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The writer is the author of ‘Everything You Need to Know About the Menopause (but were too afraid to ask)’
The story of the menopause at work is the story of the decimation of women. Literally so — research shows that one in 10 working women in the UK aged 45-55 has left a job because of menopause symptoms. And it doesn’t need to be the case.
What is happening to middle-aged women in the workplace now, and has happened in silence for years, is an unnecessary loss for the whole of society. That is counted in lost work days — worth an estimated $2bn a year in the US, according to a Mayo Clinic study — as well as a thinning out of women across all levels of society, from board directors to doctors and teachers. Finding better ways to handle the menopause at work is a no-brainer.
The menopause happens naturally to all women — at age 51, on average, in the UK and US — because of hormone deficiency when the menstrual cycle ends. The symptoms, some of which can last for the rest of your life, range from hot flushes and difficulty sleeping to problems with memory and concentration. This has led to experienced women dropping out of the workforce because of factors ranging from uncaring employers, taboos against speaking out, to misunderstandings around the safety of hormone replacement therapy.
But change is afoot, and better understanding of the menopause is at a tipping point. I am part of the movement that is helping to smash this taboo, by working with broadcaster Channel 4 to produce two documentaries, collaborating with gender equality charity the Fawcett Society on a survey, giving talks to employers, and writing a book with science-backed information.
The Fawcett Society research has revealed women have for years been gaslighted by society around their symptoms: visible hot flushes were almost the least of it. Instead, women told us how seriously their mental health was affected: 84 per cent suffered sleeplessness and exhaustion; 73 per cent brain fog and poor memory; 69 per cent anxiety and low mood. The memory loss, in particular, leads to a sudden loss of confidence at work — losing a train of thought mid-PowerPoint is humiliating. The menopause’s timing could not be more unfortunate — just as childcare demands may be lessening, those women could commit more to a cause or a career.
However, I have seen two big improvements in recent years. One is that the menopause is the new black — every HR department, and diversity and inclusion leader, is suddenly embracing the conversation.
The other is that HRT is no longer the bogeywoman it once was. Scary headlines about links to breast cancer have been debunked and the UK’s health service advises that HRT’s benefits outweigh the risks for most women. New treatments that use an exact copy of a woman’s hormones lower the risks further still. And, having researched the evidence, I’d say that for women in demanding professional jobs, the benefits far outweigh the risks.
A mysterious masochism around the menopause is starting to dissipate, too. Women felt they should soldier on without HRT, when that would keep them fighting fit. When I give talks to big employers, I explain how the menopause is not just a “transition” but a long-term hormonal deficiency that actually changes the way female brains function, as the oestrogen that fuelled them drains away.
Talking to a room of employees, there is often a dawning realisation for one or two women that they’re not crazy — it’s just the menopause. Or the perimenopause, when it can be unclear what is happening because women in their forties are still having periods. Meanwhile, the men at the back of the room often seem embarrassed at first, before embracing the good news about science and HRT.
It may surprise you that the question I get asked the most is: “How do I explain this to my GP?” If doctors had been better educated in the menopause, they would be doing the explaining, but the menopause will only be compulsory at medical schools from next year. Many doctors are experts, but some still do not understand the complexities of prescribing different kinds of HRT.
Now that the taboo has gone — with Oprah Winfrey and Drew Barrymore discussing menopause on daytime TV and MPs debating access to HRT in parliament — the battle is more medical than cultural, but some employers just don’t get it. Many smugly tout eye-catching policies, involving working from home or fans on desks, but it really needs to be about getting women access to HRT, and helping the minority who cannot use hormone replacement to improve nutrition, exercise and lifestyle. Simply changing company health insurance to include menopause care is a small cost for long-term savings in retention.
Decimation due to the menopause must end, with this good news: the new HRT now available is the greatest leap forward for women’s health, freedom and careers since the contraceptive pill. We should embrace that choice, and the wise female workforce it brings.