Talking about menopause

We will all know someone experiencing menopause symptoms among our family, friends, and colleagues. By being more open about the subject, and offering support and a listening ear, we can all make sure that those going through this transition don’t feel they must do so alone.

Indeed, one in three menopausal women, who responded to a 2021 survey conducted by consultancy Britainthinks, reported feeling isolated by social attitudes to the menopause. In the workplace, meanwhile, misplaced ideas about the menopause can affect career prospects, with some feeling they must hide menopause symptoms to avoid being sidelined, according to research published in the Journal of Management in 2020.

“Women experiencing the symptoms of menopause can face the double challenges of discomfort and stigma,” says Kelly Belcher, Head of People at LiveWell, the digital health solution from Zurich Insurance Group. “Whether at home or at work, we need to ensure those around us feel supported, and encourage openness about the menopause and its effects. The more we talk about it, the easier it becomes to get through it together.”

So, what is menopause?

The menopause is when a woman stops menstruating, i.e. stops having periods. Technically, the menopause is diagnosed twelve months after a woman’s last period. The perimenopause is the period of transition into menopause, which research suggests could begin 2 – 8 years before cessation of menstruation. Perimenopause is signposted by less frequent and irregular periods.

The menopause is a natural part of aging for women, occurring anywhere between the ages of 45 – 55. When it happens before the age of 45, it is considered premature menopause, which occurs in around 1 in 100 women.

Changing hormones

The menopause is caused by a change in the hormone balance of the body. One hormone in particular plays a big part: the follicle-stimulating hormone (FSH). FSH stimulates the development of follicles (fluid filled sacs containing immature eggs), and, subsequently, ovulation. As women age, the follicles become less and less sensitive to FSH. This means that they don’t always develop and prepare the egg, which in turn means fewer periods. Eventually, the follicles stop responding completely, and the cycle ends: this signals the start of the menopause.

Follicles release estrogen, so, when they are no longer activated, estrogen levels drop too. This causes many of the common, and often distressing, symptoms of perimenopause and menopause.

The symptoms, their causes – and what you can do to help

The most common symptoms of menopause, aside from stopped periods, include hot flushes, night sweats, low mood, and reduced libido. While some of these effects might not be observable or openly discussed, there are a range of ways friends, family, colleagues and workplaces can support people experiencing menopause symptoms.

Hot flushes/flashes
Around 75 percent of post-menopausal women experience hot flushes. These are periods of sudden warmth in the body, usually concentrated in the cheeks, neck and chest, which may become reddened. They usually last between one and five minutes, can be very uncomfortable, and can make some women feel embarrassed. Research suggests that the drop in estrogen from menopause leads to a rise in the core temperature of the body, and an increase in the sensitivity of the brain to the body’s temperature.

How to help:
Many women can alleviate hot flushes through hormone replacement therapy (HRT), a combination of estrogen and progesterone, that increases levels of these hormones in the body. Some women may not be offered HRT automatically, so if someone confides in you about their symptoms, you could suggest they discuss HRT with their doctor.

More generally, being open to changing the temperature in your office or home, and supporting women to take time out from stuffy rooms without question can support easier management of hot flushes.

Low mood
Around 20 percent of women will experience depression at some point during menopause and perimenopause. It’s important to remember, though, that not every woman will experience low mood during this time, and for those who do, it may be linked to other factors like lifestyle or stress.

While we don’t know exactly why menopause can increase risk of low mood and depression, estrogen is known to impact on serotonin and norepinephrine levels – key hormones that regulate mood.

How to help:
Bear in mind that someone going through menopause might be experiencing a range of emotions. Try not to be judgmental, or take mood swings personally. It’s also important to not assume that low mood is down to menopause, which could cause offense when someone has a genuine grievance. Being there to listen without judgment is a great way to support someone going through menopause.

Insomnia
Sleep problems occur in 40 percent to 50 percent of women going through menopausal transition. This is in part linked to hot flushes disturbing sleep, but estrogen may also be involved in regulating sleep centers in the brain. Poor sleep can lead to a range of detrimental knock-on effects, like increased risk of depression, and impaired cognitive function.

How to help:
If you share a bed with someone who is menopausal, talk about how you might be able to change the environment to support good sleep. It might mean changing the bedding, the temperature of the room, or sometimes sleeping separately.

At work, colleagues could offer more flexible hours so that women experiencing insomnia can arrive later in the day, after catching up on sleep. By extending this flexibility to all employees, managers can avoid singling out or stigmatizing menopausal women.

Breaking the taboo
As with other taboos, a lack of openness encourages shame and embarrassment. Encourage open discussion of menopause in your home and among friends.

In the workplace, training for employees and managers can raise awareness of the effects of menopause. When these facts of biology are viewed as individual flaws, it can negatively affect women’s careers and self-esteem.

When they are understood and accommodated – like providing a quiet space to take a break when experiencing symptoms or providing a safe space to share workplace challenges - women going through menopause can participate fully and confidently in their work and social lives.