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“What is the company doing to support menopause? Do they have a policy in place? And if that policy is in place, is it in some sort of filing cabinet, stored away? How accessible is that policy and how relevant is it to the managers that may refer to it and the employees that may find it useful?”

Dr Laura David, NHS GP & founder of Smart About Health

In the UK, menopausal women are the fastest growing demographic in the workforce. Yet one in four women consider leaving their jobs due to menopausal symptoms. And despite affecting everyone – whether directly or indirectly – menopause is still seen as something of a taboo in the workplace. Or, at the very least, it isn’t openly discussed.

And it’s time to change that.

This week, Lucinda Quigley, Head of Working Parents and Executive Coach, is joined by Dr Laura David, NHS GP and Founder of Smart About Health, to talk all things menopause.

Together, they’re diving into what it is, the effects of different symptoms, and – crucially – what needs to happen in the workplace to avoid losing (or pushing out) women going through the menopause.

In this week’s episode, you’ll learn how to:

  • Build menopause support into the workplace (and what that support looks like).
  • Open and hold conversations about menopause.
  • Direct people to resources that can educate and empower.

Watch the interview

 

Or read on for the transcript

Lucinda Quigley: Hi, I’m Lucinda Quigley. I’m Head of Working Parents and an Executive Coach at Talking Talent.

Laura David: Hi, I’m Laura David. I’m an NHS GP in London and I’m the founder of Smart About Health. This podcast is all about helping you tackle challenging and taboo areas of health and wellbeing in the workplace.

Lucinda: And it’s produced by Talking Talent in partnership with Smart About Health. So, today we’re going to be talking about the subject of menopause.

Lucinda: So, today we’re going to be talking about the subject of menopause. Laura let’s start off with what is meant by the term menopause. Tell us a little bit more about actually, what does that mean, and also what does perimenopause mean?

Laura: So, Lucinda, I mean, menopause is really a retrospective event that happens in a women’s life. It’s also physiological. It’s not a disease, it’s not a condition. And what I mean by retrospective is that it’s officially defined by the last menstrual period. So, being one year after your last period is when you can say right, that’s it, I’ve had the menopause. However, we’ve got this really potentially quite a long period of time in a woman’s life, let’s say up to 10 years, where a woman could be perimenopausal. So, that’s where there are lots of hormonal changes going on for a woman.

Now, of course, we experience regular hormonal changes when we have our periods and that’s due to ovulation. But as we approach the perimenopause and approach our menopause, the ovulation may become a bit more erratic. We may see changes physically, especially around our periods. So, less frequent periods or more frequent periods, changes to our cycle, and that may also manifest as heavier periods or lighter periods. All of this is due to hormonal changes and particularly, in changes in estrogen. So, during the perimenopause, we experience lots of fluctuations. It might go really high or really low and these changes are partly responsible for how we feel during the perimenopause.

Lucinda: Thank you. I think it’s so useful to hear that definition because as someone who’s recently moved into my forties, these words are becoming a lot more common in my friendship groups and obviously, you know, we’re hearing a lot more about them in the media now. I think it would be really useful to understand actually what, you know, what are the really common symptoms that people might experience? We know it’s a spectrum, but tell us a little bit more about what might people experience when they’re going through perimenopause.

Laura: Absolutely, and like I said before the average age of menopause in the UK is 51. So, you’re quite right. Women in their forties may well be experiencing perimenopausal symptoms, and of course, they may be trying to navigate a complex lifestyle of working and family life. So, there are lots of features which may come up for them. This can also be a really confusing time for women because we’re not sure what’s going on for us and things are changing. Things can be quite subtle, or they might be more obvious. For example, when I talked about the actual changes to your period, but there are lots of signs and symptoms which could be related. Actually, as a GP, what I see is that a lot of people maybe come in with something that is possibly misdiagnosed as something else.

So, for example, joint pains, joint aches can be features of the menopause, but they often get lots of other tests done looking for arthritis and things like that, when actually it perhaps is menopausal symptoms. So, I’ve got a really nice six signs of menopause but there are others.

So, one is sort of feeling that you are really hot, literally really hot. So, we’re talking about hot flashes here and these flashes or flushes – we call them different things – but they can come out of nowhere, and they can take over and often feeling quite hot, particularly around the chest area and sometimes soaking clothes. I kind of get this impression from some of my patients that they’re lying in bed at night and they’ve got the window open, they’ve got the fan on. The covers are tossed off and the husbands under the covers with three layers of duvet on because at night there can be more hot flashes.

The other things that you can have are being dry down below. So, thinking about vaginal dryness, that’s often attributed to the reduced estrogen levels in the body. Actually, one of the treatments for vaginal dryness is to replace some of that estrogen around the vagina. Weeing all the time. So, that’s what we call urogenital symptoms. So, because the vagina and where we pee from the urethra are so close together that it can have an effect on our bladder and on peeing. So, we might need to pee more often.

Feeling moody. So, mood swings, emotional, feeling erratic and also feeling essentially brain fog, difficulty concentrating. So, there are lots of cognitive effects of menopause which often sometimes get diagnosed as anxiety. That may be a feature as well that’s going on for somebody, but it could also be potentially part of the menopause. Let’s talk about this brain fog. So, I’ve got this, wait, what’s going on, I’ve forgotten what’s going on. So, brain fog affects about two-thirds of women in menopause. So, the sensation that you just can’t remember somebody’s name or what somebody said that might take over for people.

I’m just going to get back to hot flashes quickly because this is the typical picture that you expect from somebody in the menopause. You’ve got this image, somebody fanning themselves. Actually, I’ve kind of given the picture there that actually there are lots of other features of menopause and some of them are related to these what we call vasomotor symptoms so those hot flashes. About 25% of women will have no vasomotor symptoms.

So, it might not be your biggest feature. You may be experiencing, as I said, more of the vaginal dryness. This might also have an effect on your libido. So, wanting to have sex, wanting to be intimate might be painful for you as well.

So, there are lots of things going on and I suppose my message is to really consider the perimenopause to be a multi-system effect on the body. Now, I don’t want it to sound like it’s all doom and gloom, and this is going to happen to everybody. Maybe some will have it more subtly. Only about 25% of women will have severe symptoms. But if you think about all the women in this country, that is quite a big proportion and that’s going to affect people. So, we want to think about how we can help women as well.

Lucinda: I mean that’s just so useful, isn’t it, to know kind of the key things. But the thing that strikes me about it is that actually one of the challenges is not knowing whether you are experiencing it, or you are not experiencing it, or whether it could be something else or that kind of thing. I think that can then lead to increased anxiety potentially around health and just how you’re feeling mentally I’d imagine.

Laura: Absolutely. As I said it can be a really confusing time and it’s really important that women and men who, of course, are affected as well indirectly, but there was a really nice study done by the British Menopause Society which revealed that 38% of partners felt completely hopeless in knowing how to support their loved one through the menopause. So, we’re thinking about menopause affecting everybody and particularly we think also about the workplace, but you’ve got to have somebody you can talk to about it and that could be a professional. It could be a friend. It could be a colleague. It could be somebody who’s going through it as well, and to really normalize these conversations so that women and men and families can sit down and really try and work out what’s best for them as a unit.

Lucinda: So, Laura, we’ve heard from you a little bit today about what I suppose a more typical menopause experience might look like, although we know that there is a really broad range of symptoms that people may experience. But I also know that there are other reasons why people might go through menopause. So, can you tell us just a little bit more about that and what we should know about the reasons why other people might experience menopause?

Laura: Absolutely, and you’re right. It’s such a big, broad spectrum anyway, but there are some people who may experience menopause outside that sort of typical picture that we’ve given that sort of, okay, you’re 40 now, let’s start thinking about menopause. So, before the age of 40, there are a few percentages of women that do experience what we call premature menopause – so early menopause. And that may be for a variety of reasons. Sometimes it’s in your family history and so actually that’s one really good way to start talking about menopause at home is thinking, okay mom, okay auntie, what happened to you? When did you have your menopause? So, typically there is often a family history of early menopause, but there may be other reasons. But going back to the early menopause, we sometimes call it premature ovarian failure insufficiency. I don’t really like those terminologies.

Lucinda:  Lovely technical terms that we have aren’t they. Failure. Yeah.

Laura: Exactly. Exactly. Let’s not talk about the language in this podcast, but their medical language can be quite disempowering. If we think about it as early menopause there are things that we can do. So, if you are under the age of 40 and you’re noticing some of the symptoms that we’ve spoken about, potentially changing or stopping your periods before the age of 40, that it is important to speak to a GP. We can investigate this as there are other reasons where your period may be affected before the age of 40 that’s not related to menopause. But there are tests that can be done. So, anyone who may be experiencing that, or concerned about that, could go and see their doctor about it. The other thing to highlight here is that some people may have induced early menopause if they’ve had surgery. So, that may be for cancer. That may be ovarian surgery. There are some reasons why people may go into early menopause. For those women, generally, broadly speaking HRT will be offered if that’s safe for them because there are lots of benefits of HRT of course, aside from helping with symptoms, and that’s around bone protection, around cardiovascular protection. So, there are other scenarios albeit they are less common – and it’s important also for employers to be aware of those situations as well.

Lucinda: I have a question actually that I’ve always wondered. If you start your periods earlier, does that make it more likely that you’re going to finish or have your menopause earlier? Because I started when I was 10 so I’ve always wondered does that mean that I’ll have menopause earlier?

Laura: No. As far as I’m aware there isn’t a direct correlation there, but for moms and dads of children that are approaching their teenage years, 10 is quite a usual age for girls to start periods. Certainly not a young age. I mean the average age is around 10 or 11. So, there’s no direct correlation between if you had an early period, which 10 wouldn’t be considered, and early onset of menopause. It could be random, but the family history is really important.

Lucinda: So yeah, as you say, a good opportunity to open those conversations and start talking.

Laura: This is such an important subject, isn’t it Lucinda? So, we’re seeing well-being getting a bit more airtime in the workplace. Tell us from your perspective why it’s such an important aspect of wellbeing.

Lucinda: Well, I think that’s a really good point, isn’t it? I think particularly with everything we’ve experienced recently and just generally. The world is a very busy place and there’s lots more conversation now around mental health in particular. I think it’s great that there is this focus from companies on their employee’s wellbeing, quite rightly, but I think as part of that we are also seeing a lot more conversation. Let’s be honest, it’s being seen as a taboo subject, hasn’t it in the past.

Laura: Yeah.

Lucinda: I don’t think my mom had a conversation with me about it or talked about it when I was sort of growing up and she was experiencing it. But we’re seeing a lot more about it in the media now, and there’s more opportunity to talk about it. So, I think it makes it even more crucial that companies recognize the menopause as part of their wellbeing policy and wellbeing activities and events that they’re running. But also, we don’t want it to be a sort of a tick box exercise. I think companies really need to think about how can they really build it into their strategy? Because we know that this is something that, as you said, every woman experiences in the world at some point in their lives. It does have an effect on the people who are supporting them as well.

I think it’s important because we want women to feel empowered in this phase, to be able to make the choices that are important to them, but also for it not to affect where they want to get to in their life – whether that be how they want to be a parent or their relationships. So, it does really need to be included when we are talking about wellbeing. We need to really think about menopause as a part of that, I think.

Laura: Absolutely. I totally agree and it’s really pleasing to see that it’s getting more prominent on the agenda and we’re recognizing the impact that it’s having on women in the workplace in particular. Thinking about all of those symptoms, what’s going on for somebody, all that confusion, that can really affect somebody’s confidence. There are obviously so many points in people’s careers where confidence can dip and that may be after big transitions. But if we think about the menopause as this long haul, we’re talking about 10 years in the perimenopause for some people. Then of course not forgetting that after the menopause, the symptoms don’t just disappear. This period of time may last for 20, maybe 25 years for somebody.

We’ve got patients that are still taking HRT in their eighties. Now I’m not going to get into a debate about the safety of HRT, but I’m just saying that actually for a lot of women these hormonal fluctuations and the symptoms can last for a long time, and it can affect women’s confidence. So, particularly when we’re thinking about women and what they can do from your perspective, how can we sort of help women to manage their confidence during this perimenopause and menopausal time?

Lucinda: Yeah, it’s a really difficult one, isn’t it? Because I think as you say confidence can wax and wane through your life and your career. I think also, I don’t know, in my experience, I think sometimes this can come as a bit of a difficult one because you might be in a position actually for a lot of women where they’re at quite a high point in their career. They’ve worked really hard, they’ve been acknowledged, they’ve got to a point where they’re really proud of what they’ve achieved, and they may even be striving to go up further, and then they start experiencing these symptoms – and that can really knock their confidence for the reasons that you’ve outlined.

I think there are a couple of things when it comes to confidence that people can think about. I think there is definitely something, first of all, about almost a back-to-basics approach around focusing on the things that make you feel good, I would say and I think in busy lives, sometimes that can be lost, but things that actually make you feel good. So not going to talk about the medical side, but we all know the power of endorphins and whether it’s exercise. There are lots about singing I’ve been reading at the moment.

Laura: Yes, the choirs, yes.

Lucinda: If there is such a thing. Choirs.

Laura: It might not be.

Lucinda: It might not be, but yeah. Whether it is team sports, whether it’s getting back into reading, whether it’s just spending time in the fresh air, I think it’s really, really important, or spending time with people that you enjoy spending time with. It’s about what you as an individual, what makes you feel good. What is going to make you feel good and happy and how can you get a bit more of that into your busy life, I think is a good focus to have.

We’re going to talk a little bit later about from an employee’s perspective what they can do. But I do think being able to – as someone experiencing confidence issues and experiencing perimenopausal symptoms – being able to have an open and honest conversation with your line manager – and if not your line manager, then someone else at work, about how you’re feeling, and just talking that through, and what that might be feeling for you at that time can really help. Then hopefully from that, getting a bit of a plan of action as to how, maybe practically at work specifically, you might get some help in terms of improving your confidence.

So that might be supporting certain areas, additional training, maybe having a sponsor or a coach or a mentor. All really good ideas to consider I think because we know that the spectrum is really large in terms of what people abroad, in terms of what people experience. But we’re talking about daily occurrences, aren’t we for women when they’re going through the menopause. What do you think are the key things that, for a woman in the workplace, what do you think are the key things that might affect their confidence or maybe hold them back?

Laura: I think for many people, it’s a really complex time of their lives as well. As you said, getting into your forties, perhaps approaching your fifties, you may be in quite a senior position at work. You might be taking on a lot of responsibility. Things may be quite complicated at home as well if you have a family. You may have children that are growing up that have various needs. There may be teenagers at home and that can present its own issues. There may be, as we said, potential relationship challenges which can come with hormonal fluctuations such as lack of libido, vaginal dryness, pain, lack of confidence. Changes to your body that you might not feel are great for you, but to really try and take it back and love yourself because this is a physiological change, and we should try and embrace it.

But it can be difficult thinking about some of the features. If you’re having hot flashes at night and you’re not sleeping well, you’re potentially going to be very tired. You might also have insomnia, which is also a feature of the menopause, perimenopause. So aside from the flashes, you might not be able to get to sleep. So, tiredness may also have a huge impact on your output at work and how you feel during the day. We all know how we feel after a bad night’s sleep, but people who are having insomnia may feel particularly disorientated or feel that it’s difficult to be fully productive. And of course, to enjoy the aspect that we want to enjoy the work and the family. So, things can be quite difficult.

I think concentration may be an issue for women in the workplace, and of course, if you’re having hot flashes at work or you are needing the toilet all the time, lots of these aspects can affect your day job. In a way, working from home, home working, has sometimes made it a bit easier for us because we can just slip to the toilet whenever we want, most of the time. But I think for the workplaces to try and think about the adaptations that they can make that can support women because nobody wants to lose these talented people. Nobody in this position really genuinely wants to give up work. But people within that quarter of women who are experiencing severe symptoms, many of them are considering leaving their jobs. So, we’re going to talk about that a little bit later in this podcast.

But I think there are many aspects of those features of the menopause that can have an impact on confidence, productivity, and how you feel, and how you relate to your work and the workplace. Of course, some of those issues can be allayed by making sure that menopause is high on the agenda and is spoken about, is not taboo, is something that workplaces understand that this is something that happens to all women, and it’s okay if you’re affected severely, then perhaps the workplace can be a source of support and a source of empowerment. Because through menopause training and menopause awareness you can find out more about what’s going on for you and what your choices are.

Lucinda: Yeah. I think the point you made about hybrid working is a really interesting one though, isn’t it? Because actually with the increase of hybrid working and it becoming more popular, and I think there are still some questions around how is that going to work for people. But that is a really good one to be aware of it, the fact that there may be people who have been out of the office for 18 months who may have started experiencing some of these symptoms. So actually, going back into the workplace is going to be filled with even more anxiety for them about what that is going to be like. Obviously, there are lots of reasons why someone might feel anxious, but particularly if they’ve started experiencing these symptoms. I think it’s a really challenging one to think about, adds another layer of things to consider. You spoke earlier about the effect on partners which I think is a really important one. I know when I was preparing for this, I had that question actually from someone to say, well it’d be really good to know what do I say? What can I do as a partner of someone who’s experiencing it? Or a family member of someone who’s experiencing it? What do you think you can do to support people, Laura?

Laura: Yeah, look, there are so many things you can do, and I suppose it partly depends on your relationship with that individual. But what I would say is that people shouldn’t feel afraid to talk about the menopause. So, that comes from the individual who might be experiencing some of the symptoms or the issues and the person who’s on the other side of that conversation, because of course they’re affected as well, especially if you are in a household if you’re in a family. If you’re a child, if it’s your mom that’s going through this. You mentioned that your mom didn’t talk to you about menopause, and actually this is a great time to make menopause part of that normal conversation. Sit down at the dinner table and talk about it. Why should we be afraid to talk about the physiological effects that the human body has, and that we’re going to have?

So, part of that is also educating that next generation about what’s going on for women and for families at different points in their lives. But I think the key is really about listening, and to listen actively and listen with empathy and really find out what’s going on for that individual, and to have honest conversations about it. It may be that you are talking about, okay, how is this affecting me at work, what’s going on for me. And that could be that you’re talking to your loved one who talking to your manager or your line manager, your boss, a colleague, sitting down having a coffee talking about it, and probably when you do start talking about it with colleagues, you find out, hey, there’s somebody else who’s going through this as well and you can be a source of support to each other. That peer-to-peer support is a really important part of the normalizing piece, but also about how people can give their own opinions. People can tell what’s been working for them.

So, I think really support is about listening, and making sure that when you do listen, you give people time, you give people opportunity to speak. You may have an opportunity to share a little bit of what’s going on for you as well.

Then the other aspect of support, which we can come on to, we’ve talked a bit about the workplace being a source of support. I think there are so many things that you can say which are sort of phrases like ‘that’s okay’, ‘we can talk about this’, ‘what do you want to do’ because it’s about empowering somebody. And if they don’t have the knowledge or the choice. People that come to me as a GP often don’t really know much about what’s going on and sometimes, they don’t say to me, I think I’m going through the menopause. Sometimes it’s a suggestion from my side to say, well, look, this potentially could be related to the menopause. Has that ever crossed your mind? And some people say no, and that’s okay because we don’t always know what’s going on for us. And it’s the time of our lives to go away and research and become empowered through knowledge and choice. And I keep going on about this, but this is so important, that in order to take our lives into our own hands and make the choices that are right for us and our family, we can support ourselves by looking at really good resources.

I always signpost people to this amazing website called Menopause Matters and it’s got fantastic resources on there, really important things that people can look at. It’s not all about hormone replacement therapy, lots of it’s around other aspects of the menopause, natural ways of managing menopause, and to really find out what is going to work for you, and to tell that other person who’s listening this is how you can help me, and for that person to receive that information and really try and help.

Lucinda: Yeah. Yeah, absolutely. It’s a fantastic website. Not just for, as you say, people experiencing it, but also people who want to support as well.

Laura: Exactly. Absolutely. What do you see with your coachees then Lucinda, because you are coaching lots of people in their forties, at this period of their lives? What kind of things is coming up for you?

Lucinda: Yeah. So, I think it’s really interesting what you said about not many people are kind of presenting and you know, sitting down and saying I’m experiencing menopause, and these are the challenges I’m having. I think it’s much more, something that people are experiencing, and they don’t know what it is. But as you say, it can be affecting different parts of their life, whether that be their career, or even the ability to make the right choice, I think sometimes people feel worried about. I definitely think anxiety is something that is definitely becoming more prevalent now. Actually, I know, not just from my coachees, but also managers of coachees – we run managers’ programs – are coming and saying I’ve got people who are presenting around, talking around being more anxious.

Laura: Yeah.

Lucinda: So, I think that definitely is something that is really, really prevalent, that sort of anxiety. We all know that – in fact, we’re doing another podcast aren’t we on anxiety – but we all know that anxiety is a really normal emotion to have, but it’s important to understand if it might be getting in the way of you leading your life in a normal way. I think that’s the thing to consider.

I think the other thing is emotions – whether it be tearfulness or anger, I think feeling, feeling a bit more triggered or a bit more cross or those kinds of things, and just being a bit overwhelmed by that – I think that’s really difficult for people. And particularly in a work setting, people don’t want to feel like they’re not in control of their emotions. In fact, people don’t want to feel like they’re not in control! I think this is a really good example, isn’t it, where actually for a woman experiencing perimenopause and menopause, there are going to be lots of parts of their life and their bodies, which they feel a little bit out of control of and that’s really challenging.

Laura: Exactly, and I would just want to pick up on that because one is anxiety is such a multifactorial experience and of course hormonal factors/changes that are a result of the menopause can be a huge part of it. Going back to some of the other complexities that are going on in people’s lives at this time, and of course, at each stage of our life, there are always complications and issues going on. And it can really affect our emotions. I think the difficulty is, is that even looking back two, three years ago, we were sort of told really that the workplace is separate to the home, and that actually bringing your emotions to work might not really necessarily be a good thing.

We have seen a shift in the pandemic because one is: obviously home, and work-life has been completely blurred. We’ve all had problems. We’ve all had something that’s affected us. There have been challenges in all of our lives and it’s been a really humanizing experience for us and I think there’s a recognition, a little bit more now, that in some cases bringing your emotions to work, expressing how you feel – of course, if it’s out of control, that’s a difficult scenario to be in – but bringing some of your emotions to work and how you’re feeling, what you’re struggling with, can actually be a good thing. Bringing a bit of vulnerability to yourself, and to the workplace, and to your colleagues can really help people connect on an authentic level.

So, in a way understanding our emotions and that emotional intelligence piece, I know is a big part of the coaching that you do, but really being able to name what’s going on, understand what’s going on for you, and think about, do I need a solution. If I don’t, if I can just forget it, or if it’s not that important then that’s okay. But if I need to find something, a way to manage it – and when we talk about menopause, there are so many different ways of managing what’s going on for people. Some of that may be medical, some of it may be really personal things like you talked about – getting outside, doing things that you like doing, so that really helps with stress and gives you purpose in life as well. Thinking about things on a spiritual level, on an emotional level, physical exercise, all of these different aspects of wellbeing ultimately can really influence how we manage, especially at work. It’s really interesting to hear the emotional pieces coming out from your coachees as well.

Lucinda: So, on the note of talking about it, which we’ve mentioned today, the importance of being able to try and have open and honest conversations, and what can people do to feel empowered to have these conversations, it’s really important to also acknowledge that there are going to be some people who have challenges with this based on – it might be generational, it might be where they come from, it might be how they’ve been brought up, it might be cultural. What’s your experience of this, just in terms of the different groups of people, I suppose that may experience challenges in getting support?

Laura: Look, I think it’s often a very difficult subject for anyone to bring up, especially with the health care professionals in their social circles and there is definitely a generational and a cultural aspect to it. It may be that it’s just not that usual for you to talk about your bodies, talk about hormonal changes. Of course, as a society here in the UK, we’re hoping to build on that and help this become part of the conversation, but it may be that in your family, in your upbringing that isn’t easily talked about, and that can be applied to so many aspects of health and wellbeing, as well including mental health. It’s really important.

I think there are certain groups in society, certainly in my experience that may feel even more difficult to access the support that they need. They may be people in the LGBTQ+ community, in particular trans men who may go through menopause as well. There are not very many specific services that are available and that may feel that it’s even more of a barrier. So, I think just to recognize that where we are as a society is to ensure that we include everyone in this conversation and think about the position that people are in and what kind of barriers they may have faced, what kind of challenges they may be facing and what kind of support they may need. Certainly, that may also dictate the kind of treatment that you want or that you’re looking for. That may also be influenced by your culture and what’s accepted in your culture, and how you’ve potentially been brought up, and what messaging you received.

So, I think with menopause just like many of the other subjects around health, it’s important for us all to consider the different experiences of others and to be able to listen and help people feel heard. Hopefully with more listening, with understanding conversations will help people to get what they need for themselves and for their loved ones.

Laura: The really important piece, and we’ve alluded to it so many times, is about the workplace recognizing that menopause exists and is a really important part of somebody’s life. And that it doesn’t just affect women, that it’s affecting everybody, and within that, everybody has the capacity to talk about it. If you’re a 25-year-old male manager of a 50-year-old woman, you’re going to have to embrace this conversation, because it’s what’s going on for people, it’s the reality. So, what can employers do to be more inclusive of women – and their families – experiencing the perimenopause and menopause from your point of view?

Lucinda: Yeah. So, I think we have talked about this a little bit, but I think to be really clear, it’s about taking it out of the box and putting it out to show. Taking it out, as you say – I love that idea of the poster on the back of the loo door, which I’m sure everybody can sort of remember, and actually putting it on the main notice board, if we’re going with that metaphor, in the main notice board, or the main bit of the internet – putting it loud and clear that this is recognized as an important part of women’s wellbeing, and something that actually everybody has a responsibility to know more about and to learn more about. I think one of the words I’m always really keen on using in these situations is also curiosity and encouraging.

I think if workplaces can invoke almost a feeling of curiosity, encouraging people to learn a little bit more, to want to learn a little bit more about the experience, what it means and how they might support people, and to be a little bit more curious about that, I think can be really helpful. And that might be through running events. Obviously, we know that Smart About Health runs some amazing events on the menopause. It might be actually more about creating a safe space for discussion. So more of a coaching-led conversation with people so that they can feel – I think you made a wonderful point earlier on about not just the space to be vulnerable, but also the space to be listened to as well. So that creating safe spaces for different groups of people, whether it’s people experiencing the menopause, whether it’s people managing people, or whether it’s people who are supporting people just generally, I think is a really helpful thing that employers, from a sort of a company level, can do.

Laura: Yeah. Yeah, and I love this concept that one is, we’ve all got the ability to lean in conversations about things that don’t affect us, but that we know that affect other people. So that’s all about this empowering everybody to be more open to everyone’s experiences. That’s the general concept, but the other concept is around enabling that peer-to-peer support. You talked briefly there Lucinda, before about mentoring and we’ve got reverse mentoring, we’ve got sponsorship. We’ve got all different ways that people can actually help in their careers, but actually connecting people that are going through the same thing.

We’ve got this really amazing way of connecting people through something called a Menopause Café. This is actually a concept – doctors have a Menopause Café and it’s an opportunity to learn from each other, an opportunity to share experiences – and this Menopause Café is a really wonderful way to bring it to the workplace, to create that sense of normality around it. You can just have a cup of coffee, that can be virtual, that can be in person, you can have a cup of tea and you can talk about the menopause. You can talk about your experiences and have that also facilitated by an expert in the menopause so that, you know what, you may think you may realize that I don’t know enough about this area of the menopause, but I want to, and I want to get the answers. That’s where we bring our specialists in menopause in, to give people the answers that they want. And so they can again feel armed with that knowledge and choice, feel empowered by one, connecting with other like-minded individuals, people who want to know more about menopause anyway, and getting the answers that they might need personally so they can manage how this is affecting their lives.

How can employers really encourage conversation around – let’s say – we’re talking about menopause here today, but this is way bigger than the menopause, when we think about conversations around various aspects of health – but how can employers encourage more open conversations to take place?

Lucinda: I think that there’s something isn’t there, about recognizing the importance of managing the whole person, and I think we’ve talked a little bit about that, and employers have had to do that more over the last couple of years. I think there’s some really helpful language that managers and employers can use, and it is about using phrases such as ‘what can I do to support you’, and maybe if you’re braver, saying things like ‘tell me about what you are experiencing’, and really creating that safe space, and inviting that person to be open with you about what they’re experiencing. Sometimes, it might not be about asking a question, it might just be about acknowledgment and saying ‘I understand that this is a really difficult time for you at the moment’.

I think the thing to be wary about in conversations is not bringing too much sort of anecdotal evidence of what you might have heard. I think that can sometimes be a bit tricky because as we’ve heard, the menopause experience is different for everybody. So, just being aware that what you may have heard – a family member, a partner’s experience – might not necessarily be the same. But you can still be empathetic and supportive by telling them that you are aware of what they might be experiencing and asking them what support they need, I think.

Laura: Absolutely, I think these conversations should be taking place. I mean we are encouraging all of our clients to take on wellbeing conversations. They don’t have to call them wellbeing conversations because that can sometimes increase anxiety. But thinking about check-ins, thinking about making sure that people are doing well physically, mentally, spiritually, emotionally, and that’s all they’re able to do their work to the best of their abilities. If those things are affecting or invading their lives, then what can they do to help?

I think from our perspective as well, when we do our manager sessions and training, is that we don’t expect managers to have all the answers. That’s too much pressure, and we’re not expecting anyone to become a doctor or a psychologist or a menopause expert! What you talked about there is the individuality of the experiences and to recognize that, and that is an empathic leadership stance, that’s an important conversation.

When I talk about vulnerability, if somebody has their own experience or a relative, or they know a bit about the menopause, what I often encourage people to do is to ask for permission to share. To say look, we understand everyone goes through something different when it comes to the menopause and maybe I can tell you a little bit about what I know about it, or what my experience is, and that can really help connect people together. It might not always be appropriate. Depends how the conversation’s going.

Lucinda: Yeah.

Laura: But enhancing that vulnerability especially if you’ve been affected yourself by symptoms or features. It may not be the answer for that individual, but it is a nice way to carry that conversation forward and also for managers to be able to signpost in their conversations. So, if somebody is experiencing difficulty, it could be related to the menopause, it might be related to other factors in their lives. What is it that the company is doing to support menopause? Do they have a policy in place? And if that policy’s in place, it’s not in some sort of filing cabinet or stored away hiding somewhere on the internet. How visible is that policy? How accessible is that policy and how relevant is it to the managers that may be referring to it and the employees that may be finding it useful? What other resources or support mechanisms are in place in the company? Managers do need to have access to this so that they can signpost, and also that then takes some of the pressure off them thinking that they might have to have the answers because they will not always have the answers and that’s not necessarily expected.

Lucinda: Yeah, and I think that really speaks to the acknowledgment piece, doesn’t it?

Laura: Yeah.

Lucinda: If a manager even just has one resource that they can reference, it shows that they’ve really thought about it, and they do see it as important. So, on resources, I think it would probably just be good to hear from you, Laura. We’ve covered so much today, and I think it would be really helpful for you to maybe just talk about the resources. If people are experiencing or have concerns around menopause, whether it’s them themselves or supporting someone, where can they go for help? Where would you advise people to go for help?

Laura: Yeah. Look, and I think part of the empowerment journey is to go and find places that you can research yourself, and then you can make an informed decision about what you want to do about this, if anything, in your life. Also, that you can use that as a conversation point if you want to bring it up at home or with your family, or even with a colleague or somebody at work if you’re affected.

So, like I said, Menopause Matters. It’s a fantastic resource. So that’s www.menopausematters.co.uk. There’s also a really great resource from Louis Newson who is an expert in menopause. She has a website called My Menopause Doctor or menopausedoctor.co.uk. She’s got lots of resources. She’s actually got a book out. She’s somebody in the industry that we all look to, to get more information about the menopause, but it’s all very friendly to laypeople as well.

Then we’ve also got the British Menopause Society. It’s a great resource and even if you are not in the UK, all of these resources can give you information about the menopause. Just one thing about Menopause Matters is it also has a questionnaire, a quiz which can help you understand what’s going on for you. And that may inform some of the ways you approach what kind of treatment, if any, do you want. So, these are great things for managers to also direct people to if they’re having these conversations.

Lucinda: So, that’s all we have time for today. Thank you so much, Laura, for all of your insight you’ve brought to this podcast today.

Laura: Thanks so much, Lucinda. It’s been really great working with you on this. We’re also running two other podcasts in this series covering perinatal mental health and parental anxiety. So, please look out and join us for those.

Lucinda: Absolutely and thank you, everyone, for listening.

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Episode #6

Is your business putting menopause on mute?