Menopause: The ultimate taboo
CIPD Podcast about the effects menopause can have on work and what employers can do to support their colleagues awareness, education and support.
Deborah Garlick, of Henpicked:Menopause in the Workplace talks with Philippa Lamb, CIPD’s Senior Employment Relations Adviser, Rachel Suff and Janet Trowse at Network Rail.
Deborah Garlick: I’m Deborah Garlick from Henpicked: Menopause in the workplace.
Philippa Lamb: Deborah is the founder of a website called Henpicked. It’s for women aged over 40 and three years ago a TV network got in touch with her and asked if she knew of any organisations with a menopause policy.
DG: it was a bit of an interesting question for me, I’d never seen one and as I’d not seen one I didn’t think anybody else would either. So I got in touch with a lot of the HR directors that I know and said, ‘Do you have a menopause policy?’ and it was a resounding, ‘No we don’t,’ but there were a few of the HR directors that came back and said, ‘But if you’ve got one I’d like to have a look at it.’
PL: It’s fascinating isn’t it that not a single HR you spoke to had a policy or had even really thought about it. And having researched it myself it is just I think the first area I’ve ever come across where no one is talking about it, not even women are talking about it. Why do you think that is?
DG: It’s a complete mystery isn’t it because we haven’t invented this; menopause has always been around for as long as there have been women there’s been menopause. But what is very different Philippa is that there are more women in the workplace than ever before. Menopausal women are the fastest growing workforce demographic and of course we’re working for later. So once upon a time, you know, when early retirement was on the radar maybe some women could just think, well I’ll get through this I’m going to be retiring in a couple of years. But with menopause average age being around about 51 and women working until their late 60s menopause can be a real bump in the road and something that can completely derail some women’s career, their work, it’s an absolute mystery. But when you say lack of awareness, this isn’t just lack of awareness in the workplace it’s generally, it’s UK-wide. A lot of people will say, well men don’t know a lot about menopause but we actually say neither do women.
PL: So give us a bit of a primer Deborah. I mean as you say it’s not a thing people know about it’s not a thing even women know about, what sort of symptoms are we talking about? What sort of timeframe are we talking about?
DG: Timeframe-wise I think that’s one of the biggest misunderstandings. We have women and a woman said to me earlier on this week, ‘I don’t think it can be menopause because I’m not 50 yet.’ And certainly when we start talking to organisations the conversation is often, ‘Well we don’t have many women in their 60s and 50s working for us.’ So that is a good place to start. The average age for menopause is 51 but symptoms start years before that in the 40s and that’s for women that go through menopause at the average age. There are so many women that go through menopause early, naturally, or as a result of surgery or illnesses like cancer, cancer treatments can cause menopausal symptoms. So timeframe-wise we have to adjust our own mindsets. But you mentioned symptoms now we all recognise hot flushes. It’s the stereotypical menopausal symptom but some work we did last year around about 5,400 people filled in the survey and what was very clear is it’s not always the physical symptoms. Actually it was the psychological symptoms that were getting in the way most. So what was on that list it was insomnia, fatigue, anxiousness, nervousness, problems with recall. Often women feel that they’re – I’ll say falling to bits. We hear women saying, ‘I thought I’d got early onset dementia.’
PL: As Deborah says it’s not uncommon to go and get tested for early onset dementia when in fact they had menopausal symptoms. And it’s not just men who don’t know about the symptoms, it’s all of us. Deborah’s other revelation about menopausal women being the fastest growing sector of the workforce is vitally important too.
Rachel Suff: I’m Rachel Suff and I work in the Public Policy team at the CIPD and I lead on health and well-being issues.
PL: Rachel has been instrumental in the CIPD’s new work on menopause. So tell me in a business context from an employer’s point of view why does menopause matter?
RS: It matters because if you think about the age range that people are affected by the menopause, that’s about 45 to 55, nearly four million women are in that age group over 50 in work and nearly every one of us will experience the menopause. Around 80% of those women will experience symptoms so it is a really significant health issue. So if you’re serious as an employer about attracting and maintaining women, your female talent, you have to take the menopause seriously as a health issue.
PL: This is a highly personal matter for women, perhaps even more intimate than pregnancy or fertility treatment for example, they probably won’t want to discuss it at work but some will find they just have to because their symptoms are so hard to manage. So the task for employers is to create a culture where everyone knows about menopause and can have those conversations if they need to or want to.
RS: I think you’re right and I think some of the symptoms can be quite intimate. It can feel quite personal. So for example things like hot flushes, heavy bleeding, you know, we have to talk about these things quite openly and I think the key to it at work is just trying to open up the conversation and I think the less embarrassed you are as a manager for example in that organisation the less embarrassed women will be to raise the issue and I think the responsibility is on the organisation to try and create that open environment. You’ll find that it can happen quite quickly that opening up of the culture. We talk about it much more now in our own organisation at the CIPD.
PL: Do you?
RS: Much more openly and it’s really made a big difference and if you think about it even young men may come up against this issue because they might have a mother who’s going through the menopause and some men in the organisation have been really pleased to have the chance to talk about it. The menopause I realised that until I started working on this project I don’t think I’d really had a conversation about the menopause and now I’ve had lots and lots and lots and that can create a really positive knock on effect.
PL: I’m just so intrigued by this because every woman we speak to about this says exactly the same thing and no one is ever talking about the menopause, it’s the greatest taboo isn’t it?
RS: It is.
PL: And I think in researching this programme has made us really this is the greatest workplace taboo we’ve ever encountered.
RS: And I think a lot of people the trouble is they don’t even realise it is a taboo because it’s so buried and not even talked about. And I think that makes a lot of people in organisations think, well I shouldn’t talk about it, maybe it’s not appropriate for me to actually mention the menopause, am I putting my foot in it?
RS: I was shocked to realise there are about at least, oh 40 different symptoms you can have. Everyone’s going to experience them in a different way probably. They’re going to fluctuate. So what you need from your employer can change over time as well. You need to have that ongoing conversation with your manager.
PL: And the timeframe can really vary, we talk about average age 45 to 55, quite a lot of women much earlier, quite a lot of women much later, but generally we can be talking about, I think it’s an average of about seven, eight years of symptoms isn’t it, it’s a long time.
RS: Yes and I hadn’t realised that as well before I really started looking at this as part of the project and it was an eye-opener for me as well, I thought it was something that maybe lasted a couple of years, you came through the other end, that’s not necessarily the case!
PL: Disappointing for all women.
RS: The symptoms, I’m sorry to tell you, can go on for many years and we have the post-menopausal situation. We have the peri-menopause, before the menopause and that can last for several years when your hormones are starting to change. Then we have the menopause itself and then afterwards as well you might still have some of these symptoms. So it’s a very personal issue as far as how far your symptoms are going to affect you and for how long.
PL: There’s another side to this and that’s stigma. In the past menopausal women have been acutely stigmatised and at work that can potentially lead to a whole range of negative or outright illegal discriminatory behaviours. Deborah Garlick?
DG: Absolutely stigma. I think that one’s evident that how many women don’t talk to their line manager about menopause.
PL: Or indeed each other.
DG: Or indeed each other, yes, and that is something that’s UK wide, that’s not just something that happens in the organisation. And when you think the perception, we mentioned it earlier, about menopausal age, and certainly one of the graduates that we started working with his first question was, ‘Aren’t all menopausal women retired?’ So that shows what they think.
PL: Right, disappointing.
DG: I know yeah, whether all menopausal women are so much older than people think so why would a woman put her hand up and say, ‘Actually I’m menopausal,’ when there’s this perception that it’s so much older.
PL: Okay. For organisations, yes we need to get on to this, it’s crazy not to on all sorts of levels. What is the starting point?
RS: First of all trying to open up the culture so people can talk about it openly, therefore women don’t feel embarrassed about going and having a conversation with their manager about some tweaks and changes they might want to their working day, but I think as well look at what your framework is, do you have any support that could be helpful, because it’s a health issue just like any other health issue it should be treated as such. So do you have things available like counselling and so on? But then I think it’s looking at issues like sickness absence, you might need to take a bit more short-term absence, if you’ve had terrible nights for example. So it’s being flexible around hours of work. And then I think definitely training and educating line managers. They need to be knowledgeable so they’re not embarrassed when somebody comes to talk to them.
PL: Yes, you don’t want any squirm factor do you in those conversations?
RS: No. You need to talk about the symptoms. You need to understand what the symptoms are.
PL: And here’s an organisation that’s trying to address menopause head on, Network Rail has 4,000 women on the payroll, some work in office roles, others are out and about in railway maintenance, engineering and construction roles. Janet Trowse is head of HR system operator.
Janet Trowse: So we started in 2017, not so long ago but we were doing it as a passion it has to be said and in truth my colleague and I started from the point of personal experience of menopause. We also recognised that something needed to be done as we talked with colleagues it’s quite evident that it is a challenging thing to be talking about any sensitive subject, whether it’s mental health, any diversity challenge, but menopause in particular is a word…
PL: It’s the big one.
JT: …that’s not said out loud.
PL: So when you started chatting with women about it did it quickly become apparent that there were problems, they were experiencing difficulties and they wished that stuff would be done for them?
PL: So how did you start that process then? How did you put the word out that this was something that you wanted to see discussed?
JT: We started by structuring up terms of reference, going really bog standard, so we treated it as a proper project and not as a personal campaign. I think with a subject area such as menopause it’s really important to not make it too personal, so if you’re engaging the finance directors or very senior people it’s being able to talk about it in a people context but importantly in a business context.
PL: It was an educative process for everyone in the organisation regardless of gender and simply having the conversation helped a lot of women who had been suffering in silence.
JT: I think it’s really comforting when you talk to people and they may have experienced similar type symptoms. That in itself normalises what people are going through. So I’ll give you an example, for me personally and for many women I know that we can become quite forgetful. We can start to lose our confidence a little bit because we start to make it to be a bigger thing than it actually is.
PL: This reassurance and comfort that women feel by coming together and talking about their experience of menopause at work has produced some innovative ideas such as menopause cafes. Here’s Deborah Garlick again.
DG: Menopause cafes in organisations or outside have been something that some organisations have adopted because that brings women together to talk about it and just being able to talk about it is good for you, you know. That was some work that was done at Kings College in London that talking about menopause is actually a way of relieving menopause. It might sound a bit strange for some people, but if you’re bottling it up and not talking about it, or actually we hear a lot from women that it’s reassuring that they’re not alone.
PL: At Network Rail Janet has done a lot of thinking about the problems that her menopausal colleagues were having and what she could usefully do to make life better for them at work.
JT: There are so many things that you can do within an office or an external environment to think about temperature control, clothing, hours, I mean never before has flexible working been so important I think in the workplace.
PL: And this is around insomnia, is that what’s driving that?
JT: Yes. So I know of a colleague who sleeps so badly that she probably falls asleep at four or five in the morning so to get up at seven is just not on and why would any employer try and hold her to that because it becomes unsafe, not just for her but for the people around her.
PL: Or just making poor decisions.
PL: Whatever your job.
JT: Whatever your job.
PL: There are big wins for employers here in reputation, recruitment and retention, to name just three a menopause-friendly organisation is going to surprise and appeal to women jobseekers and of course it’s a great way to push inclusivity into new territory.
DG: This ticks all of the boxes for HR, diversity and inclusion, equality, health and safety; you’re looking at potentially reducing absence. Now I don’t necessarily like to associate menopause with absence but we know a lot of women don’t know they’re experiencing menopause, they don’t feel great but they can’t put their finger on what it is. And so raising that awareness, we’ve only got verbatim statistics at the moment but it does appear to be a tick in the box for absence.
PL: And just thinking about the sort of adjustments that employers might want to think about in this context we’re not general talking about complex things are we?
DG: No we’re not talking about complex things and I think that’s something that we find interesting when we’re training line managers because when they see the big numbers and they start to understand the context you can sometimes see line managers thinking, crikey what have I got to do with all of this?
PL: Yes to make this work.
DG: How am I going to run my team if we’re going to have this, or how is this going to work? But actually it’s often the small things that make a world of difference for a short period of time while a woman gets that support and learns how to manage her symptoms. It’s not forever.
PL: Network Rail has deliberately made its menopause policy publicly available.
JT: Our information, and I’ve purposely done this with menopause, is we’ve put it onto our Safety Central site, which is accessible externally as well as internally which means that we can engage with our suppliers and contractors, anybody we deal with, and actually if you want to you can look at that information.
PL: So a member of the public can go on that site?
JT: Correct yes. And I think that’s really important.
PL: And then there’s retention and this is a huge issue around menopause. Here’s Deborah.
DG: There is research that says one in four women considers leaving work as a result of their experience around menopause.
PL: Yeah I’ve seen data that says 10% of women stop work due to difficulties around menopausal symptoms which struck me as a very big number indeed.
DG: It really is a big number, 10% leaving and the big number of one in four women considering it, now when you think of business case, and we know from Oxford Economics, it costs around about £30,000 to replace a colleague on an average salary of around about £25,000. That’s not just the recruitment process, that’s the induction, the bringing them up to speed, and you don’t have to avoid many women leaving the organisation for this to be a significant payoff.
PL: And we should say of course and everybody will understand this, there are legal obligations here too, workplace conditions, you cannot exacerbate someone’s medical symptoms, discrimination, so issues around training, advancement, career progression, all those questions get wrapped into this don’t they because of people’s perceptions about what it means when a woman is menopausal.
RS: Yeah and again I don’t think a lot of employers realise that there is a really strong compliance case to take the menopause seriously. We have had case law at tribunal where somebody’s symptoms are so severe that it’s considered a disability. There’s also the whole body of health and safety legislation, you have to assess, as an employer, the risks to people’s health and that includes looking at factors in the workplace that could exacerbate somebody’s symptoms. So there’s a very hard-edged business case supporting this too.
PL: So do you think we’ll see more of that because obviously more women are working longer, there are more women in the workplace who are going to be menopausal and the call for appropriate adjustments and just for the workplace to be more menopause friendly they’re going to be louder aren’t they?
RS: I think you’re right because with more awareness as well you could have more complaints being brought because a lot of women themselves might not be fully aware of the implications of what their menopausal symptoms might mean at work.
PL: And the rights they have.
RS: And the rights they have. So with more awareness we’ll bring more awareness about people’s regulatory position and their ability to bring a claim and I think once you’ve had successful claims at tribunal and they’ve been around sex discrimination and around disability discrimination already that’s already put a precedent on the statute books.
PL: This may very well be the first discussion you’ve ever heard about the menopause at work but I think we can say with confidence it won’t be the last. If you’d like to brief yourself about menopause and how you can help to smash that taboo around it you’ll find all the CIPD guidance in one handy place, cipd.co.uk/menopause.
Further reading: Why menopause in the workplace ticks all the HR strategy boxes
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Or get in touch: Menopause@henpicked.net