Menopause support must tread a fine line between awareness and stigma

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Should the menopause be classed as a disability or natural life stage? The argument arose last month when Britain’s Equality and Human Rights Commission warned employers to make “reasonable adjustments” for menopausal employees experiencing serious symptoms or risk being sued for disability discrimination.

The Lancet medical journal fanned the flames by suggesting “it is time for a sensible conversation about menopause” — words that could be viewed as tantamount to telling women to calm down.

Menopause has risen up employers’ agenda, encouraged by a growing acceptance that once-private issues, such as mental health, have an impact on working life. It is also part of what Deborah Jermyn, an academic at the University of Roehampton, calls a “menopausal turn” in the broader culture, whereby campaigners, including celebrity activists, have sought to break taboos, highlight gaps in healthcare, guide others to identify their problems and seek help.

Perimenopause and menopause (which begins a year after periods have stopped) are triggered by declining progesterone and oestrogen levels, typically experienced by women between the ages of 45 and 55, but it can happen earlier.

Increasing numbers of employers are offering help through menopausal ambassadors, apps and professionals who can give advice on hormone replacement therapy (HRT), and help to identify and alleviate symptoms that include brain fog, hot flushes and sleeplessness. A report by Mercer, the consultancy, published this year, found that 22 per cent of employers are offering menopausal support, and 54 per cent plan to do so in the next two years.

Workplace advice and accommodations, such as temperature control, flexible working and quiet rooms, can make a difference to menopausal women, who, according to the human resources body CIPD, say the most common symptoms are feeling “less able to concentrate and an increased amount of stress”. Talking about the issue is illuminating not just to those experiencing symptoms but also to those supporting colleagues, friends and family. This may plug gaps in public healthcare provision.

Some employers offer healthcare advisers who can prescribe HRT; Timpson, the UK retailer, reimburses staff for it. Tesco, the grocer, allows time off for symptoms outside sick leave calculations. The Bank of Ireland offers up to 10 days menopause leave.

But some initiatives amount to “meno-washing”: the posters in the canteen will not do anything if a line manager is hostile. According to the CIPD, 41 per cent of those missing work failed to cite menopausal symptoms because they worried it would affect how their performance was viewed, while 34 per cent said their manager would not be supportive. A report by Bank of America found that “many [US] employers say they offer menopause-related benefits while only one-third of employees say they are aware of the benefits”. It also highlighted the gulf between the 76 per cent of HR benefit managers who say they discuss menopause-related issues with employees and the 3 per cent of female employees who say they have talked about menopause with HR.

There is a fine line between creating awareness, which is positive, and exacerbating stigma, which is not. Belinda Steffan, chancellor’s fellow at the University of Edinburgh Business School, says for every three women she speaks to, one, typically working in a male-dominated sector, worries about menopause becoming “another stick to beat them with”.

“Increasing awareness about what menopause does to bodies,” can unintentionally reinforce stigma, warns Steffan. “Not all women want to talk about menopause in the workplace”, she adds. Senior women and those in male-dominated industries are often reluctant.

The workplace, Steffan says, is generally designed around the ideal worker “unencumbered by physical or domestic needs. The menopausal body doesn’t necessarily fit with that.” It is further complicated by the “messiness of mid-life”, she says, when women may be juggling work, children and ageing parents.

She suggests employers encourage an open workplace culture. “This opens the door for people with other health and wellbeing concerns to reach out for help, taking the focus off menopause. A menopause-friendly employer tends to be a good overall employer in terms of supporting a range of health and wellbeing concerns.”