When Kate from Pembrokeshire started experiencing vertigo, flooding periods, exhaustion and brain fog at 51, she had no idea what was happening to her. “It was really scary,” she says, “I felt like I was losing my mind.” Working as the general manager of a travel company, she was surrounded by younger colleagues she didn’t feel she could confide in. She recalls sitting at her desk one day thinking, “What is my job?”
She eventually quit, feeling like she couldn’t manage any more. It wasn’t until the hot flushes began after a year that she saw a doctor. “I didn’t know I needed help until I was put on HRT and a miracle occurred – I began to feel like myself.” But it was too late to rescue her working life: she had already given up her job.
Despite a growing awareness of the often debilitating nature of perimenopause, many employers do little to accommodate the difficulties that female employees endure. In 2023, the Chartered Institute of Personnel and Development surveyed 2,000 women between the ages of 40 and 60: two-thirds said menopausal symptoms had a mostly negative effect on them at work. A 2022 study by the Fawcett Society found that one in 10 women who had worked during menopause left their job because of symptoms; eight out of 10 said their employers offered no support.
“Menopause can be really impactful on people’s ability to work,” says Dr Katherine Kearley-Shiers, a GP based in Bristol who works in a menopause clinic for women who have complex medical conditions. “Patients can struggle with brain fog and difficulties multitasking – women are balancing loads of different things at work, but also within their lives more widely. Memory is really important: women tell me they can forget to go to a meeting, or be in a meeting and struggle with finding words. Anxiety caused by this can then trigger a hot flush, which some women can find embarrassing and this can make the flush more intense.
“All of this can contribute to a loss of confidence. Women can feel that they can’t participate in their working lives in the way that they want to. But it can be managed.”
A recent menopause gift bag initiative for female employees of train company Avanti West Coast was much derided, with contents including a fan, tissues and a jelly baby, “in case you feel like biting someone’s head off”. What is actually needed is “being able to speak to HR, because they can try to modify the working environment”, says Kearley-Shiers.
Charlie, 46, a civil servant from Manchester, says her workplace introduced menopause awareness training, which has been transformative. “As a result, I feel completely comfortable discussing menopause in day-to-day conversations without it being a big thing,” she says.
Proposals for a national menopause policy – which the government rejected last year – are well-meaning, says Dr Katie Myhill, an assistant professor in law at Heriot-Watt University, but there is a danger of increasing the stigma around the cost and legal risk of menopause, leading to women of this age being overlooked for roles. “We need to be careful how we introduce further protections. We don’t want to further stigmatise menopause in a way that could result in an increase in discriminatory conduct,” says Myhill.
Equality and Human Rights Commission guidance earlier this year stated that long-term menopause symptoms that impact on a person’s ability to work could be considered a disability. This received a mixed response: the broadcaster Mariella Frostrup, who has campaigned extensively on this issue, described it as “a backwards shuffle”.
Fiona McKay, of The Menopause Maze, coaches women on navigating their careers during perimenopause, as well as working with employers to be more supportive. “Menopause gives you the opportunity to look at the next phase of your professional life,” she says. She speaks from experience: just over 10 years ago, McKay was running several businesses when she had a hysterectomy that caused immediate surgical menopause. “I’m a completely different woman than who I was when I went into that operating theatre,” she says. Having worked with a variety of companies since, she says she is “beyond frustrated that they think that a menopause policy is the panacea for all. A piece of paper does not change the dial for culture and inclusive, progressive opportunities for menopausal women. It is just signposting.”
Consulting women about what they want is a good place to start, says McKay, as is making more budget available, “because so far this has been done on a shoestring”. Awareness and symptom sessions should be held, not just for women but across the whole organisation. She also advocates flexible working arrangements, “because if you’ve not slept the night before, being able to work from home really makes a difference, and flexibility costs next to nothing with significant business returns”.
Kate agrees flexibility is key, as she recalls in horror when she was at her lowest ebb, and constantly bleeding, having to go to the toilet every 20 minutes. After leaving her job in 2020, she got another role working for a local authority. There is a menopause group that meets regularly and has guest speakers on everything from nutrition to cold-water swimming. It’s made a huge difference. “I’m in a great job and I feel like I am valuable – I’ve got something to offer.” Kate says she can’t imagine coming off HRT, but it is reassuring there is a more sympathetic attitude at her current workplace.
“The shame of having to ask for accommodations is really hard,” she says. “For organisations to promote the idea of flexible working and other things is brilliant – because we’re not having to do it ourselves.”
Some names have been changed
