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
moving the worker's desk close to a window that opens
being flexible where possible over the worker's start and finish times to help them manage their symptoms
allowing them to work from home when practical
allowing the worker time off if they cannot carry on working that day
Alternatively, both employer and worker might discuss and agree other changes which should be reviewed if the worker's symptoms alter. For example:
changing certain duties in the worker's role
the worker moving to a more suitable role in the circumstances
the worker going part-time
the worker switching to a job share
If an employer feels, or an employment tribunal decides, that the effects of an employee's menopause amount to a disability.
It is good practice for an employer to allow a worker to go to medical appointments, including about menopausal or perimenopausal symptoms. However, there is no right in law for time off, but the worker may have a right to paid or unpaid time off in their terms and conditions of employment.
Menopause and the law
There are two main strands of law that may relate to the perimenopause and menopause:
The Equality Act 2010 protects workers against discrimination. This includes because of their sex, a disability and their age
The Health and Safety at Work Act 1974 says an employer must, where reasonably practical, ensure health, safety and welfare at work
Risks of sex discrimination, disability discrimination and age discrimination
Menopause and perimenopause are not specifically protected under the Equality Act. However, if a worker is treated unfairly because of the menopause and perimenopause, this may amount to discrimination because, for example, of their sex and/or a disability, and/or their age.
Sex discrimination: Unfair treatment of a worker because of their sex could lead to a discrimination claim. For example, this is likely if an employer treats a woman's menopause or perimenopause symptoms less seriously than it would a male worker's health condition when considering a drop in job performance.
Also, for example, unwanted comments, jokes, banter or ridicule about a woman's menopause or perimenopause symptoms could amount to harassment, or sexual harassment depending on the nature of the unwanted behaviour.
Disability discrimination: A worker's menopause or perimenopause could potentially be regarded as a disability by an employment tribunal. If a worker has a disability, an employer must consider making changes to reduce or remove any disadvantages the worker experiences because of it. Regarding disability, the law calls these 'reasonable adjustments'. An employer must make adjustments if they are reasonable. For example, this might include an employer agreeing to record a worker's absence because of the menopause or perimenopause separately from other illness absence.
Also, disability law protects a worker against what is termed 'discrimination arising from disability'. This is where a worker is treated unfairly, not because of their disability, but because of something linked to it. For example, this could include a worker being dismissed because they forgot to do a task set by their employer. And this is when they have become forgetful and confused as a result of anxiety caused by their menopause. Their anxiety would have to meet the Equality Act definition of disability.
Employers may wish to bear in mind that the not-for-profit organisation, Business Disability Forum, advises employers against wrestling with whether the effects of a health condition amount to a disability under the Act. Instead, it encourages them to focus on making 'reasonable adjustments'.
Age discrimination: Workers are protected against unfair treatment because of their age. This may include unfair treatment of workers because they are going through the perimenopause or menopause which are usually in their mid-forties to early fifties.
Health, safety and welfare at work
Managing the effects of the menopause and perimenopause includes making sure health and safety checks are already in place, are regularly carried out, and risks minimised, reduced or where possible removed.
Managing colleagues of a worker being supported through the menopause
A manager making changes to support a worker going through the menopause or perimenopause may find that some of their colleagues, particularly those not going through the menopause or perimenopause, may complain that the worker is being treated more favourably - for example, being allowed extra breaks, or flexibility over start and finish times on some days. Some may ask for similar flexibility.
The manager should bear firmly in mind that they agreed the changes for the worker experiencing the menopause or perimenopause to support them through the health change. This does not mean the manager must or should then automatically make the same changes for other members of the team.
The manager should deal delicately with such a circumstance and respect wishes for privacy of the worker experiencing the menopause or perimenopause. This means the manager should not be drawn into giving information or details they had agreed to keep confidential.
Business reasons why an employer should handle the menopause sensitively
It is very much in the interests of an organisation to support workers with perimenopausal and menopausal symptoms in the workplace. As well as being an important health and wellbeing matter, managing menopause in the workplace sensitively and effectively will help an employer retain and recruit skills and experience.
An employer should bear in mind that currently around one in eight of the British workforces are women over 50. By 2022 it is forecast that around one in six will be women over 50.
Most women over 50 will have, or have had, perimenopausal or menopausal symptoms that affect their work. For one in three the symptoms will be severe. For one in four the symptoms will be mild.