Nearly half of the female NHS workforce between the ages of 45 and 64. Managers and colleagues should talk with them about the menopause and entwine acknowledgement and support into their policies and processes, suggests Jacqui McBurnie

mental health sad depressed middle-aged woman

(**Please note that I use the term woman throughout for ease, but recognise and respect the trans (and fluid) gender population that is not reflected in the published data and is discussed even less frequently**) 

Menopause: A biological stage in a woman’s life that occurs when she stops menstruating and reaches the end of her natural reproductive life. Usually it is defined as having occurred when a woman has not had a period for 12 consecutive months (for women reaching menopause naturally). The changes associated with menopause occur when the ovaries stop maturing eggs and secreting oestrogen and progesterone.  

There are also a number of women that will experience a clinically induced and/or early menopause as a result of conditions such as cancer and interventions such as hysterectomy.

The NHS has approximately 77 per cent of women across the workforce – of these nearly half are between the ages of 45 and 64. There are of course, some that will not experience symptoms and/or maintain a good level of functioning through the menopause.

However, a significant number will experience symptoms that range from the well observed hot flushes, to those at the other end of the scale (estimated at 25-50 per cent), experiencing symptoms, which negatively affect their quality of life.

 “Three quarters of women say that the menopause caused them to change their life and over half say it had a negative impact on their lives”.

When I ask colleagues about their experiences, I hear the following;

“I didn’t realise how disruptive, intense and severe some of these symptoms can be. I wasn’t expecting bouts of dizziness and nausea requiring me to lie down for an hour at random times of the day. I wasn’t expecting to feel completely out of control of my emotions to the point that antidepressants were the only logical answer. There is a myriad of other relatively minor things that go alongside the more severe symptoms like – forgetfulness, poor concentration, weight, forgetting what I wanted to say mid-sentence, aches and pains and general fatigue”.

“I feel as if my line manager thinks I am totally incompetent, I make mistakes, I feel useless and dread coming into the office every day to start over again”.

“I can’t sleep, I get several hot sweats each night – so much so that I take several showers! I am up numerous times. When I asked for flexible working, I was refused, so I will probably end up leaving my job because I can’t cope with this”.

At a time when we recognise huge gaps in staffing, when we need to avoid the expense of recruitment and when we have the opportunity to retain and value the skills and experience we have, care through menopause is essential. 

So, what should we do as colleagues, friends, peers, managers and what should employees expect?

  • Talk about it; As menopause is a natural process which affects half of the population, why is it that we do not talk openly talk about this subject? We need to remove any taboo around the menopause and weave acknowledgement and support into our policies and processes. 

  • Consider the impact of this in the workplace and provide awareness, training and support for managers (and colleagues); this can’t be left at home during the working day, neither does it have an ‘end date’. Some workplace adjustments are minor and free – do you ensure that offices are ventilated and have quiet spaces to support concentration if needed? Do you have guidance, policy or training?

  • Ensure specialist menopause support is secured through occupational health; this can be a port of call for capability and performance issues when menopause could be underlying. Without specialist support we could miss the opportunity to offer coping strategies and let staff down.

The NHS England/Improvement Menopause Group has worked extensively with the Cross Government Menopause Group to champion the development of workplace guidelines and a toolkit for managers and staff. A number of practical tools are included in the toolkit:

  • Champion your team culture and climate on openness;

  • Recognition of the range of (approximately) 34 symptoms which span vasomotor symptoms, such as hot flushes and mental health issues, such as anxiety and low mood/depression;

  • Consider an employee Passport: identify which symptoms you experience, how often they usually cause problems and when. This can also be taken to new jobs;

  • Mechanisms to directly manage your day to day working life; use lists, quiet spaces at work, flexible working patterns, simple changes like a desk fan, clothing;

  • Signpost to resources, utilise a toolkit, training or guidance, utilise Menopause Ambassadors and permit time to talk;

  • Recognise that some of our colleagues may struggle more than others – this is a subjective process;

  • Recognise that those who struggle can’t give an end date – they just don’t know.

This is a transition stage; with the right approach we can support and maintain our female workforce to be the best they can be at work, to continue to be as productive, feel valued and recognised as a critical asset.