects
have been trained to have sensitive conversations
know senior managers in your organisation will support workers experiencing menopause and perimenopause symptoms
know that a worker's concerns will be taken seriously and dealt with fairly
Also, the manager should understand:
the organisation's policy on the menopause and perimenopause at work, if it has one
their individual role in the situation
the range of support available in the organisation
that effects of the menopause and perimenopause can vary widely from person to person
consequently, that the changes required to help support a worker can vary from person to person
The manager must leave it to the worker to disclose their concern. A manager can ask general questions, such as 'How are you?', but the manager must not ask them if they want to talk about the menopause or perimenopause, or suggest they might be experiencing symptoms. And a manager should respect a worker's wish for privacy.
As a worker, if you are having difficulties at work because of symptoms, you could:
speak to someone at work, possibly your line manager, about your concerns
ask what support could be offered to help you manage your symptoms when doing your job
If you want some information about the effects of your symptoms to be shared, your manager should talk with you about:
what you want and don't want your colleagues to know
who will be told and who will do the telling?
These must be the worker's decisions, without any pressure from the manager.
Both employer and worker can find it helpful to keep a written record of what they have agreed about confidentiality or the sharing of information.
Also, the worker could join a menopause support network at work, if there is one, for moral support and advice. Further, they may want the support of a trade union representative.
Agree changes at work
There should be steps towards agreeing changes at work to help a worker manage their symptoms when doing their job:
Step 1 - a worker with concerns about the menopause or perimenopause may already have talked to their GP and/or a medical specialist, and may have talked too to the organisation's menopause or wellbeing champion, if there is one.
Step 2 - the worker's line manager should be involved in confidential discussions with the worker, perhaps with the menopause or wellbeing champion or HR's support, about their menopause or perimenopause concerns, the effects they are having difficulties with and how they might need support.
Perhaps with the help of the champion, HR or an occupational health specialist, the line manager and worker should discuss changes which would help the worker manage their symptoms when doing their job.
If the line manager does not have access to a menopause or wellbeing champion, an occupational health specialist, or HR support, they need to make sure they are objective and knowledgeable in discussing, considering and agreeing changes.
Remember, the worker may prefer to talk initially to someone other than their line manager. However, their manager will need to be involved in agreeing any changes.
Step 3 - agree changes in writing and to have follow-up discussions to make sure the changes are working for both worker and employer.
Step 4 - follow-up discussions need to be whenever necessary, as a worker's symptoms can fluctuate and/or alter. This means the adaptations at work may need to change.
Changes, for example, might be as simple as:
providing a fan
allowing the worker to take breaks when needed
providing a private area where the worker can rest for a while to help manage their symptoms