I have had a tough ride with menopause, despite no major health issues. There have been times when I have looked at myself in the mirror and asked; ‘who is this person staring back at me?’ The aches and pains, the hot flashes and the brain fog, they don’t quite make you feel like yourself. I literally had to change my dressing style because I had it bad with hot flashes. Dr. Ranjani Rao, a Singapore-based Pharmaceutical Scientist who has held senior positions in the United States, India and Singapore shares her experience around menopause. Dr. Ranjini is not alone.
Research from across countries tells us that menopause is a leading cause of early retirement among women. A 2019 survey by the UK-based Chartered Institute of Personnel and Development, showed that 3 in 5 working women between the ages of 45-55 said it had a negative impact on them at work. Insights from Bupa, a UK health insurer, revealed that nearly a million women have left the workplace because of menopausal symptoms.
‘While not every woman experiences pregnancy, every one of us experiences menopause,’ continues Dr. Ranjani. If every woman will experience menopause at some point in their life then it is also equally essential for workplaces to be sensitised about this life stage, as most women are likely to be working in significant positions during this stage. Workplaces must understand the implications it may have on women employees’ health and also put in place support mechanisms for those who experience challenges.
Menopause: not a prominent subject in workplace discourse.
The average age for menopause in Indian women is 48 years, which is much earlier than the global average (51.5 years). Perimenopause begins 8-10 years before menopause occurs. As with menstruation, physical symptoms during menopause and perimenopause can vary widely across women.
‘Scientifically, there are 34 physical symptoms that can be experienced during perimenopause and menopause,’ says Anupama Gopal, an internationally certified fitness trainer and women’s health coach, with an emphasis on perimenopause and menopause. ‘Some of the most prominent symptoms include hot flashes, insomnia, weight gain and changes in skin and hair condition, sexual health and wellness, intimacy and relationships, predisposition to cardiovascular risks, sudden palpitations, insulin resistance and osteoporosis,’ she explains, adding that many of these symptoms will manifest in most women irrespective of their lifestyle and health history.
While these are largely physical symptoms, there are also mental health implications to contend with, ‘anxiety and depression occur because of hormonal changes. In addition, physiological changes can impact mental well-being,’ Anupama says.
What makes these physical and emotional challenges worse is the isolation and silence surrounding this stage of life, in both private and public spheres. While there has been a slow uptick in conversation about women’s health on topics such as menstruation, fertility, PCOD and endometriosis in recent years, menopause and perimenopause have been largely left out of this discourse.
This in part, is also due to how it is portrayed in the media and popular culture, opines Indira Rangarajan, national content director in a top media house in Mumbai. ‘While pregnancy and babies evoke images of nurture and care and are shrouded in ‘loveliness’, the standard imagery of a menopausal woman is quite terrible- where they are portrayed as grouchy and grumpy women who are always sweating. Who wants to associate themselves with this image and talk publicly about this life stage?’ she asks.
Not easy to navigate the double bias for women above 40.
Women in their 40s and 50s face a unique challenge in the workplace. They are often caught in a double bias because of their age and gender. While many diversity and inclusion initiatives are aimed towards increasing and retaining women in the workplace, they fail to acknowledge the physical and mental realities of women in this demographic.
Although we are far from closing the gender gap in the formal economic framework, an important aspect is working towards retaining middle-aged women in the workplace. By the time they are middle-aged, most women have already left the workplace, either because they are trailing spouses or they shoulder a disproportionate amount of unpaid work at home.
‘Having a significant number of older women in the workplace means it has done something right in encouraging women’s professional paths and retaining them. One rightly sees adulation of women who are CEOs/ CXOs, but there is something to be learned from the career paths of all women,’ says Dr. Ranjini.
While many organisations have stepped up to cater to the needs of pregnant and lactating women, by offering dedicated rooms for pumping breastmilk and resting in the afternoon, they should do the same for women experiencing menopause symptoms, suggests Anupama. It is also important that leadership teams (both men and women) are sensitised to the physiological and emotional realities of menopause and perimenopause.
Countries like the UK and Ireland have taken strides towards institutionalising and implementing menopause policies at federal levels so that employees can access paid and unpaid leave and sabbaticals without having to utilise their privileged leaves for bodily functions. In countries where there are no such federal mandates or directions, individual workplaces could consider instituting menopause policies so that women feel empowered to take and ask for accommodations.
What can workplaces do?
- Health insurance top-ups
- Interest-free loans to cover out-of-pocket health expenses
- Cool rooms that one can retreat to while experiencing hot flashes
- Temporary or permanent remote working options
- Reimbursements for mental health therapy costs
Beyond accommodations, the leadership must examine their organisation’s hiring, promoting and appraisal policies for conscious and unconscious gender and age biases.
Anupama who works with organisations to support employees experiencing menopause and perimenopause adds that support groups within workplaces can go a long way in normalising these conversations and improving awareness. ‘Inviting health specialists and researchers who have studied this life stage to speak to your female employees can improve preparedness for the challenges that come with it and empower male employees to be sensitive to their colleagues, while also informing senior leadership to enable affirmative policies and accommodations. We must remember that despite physical and emotional challenges, women’s cognitive and decision-making abilities do not change through and beyond this life stage,’ she says.