1. Introduction
1.1 St Georges, University of London recognises that employees may need support during the menopause, particularly as the menopause is not a widely discussed subject and can be misunderstood. The University has a positive attitude to the menopause and will endeavour to make reasonable adjustments where necessary to support employees experiencing the menopause. It also wants to develop a culture where the menopause is openly recognised and discussed by both male and female colleagues in a respectful and supportive manner.
1.2 Some employees may find it difficult to discuss the menopause with their line manager and may feel that they need to take time off work to deal with their symptoms without disclosing the reason to their line manager. This procedure aims to raise awareness about the menopause amongst employees and provides additional guidance to enable employees to understand more about the menopause.
1.3 Alongside this policy, the University will aim to provide training, where possible, for employees so that they are able to better understand the effects of the menopause and be comfortable about discussing and addressing the impact that it can have on employees in carrying out their roles. Any training will be supported by awareness campaigns also aimed at supporting the development of an understanding and supportive culture.
1.4 The menopause, often referred to as ‘the change’, usually occurs between the age of 48 and 55. The average age of menopause in the UK is 51, but it can happen much earlier. More people are now working through and beyond the menopause.
1.5 Menopause is not usually associated with the workplace or with workers’ health and safety. Although many experience few or no problems around this time, others do. These problems can sometimes arise from the way work and working conditions can impact health during the menopause.
1.6 If required, the effects of the menopause will be considered in any relevant performance and capability issues, as it is recognised that the physical and psychological symptoms of the menopause and side effects of hormone replacement therapy may have a detrimental impact on work performance.
2. The menopause
2.1 The menopause is part of the natural ageing process. It refers to the time when menstruation has ceased for 12 consecutive months. This occurs naturally, normally between the ages of 48 and 55. Overall, this period of hormonal change and associated symptoms can last from four to eight years. When menopause occurs before age 40, it is considered early. Early menopause can be caused by medical treatments, or it can just happen on its own.
2.2 The menopause occurs when the ovaries spontaneously fail to produce the hormones oestrogen and progesterone. The resulting low and changing levels of hormones, particularly oestrogen, are thought to be the cause of menopausal symptoms, if they arise. The changes involved affect different people in different ways. Some experience few or no symptoms, others experience mild to severe symptoms. Recognising these changes can help in making the links between workplace health and safety and the problems some employees experience when working through the menopause.
2.3 Menopause is usually a natural process involving gradual change, sometimes it can be sudden and acute resulting from medical intervention eg following a hysterectomy involving removal of the ovaries, or certain cancer treatments.
2.4 Menopause is not an illness, but changes in hormone levels can result in symptoms including hot flushes, heavy periods, urinary problems, palpitations, night sweats and sleep disturbance, fatigue, poor concentration, poor memory, irritability, mood disturbance, skin irritation, anxiety attacks, aches, pains and dryness of the skin and eyes. Not everyone will experience all of these symptoms and they may not occur continuously.
2.5 Hormonal changes associated with the menopause can affect future health as well as producing menopausal symptoms. Some people require medical advice and treatment such as Hormone Replacement Therapy (HRT). Seeking medical advice about menopause-related symptoms may mean the requirement for time off work to attend medical appointments and/or treatment. HRT can produce some benefits, eg by helping to reduce risks of osteoporosis in high-risk groups, but is not suitable for everyone – medical advice and supervision is essential.
2.6 Normally menopause is a natural process involving gradual change, but it can be sudden and acute if it results from medical intervention, for example, hysterectomy or certain cancer treatments. Those who have sudden menopause following serious illness or surgery tend to experience more severe problems than others, and may require treatment and/or post-operative care afterwards to prevent further problems.
2.7 Employees experiencing the menopause may encounter difficulties at work as a result of their symptoms. Some find themselves feeling less confident as a result of significant and embarrassing symptoms. Tiredness and night sweats can also make employees experiencing the menopause more susceptible to fatigue and stress at work.
2.8 While experience of the menopause differs, workplace factors that can make working life difficult for employees experiencing the menopause include:
- Lack of suitable risk assessments;
- Lack of awareness of the menopause;
- Lack of management training on the menopause;
- Poor ventilation and air quality;
- Inadequate access to drinking water;
- Inadequate toilet access and inflexible break times;
- Negative attitudes;
- Unsympathetic line management/colleagues.
3. Accessing support
3.1 It is recognised that the menopause is a very personal experience and different levels of support may be needed. As with all longstanding health-related conditions, St Georges, University of London is aware that sympathetic and appropriate support is required from line management to help employees deal with any issues arising from the menopause.
3.2 Employees may feel uncomfortable going to their line manager if they are experiencing problems with the menopause, especially if the line manager is male. There are other options available such as approaching the Human Resources Department, Occupational Health, or another trusted manager.
3.3 St Georges, University of London is committed to ensuring that conditions in the workplace do not make symptoms worse. Adjustments may be necessary to support employees who are experiencing the menopause and may include:
- A risk assessment should be undertaken in order to consider the particular requirements of the individual experiencing the menopause and ensure that the working environment will not make their symptoms worse. The risk assessment will assist with the identification of any potential adjustments which may be required and considered by St Georges, University of London.
- Working time arrangements should be flexible enough to ensure they meet the needs of the employee, who may at times require access to more flexible working in order to deal with their symptoms, including starting later after difficulties sleeping, needing to leave work suddenly or take more breaks during the day.
- Consideration should be given to environmental factors. Issues that have been highlighted as useful among the general working population include temperature and ventilation controls, such as the use of fans. Office seating plans could also be reviewed to enable the employee to sit near the window in order for them to adjust the temperature of the room accordingly.
- Consideration should be given regarding access to chilled drinking water and access to adequate workplace sanitary facilities.
- Uniforms may exacerbate symptoms in terms of hot flushes and sweating therefore flexibility may be required to enable employees to cope with these symptoms.
- Adjustments may be required to the employee’s duties as hot flushes can be more difficult to cope with when undertaking high visibility work such as formal presentations and formal meetings, for example.
4. The role of line managers
4.1 The role of line managers in supporting employees experiencing the menopause is crucial. Effective management of team members with menopausal symptoms that are impacting on their work will help improve the team’s morale, retain valuable skills and talent, and reduce sickness.
4.2 The day-to-day interaction by line managers can have a positive impact on the employee/employer relationship:
- building relationships based on trust, empathy and respect will make it easier for an employee to feel comfortable about raising a health issue like the menopause;
- having regular and informal one to ones with staff can provide a forum for a conversation about any changes to someone’s health situation including the menopause;
- asking people how they are on a regular basis will help to create an open and inclusive culture and encourage employees to raise any concerns;
- not making assumptions – everyone is different, so line managers should take their lead from the individual. 4.3 Menopause can affect people’s confidence and it can be very daunting talking to someone who has no knowledge/awareness of the menopause. The more supportive and knowledgeable a line manager is about the range of menopausal symptoms, the less likely that an employee will feel embarrassed to discuss how the menopause is affecting their health and their work. Awareness about the symptoms and range of support available in the organisation will also increase line managers’ confidence in discussing the menopause.
4.4 Line managers are responsible for:
- Ensuring that no one experiences less favourable treatment as a result of the menopause;
- Ensuring that any conversations are kept strictly confidential;
- Putting in place any required support/adjustments;
- Recording any agreements made;
- Holding regular dialogue with employees regarding support required, including follow up meetings to review adjustments that have been made;
- Seeking additional advice from Occupational Health where necessary;
- Signposting relevant sources of support, such as the University Counselling Service;
- Agreeing with the employee if other colleagues should be informed about any adjustments that have been agreed (even if the reason is not disclosed).
4.5 Line managers can contact the Human Resources Department for additional guidance and information where necessary.
5. Self-help
5.1 Current health promotion advice highlights the importance of lifestyle choices before during and after the menopause and the benefits of:
- Eating healthily - research has shown that a balanced diet can help alleviate some symptoms;
- Eating regularly;
- Wearing natural fibres;
- Exercising regularly to maintain aerobic fitness levels;
- Consulting with their GP on the management of the menopause and to ensure that any symptoms are not due to any other causes;
- Contacting Occupational Health about their symptoms in order to obtain advice and support;
- Obtaining support and discussing their symptoms with a trusted manager;
- Drinking plenty of water;
- Not smoking;
- Ensuring alcohol intake is at, or below, recommended levels;
- Having access to natural light;
- Getting adequate rest and relaxation. 5.2 These can help with some symptoms of menopause and may also help reduce the risks of other conditions in later life.
6. Sources of further advice and guidance
Katie Stringer, Equality, Diversity and Inclusion Adviser - kstringe@sgul.ac.uk
British Menopause Society – https://thebms.org.uk
Menopause Matters - https://www.menopausematters.co.uk/
NHS Menopause Guidance - https://www.nhs.uk/conditions/menopause/
The Daisy Network (supporting women who experience premature menopause) - https://www.daisynetwork.org.uk/
The Hysterectomy Association - https://www.hysterectomy-association.org.uk/
Women’s Health Concern (the patient arm of the British Menopause Society) – www.womens-health-concern.org