British MPs are pushing for clear workplace policies to protect women going through the menopause, which exacts a hefty personal and professional toll on as many as one in four females.
A menopause policy should be as commonplace as maternity schemes in businesses and organisations, said the MPs, some of whom want legislation to force through the reforms.
Women have told the Guardian how their careers have been ruined by symptoms such as anxiety, confusion and loss of confidence. Some have faced disciplinary action and many have been forced to take time off, while others have sold their homes so they can afford to work part-time or stop working altogether.
The Labour MP Carolyn Harris said: “You wouldn’t dream of having a workplace where people weren’t entitled to certain things because they were pregnant, and it’s exactly the same for women with the menopause. I firmly believe there should be legislation to make sure every workplace has a menopause policy, just like they have a maternity policy.”
The often unspoken impact of menopause on women at work has become a cross-party issue. The Conservative MP Rachel Maclean was the first to speak out about it in the House of Commons and has been campaigning to normalise menopause as a workplace issue.
She said she wants women to be able to have time off or change shift patterns or conditions of work when they need relief from symptoms that often go well beyond the stereotypical hot flushes and night sweats.
Q&AWhat is the menopause and how does it affect women?
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The menopause is a natural part of ageing and usually occurs between 45 and 55 years of age after levels of the hormone oestrogen have declined to the point where ovulation and menstruation stop. It is defined as a woman going 12 months without a period. In the UK, the average age for a woman to reach the menopause is 52. However, about one in 100 women have their menopause before the age of 40.
Common symptoms can include hot flushes, night sweats, vaginal dryness and discomfort during sex, a reduced sex drive, low moods or anxiety and difficulty sleeping. Memory and concentration can also be affected.
Symptoms can begin months or years before periods stop – this time is called the perimenopause – and can last around four years after the last period. However, some women have them for much longer, with 10% experiencing symptoms for up to 12 years.
About 25% of women experience such severe symptoms that they can be diagnosed with mental health problems. The principal treatment is hormone replacement therapy, which can control symptoms well, but does increase the chances of breast and ovarian cancer.
“I absolutely agree that employers need to do more. It’s not well understood,” Maclean said. “Employees don’t get the support they need. It is very difficult for women at work often.” She said she had heard many “horrific and heart-rending” accounts.
“My central message is: menopause is the last taboo because it is still hidden and it only affects women and it only affects older women. It’s ageism, it’s sexism, all rolled into one.”
Harris said she believed that if legislation was required, it would be passed by MPs. There was “tremendous support” across the benches when the house debated the issue recently, “especially from men whose wives have been through it. They understand.”
About 80% of women experience some symptoms of the menopause, brought about when ovulation stops as a result of hormone levels dropping. One in four have severe symptoms, including anxiety and depression, which can lead to them being diagnosed with mental health problems and prescribed drugs.
Harris told of going to see a GP in 2010 after she had treatment for a gynaecological condition. “I was having a nervous breakdown,” she said. “I was really depressed and had mental health issues. I think that’s down to the fact I was going through the menopause. So many women end up on antidepressants or being told to pull themselves together.”
Amanda Griffiths, a professor of occupational health psychology at the University of Nottingham who has done substantial research on the impact of the menopause on working women, said it had “quite a significant impact” on the personal and professional lives of up to a quarter of women.
She said women made up an increasing proportion of the ageing workforce. “For me there is a big issue here, which is not just about women having problems with menopause. It is about managers understanding it is perfectly normal for us to have health problems,” she said.
There needed to be an atmosphere at work where people could talk about health, she said, “instead of which we tend to have this fear in some organisations that if we have a health condition there will be some sort of stigma attached to it”.
Two separate surveys of women going through the menopause and perimenopause – the time leading up to when ovulation stops – found they were struggling in work and felt unsupported by managers.
In one survey of more than 1,100 women, undertaken by the menopause clinic Newson Health and published last month, 94% said they felt their work had suffered as a result of their symptoms, and 53% said their colleagues had noticed a deterioration in their performance.
Just over half had taken time off sick, and one in 10 had missed more than eight weeks of work.
A separate survey by the shop workers’ union Usdaw found that one in five women had taken time off work and that more than half did not feel able to approach their managers if they were suffering.
In the Newson Health survey, more than a third said their employer did not offer any kind of discussion group, awareness session or training on the subject of menopause, despite there being more than 5 million working women aged between 45 and 60.
Dr Rebecca Lewis, a GP who works at Newson Health, said: “Women are suffering quietly for fear of saying ‘it’s the menopause’ and being laughed at and told to get on with it.
“A GP might not think to put it down, or the woman might not want it put down because of a feeling that it’s not a ‘proper’ illness.”
Sue Hackett, the London regional equality officer at the GMB union, said: “It is high time we stop treating menstruation and menopause as taboo subjects. Women have put up with insulting comments and a woeful lack of provision for far too long for what is a completely natural condition.”
She said workplace policies around sickness absence or performance management could unfairly penalise women “because of key symptoms like memory loss or lack of concentration”.
Unions said there were examples of good practice in workplaces. In 2017, Nottinghamshire police introduced a menopause policy and issued guidance to managers saying they could consider requests from women who needed to adjust their uniform or their working hours.
Among other practical support, it recommended access to private areas where women could “rest temporarily, cry or talk with a colleague before they can return to their workspace”.
The Welsh government has put in place guidance for its workers. It said: “All reasonable adjustments will be considered when a health issue may be impacting on a person’s ability to carry out their role – this can include changing working location or conditions for a more comfortable working life.”
Unfair dismissal case
Last year an employment tribunal judge found in favour of Mandy Davies, a court officer working for the Scottish Courts and Tribunals Service who was dismissed after an incident involving medication she was taking.
Davies alleged that under the 2010 Equality Act she had been unfairly dismissed and discriminated against as a result of a disability.
The tribunal heard how she had been suffering from symptoms including heavy bleeding, memory loss and confusion, and that she had previously had a 20-year unblemished employment record.
Her employer accepted that the menopause was a disability, but argued it had not unfairly dismissed her as a consequence, a position the judge did not accept, ruling that she should be reinstated and paid £14,000.
The court service is appealing against the decision.