We have seen a rise in conversations about how menopausal women are experiencing life in the working world. And there has been debate over whether employers have a role to play supporting them. A third of the population are menopausal or perimenopausal, so they make up a sizeable chunk of the workforce, and are the fastest growing - and as such their health and wellbeing deserves to be taken seriously. For their health, and for economic participation. On average women go through menopause in their early fifties, and symptoms may start years before menopause, during the perimenopause phase. According to the Faculty of Occupational Medicine almost 8 out of 10 of menopausal women are in work. Looking after those going through the menopause is important for workplace culture, retention, and the company bottom line. Research from Oxford Economics found that for those on a salary of £25,000, replacing an employee costs an average of £30,614. 

We live in a society with an ageing population, with fewer younger people joining the workforce every year. As a result, responsible - and smart - employers need to look after older workers to ensure that they have the talent and resources to run their business effectively. The menopause at work is something that should be on the agenda, just in the same way pregnancy and parenting now is.

Mental health and menopause can be closely aligned, although the menopause isn’t a mental health condition, and not all menopausal symptoms cause mental health problems. However, some studies have found that during menopause, women who are already vulnerable and have associated risk factors are more likely to succumb to depression. Menopause increases vulnerability to depression and anxiety, potentially due to fluctuations in estrogen which affects the ‘happiness hormone’ serotonin and Gamma-aminobutyric acid (GABA) a neurotransmitter in the brain which blocks specific signals in your central nervous system and produces a calming effect. Issues around sleep, confidence, weight gain, health issues and more can reduce wellbeing, and make life harder for working menopausal women. 3 out of 4 women experience symptoms, whilst 1 in 4 could experience serious symptoms. The Americans with Disabilities Act requires employers to provide “reasonable accommodations” for workers with disabilities. However, menopause, even when its symptoms seriously affect a woman’s ability to do their job, is not deemed to be a disability by U.S. courts.

The onus is on employers and individuals to explore treatment options, workplace issues, lifestyle changes and health policies at work to provide a safe and healthy environment for everyone to enjoy and succeed at fulfilling work.

6 ways the menopause impacts mental health and work

Mood changes

Fluctuating hormone levels during perimenopause and menopause can lead to mood swings, irritability, and increased risk of depression and anxiety. Women may experience a decrease in serotonin levels, which can affect mood and cause feelings of sadness or depression. This may leave them vulnerable to needing to take time off from work, or affect relationships with colleagues and peers. Longitudinal studies in the US show that the menopause is correlated with onset of major depressive symptoms, which can adversely affect women’s health generally, as well as them in the workplace.

Cognitive function

Some women report difficulties with focus, learning, and memory during menopause, often referred to as "menopause brain fog." This poor concentration is one of many common symptoms and might result in difficulty focusing, leading to errors or a waning job performance which could end up with bigger workplace issues around deadlines not being met and targets not being hit. It’s also incredibly frustrating for women who may have previously been high performing or found work easy, and now find themselves struggling with the tasks of their daily job or needing to put more effort in to achieve objectives. Which can all lead to overwork and burnout.

Sleep disturbances

Symptoms such as night sweats or hot flashes and insomnia can disrupt sleep, leading to fatigue and exacerbating mood disorders such as depression and anxiety. Low quality sleep is correlated with depression, and poor sleep can make people irritable and anxious. As a result, they may have reduced energy levels, impacting productivity and engagement. In one study from the Journal of Occupational Medicine around half of women reported on the challenges of sleep, fatigue, brain fog and lack of concentration.

Self-image and confidence

Physical changes, such as an increase in weight and skin changes, are also common menopausal symptoms and may affect self-esteem and confidence. As a result, women may find that as a result of menopausal symptoms that are entirely natural, they are reluctant to put themselves forward for leadership roles or speak up in meetings. Due to age discrimination or biases, women might be overlooked for promotions or professional development opportunities - just a tenth of executive positions in the FTSE100 are held by women. We know that boardroom bias already exists, and at a stage in the career where people should be accelerating to seniority, the menopause transition can feel like it is holding them back.

Absenteeism and presenteeism

Women may require time off due to severe symptoms. According to a Mayo Clinic Study, the menopause costs American women an estimated $1.8 billion in lost working time per year, through symptoms such as hot flashes, night sweats, mood changes and more. Presenteeism, where an employee is physically at work but not fully functioning, and maybe experiencing issues such as memory problems, results in lower output and productivity. This can cause frustrations for individuals as well as teams, who are unable to deliver against targets.

Workplace relationships

Mood swings and irritability can strain professional relationships and communication, resulting in conflict at work. Mental health struggles can lead to isolation or misunderstandings. Although not deliberate, menopausal symptoms that affect personal interactions can lead to friction in teams that result in struggles with work output and targets, rippling out into wider working patterns. By improving awareness employers can help alleviate tension or conflict, based on an understanding of what an individual is experiencing.

6 ways employers can support women going through the menopause with their mental health

Awareness and education

Like with so many health conditions, mental health or otherwise, employers need to focus on increasing awareness. Despite half of the world’s population going through the menopause at some point, and the other half affected by it, the menopause and its symptoms are still taboo, and especially so in the workplace. Provide education on menopause to all employees to foster understanding and empathy with women going through the menopause transition, and train managers on the potential impact of menopause so they can support affected employees effectively. Facilitate discussion around what the menopausal experience is like, be open and frank about menopause symptoms, and discuss any workplace issues that might arise so that managers and colleagues are aware and armed with the best information.

Culture and policy

Foster a supportive culture that normalizes conversations about menopause and encourages employees to seek support. A culture of psychological safety is essential for ensuring that people feel comfortable enough to speak up and discuss how they are feeling, their wellbeing, and the impact that the menopause may be having on not only their life but work.

And develop and implement a workplace menopause policy that addresses things that may make it easier for women and alleviate some of the impact of menopausal symptoms such as flexible working hours (we know that commuting affects health so make it easier), temperature control, and access to health and wellbeing resources. Ensure that the work environment is comfortable, with attention to temperature control and private rest areas.

Health and wellbeing

Provide health and wellness programs that include advice on nutrition, exercise, and stress management techniques that can mitigate menopause symptoms. Lifestyle changes don’t fix everything and many women find that Hormone Replacement Therapy (HRT) is the only feasible solution that works, but a healthy lifestyle is still beneficial. Talk through with your employees what kind of resources they would find helpful, rather than a one size fits all approach. 

Employee assistance programs

Offer access to counseling services, holistic wellbeing support, medical assistance and coaching through employee assistance programs (EAPs). Typically uptake is low, around 3-7%, but if you choose an EAP provider that has wraparound services such as training, marketing and support, like Wysa, awareness of the tool and its ability means utilization will be much higher.  While talking to Wysa, 42% of employees opened up about their declining mental health.This doesn’t just mean your investment is worthwhile - higher and more frequent use of Wysa is correlated with better results. But monitor usage and take up and ensure that you’re providing resources in the right way to the right people. You can get an anonymous snapshot of the mental health of the workforce through the Employee Mental Health Barometer and use employee feedback for more qualitative and personal responses. 

Work environment

Numerous psychosocial factors related to the work environment affect our mental health and it's important to be aware of what can be done to support women’s health generally, as well as those with menopausal symptoms. This can include flexible working arrangements, such as hybrid working options or flexible hours. Look at the workplace environment and how you can provide for reasonable adjustments to it and the working day. Train line managers on what they can do to be supporting women experiencing symptoms, such as how to encourage them to speak up, how to talk to people who appear to be struggling, what workplace changes can be made, and to make wellbeing at work a priority.

Employee voice

Encourage feedback and dialogue with employees about what support they need.

Create peer support groups or networks for women going through menopause. A specific menopause Employee Resource Group committed to improving the experience for women with menopausal symptoms would be beneficial as it would enable honest and open discussion about menopause symptoms and what employers can do to support women. 

By recognizing menopause as an important health and wellbeing issue, employers can take proactive steps to support affected employees, which can lead to a healthier, more inclusive, and more productive workplace.

Image by SHOTPRIME, Canva.