Canadian HR Reporter

CANADIAN HR REPORTER February 22, 2016 8 NEWS Employers encouraged to break through stigma of menopause Reports recommend understanding, accommodation, networks BY SARAH DOBSON DESPITE aff ecting 50 per cent of the population, menopause re- mains somewhat of a taboo topic in the workplace. Employees and managers alike are often reluctant to discuss the condition's symp- toms or impact on women. But change is afoot, particularly when it comes to employers and the role they can play, according to Margaret Rees, executive director of the European Menopause and Andropause Society (EMAS). "It is becoming an increasing hot topic that women need to talk about, and employers need to be aware about, and not to dismiss." It's particularly important be- cause there are more women in the workforce now, and they're also working longer, she said. "There's awareness among employees but there needs to be more awareness among employ- ers. is is a normal process and it's not an issue that's going to last a very long time but during that time, (it's important) to make the workplace conditions acceptable." Reports highlight issues In late 2015, EMAS released rec- ommendations on how to im- prove conditions in the workplace for menopausal women, pushing for greater awareness among em- ployers, along with sensitive and fl exible management. It's about helping everyone to approach this in a straightforward way, with less embarrassment, said Amanda Griffi ths, co-author of the article and professor of oc- cupational health psychology at the University of Nottingham in the U.K. "After all, this is a perfectly normal thing that aff ects half the workforce. (It's) time to talk and get rid of the taboo." In December, England's chief medical officer, Sally Davies, made recommendations on a wide range of health issues in- cluding "taboo problems" such as menopause. Employers can lead the way, she said in the report, by making it more acceptable for female staff to discuss health issues. "Women report that they do not feel able to discuss the issues of menopausal symptoms aff ect- ing their performance at work with their employer. Evidence- based advice for employers and women at work will help women working during the transition to the menopause. With an aging national workforce, positive ac- tion by employers would benefi t those with symptoms, and con- tribute to employee engagement, productivity and retention." Symptoms Overall, this period of hormonal change and associated symp- toms can last from four to eight years, according to Griffi ths. A 2011 U.K. study of nearly 900 working women by her univer- sity found the main symptoms that cause women diffi culties at work include poor concentration, tiredness, poor memory, feeling low or depressed and lowered confi dence. Hot fl ashes are also a problem. " at's a big one in that when women are having the fl ash, it's from inside to out, essentially; it's this internal heat that can be very distressing to the woman, not only because of the heat itself but because she starts sweating, so that can be visible to other work- ers, and it can happen frequently or infrequently," said Unjali Mal- hotra, interim chair at the Ca- nadian Foundation for Women's Health in Vancouver. A menopause "fog" can also mean cognition and memory are diminished because of an acute lack of estrogen, she said. " at doesn't mean they're going through this permanent decline in cognition — it's a temporary time period that can be very distressing, and they're leaving sticky notes for themselves, they're really just hav- ing to manage around it to main- tain (their) work level… that can be something that's embarrassing but also very scary for them where they themselves might think, 'I'm losing my mind.'" Vaginal discomfort and heavier periods are also common, said Malhotra. " at's something that people don't want to, and often don't, talk about because these issues are very intimate, and to be in a work- place discussing these is actually a challenge and really shining a light on a woman at a time when she's struggling already." More serious gynecological is- sues could mean women have to take time off and accommodation may come into play if a woman requires several doctors' appoint- ments. If symptoms are particu- larly severe, a woman may need to go on disability, said Malhotra. "But it depends on what the underlying issue is and what led them to that point. We can usually get people back on track pretty quickly and eff ectively," she said, citing solutions such as hormone replacement therapy. It's important to deal with the issue as women need to continue in the workforce "and not be dis- missed because they've got to take time off work, because they feel so awful because they haven't had a decent night sleep because of the night sweats," said Rees, co-author of the EMAS article. " e thing about concentration and memory is they are probably related to poor sleep and this is manageable. e whole thing is manageable as long as people talk about it." Dealing with stigma ere is defi nitely a stigma around menopause, and around women's health issues in general, said Malhotra. "Even within one's home, never mind at their workplace, so I think that we have a long way to go with the understanding, and I do agree fostering a culture is helpful." It's about opening up the con- versation and being more under- standing, she said. " is is a situation that pretty much everyone in the female pop- ulation is going to go through and there's nothing they can do about it. And they aren't trying to cause issues within the workplace — they are more uncomfortable than you are, so understanding that and having some sympathy and empathy are always appreciated." Some women feel their meno- pausal status opens them up to being stereotyped and they prefer not to reveal age- and gender-re- lated matters at work, said Davies in her report. "When women take sickness absence because of menopausal symptoms, they do not always di- vulge the real reason to their man- ager. However, when women do disclose diffi culties to co-workers and line managers, their subse- quent support is highly valued." Women may encounter criti- cism and ridicule about meno- pausal symptoms from co-work- ers and managers, she said, so it's important not to underestimate the accumulated and negative consequences for mental health. "Women are generally reluctant to divulge their menopausal status or symptoms, but particularly so at work, where fear of stigmatiza- tion is common, and where poise and control are highly valued." Nearly one-fi fth of the women in the U.K. study thought meno- pause had a negative impact on their managers and colleagues' perceptions of their competence at work, and felt anxious about these perceived performance defi cits. The stigma remains because many people don't know much about menopause and are embar- rassed to talk about it, especially to male managers or younger managers, said Griffi ths. "And many women told us they were not aware of the menopause either, until it was upon them." Recommendations To support women, working conditions should be assessed to consider the specifi c needs of menopausal women and ensure the working environment will not make their symptoms worse, ac- cording to EMAS. Particular strategies might in- clude: fostering a culture where employees feel comfortable dis- closing health problems, allowing fl exible working, reducing sources of work-related stress and review- ing workplace temperature and ventilation. Information about menopause and strategies for coping with symptoms at work should also be provided, whether formally (by employers) or informally through networks of working women who have experienced menopause. Networking among women can be a powerful solution, said Malhotra. "Women do very well with communication and with really supporting one another… in the age of online communication, the ability to reach so far to each other and know that you're not the only one, that is the biggest thing." Women who have previously suff ered from mental health issues may go into full depression dur- ing perimenopause, not knowing it's related to a drop in hormones, she said. "All the psychological/psychiat- ric issues worsen at this time and that's something that we might not know or be aware of but if they had other women to speak to and bring this forward to, they would probably be more inclined to see their doctor and tell their doctor and ask for therapy." Managing menopause Women should feel empowered to speak openly about their health issues and ask for help. Employers can help by communicating to their workforce that health-related problems such as menopause are normal. Helpful workplace supports: • Greater awareness of managers about menopause as a possible occupational health issue for women. • Increased fl exibility of working hours and working arrangements. • Better access to informal and formal sources of support. • Improvements in workplace temperature and ventilation. Source: Work and the Menopause: A Guide for Managers, British Occupational Health Research Foundation

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