Menopause and its impact on working women

4 in 10 women said symptoms interfered with their work performance or productivity on a weekly basis

MedlinePlus defines menopause as the time in a woman's life when her period stops.

The median age of menopause is 51, and the average age of nurses nationwide is 52. In the United States, about 1.3 million women become menopausal each year. With a workforce that is about 90% female, that means nursing might soon see what effect widespread menopause will have on its ranks.

Nursing involves grueling shifts spent standing, lifting and walking, with emotionally stressful caseloads that can be even more challenging when dealing with the physical and mental symptoms of menopause. Leaders in the women’s health industry are seeking ways to mitigate this.

Taboo topic at work?

Although menopausal women can experience a wide range of symptoms, many professionals remain unsure about how to address it at work, if at all.

According to a recent survey of more than 1,000 working women, 4 in 10 said menopause symptoms interfered with their work performance or productivity on a weekly basis. Additionally, 2 in 10 noted that menopause interfered with their work performances/productivity either daily or multiple times a day. The survey was conducted by Biote, a hormone optimization company.

“We saw a gap in research on menopause and women at work. There just wasn’t much out there on the topic, and it’s hurting our society,” said Terry Weber, CEO of Biote. “The Harvard Business Review reports that menopause occurs when women are most likely to move into top leadership positions, and with up to 20% of the U.S. workforce — or 27 million women — affected by menopause symptoms, this could be a factor in why women are leaving the U.S. workforce in record numbers.”

Weber said Biote conducted the survey in hopes of facilitating and inspiring awareness, and perhaps new and better clinical resources for menopausal women, noting a “lack of scientific attention” to older women in medical research and development.

“Societally, women, and particularly aging women, are simply not studied,” Weber continued. Therefore, “we have fewer options for treatment of hormone-related issues. There are dozens of formulations of testosterone for men; there are none for women.

“We saw a chance to call attention to a natural evolutionary process that half the world’s population will go through as they age,” Weber continued. “This is a strong moment to make decision-makers aware that, yes, there are things we can do to retain some of our most experienced and reliable teammates, and at the same time to relieve some of the silent suffering that U.S. women have put up with for so long.”

Terry Weber, CEO of Biote

Credit: Thaddeus Harden

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Credit: Thaddeus Harden

Even as the CEO of a health care firm, Weber said she was surprised at the enormity of menopause’s effect, as revealed by the survey. “I was struck first by the large number of women whose work lives are so strongly affected by menopause, and second by the general belief that they can’t talk about this without strong discomfort,” she said. “It’s such a hard place to be, especially when you don’t know where to turn for support. We also know from a 2018 AARP survey that only 80% of medical residents in the U.S. feel ‘barely comfortable’ discussing or treating menopause, and only 20% of OBGYN residency programs provide menopause training — mostly through elective courses.”

Weber also noted that more than half of survey respondents reported hot flashes, night sweats, lack of sleep, joint stiffness/aches and pains, and fatigue. In addition, 47% of women reported anxiety, 43% reported headaches, and 42% reported memory lapses. “This is on top of any routine mental and physical distress women nurses may already be experiencing at work … and this is all outside of COVID-19,” she emphasized.

Menopause often affects women in the prime of their careers. “These women are some of the most crucial care providers the world has — most experienced with clinical care, with coaching younger nurses and with managing stress,” Weber said. “The health care industry is currently struggling with staffing for myriad reasons,” and therefore, health care employers need to do everything possible to recruit and retain strong teammates.

You are not alone

Biote’s survey also revealed that women struggling with menopause symptoms at work are not alone.

About 1 in 4 respondents said their menopause symptoms “negatively impacted their career development or work-related opportunities, while 17% have actually quit a job or considered quitting due to menopause symptoms.”.

Accommodations and treatments are now available, Weber said, but women likely won’t know about them unless they ask for what they need. “Women have historically pushed through, or just left jobs. But ask. Sometimes the ask might be simple — a lower temperature in the break room, or permission to adapt a uniform to accommodate layers” — but it can make a world of difference in your physical comfort and help you feel more supported and heard.

“A discussion with your OB/GYN, PCP or whole health provider may also be helpful,” Weber added. “Hormone therapies can help alleviate symptoms that are disrupting your work, and multiple treatment delivery options are available. Hormone optimization is a broad category, and not all approaches will work for all bodies, so work with your doctor to find one that meets your needs.”

Nursing is a particularly demanding profession, physically and mentally, and menopause can make it more challenging. “I can’t speak as a physician, but as a woman who’s gone through menopause I can tell you that after a challenging day, adding the hormonal components of lack of sleep, brain fog and hot flashes isn’t going to make it any better,” Weber said. “On top of that is the mental distress — perhaps embarrassment, perhaps stress to ‘get it all done.’ Get help. It can change your life. It changed my life.”

Tips from a physician

Tomi Mitchell, a board-certified family physician at Holistic Wellness Strategies, treats many women experiencing personal and professional challenges exacerbated by menopause. She estimates that approximately 60% of them are negatively affected by menopausal symptoms, to varying degrees.

“Symptoms of menopause may include hot flashes, night sweats, mood swings, trouble sleeping, vaginal dryness, headaches and fatigue. The symptoms can make it difficult for women to concentrate and be productive. Many women feel like they are not performing at their peak performance and might feel that their jobs have been jeopardized, and some feel threatened by the younger employees,” Mitchell said. “The likely result from these psychological and physical concerns can lead to a loss of confidence and self-esteem.”

Therefore, Mitchell said, she recommends that women take extra time for self-care, growth and development when experiencing menopause.

“When meeting deadlines and working under stress, take care of yourself by eating balanced meals, getting exercise, taking breaks when needed, and not overworking. Being organized helps as well. Understand company policies for medical leave and use them when necessary. Keep communication open with employers, co-workers and clients,” she advised.

Adding to the challenges of physical symptoms is the physiological impact of menopause. “Hot flashes, night sweats, and mood swings are just a few symptoms that can make working difficult. Many women feel like they are ‘going crazy,’” Mitchell said. “Sleep deprivation exacerbates all of these symptoms. Workplaces are not always understanding or accommodating to women going through menopause. Often, women are told to ‘deal with it,’ which is unacceptable.”

Mitchell offers additional tips for menopausal women:

  • Recognize the symptoms you are experiencing and how they affect your work.
  • Be proactive in communicating with your employer what you’re going through and what accommodations you may need (e.g., flexible hours, working from home, reduced workload).
  • Educate yourself about the available treatments.

Fostering awareness, compassion and empathy

As a CEO, businesswoman and advocate for women’s health, Weber speaks passionately about the open communication needed to help women manage menopause’s impact in the workplace.

“Our entire society needs to work to normalize menopause and allow the conversations. The burden of doing so shouldn’t be placed on working women who may fear for the impact on their work relationships or their careers. Employers need to realize there’s great work they can do with very simple actions,” Weber stated.

Only 34% of the survey’s respondents said they believed colleagues would support them if menopause were making work difficult. Weber said she understands the reality that not all employers are able to offer the flexibility of working from home or employee-directed temperature controls. That’s when listening and understanding can help.

Not everyone is going to be comfortable saying, “I’m having a hot flash,” Weber added. Therefore, she recommends colleagues try to be as empathetic as possible. “If your colleague is sweating, just offer her a glass of water, and follow her lead. Don’t make it weird. Normalizing menopause is one of the most important things we can do to create supportive work environments.”

Weber hopes that with time, education and increased awareness, people will eventually become more comfortable talking about menopause and learning about it. “Hopefully in the near future, menopause will be taught alongside puberty in health class, and future generations will never have a taboo to overcome.”

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