Why we're now talking menopause – and how we can support women

Scotland has a new festival called Flush Fest, there are Menopause Cafes popping up all over the country and the Scottish Parliament held a debate on it in May – the first time the stigma and taboo around the menopause has been discussed by a government in the UK. An Elgin woman, Karen Kenning of menopause campaign group Pausitivity, has co-founded a poster campaign raising awareness of the symptoms.

It makes a change for “the change” to be taken seriously instead of being dismissed as a minor matter or even a joke – why does it take six menopausal women to change a lightbulb? It just f***ing does, right?

Irritated women claim that if it happened to men, effective treatments for symptoms like night sweats would have been developed long ago.

But why is there so much publicity about it now? Could it be because women over the age of 50 are the fastest group of workers in the UK and employers are finally realising they should take steps to prevent them leaving their jobs because of their debilitating symptoms?

During the Scottish Parliament debate, Scotland’s Older People and Equalities Minister Christina McKelvie called on all employers to develop policies to support women going through the menopause. She said the Scottish Government was currently reviewing its own policies.

This follows a recent survey of nearly 4000 women by the STUC women’s committee, where 63% said the menopause had been treated as a joke at work.

One described having a hot flush in an office which was already uncomfortably warm without access to a fan or being able to open a window.

“Menopausal insomnia has meant I have taken days off work as I couldn’t function,” she added.

As a result of the study, the STUC women’s committee recommended improved workplace policies such as flexible working to deal with fatigue and the ability to work from home when symptoms are particularly acute.

Quiet areas and access to fans are other ways forward that have been suggested, as well as awareness-raising and support for menopausal women and colleagues via training.

The Scottish Women’s Convention has also recently surveyed 1000 women about their experience of the menopause in order to raise awareness and improve conditions in the workplace. The survey was launched following a Menopause Conference earlier this year addressed by McKelvie, STUC women’s committee chair Joyce Stevenson and Collette Stevenson, depute provost of South Lanarkshire Council, which has already introduced a menopause policy to give support to women going through the menopause.

“This is a health issue that will affect all women, usually between the ages of 45 and 55 but, in one per cent of cases, before 40 years of age,” said Councillor Stevenson.

“It is important for any organisation of any size to recognise the support that is needed, but considering there are more than 11,000 women working for South Lanarkshire Council, we have considerable responsibility to treat them with understanding and provide them with support when this natural part of aging affects them.

‘‘It is important not only to implement the actions of this policy, but also to make sure that women know that the council has a positive attitude towards the menopause and that it is not something they should feel embarrassed about discussing.”

McKelvie agreed the menopause had been a “taboo” subject for “too long”.

“I want that to change and for there to be a greater understanding in society of the symptoms that women face and how it can impact on their lives,” she said.

“This is particularly important in the workplace. With increasing numbers of older women in employment, many more will now experience the menopause while part of the workforce. Research shows that paid employment can lead to increased self-esteem for women and demographic and societal changes mean that more women want to work later in life – and, importantly, our economy needs them.”

McKelvie added: “Something as natural as the menopause should not be a barrier to work. We need to ensure that public services are there to support women and that employers are more aware of the issues, and ensure that women are supported in work.”

The survey found that almost two thirds of women felt there was not enough information available at the beginning of their menopause and almost a quarter reported a poor experience when they went to their GP for help.

The majority of women who responded to the survey were in employment when they began to experience menopause (96%) but only 21% shared their symptoms with their employer during this time.

Reasons given were fear of discrimination, the stigma attached to menopause and the resulting assumptions about a woman’s inability to carry out her job and the lack of policies within workplaces to support women through this time in their lives.

The respondents also reported that symptoms were not taken seriously by management, with derogatory jokes and comments made. There were genuine concerns that they would lose their jobs if they disclosed the full extent of their symptoms.

“The creation and introduction of menopause policies across all workplaces is vital,” the report concluded. “Too many women are struggling to deal with their symptoms in work with little to no support. Policies and practices should explore the idea of training for all staff on what menopause is and how it can impact on women, the availability of flexible working for those experiencing menopause, creation of formal support networks within workplaces (such as menopause cafes) and the removal of stigma overall on the issue.”

DEBORAH’S STORY

Deborah Ridgway 'got her life back'

DEBORAH Ridgway, from West Linton in the Scottish Borders, found the menopause affected her work with symptoms beginning when she hit her early 40s and entered the peri-menopause, the hormonal transition before the full menopause.

“I had regular periods but it was the mood swings that got me and they just got worse and worse until I couldn’t cope with the way I was feeling,” she said. “I tried acupuncture and all the other natural remedies first of all to see if they could help but nothing did.

“When it came to the actual menopause, my main symptoms were night sweats which were so bad I would be woken up with sweat running down my body.

‘‘At first I would get up and change the bed, but that’s not great for either you or your partner, so then I just kept a big beach towel by the bed and I would dry myself down, then lie on it so I wasn’t on the wet patch and go back to sleep.

“Towards the end I also got very heavy bleeds and cramps – so bad I would be bleeding through my clothes and couldn’t go to work.”

When Ridgway first sought medical help she was put on antidepressants.

“That annoyed me because then I did not really know when I was happy as antidepressants just level everything out.”

She was then fitted with the coil but it didn’t work well, so she was finally referred to a specialist who gave her an oestrogen-only pill.

After taking it she said she “got her life back”.

“After a while I realised I didn’t need the pills any more and just stopped taking them, and since my periods have stopped I have never looked back,” said Ridgway, a retired teacher. “I don’t have mood swings any more and I’m as normal as can be.”

RUTH’S STORY

Author Ruth Devlin wrote a book which aims to help men understand how the menopause affects women

LIKE Ridgway, nurse Ruth Devlin had “horrendous” bleeding. “It was so bad I found myself hibernating for 48 hours every month,” she said.

“My symptoms were really affecting the quality of my life – and probably the rest of the family’s! I was borderline anaemic, I had night sweats, hot flushes and my joint aches were so brutal I thought I was getting arthritis.”

After repeated visits to her GP she was eventually given tranexamic acid which helped a little but still didn’t really manage her symptoms well.

“Having been back about ten times I finally asked to be referred to a menopause specialist,” said Devlin. “The specialist had more time to talk through options including explaining the benefits and risks of hormone replacement therapy (HRT). I got an oestrogen patch and had a Mirena coil fitted which not only provides the progesterone component of HRT that is there to protect the endometrial lining but it also provides contraception.”

The treatment “transformed” her life, she says.

“The majority of my symptoms started to dissipate within a short period of time, I got a decent night’s sleep for the first time in ages and had so much more energy. It’s only when you get the symptoms vaguely under control that you realise how badly you have been suffering and that the psychological symptoms such as irritability and lack of concentration are all part of it.”

Devlin was so concerned about the lack of information available about the menopause that she researched the matter for two years, signed up for several courses run by Kathy Abernethy, now chair of the British Menopause Society, and then set up the organisation Let’s Talk Menopause to help raise awareness and provide accurate information.

Devlin has now written a comprehensive guide for men to help them understand what is going on with their partners and employees called Men... Let’s Talk Menopause.

SPEAKING OUT

MANY women in the public eye have also started to speak and write about their experiences, with TV’s Kirsty Wark fronting an informative documentary on the menopause for the BBC after she found she was suffering debilitating symptoms.

“The most disconcerting side-effects were disturbed sleep and night sweats, waking up literally wrung out, with no discernible pattern to either,” said Wark.

She had a “medical menopause” at the age of 47, following a hysterectomy and after coming off HRT because of fears raised at the time over its reported link to breast cancer.

“Suddenly, I had no oestrogen and the disturbed sleep and night sweats started,” she said. “By the time I started making the documentary, nothing much had changed for me in 12 years, and I just coped with it, as so many others do.”

Jennifer Saunders, of Absolutely Fabulous fame, who features in the documentary, said: “There’s a moment when you realise everything’s changed. Your metabolism, energy levels, skin, hair … so I just had a large glass of champagne and got on with it.”

The X-Files’s Gillian Anderson said she felt as if her life was falling apart when she started the peri-menopause.

“All of a sudden, I felt like I could handle nothing. I felt completely overwhelmed,” Anderson said.

“When I talked to the specialist, she said she often gets phone calls from female CEOs screaming, ‘I need help now! I’m losing my mind!’ I felt like somebody else had taken over my brain.”

Sex in the City star Kim Cattrall became a supporter of the Tune Into Menopause campaign after her experience of hot flushes.

“Literally one moment you’re fine, and then another you feel like you’re in a vat of boiling water and you feel like the rug has been pulled out from underneath you,” she said.

Veteran actor Julie Walters also suffered from sweats. “It was like a chimney and came from the base of my spine,” she said. “Every take there’d be ‘stop, she’s having a flush!’”

The menopause begins when women stop producing egg cells and the key hormones in their production start to reduce, causing all the symptoms in various degrees.

HRT, which can be taken as a gel or pills or via patches, helps replace the hormones lost, but American research published in 2002 cast doubt on its safety after linking it with a higher risk of breast cancer.

Subsequent studies have suggested the 2002 work was flawed and it is generally accepted now that the risks of HRT are not high and usually outweighed by the benefits. Exercise and a healthy diet have also been found to reduce symptoms.

“Herbs and other medications can be used to treat one or two symptoms but HRT can treat a whole variety of symptoms,” said Devlin. “Also, every woman needs to look at their lifestyle choices – their diet and exercise – because you can really alleviate the intensity of the symptoms by how fit and healthy you are. It does make an enormous difference. Training yourself to do some simple cognitive behavioural therapy techniques can help a lot with the psychological symptoms and can reduce the intensity of the hot flushes as well.”