What is the menopause
A quick guide
The menopause is a normal, inevitable stage in a woman’s reproductive life where her sex hormones gradually wind down, the ovaries stop releasing eggs and ultimately her periods stop.
When she reaches the perimenopause, that regular rhythmical flow of hormones can become chaotic causing a ‘hormonal rollercoaster’, and this is when menopause symptoms (physical, emotional and cognitive) can kick in.
In fact, many people use the term menopause without knowing about the three distinct menopause phases: perimenopause, menopause and post-menopause. Technically speaking, the actual menopause chapter is the briefest of all three.
Still speaking in threes, there are three different kinds of menopause: there’s a medical menopause (triggered deliberately by medication), a surgical menopause (usually done out of necessity in cases of ill health) and natural menopause.
The natural menopause is the one people talk about most and the one that is preceded by the perimenopause. Generally, it starts in a woman’s mid-late 40s or early 50s but it also happens fairly regularly outside those age parameters.
For example, right now, roughly 1 in 100 women going through a natural menopause are under 40. 1 in 1,000 are under 30 and 1 in 10,000 are under 20.
In terms of symptoms women roughly fall into three camps: some 25% of women experience minimal menopause symptoms, 50% experience moderate symptoms and 25% experience severe symptoms.
There are literally hundreds of possible menopause symptoms but the most famous ones include hot flushes, brain fog, joint and muscle pain, weight gain and insomnia. And the phase where these symptoms flare (the perimenopause) can last anywhere between a few months and a decade … or more in some cases.
How can I help?
Well, from the outset you’re on this page … which means you proactively want to help and that’s a fantastic first step. Too many women face the menopause alone due to shame or, simply, because it’s seen as private women’s stuff.
So being exposed to credible information, documentaries, podcasts and books on the subject (I’ll leave some links at the foot) is a great way to tool up.
Menopause at home
Make her the priority
The key thing when supporting a loved one going through menopause is supporting her to make herself the priority. For women who are used to putting others (family, kids, friends, colleagues) first this can be tough to sell and harder to enforce.
In a sense, your job is giving your loved-one permission to prioritise her own health. You’re gifting time so she can focus on self-care. In a practical sense, that could mean taking tasks off her hands so she – ideally without guilt and that can be tricky – make use of her time.
Also, by showing care through your body language, words and actions you remind her in those subtle everyday ways that you’re here to offer support, with calmness and compassion, while she remains the priority.
There are other practical ways you can help. Research products in the menopause space (it’s a buoyant market) and you can make suggestions on products that can ease those symptoms. But a note: keep them as suggestions – don’t press too hard.
You can help her keep dietary triggers on her radar and watch out for any cause-effect relationships with food and drink. Dairy, sugar, caffeine and alcohol are some of the big offenders that inflame menopause symptoms. Let’s say she does decide, for example, to give up alcohol: you can support her by following suit … or at least not drinking in her company.
Lastly, laughter is important. I’ve seen so many patients who, in tough times, have been able to laugh with another person at the absurdity of their situation. It can be a very healing way to take the power back. But there’s a big difference in laughing with someone and laughing at them …
Menopause laughs? Only if she’s comfortable with it.
Menopause at work
Stay menopause sensitive
Still on jokes, at work they’re just a no-no. For one, you probably won’t know if a colleague is going through the menopause unless (or until) there’s an obvious tell. For two, when you see those symptoms for yourself you’ll realise they’re no laughing matter.
At work, the key is to try and keep menopause on people’s radar. If your workplace hasn’t got a menopause policy, you can suggest it.
When colleagues know how to take comforting and / or practical action, it makes a big difference. When there are workplace awareness and / or training programmes, it makes a big difference. When there’s a safe space where women can take time out for 10 minutes, it makes a big difference. When products and solutions are subtly available at the point of need, it makes a big difference.
And before anyone starts to question the economics or costs of tackling menopause at work in a more proactive way, the situation right now is utterly rinsing businesses … whether they know it or not.
The cost of menopause
Roughly 13 million UK women are currently going through menopause and up to 80% (~10.4 million) of them are currently in active employment.
And out of 10-million-plus menopausal women with jobs, over 2.5 million are, as I type, thinking of quitting. Why? Mostly because their symptoms are too intense and / or because they don’t feel they’ve enough practical support / understanding at work.
In lost hours, colleague training, overtime and recruitment, replacing an employee who earns £30,000 or more per year is said to cost a business upwards of £25,000 a time.
Put that up against the costs of some low-key practical solutions and it’s a no-brainer … hence why more and more companies are now, we’re happy to say, taking menopause policy super seriously.
At work: problems and solutions
Problem: A common menopause symptom is brain fog. For women at work this can be frustrating and deeply embarrassing. I’ve heard of board members stopping dead in the middle of important talks and presentations because the brain fog hits. And it compounds too: the more a woman starts to panic the thicker the fog gets.
Solution: Be aware. If you notice that a colleague has lost her train of thought don’t draw attention to it. If possible, try to gently guide her back to where she was in the conversation/ presentation or suggest a five-minute break for the whole room. It’s better if you can frame it as a break for everyone so she doesn’t feel too singled out.
Problem: During menopause, women can feel a sudden and overpowering urge to pee. If she hasn’t access to a toilet in the next 10 seconds then accidents can and do happen. I’ve had patients recount scenes of them sprinting across the office floor so they make it to the loo on time.
Solution: If your workplace has designated breaks or toilet times, please relax these rules. During menopause, now means NOW! There’s no waiting until 11.15. Also, you can subtly ask colleagues if they’d like to switch desks or positions for any reason. Really, you’re asking whether a colleague wants to be nearer the facilities … but you don’t need to broadcast that.
Problem: Perimenopause can mean going without a period for two months, five months, ten months … and sometimes after a significant break, an unpredictable ‘super period’ can seemingly come from nowhere.
A patient of mine was recently hit with a hideous, unexpected very heavy bleed at work after six months of no period. It showed through her uniform, she didn’t have products or spare clothes, and her supervisor, a 25-year-old male, simply froze. He didn’t know what to do or how to help. She told me she didn’t know who was more embarrassed.
Solution: Caught short kits in workplace toilets are as cheap and effective as it gets to help women (of any age) in such a predicament. There’s also the value of a little workplace education on the subject so colleagues can practically help one another – and not just reel back in horror – when there’s a situation to deal with.
Problem: Hot flushes are one of the more common perimenopause symptoms and women who experience them feel very exposed. They can feel that they are going bright red. They can feel that they are starting to sweat. They are worried that people can see.
When a woman has control over her working environment she’s more likely to find ways to cope. Fans, open windows, appropriate clothing, access to outside space … all good solutions for getting through a hot flush. But not everyone can control their working environment to that extent.
Solution: If you work in a rigidly controlled environment, you may want to relax some rules. You could buy in hand fans and increase ventilation. You can offer more generous or flexible breaks, access to outside space and / or chillout space. Then there’s uniform – does policy have to be so rigid?
For those who think bringing in such changes are impossible or cost-prohibitive then have a look at this incredible campaign for change organised by Julie, who I worked with a few years ago.
The importance of movement
Women may hear that exercise during menopause is important. And it is, massively. Exercise and lifestyle are the two best weapons we have to tackle weight-gain, muscle deterioration and stress, and to promote better mood, sleep and general health.
If a loved one is going through menopause, you can support her to find the types of exercise (and the non-negotiables around it) that’ll help her stay fit and positive, keeping symptoms and problems at bay; now and in future.
But it’s not just exercise … moving in general is crucial.
You may have heard the phrase sitting is the new smoking … and that’s a mantra midlife women need to be especially wary of. Sitting too long inflames menopause symptoms, it slows the system down. It amplifies aches, pains and physical stress.
And because sitting is a mainstay at work, we once again need workplaces to take the lead and encourage more movement during the 9-5.
Standing desks, standing meetings, incentive programmes – there are many creative ways to get people out of their chairs. At the very least, we suggest that long meetings or conference calls stop for a ten-minute break every hour so colleagues can get the limbs moving and the blood pumping.
Menopause is unique
There’s a lot of ground to cover when talking menopause. Each woman’s experience is, or will be, unique and the list of possible symptoms is unfathomably long.
So we encourage further digging, and this list is a good start.
Bodystuff with Dr Jen Gunter
The Doctor Louise Newson Podcast
The Mid Point by Gabby Logan
Listen to this: Doctor’s Kitchen podcast with Dr. Hannah Short and Dr. Rupy
Menopausing by Davina McCall and Dr Naomi Potter
The M Word by Dr Philippa Kaye
Everything you need to know about Menopause (and were too afraid to ask) by Kate Muir
Menopause by Dr Louise Newson
A Complete guide to POI and early menopause by Dr Hannah Short and Dr Mandy Leonhardt
The Happy Menopause – Jackie Lynch
Because menopause is so unique to the individual, the ways by which you can help someone close by will be very specific … specific to their circumstances, job, symptoms and so on.
All that any of us can do – whether we’re a partner or a colleague or a child or an employer – is to learn a little more about what’s possible during a condition that circa 50% of the population will go through at some point.
By having that information in the bank, you will be able to approach a situation with confidence. You’ll be able to feel your way through from a position of knowledge and power.
Do that and it’ll massively valuable for the women in your life.
In fact I’ll go further: learn how to support women in menopause and you’re making progress for all womankind after centuries of suffering in relative silence.