The Dr Louise Newson Podcast - 270 - Managing menopause at work: how to help yourself and your colleagues

Episode Date: August 20, 2024

Menopausal women are the fastest-growing demographic in the UK workforce, yet a 2022 survey by the Fawcett Society found one in ten women leave work due to their menopause symptoms. This week, Dr Louise is joined by Oonagh Ferson, who researched the experiences of perimenopausal and menopausal women in the workplace as part of her MSc in HR management at Queens University Belfast. Oonagh shares her research findings and some of the stories of women she interviewed, and with Dr Louise discusses the impact of perimenopause, menopause and other conditions such as PMS and PMDD in the workplace. Oonagh offers advice on how women can thrive at work, including the three things she believes would make the biggest difference to women in the workplace: A bottom up approach, where employers sit down with women and ask them: what would help you? What can we do? Even though it may be difficult at times, advocate for yourself: be open with your employer to secure the support or adjustments you need  Having open discussions, using clear language and avoiding terms like ‘the change’, can help dispel the stigma around menopause   There is a chapter dedicated to menopause and the workplace in Dr Louise’s bestselling book, The Definitive Guide to the Perimenopause and Menopause. Order your copy by clicking here. Click here for more about Newson Health.

Hello, I'm Dr Louise Newsome. I'm a GP and menopause specialist and I'm also the founder of the Newsome Health Menopause and Wellbeing Centre here in Stratford-Pon-Avon. I'm also the founder of the free balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause symptoms and treatments and often share moving and, and always inspirational personal stories. This podcast is brought to you by the Newsome Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. Today on my podcast, I've got someone called Una with me,

who reached out to me a while ago and very kindly sent me a copy of her master's dissertation. And it was a focus on menopause in the workplace, which is something that we talk about a lot, the stories I hear of women giving up their jobs or reducing their hours because of their symptoms and they've been unable to get help. Sadly, the stories are still there and I hear them most days. So welcome to the podcast, Una. Thanks for joining me. Thank you for having me. So do you mind just saying a bit about your background and why you decided to do this dissertation?

Yes. So I began studying September last year, a master's in HR management at Queen's University and I came to sort of deciding on our dissertation topics. And for me, I kind of had a personal interest in this topic because my mom, unfortunately, had gone through a pretty rough time with menopause and she was still working full time. And I just, you know, trying to see what support was out there for women in the workplace. There didn't seem to be a lot. So I wanted to take the opportunity to research it.

and, you know, hopefully come up with some answers that could perhaps help women who are struggling with this in the workplace. So you interviewed some women, didn't you? Yeah, I interviewed 18 women in total. I was very lucky I attended the event that you spoke at in Belfast, organized by Roshin, who runs the menopause support group and now charity. So I'm sure, you know, she's a powerhouse of a woman. She does amazing work. So she was very, very supportive and allowed me to sort of hand out the flyer at that event.

And luckily, I was actually inundated by responses of women wanting to share their stories and experiences. So, yeah, I got some women speaking from their own personal experience and some were speaking from sort of an organizational perspective. And obviously, I all surrounded menopause and work and the issues with retaining women and the loss of not. knowledge and experience. Yeah, and it's such a problem. So many years ago, before I opened my clinic, there was a report coming out talking about menopause in the workplace, and I'm quite ashamed to say that they were talking about it on Radio 4. And I thought, what waste? Surely just give people some fans, let them get on with it. And I had no idea the impact of menopause in the workplace because I knew actually very little about menopause in general other than the flushes and

sweats because that's all anyone he spoke about. And then a couple of years after I started working from West Midlands Police and Fire Brigade. And the first meeting I went to, I was listening to women telling me how they'd reach 50. They were going to take retirement because they often do retire earlier in the police. But they were really struggling to know what to do because even in their retirement, they said, I don't think we're going to be having a great retirement because we feel so tired. We've got muscle and joint pains. We find just, I remember one lady saying, just lifting up my grandchild to put him on the swing and the playground is really uncomfortable. So we end up just sitting watching telly. I don't take him out at the same time. I want to spend more time

with my grandchildren, but I don't really feel any pleasure in things. I don't really want to look forward to holidays. And then someone else was saying, oh, I've changed my shifts, so I'm not working on the beat anymore. I'm doing an office job because I'm finding it really tiring. I don't go for any overtime, so we have less money coming in. And I was just saying to them, look, I don't know how to help you. you in the workplace, but what I can do is educate you about the menopause and the treatments available. And most of them were taking antidepressants. Most of them, this was seven years ago, so most of them hadn't even heard of HRT. So I just spoke to them about the menopause,

what it means, what it is, what the symptoms are. And then we did a big survey and we found that 78% of women who were menopausal didn't know they were menopausal until they were given the right information. And I was really shocked, actually, that these women were just, well, that's my bag, that's it. And even when they realized they were menopausal, they weren't able to get the best help, support, advice and treatment. So they were still struggling. And the top three symptoms that were affecting their ability to work were fatigue, anxiety and memory problems. So giving these women a uniform change or a fan would make no difference to most of them. So how does that echo or how does that compare to what you found with your research?

Yeah, definitely many of the women had shared that it was sort of a shock when it all kind of clicked and they realised that all of these symptoms are being, you know, a result of starting the transition through menopause. So I don't know, well, I know across the board there is a sort of knowledge gap. Even we're coming from somewhere like Northern Ireland and we're notoriously quite conservative. So I had wondered perhaps was that part of the reason. I know myself, I'm only 34, but going back to sort of my sex education at school, it certainly wasn't discussed in any great detail.

It was just sort of, like you mentioned, the sort of, you know, hot flash and maybe you feel a bit moody and that was about it. So certainly women who are older than me, my mum's generation, if that's what I had, they certainly had a lot less than that. And again, the culture surrounding it is, it's very still, unfortunately, quite a taboo. And it's not something that women feel comfortable disclosing in the workplace. I found in my research a lot of women shared that they would perhaps maybe have managers who were younger than them or male. And that really kind of put them off feeling that they could divulge their symptoms or that they were struggling or required any sort of adjustments.

And do you think they're nervous because of how people might respond to them in the workplace? Or what are their main reservations for not wanting to talk about how they feel at work? I think it's sort of that double-edged sword with, you know, ageism and sexism. The very negative stereotypes that are unfortunately still quite prevalent, that you're over the hill or you're losing the plot, you're hysterical, all these very ridiculous things. so that maybe you're not capable of doing your job anymore. You can't be entrusted with responsibilities.

And as you know, the menopause is going to intersect at a time in a lot of women's lives where now is the time for them. They might be able to sort of advance in their careers. But the symptoms are so debilitating in many cases that they don't feel confident to put themselves forward for promotion. And, you know, they don't feel maybe that they're able to work for. time anymore due to lack of support and there may be going part-time or exit in the workplace altogether. Yeah, which is a real concern and certainly echoes what we see and hear a lot. So there's a lot of women who are going more part-time. There's a lot of people that are not going for

promotion and a lot of people who are taking sick leave as well. And it could be quite long length of time sick leave. We did a study a while ago and 18% of women who answered had had at least eight weeks off work. Now I can cope if one of my staff or team are off for a week or two, but eight weeks is really hard for someone else to pick up that job, isn't it? And I spoke to someone a while ago and she said, well, of course, because I'm menopausal now, I have a very different job to how I had before. And I said, hang on a minute, what do you mean? Why do we have to have different jobs because we're menopausal? And obviously, if you're having symptoms that are untreated, then it is really difficult to carry on doing the same job. And I only was working

one day a week as a GP when I became perimenopausal and I had several months of not recognizing my own symptoms, believe it or not. But I remember looking at patients who I've known for 20 years and just saying, hang on, can you just tell me that again? And I couldn't remember like what they were telling me. I couldn't remember what happened last time they came in. Obviously, I had my notes, but normally my memory is very good and I was really struggling but I was also couldn't remember drug doses very easily and that's really disconcerting when it's your sort of craft your bread and butter is to be able to, you know, pivot and change and talk to patients and then prescribe the right medication and then I'd look at my examination couch and think, I wish I could just lie down

and have a little dose. I'm really tired and people at work were saying, well, you're just quite slow, you know, you're taking longer. Like, I would do home visits and I couldn't remember where people lived and I'd have to get the map. It's just everything took so much longer. And I thought, oh, it's just because I'm juggling too much. I've now got three children, not two and I'm not coping very well. But then even when I recognized, if there'd been a menopause policy at work, which there clearly

wasn't, what would I do? I couldn't, it's not about a uniform. I'd never had a hot flash. If they'd said to me, reduce your hours, well, you can't. work less than one day a week as a GP because you won't have enough clinical experience. So I would have had to have just given up my job. And I know a lot of GPs do give up their job. Lots of people give up their job about 10% because of their symptoms. But what really frustrates me is that the majority of women aren't getting any treatment for their menopause. Yeah. I think as well,

a lot of women that I interviewed had mentioned when they had eventually decided to see their GP and, you know, seek help. They found basically a lot of medical misogyny. GPs and some of the women had discussed were extremely dismissive. And I think that is very disheartening. You know, for many people, that would be your first port of call. You're going to go to your GP and then to feel that you're dismissed there. It's just really going to knock your confidence. Also, unfortunately, in Northern Ireland like many other places in the UK, it's a postcode lottery for, you know, whether you can go to a dedicated menopause clinic if there are any in the trust where you live. So there's just, you know, so many things that they're up against while they're trying to

navigate through this time in their life and again, sometimes very debilitating symptoms, juggling your career, home life, current responsibilities. Yeah. And I think it's also hard for it. employees because no two menopoles or perimenopals of women are the same. So the symptoms I had affecting me are different to one of my colleagues who was exactly the same age as me. And so you can't know exactly how many symptoms are related. And of course there will be external stresses like you say, people maybe at home or with their personal life or family life or there might be

stresses in the workplace. And so we can't blame everything onto our hormones, but you don't know how much is related and then the workplaces don't know how much are related either and I feel like sometimes there's too much onus put on the workplace taking responsibility for menopoles or women. I don't know whether that's something that came through with your research. I think my takeaway from having completed the research and speaking with all these brilliant women who gave their time is that the workplace needs to really make a proper effort here. It's not just enough to have a menopause policy, just something that many places just download off the internet. It needs to be a live document. It needs to be well researched. And, you know, very simple things

organizations can do that are very cost effective. I know sort of on your own website, there's lots of free resources and, you know, you can download things. So I think even saying, you know, that these are in the workplace, maybe just having a poster up, it generates discussion. And that's very, very important. That helps to spell the stigma that still surrounds this. But unfortunately, I think a lot of women feel that the onus is actually on them. They need to go and seek, you know, are there any resources here? Is there a menopause policy?

It's not something that's very well advertised or openly discussed. So that can cause, you know, feelings of alienation in the workplace. Yeah, and certainly we've done some posters through the balance hyphenopause. website where their awareness posters, so, you know, about headaches and joint pains. So making people realise that it's not just about flushes and sweats. But actually what's also interesting is it's not just about menopause. It's obviously perimenopause, but also PMS and PMDD are related to hormones. So it's more about hormonal changes.

And so, I mean, how you have a hormonal change, you know, policy is quite difficult. but it is really relevant because there are some people that say, well, I'm not menopausal yet. So therefore, this isn't relevant to me. And of course it is if you're getting perimenopausal symptoms. And there are those women who have PMS or the more severe form PMDD where they feel horrendous for three or four days a month. And they say, oh, well, it's just the way I always am. But actually, if you're working full time and three or four days a month every month, that's equivalent to a month a year. you're really struggling.

And to know there's a hormonal component is really important, but also so that employers can recognise that women who are still having periods, for example, can still have symptoms. And some women actually tell me it's their heavy periods that are the most debilitating form. And one lady recently said, I was on a board meeting. I could feel that I'd leaked through everything, despite wearing extra sanitary protection for her three-hour board meeting. She said, I had to sit there and wait for everybody to leave before I stood up because I knew

I couldn't explain what had happened. And that's really awful, actually. Of course, yes. But it's also, I think some people are scared of saying in the workplace, could you be menopausal? Because they worry about the response that menopausal or perimenopausal woman is going to have to that. So I don't know whether that came out at all in your research about how to approach

women. Like if you as a man or a non-menopausal person, recognise your colleague might have some symptoms and they've changed, you might have known them for many years, how do you bring that up? I think, you know, you need to respect that for some women they may regard this as sort of a private, you know, medical matter and they don't want to discuss it. But there are instances where if it's not discussed, then how can the reasonable adjustments be made and how, how you can the reasonable adjustments be made and how can help be offered. So I think asking maybe open-ended questions in those instances where, you know, you're sort of allowing them to take the lead and just maybe take their time with things. It's about, you know, having trust and respect and perhaps appreciating that not everyone wants or feels

comfortable being very open and discussing it. But I think just sort of letting these women know that should they want to come and discuss it, that you're very very, open to that and that you're approachable as a line manager, that all makes a big difference. Yeah, and that is, it is really important. And I feel lots of people think they're walking on eggshells when they're around menopausal women and they have to be careful. And I know when I was experiencing symptoms, I was quite short-tempered and irritable. And maybe if someone had said to me at work, do you think you're menopause that I might have bit their head off and got quite crossed because I was still having periods, although they'd become very scanty. But actually, if someone

had said, oh, I've got this booklet or why don't you download balance and have a look, because are your hormones changing? Because I think saying, do you think your hormones might be changing as opposed to do you think your menopausal actually sounds a bit less confrontational somehow, doesn't it? Yeah, there was a really good sort of study regarding the bottom up approach and a lion, you know, taking feedback from women who had kind of, you know, already experienced this sort of discussion in the workplace as to whether or not they divulged that they were menopausal or perimenopausal and, you know, how they felt that went. And it was sort of a list of do's and don'ts for line managers. So perhaps something like that in an organisation would be very

beneficial. It's sort of, you know, a real advocate for taking a bottom up approach. I think, why would you not go to the source and sit down and discuss with these women? I'm sure they would appreciate, you know, when they're directly asked, well, what can we do? What has helped you? What would help you? It's very simplistic, but I think it goes a long way. Yeah, absolutely. And involving people as much as possible and knowing everyone's different is hugely important.

What frustrates me, as I'm sure you're aware, is that, you know, there is treatment that can improve the majority of women and it's first line treatment from all the guidelines yet only the minority of women and it's certainly in Northern Ireland definitely the minority of women are taking treatment and as you say they're finding it difficult to get it as well and so then workplace are trying to help like put a sticky plaster on almost and we know that some symptoms can last for many years I've seen women who've had symptoms for decades but it's not just about the symptoms it's a health risk so if I was younger and became menopausal in my 20s and 30s. Without treatment, I have an increased risk of heart disease, osteoporosis, diabetes, clinical depression. So if I'm going to be in the same workplace organization

for 30 years, for example, I've got an increased risk of diseases, which is then going to mean that I'll be off work with those. So actually, it's really important for not just symptoms, but for future health, that we are trying to address treatment options. And, you know, And I sometimes sort of compare it to if someone has a broken arm or leg, they might be able to do their job. They might have to have some adjustments because they're in pain or they can't use a keyboard if they've broken their wrist or whatever. But as an employer, you would still encourage your colleague to go and get treatment. You wouldn't see them with an abnormally shaped arm that's really painful because they've fallen over and say, oh dear, shall I give you a different chair to sit on? Or would you like to go and sit home and see what happens?

and we'll just talk about it. You'd say, well, look, the hospitals down the road, you want a lift, take a bit of time off if you're in pain, and then we'll just adjust things as you come back, and then hopefully you'll be back to how you were before when you've had your treatment. And that's the biggest stumbling block with a lot of this workplace is that the women are not able to get help and treatment.

So then it's compounding it in the workplace, really, isn't it? Well, I think as well, in more recent years, this is sort of the first time that we're seeing women working through their entire menopause cycle, whereas years ago women, as you had mentioned before, maybe at the start of preying menopause may have retired, or there were a lot less women in the workforce generally. But in more recent years, especially cost of living, the retirement age increasingly rise in all of these factors, meaning that women are in the workplace and they're staying on in the workplace.

It's the fastest growing demographic or women in the age bracket. So that's something certainly that can't be ignored. Absolutely. It needs to be addressed. Yeah, which is great, but then it's not great because there's so much suffering. And women are less likely to be promoted and have more senior positions, aren't they? Yeah, and that's very unfortunate. You know, again, this is a time in many women's lives where they've put the work in,

they've put the years in, they have all this great knowledge and experience. And unfortunately, they're, you know, just left the feel so unsupported that they've lost confidence. Their symptoms are impacting them so much that the field, there's no other option, but perhaps to, you know, exit the workforce altogether or as we're discussing, reducing ours. It's one of the ladies that I interviewed described it as brain drain, you know, and I thought that was a good way of putting it. it is, the workforce is losing all these highly educated, skillful women and it could be prevented. Absolutely. And most of us don't want to not work or reduce our hours. And it's all very well saying, well, we can have flexible working or we can reduce our hours. But that is associated with

reduced pay as well. And if you're already stretched with your income, why should we have to reduce our pay and income because we're not receiving the right treatment for something that's affecting us. It doesn't make sense. And also, I mean, I look and think about absenteeism for other conditions that are associated with the menopause. So for example, migraines can be far more common in the perimenopause and menopause. There's billions lost every year by people with migraines not being able to work. And mental health issues as well, we know clinical depression increases in the menopause. So there's lots of people that are off work with depression. And then there's a lot of women we see and speak to all the time who are having investigations

for their symptoms. So they're having heart tests for their palpitations. They're having brain scans for their poor memory. They're having bladder tests for their urinary tract infections. But every time you go and have an investigation, especially if you're working, full time, you have to take time off work, don't you, to go and have the test and then see the doctor for the result. And so even if you're not taking time off work because you're feeling awful, you're still taking time out of the workplace that you wouldn't have to do if your symptoms were addressed early and you didn't have any of these other symptoms. Yeah, that's true. And as well, surrounding all these issues of, you know, taking time off

and, you know, possibly leaving all together. This also contributes to. to the pension gap. Plus it does. We all know there's the gender pay gap, which is a factor, but the link then goes on to the pension gap. So it's going to hit women later as well in their retirement, as well as maybe the interim when they've left work and they're struggling in between,

then perhaps when they are feeling better, but it's time for them to retire. Then their pension is also affected. So there are economic factors. Yeah, of course. And so did you find your research rewarding or frustrating or surprising? Unfortunately, I heard some really sad stories, actually some horror stories. One that sort of stuck with me was I interviewed a lady who's a union representative.

And of course, you know, she maintained confidentiality. She didn't name names or the name of the organisation. But she went in to represent a lady who worked in a care home as a car. assistant and obviously through no fault of her own. She was perimenopausal. She had a blade in work and with working somewhere like a nursing home, they obviously have to be very careful and strict with hygiene and things like that. But she was actually put into a disciplinary meeting for supposedly breaching the hygiene regulations because she had had a blade and work. And something like that is just so shocking that someone we have to do.

have to sit and go through, you know, further humiliation, that there was absolutely no empathy there. That was truly shocking and that's one of the horror stories that has really stuck with me. It was just unbelievable. It's really shocking because, you know, it's now 24. We're not living in the Victorian times. We're not living in the dark ages. Women shouldn't be shamed and named and treated as an inferior because something's happening to their body. and especially when obviously there's treatment available, but especially if we know there's something that's happening, we should be offering support,

whether we're friends, relatives, colleagues, or who we are, because, you know, I always at work want to treat people the way that I would want myself to be treated. And so stories that I hear and I hear them all the time are not that way. And I can't believe that people can be like that, especially when we've got more knowledge and information, that we should all be sharing.

with each other to reduce the suffering because there is still a lot of suffering, isn't there, by women? Yeah. And I think something as well, it's another thing somewhere like the care sector that's women work there predominantly more than men in these sort of sectors, as well, women who maybe aren't English isn't their first language. That's another barrier that they face. There's, again, you know, culturally perhaps they wouldn't feel as well.

open discussing something like menopause in the workplace. So there's just so many factors to consider and it is difficult, but I truly feel especially having completed the research that sometimes all it does take is a conversation generating the discussions and, you know, just letting women know that there is support there and, you know, they can come to their manager and sometimes that goes a long way. Absolutely. And certainly one of the things I realise in the police is that lot of women had been signed off with depression, anxiety, and then they were really relieved to know that it was their menopause. It wasn't that they had clinical depression. They didn't need antidepressants. So a lot of the work, certainly that I'm doing is about empowering people,

so they have the right knowledge and tools, and then they can try and get the right information, support, treatment that they want. So certainly the conversation starting in the workplace is really important. And so I'm very grateful for you sharing your time and your great research as well. Thank you. So before we end, three tips really, if you don't mind. So three things that you think would make the biggest difference to women in the workplace. As I had mentioned, the bottom up approach, you know, you can do all this research, which

is very well, you know, you've got great intentions doing that, no doubt for organisations, but sit down with women in the workplace and go directly to the source, ask them, you know, what would help you, what could we do, that sort of thing. I think importantly, women also need to advocate for themselves, as difficult as that may fail to them. But if you aren't open to an extent with your employer, then they can't possibly provide, you know, you with any support or make these reasonable adjustments

that will ultimately, hopefully, make things better for you and easier for you at work. And just again about trying to dispel the stigma and the still surrounds the menopause. So I think that can be done again just by having open discussions, not using euphemisms like the change and, you know, use the actual word, menopause. It's not a dirty word. It's not a bad word. And the more open discussions we have using the appropriate language, then I think that will also go a long way and make the difference. Yeah, really good advice. So thank you so much for your time.

I look forward to seeing how this conversation develops to help more people stay in the workplace, but also enjoy their work and make the most and have the careers they want. So thank you ever so much, Shona. Thank you. Thanks. You can find out more about Newsome Health Group by visiting www. www.newsonhealth.com.uk. and you can download the free Balance app on the App Store or Google Play.