Fifty-one per cent of the population will experience menopause; around a third of women – 13 million – are estimated to either be going through or have gone through it. Yet like so many aspects of female health and wellbeing – from pregnancy to conditions such as endometriosis and childbirth – menopause is stigmatised, under-researched and its symptoms undertreated thanks to the sexism and ageism directed at middle-aged and older women.
So the new guidance for employers, published last week by the Equality and Human Rights Commission (EHRC), on their legal obligations to female employees in relation to menopause is to be welcomed, although we must be alive to the risks that, without a broader campaign to change attitudes towards older women, there is a risk it could play into harmful societal stereotypes about women in the workplace.
Menopause occurs when a woman’s periods stop because of falling hormone levels. It usually happens naturally between the ages of 45 and 55, but can occur earlier as a result of genetic factors or surgery or cancer treatments. It can result in no symptoms at all, but around three-quarters of women experience some during menopause and in the years leading up to or following it, and occasionally they can be serious.
But in the majority of cases, they can be treated relatively easily and cheaply through hormone replacement therapy. HRT is recommended by the medical evidence specialist Nice because it is proven to reduce the symptoms of menopause, and its benefits far outweigh its risks for almost all women. But only 14% of menopausal women are taking HRT, a fraction of those who could benefit. This is down to a combination of factors, including the misreporting of scare stories about the risks of HRT, which has made many GPs reluctant to prescribe it despite its benefits. Too few primary care doctors have enough knowledge about the menopause; four in 10 medical schools do not even include menopause as part of their mandatory curriculum. While the annual prescription costs of HRT were last year reduced to just under £20, many women who want to take it have not been able to get hold of it because of acute shortages. Ensuring all women can access medical treatment to alleviate any menopause symptoms must be a priority for the government and the NHS.
But some women may not be able to benefit from medical treatment, and others may still experience symptoms that affect them in the workplace. As the EHRC guidance makes clear, the Equality Act 2010 provides robust legal protections for women experiencing serious menopause symptoms. Employers cannot discriminate against them and must make adjustments where needed.
Some campaigners are justifiably worried that emphasising the potentially debilitating symptoms of menopause without being clear that they are often treatable, and do not affect anything close to all women, may reinforce the negative perceptions society has of women as they age.
The writer Victoria Smith wrote powerfully about the pernicious misogyny that affects older women in her book Hags last year. There remains a huge amount of stigma around menopause, and around female ageing more broadly, which is the product of sexism, pure and simple.
So educating employers about the rights of menopausal women in the workplace cannot happen in isolation from a wider conversation about addressing, once and for all, the deep-seated and depressingly common prejudice that a woman past her childbearing years is somehow a lesser person.
