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Ask the Expert: Menopause – time to talk business

Following World Menopause Day on 18 October we ask the experts at the Liverpool Womens NHS Foundation Trust for some practical advice for employers.

Employers have a general duty to ensure the health, safety and welfare of employees at work, which covers the full spectrum of women’s health-related issues, including menopause. They also have a legal duty to carry out suitable and sufficient assessments of the risks to the health and safety of employees in the workplace, looking at what adjustments an employer could reasonably put in place to help alleviate the impact of menopause symptoms on an employee’s work.

In this article, Dr Paula Briggs, Chair of the British Menopause Society, provides a practical overview of what the menopause means for those affected which you might want to share with staff. We also look specifically at menopause in the workplace and some simple steps employers can take including signposting staff for additional support.

Menopause and the workplace

Whilst many people may feel reluctant to discuss the menopause with their employer, increased awareness enables more employers to understand how it may affect their staff, and often just a few simple changes can help people to continue to perform their role

If staff are unable to approach their line manager or employer directly then they should have access to an alternative contact. You might also want to consider training for managers to enable them to provide support.

Some simple adjustments you could consider include:

  • Adjusting working hours or considering flexible working to support those struggling with lack of sleep
  • Enabling staff to take a break, possibly in a more private space, to allow them to manage their symptoms
  • Providing a desk fan, adjustable air conditioning or seating next to windows that open to improve ventilation
  • Providing easy access to toilets
  • Considering ways to make company policy more flexible where there is a policy around company clothing e.g. avoid uniforms made of synthetic fibres, or providing looser, more comfortable uniforms
  • Discuss with staff who might be affected so you can review your processes and procedures.

You can find more detailed guidance on the ACAS website.

Menopause – The Facts
Advice and guidance for staff affected by the menopause

The menopause is your last menstrual period. It marks the end of your reproductive years and the start of a new phase of life.

Many women experience symptoms as they near the menopause – this time of life is known as the perimenopause or menopause transition. The average age at which women start the menopause transition is 46 years. Periods usually stop by the age of 51.

The most common symptoms are heavy bleeding, hot flushes, night sweats, emotional instability, vaginal dryness and bladder problems. Symptoms can range from mild to debilitating. Much can be done to help with symptoms during the menopause transition, including lifestyle changes, hormone replacement therapy (HRT) and treatments for individual symptoms. For women under 60 years of age who are in good health, the
benefits of HRT far outweigh any risks.

What are the common symptoms and what impact can they have on a menopausal worker?

The menopause transition affects different women in different ways. There are lots of possible symptoms – you may not have any of them or you may have some or all of them, some or all of the time. They can include heavy bleeding, hot flushes and night sweats as well as poor sleep and concentration, forgetfulness, anxiety and depression.

A national survey conducted on behalf of the British Menopause Society (BMS) found that one-half of women go through the menopause without consulting a healthcare professional – even though 42% said that symptoms were worse than expected. Half the women said that the menopause had affected their home life, and one-third said it had affected their work life.

HRT and other treatments

HRT replaces the oestrogen that you lose during the menopause transition, either alone or in combination with a progestogen. It helps to alleviate menopausal symptoms and also reduces the long-term consequences of the menopause. HRT is recommended as the best treatment for menopausal symptoms – based on all the available evidence.

There are many products and delivery options for HRT, including tablets, patches, gels, a spray and implants. HRT helps many women through their menopause transition, but it is not suitable for everyone.

What’s new?

  • HRT products containing Estetrol (E4) are being evaluated in trials. Estetrol acts like oestrogen on the vagina, womb, bone and brain but blocks the effects of oestrogen in breast tissue. Estetrol may have less effect on the risk of developing blood clots.
  • Medications called neurokinin 1/3 receptor antagonists are being developed for the treatment of hot flushes.
  • The British Menopause Society has developed a training course on cognitive behavioural therapy (CBT) for doctors, nurses and other healthcare professionals to help them give better support to women who experience problematic symptoms during the menopause transition.
  • Menopause cafés are being set up across the UK – forums for women to discuss their experiences (
  • Laser treatment for urogenital atrophy is available in the private sector and may be offered as an NHS treatment in future.
  • Menopause workshops are being run by various organisations – it is wise to check the qualifications and credentials of people running such workshops.