Benefits | Menopause Support | Guidance for Managers
Menopause Support: Guidance for Managers
The purpose of this guide is to raise awareness of the impact of the menopause on individuals and how you can support them as a people manager. Management has a key role to play in making workplaces inclusive and reducing stigma around menopause.
Introduction
As line managers, we are responsible for our people, their performance and any occupational health and adjustments required. Managers are not expected to be experts when discussing menopause, but it is important to gain an understanding of what menopause is, how to respond and how to support our people. This will help to break the taboo, retain top talent and create an inclusive, thriving and healthy workplace.
The workplace is enriched by the vast life experiences shared between colleagues on a daily basis. Employees need to be able to bring their whole self to work and not have to hide major aspects of their life experience due to the potential challenges they face going through the menopause.
Women are working through perimenopause, menopause and beyond and this can mean managing the demands of work and home life whilst also potentially dealing with sometimes severe symptoms and other health-related issues. Although it is women who experience the physical and psychological symptoms of menopause, it is recognised that the menopause can also directly and indirectly affect others both within the workplace and at home. Trans, non-binary and intersex colleagues may also experience menopause.
Menopause is a normal and healthy life stage. However, for some, it may not be an easy transition. Individuals will experience varying degrees of symptoms. Not all employees experiencing the menopause will experience debilitating symptoms. For some, they can progress through this life transition without the need for support in the workplace. For employees who are experiencing debilitating symptoms, it can be a difficult and stressful time as well as a very sensitive and personal matter.
Not everyone will be willing to talk about their experiences of menopause and this should be respected as it is a personal, private and sensitive topic. For some, the symptoms may be such that sharing their experience and having the understanding of their manager and/or colleagues would be helpful.
Menopause Support
Research has indicated that it can be very challenging to approach a manager to discuss how menopause is affecting a person at work. However, managers are often the first point of contact if someone needs to discuss their health and wellbeing at work. This guide aims to support managers to have these conversations. DCU People are also a dedicated resource for managers in this space.
Starting the Conversation
Depending on the range and severity of symptoms being experienced, menopause can affect a person’s confidence, and it can be very daunting talking to someone. The more supportive and knowledgeable you are about the range of menopausal symptoms, the less likely that a person will feel embarrassed to approach you and discuss how the menopause is affecting their health and their work.
Awareness about the symptoms and the range of support available in DCU will also increase your own confidence in discussing the issue.
- Don’t make assumptions about someone’s health condition or ask them a direct question as to whether they are experiencing menopause symptoms. If you have concerns about someone’s well being or performance, ask general, open questions such as, ‘How are you doing at the moment?’ or ‘I’ve noticed you’ve been arriving late recently, and I wondered if you’re okay?’ It’s up to the individual to disclose any particular symptoms or health issues they may be experiencing. It is also important to respect an employee's right not to disclose.
- Where an employee is willing to discuss their personal situation, approach conversations with empathy and try not to be embarrassed by the issue and how the individual is feeling.
- It’s important to set the right tone when opening a conversation about any sensitive issue.
- Take your time and be patient with the employee.
- Assure them that the conversation is confidential unless they wish that it goes further, e.g. DCU People Department.
- Regular catch-ups or one-to-ones are an opportunity to start the conversation, which should always be in a private, confidential setting where the employee feels at ease.
- Allow adequate time for the discussion to occur; be aware that the employee may feel embarrassed or be noticeably upset and so it may take some time for them to talk openly.
- If appropriate, explore whether they have attended their GP and if not, recommend the employee take some professional medical advice via their GP. You can also refer the employee to Occupational Health. Advice can be sought from Occupational Health at any time by either party prior to making any workplace adjustments if guidance and medical assistance is required.
- Agree actions and how to implement them including setting time to review how the arrangement is working in practice once implemented (and follow this up in writing e.g. by email).
- Agree if other employees should/are required to be informed of the adjustments and by who.
- Signpost the individuals to supports available, including DCU’s Menopause Support Hub and DCU’s Employee Assistance Service (EAS).
| Items for discussion | Considerations |
| Information on Menopause | Is the employee aware of the DCU’s Menopause Support Policy and related Guidance, and the Staff Menopause Support Hub? |
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Symptoms |
How are symptoms affecting the employee at work? What possible temporary adjustments can be made to support the employee? |
| Stress in the Workplace |
Is the impact of symptoms on work causing stress in the working environment? If so, how can this stress be alleviated? |
| Support | Is the employee aware of staff supports in the workplace that may be able to help? |
| Occupational Health |
Has the employee been made aware of the facility for an Occupational Health referral and support to remain in the workplace? |
Supports and Reasonable Adjustments
A person's experience with menopause differs and is unique to them. Where an employee is having issues and requires some support or reasonable adjustments, these are considered on an individual basis, and with consideration of the requirements of your role.
Some examples of common adjustments are included below for reference, but please note that this is not an exhaustive list.
- Requesting changes to start and finish times, including through the use of Flexi-time where feasible.
- Requesting occasional home working when symptoms are severe, in line with DCU's Remote Working Policy.
- Requesting flexibility around the taking of breaks or asking for increased breaks during the working day.
- Requesting flexibility around attending relevant medical appointments. Managers are encouraged to be flexible when approached by individuals who need to attend appointments related to the menopause. Please consult with the People Partner for guidance on how to respond to requests for time-off.
- Ensuring there is easy access to adequate toilet and washing facilities, and to chilled drinking water.
- Seeking improvements in workplace temperature/humidity and ventilation.
- Requesting the provision of a desk fan.
- Requesting a temporary change in office/working location to enable you to be near windows (with blinds) or open doors or away from radiators.
- Where possible, individuals may request temporary adjustments to their responsibilities to help manage symptoms like hot flushes, with consideration given to operational needs. For example, a temporary reduction in the number of in-person meetings/presentations.
- Considering if clothing and protective equipment required in certain settings e.g. laboratories can be altered temporarily.
- Requesting if additional spare sets of clothing/protective equipment could be made available to support frequent changes.
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Hot Flushes/Flashes
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Heavy Menstruation/Periods
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Isolation or Low Self Esteem
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Low Mood/Anxiety
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Brain Fog (memory/ concentration issues)
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Insomnia/Difficulty sleeping
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Process for agreeing reasonable adjustments
Managing Reasonable Adjustments
Most reasonable adjustments can be agreed between a line manager and an employee.
The effectiveness of these adjustments should be reviewed regularly, taking into account the employee’s current symptoms. Changes to adjustments may be made at intervals, where required, and they should cease where they are no longer needed.
If there is a query on whether an adjustment is reasonable (e.g.: if there is a financial element to the request), then the line manager can speak to their People Partner for guidance. Where feasible, any financial costs associated with reasonable adjustments should be incurred by the relevant department.
If it is unclear what adjustments might support the employee, they may be referred to DCU’s Occupational Health provider who can carry out an assessment and ensure the appropriate supports are put in place.
Additional Learning: Understanding the Menopause
Menopause is the transition from the reproductive to non-reproductive phase of life. There are three phases to this:
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Pre-menopause where you still have periods (whether they’re regular or irregular) and are considered to be in your reproductive years. Some hormonal changes may be occurring, but there are no noticeable changes in your body.
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Peri-menopause is the actual time of transition, when hormone levels begin to fluctuate and occurs well before you officially hit menopause. In fact, women enter this stage some 8 to 10 years ahead of menopause. Most women will notice peri-menopause symptoms in their 40’s. During this time oestrogen and progesterone levels start to fluctuate and this can result in many troublesome symptoms, particularly flushes and sweats. Most hormone blood tests done at this stage will report as ‘normal’ and they are unhelpful with diagnosis. The sex hormone levels can also go up and down more sporadically than a normal 28-day cycle, which can cause irregular periods and other symptoms. During the final stages of peri-menopause, your body will produce less and less oestrogen. Despite the sharp drop in oestrogen, it’s still possible to get pregnant.
- Post-menopause, officially kicks in when the ovaries produce so little oestrogen that eggs are no longer released. This also causes your period to stop.
The above type of menopause refers to ‘natural’ menopause. However there are other types of menopause that can occur, namely; Early menopause, Premature menopause (also known as POI - Premature Ovarian Insufficiency), Surgical menopause and Medically induced menopause.
- Early menopause occurs when a woman's periods stop before the age of 45 and can happen if your ovaries stop making enough hormones, particularly oestrogen. Early menopause typically affects 5% of the female population.
- Premature menopause occurs when a woman’s periods stop before the age of 40 . It occurs because the ovaries no longer release eggs (ovulation) regularly and stop producing the usual premenopausal levels of reproductive hormones. Premature menopause can happen at any time from teenage years onwards and recent research suggests it impacts at least 3.5% of the female population.
- Surgically induced menopause occurs when a woman’s ovaries have been removed by surgery. Removing both ovaries leads to permanent and immediate menopause If you have surgery to remove your ovaries, in a procedure called a bilateral oophorectomy, these hormonal changes will happen very quickly and often straight away. Surgical menopause can be overwhelming.
- Medically induced menopause is an umbrella term that includes surgical menopause as well as menopause due to medication, such as chemotherapy or radiation damage to the ovaries, or from the use of other medications to intentionally induce menopause as part of the treatment of certain diseases. Sometimes it is permanent, and sometimes it is not.
The menopause not only affects women, but it can also indirectly affect their partners, families and colleagues and is very much a workplace issue that line managers should be aware of.
Older Women and the Menopause
Menopause can often come at a time of life when women are already experiencing other issues or difficulties, such as the onset of age-related health conditions, increasing caring responsibilities for elderly or sick parents and relatives as well as children or grandchildren. Increases in the state pension age also mean that some women will now have to work longer than they had planned.
Women who have suffered damage to their pelvic floor during childbirth may be more at risk of certain conditions as a result of the menopause. For example, problems such as incontinence or prolapses can develop as a result of the hormonal changes during the menopause as this can further weaken damaged tissue.
For older women who do not have children, the fact that the menopause signals the end of a woman’s reproductive life can give rise to additional emotional issues. It may be a particularly difficult time for women who wished to have a baby but were unable to conceive or for those who’ve suffered miscarriages or stillbirth.
Younger Women and the Menopause
Around 1 in every 100 women will have the menopause before the age of 40. In many cases there is no clear cause. Many younger women also experience a surgical or medical menopause, due to treatments for conditions such as cancer. Women who have an early or premature menopause are also more at risk of developing osteoporosis (‘brittle bones’) and heart disease.
Women with Pre-Existing Conditions or Disabilities and the Menopause
There is currently a lack of research and information about the interaction between the menopause and many illnesses and conditions. Many women report that the menopause seems to make existing health conditions worse, triggering or coinciding with a flare up of symptoms. Some women report that the menopause seems to trigger or coincides with the onset of a new condition. An existing health condition may also worsen symptoms of the menopause.
It may be difficult to tell whether a symptom is caused by the menopause or by the existing condition, or to tell which is making the other worse. Many symptoms can interconnect or overlap. For example, for a woman with diabetes, hormone changes associated with the menopause may make it more difficult to keep blood sugar levels stable. It may also be difficult to tell whether symptoms such as sudden changes in body temperature or mood swings are related to fluctuations in blood sugar caused by diabetes or hormonal changes due to the menopause. This can make symptoms harder to manage and treat.
Trans and Non Binary People and the Menopause
Trans men (those who identify as male, but were assigned female at birth) will experience a natural menopause if their ovaries remain in place and no hormone therapy is given. Trans men will also experience menopausal symptoms if the ovaries and uterus are surgically removed (this may happen at an earlier age than commonly happens with a natural menopause). Symptoms may be reduced or complicated if hormone therapy (such as the male hormone testosterone) therapy is in place.
Trans women (those who identify as female, but were assigned male at birth) undertaking hormone therapy will usually remain on this for life, and should generally experience limited ‘pseudo’ menopausal (menopausal-like) symptoms - unless hormone therapy is interrupted or hormone levels are unstable. Such treatment interruptions however can be a common experience for trans women (and trans men).
Trans people report that for those with unstable hormone levels, access to local services that responsively and proactively monitor and manage hormone levels is currently lacking. As such, many trans people are likely to experience at least some menopausal symptoms. How a trans person experiences symptoms in later life may vary depending on the age at which they transitioned and when in time that was (as treatments have changed and developed over time).
Some trans people may not wish to disclose their trans status and as a result, may be reluctant to discuss menopausal symptoms if doing so would disclose their trans status. Many trans people choose not to disclose their trans status, either before their transition, or if they start a new job after transitioning.
Non-binary and intersex persons may also experience menopausal symptoms – unfortunately there is currently a lack of information about the experiences of these groups of the menopause.
Men and the Menopause
Although men do experience an age related decline in hormone levels, this is normally a very gradual process which happens slowly over a man’s lifetime in a way that is unlikely to cause problems in itself.
It should be recognised that men can be indirectly affected by the menopause – for example if their female partner is experiencing insomnia and night sweats men may also experience disrupted sleep and fatigue. If a man’s female partner experiences significant physical or psychological symptoms (such as depression) he may be concerned for her wellbeing and feel increased levels of stress.
Since 2018, the Menopause Hub has been conducting surveys among menopausal women in Ireland to find out about their experience of menopause. Prior to this there was no data in existence. In 2023, they had over 3,000 respondents to our online survey, all menopausal women at different stages of menopause. This includes perimenopause, post menopause, early menopause, premature menopause, surgical menopause and medically induced menopause. Here are the key highlights:
Menopause - the impact
- 87% believe that menopause is still taboo, although 93% think it is more acceptable to talk about menopause now.
- 68% said that they were not at all prepared for menopause / perimenopause.
- The top 3 sources of information on menopause are: Internet (58%), social media (47%), and family and friends (46%). The GP as a source is only 21%.
- 55% are aware of 15 menopause symptoms or less (there are over 40 symptoms).
- Over 90% had symptoms (the global average is approx. 80%).
- One third described their symptoms as severe, whereas 50% said moderate, and 15% said mild.
- The top 5 symptoms experienced were: cognitive, including brain fog, memory loss (78%), fatigue (76%), anxiety (70%), weight gain (66%), and feeling overwhelmed (60%).
Menopause in the workplace
- The top 5 symptoms that impact women while working are: Cognitive (76%), fatigue (63%), feeling overwhelmed (52%), anxiety (48%), and loss of confidence (48%).
- 84% said their performance was negatively impacted by their symptoms while working (26% said ‘a lot’ and 58% said ‘a little’).
- 37% said that they had missed time off work due to symptoms, with 18% missing 3+ days.
- 77% were not comfortable telling their employer the real reason for taking time off work.
- One third of women considered giving up work due to symptoms and 7% actually gave up work.
- Hot flushes that can start in the face, neck or chest, before spreading upwards and downward; may include sweating, the skin becoming red and patchy, and a quicker or stronger heart rate. Sweating may be profuse, requiring a wash and change of clothes.
- Heavy and painful periods that can be very tiring and require frequent changes of sanitary wear and need to wash. Some affected may become anaemic.
- Night sweats, restless leg syndrome and sleep disturbance leading to fatigue.
- Low mood, irritability, anxiety, panic attacks, palpitations (noticeable heartbeats), loss of confidence, tearfulness/feeling emotional, withdrawing.
- Tiredness, poor concentration, and memory problems.
- Genitourinary symptoms of menopause (GSM), including urinary tract infections (UTIs), cystitis and vaginal dryness.
- Dry and itchy skin, dry eyes.
- Joint and muscle aches and stiffness.
- Weight gain.
- Headaches and migraines.
- Hair loss.
- Osteoporosis, where a decrease in strength and density of bones leads to bone thinning.
- Side effects from hormone replacement therapy (HRT).
There are 40+ symptoms of the menopause - see the Menopause Hub Symptom Checker for a full list.
- Supportive empathetic conversations make the difference – managers need to ensure they are equipped to have conversations with their team members and providing an effective framework allows people experiencing menopause to feel supported and valued in the workplace.
- A healthy and inclusive environment and culture is better for everyone. A wide-ranging physical and psychological symptom can feel seriously inhibiting to someone in their career.
- By providing the right support and communicating openly enables all people – and teams – to perform at their best. Creating an open, honest environment means we can all achieve our full potential at work.
- Mental wellbeing in the workplace depends on many factors. Significant loss in confidence and motivation at work can be experienced during the menopause leading to poorly affecting overall wellbeing.
- Retaining our talent – a third of menopausal women have considered leaving work because of their symptoms further contributing to the overall skills shortage and talent retention crisis. Providing the right support can retain experienced and knowledgeable employees.
- Reduce absenteeism and increase productivity – supporting employees by making simple adjustments can enable them to continue to work thereby reducing absenteeism levels and allowing them to achieve their full potential. Research commissioned by Health & Her in the UK and carried out by Censuswide revealed a potential productivity loss of up to 14 million working days due to menopause.
- The Law - Statutory equality law does not expressly provide protection for menopause or perimenopause. However, women who suffer discrimination in employment that is related directly or indirectly to them having menopausal symptoms may, depending on the specific facts of their cases, be able to seek legal remedies if a tribunal determines that they have suffered unlawful discrimination or harassment on the grounds of sex, disability or age. There have been a number of successful tribunal cases in the UK which provide employers with important lessons in how to support women affected by menopause. A failure to respond to the needs of employees affected by menopausal symptoms could be viewed as direct/indirect sex discrimination and/or a failure to make a reasonable adjustments.
The University wants to ensure that it continues to provide the best support that it can to employees on their menopause journey and to their line managers. With this in mind, these guidance documents are iterative. If you have suggestions around further supports that may be of assistance or raising awareness around this topic please contact edi@dcu.ie.