Menopause in the tech industry: how to survive

Inspired by a lot of the great campaigning going on right now for better visibility and treatment for women going through the menopause I thought I would share my own experiences of being a senior leader in the tech world who is going through perimenopause. Like so many women, my experience has been pretty awful, and if I had had better access to evidence-based information earlier, I would have suffered a great deal less. My hope is that by sharing my story I might be able to reach a few more women so that they can learn some ways to survive and even thrive at work.

Menopause and its symptoms

First, a good old fact. The average age of reaching menopause (ie when your periods stop for good) in the UK is 51. However, many women start the transition towards menopause (called perimenopause) much much earlier. My symptoms started when I was 39, but I have spoken to many women who started perimenopause a lot earlier than that. Because of the general ignorance around the symptoms of perimenopause and how early it can start, many women (and sadly many GPs) have no idea what is happening and misdiagnosis is common.

Most people think that the main symptom of menopause is something called a “hot flush” (basically, suddenly feeling your temperature soar to uncomfortable levels). However there are at least 33 other symptoms and many women seldom or never experience hot flushes. All women (and GPs) need to be made aware of what the common symptoms are, so that they can diagnose and treat accordingly.

My story

My symptoms started when I was around 39. I began experiencing joint pain and stiffness, which is a common symptom of perimenopause. I went to the GP about it and was told I had arthritis and there wasn’t much they could do. Around the same time I started noticing that I needed to pee more frequently and would get stress incontinence when sneezing. Pretty much every woman I know told me they experienced the same thing as they got into their late 30s. No one mentioned that it is a common perimenopause symptom, probably because most of us didn’t know. Women seem to accept this as an inevitable fact of life, but in fact - as I’ve found - it’s easily remedied if you take HRT (more on that later). 

The next symptom to manifest itself was hay fever. I started experiencing symptoms on 27th June 2019. I remember the date clearly because the symptoms came on so suddenly and severely and I had never experienced them before. I went to the doctor about it and asked why I was suddenly experiencing hay fever for the first time in my early 40s. I was told there was no reason - it just happens sometimes, and told to take antihistamines. In fact, allergies are a common symptom of the perimenopause, and will often happen to women for the first time during this time. Sadly, the third symptom I experienced was alcohol intolerance! Gradually I became unable to drink red wine, then beer, then white wine, then most spirits. Again, I had no idea what was causing this and no one ever suggested it might be connected to the menopause.

After the hay fever and alcohol intolerance started, other symptoms arrived very quickly. I won’t go into detail on all of them, but the main ones were constant itchy skin, dramatic mood swings, heavier and more painful periods (yes, another little known fact about perimenopause is that your periods can get much worse for a long time before they stop), anxiety, brain fog, extreme fatigue and forgetfulness. Some of the more minor symptoms I experienced included acne, heart palpitations, brittle nails, hair loss, dry skin, headaches, low libido, insomnia and - finally - hot flushes. Two and a half years after my symptoms began, and after multiple trips to the doctor where no one even hinted at what might actually be happening, I finally put the pieces together for myself after googling my symptoms for months. I had lost confidence in my GP surgery by this point and booked an appointment with a private menopause specialist, who immediately diagnosed me as perimenopausal. Still, I didn’t quite believe her, and it wasn’t until I’d kept the diary she asked me to for another two months and had a couple of blood tests that I accepted the diagnosis. 

Experiencing perimenopause at work: a total nightmare

I’ve listed the symptoms I experienced above, but the main effect of experiencing all of these was that my life became intolerable, and work in particular became extremely challenging to manage. I am a senior leader in a tech business and my job is very demanding and often quite stressful. I had always managed the stress and pressure easily: maintaining a good sense of perspective and humour, even in tough times. All that began to evaporate very rapidly. In particular, I experienced anxiety for the first time and realised that, until you experience it, you really can’t grasp what an insidious and damaging state it is. Suddenly I was second-guessing every decision I made, becoming paranoid that my colleagues were judging me, or hesitating to give my opinion in meetings because I was doubting myself so much. I also experienced rapidly changing mood swings - and would feel irrationally angry one moment and then suicidally depressed in another. I don’t use the word “suicidally” lightly. Data from around the world show an increased risk of suicide among women of perimenopausal age. Fortunately, the extreme moods would pass, and that told me that there was something irrational about them. I had been through clinical depression in my twenties and so I knew what it was like to feel truly depressed for a long period of time. My moods were extreme but they came and went without apparent reason. I knew something was affecting my brain chemistry, and with the diagnosis of perimenopause there was instant relief due to knowing the real cause of my shifting emotions - although it didn’t alleviate the feelings themselves.

For me, the perimenopause has been oddly reminiscent of the onset of adolescence, and if you remember that stage well, you’ll understand how unwelcome that is at work. I would find myself sitting slumped in meetings, sweating, moody, yawning from tiredness and barely able to participate due to brain fog. On more than one occasion I saw people looking at me out of the corner of their eye and felt humiliated. I would forget simple words or have to ask people to repeat themselves until I understood what they were saying. Often I would be unable to speak at all as I was so focused on not falling asleep in public. I felt tired all the time and would often have to use my work from home day to catch up on sleep and then work at the weekend to stay on top of things. It became apparent to me that I would either have to go part-time or give up work completely if my symptoms continued. I felt demoralised, ashamed and frustrated. I yearned to just hide under my duvet and never come out.

After my diagnosis I decided to be very open with my colleagues about what was happening to me. I am an extremely private person, and so this was not easy, but I knew that I needed to explain my erratic behaviour to them and I also felt a responsibility to the women (and men) in the company to educate them. The average age at my company is around the early thirties, and at the time I think I was the first woman in my company to experience menopause symptoms at work. I told my boss, my peers in the leadership team and my direct reports: explaining what I was going through and why. Fortunately for me, everyone was very receptive and understanding, although it was obvious most people had never talked about the subject before. Menopause and the tech industry aren’t exactly natural bedfellows. Yet with menopausal women making up the fastest growing demographic at work, that needs to change.

I still talk openly about my symptoms at work. If someone asks how I am and I’m having symptoms I will tell them: “I’m feeling perimenopausal and it’s hard to focus” for example. Often people will react in interesting ways: one younger colleague, despite having had a baby, had never even heard of the menopause. A male colleague described how a friend of his had recently been diagnosed as menopausal in her twenties. One male colleague told me he had felt embarrassed when I first mentioned my menopause, but afterwards he had had a discussion about it with his wife and realised that he admired my honesty. I don’t exactly enjoy talking about the subject, but it’s important to keep doing it. Many people in the tech industry are obsessed with optimal health and fitness. There are big discussions taking place around mental health in the workplace, and a lot of energy (and perks) are devoted towards ensuring physical health. All women who live long enough will go through the menopause. It’s vital that employers (and employees) include the menopause in their plans and discussions around health and wellbeing.

Treating the perimenopause

One of the biggest challenges around the menopause stems from the general misconception that its primary treatment, hormone replacement therapy (HRT) is a cause of breast cancer. This misconception stems from a flawed study conducted several decades ago which was widely reported at the time and which, although the finding linking HRT and breast cancer has since been comprehensively debunked, remains embedded in the popular consciousness. My mother, who had breast cancer while she was on HRT was told by her consultant that HRT had “caused” her breast cancer (something my menopause specialist has since told me was by no means proven). This idea erroneously entered my mind at an early age, as it did for many women and medical professionals. I am not a doctor, nor a medical expert, but I have been reassured and convinced of the evidence in favour of taking HRT by my doctor and I encourage you to read the vast amount of literature out there written by experts, on why HRT is not only safe for the majority of women, but can markedly reduce our likelihood of getting heart disease, osteoporosis, dementia and other diseases associated with loss of oestrogen. HRT is not a panacea, and it is not suitable or necessary for every woman. However, it is suitable AND necessary for far more women than are currently taking it.

I started HRT in December 2019. It immediately eliminated one of the worst symptoms: constant itching, but it took around 2-3 months to begin to reduce the other symptoms, and actually worsened some of them while my doctor and I worked out the correct dosage for me. HRT works differently for each woman, and this is why regular medical check ups and adjustments guided by a well-trained medical specialist are essential. The bad news is that this treatment is hard to come by. Many GPs are ignorant of how to help women get the right HRT and the right dosage or (worse) are actively hostile to prescribing it. Many wrongly prescribe anti-depressants instead.

Further bad news: many HRT regimes don’t consider or include testosterone, which also falls for women during perimenopause and can cause side effects including headaches, fatigue and loss of libido. For me, one of the main reasons I continue to pay for private treatment is that my private doctor can prescribe testosterone for me, whereas an NHS GP cannot. Without testosterone I am unable to exercise because I feel too weak and tired. Exercise is vitally important for maintaining our strength, fitness and happiness as we age. All women who need testosterone should be able to access it via the NHS. The fact that access to it is currently limited to a handful of private practitioners is a scandal.

My solution to this was, and still is, to pay for private medical treatment. I shouldn’t have to do this, and neither should any other women. The campaigning work of Diane Danzebrink and Dr Louise Newsom is vital here, and I encourage everyone reading this to support them in their fight to get compulsory menopause training for all GPs. Menopause education is scant in medical schools and many GPs have had no continuing professional development training on it since they graduated. This seems unbelievable, given that half their patients will experience menopause. 

HRT is not the only treatment I’ve used. Early on, I cut out almost all refined sugar. Dealing with unpredictable mood swings is bad enough, but surging blood sugar levels make it much much worse. Today I eat a very low fat, low carb diet, mostly plant based. I exercise often, but I keep it light: daily walks, small amounts of yoga and weight training. I never overdo it, because that triggers cascading fatigue. I have had to learn to be very very kind to myself, which doesn’t come easily after a lifetime of pushing myself to the max. This is another challenge when working in the tech industry. There is a “work hard, play hard” mentality, with a lot of people advocating intense exercise on top of an intense work schedule. I’ve had to learn to block out my desire to compete on the same playing field here. Too much exercise is bad for me at this point in my life. It’s ok to be gentle with yourself and to go easy in what little spare time you have. What else? I invested in expensive, high-thread count cotton sheets. At night when you are sweating and can’t sleep, they do make quite a difference.

How I manage the perimenopause today

I have now been on HRT for eighteen months. My natural hormone levels continue to fall as I head towards menopause; as they do my HRT dosage needs to change. The horrid symptoms I have described above have not completely ceased, unfortunately. Early this year I was so tired and miserable that my GP signed me off work for two weeks to give me a break. My menopause specialist prescribed an increased dosage of my HRT and within a month my symptoms were mostly gone and I was back to functioning well and enjoying my work. I still get a lot of fatigue and am plagued by restless legs and itchiness when tired, but in general most of the worst symptoms are in abeyance.

Without HRT I would have had to leave my job and I suspect I would have begun to contemplate suicide more seriously. My symptoms may sound extreme, but data suggest around 25% of women will experience severe symptoms. It is no exaggeration to say that taking HRT has saved my career and may well have saved my life.

Eventually my reproductive hormone levels will drop to pretty much zero and my symptoms will (I hope) stabilise, but I will need to remain on HRT for the rest of my life if I am to avoid experiencing the full brunt of these symptoms. Menopause is not a brief phase: it is an ongoing state of long-term hormone deficiency with many associated health risks. Many of you reading this will know women in your life who have reached menopause and are not taking HRT. While many women do manage this stage of life without symptoms, you will know women who have become anxious, fearful, timid, resentful or angry; women who have given up work and hobbies inexplicably; women who seem uncomfortable in their own skin. Taking HRT is a choice, and I support women who choose not to take it, but the fact is that far too many women do not know it is an option, never mind a potential life-saver. Too many women think HRT is dangerous and too many women have no easy access to it.

How you can support women going through menopause at work

Educate yourself on the menopause. You will have colleagues going through it, potentially for 4-8 years, and they will need support and an understanding environment if they are to thrive and succeed. You can start by reading the Faculty of Occupational Medicine’s guidelines and following through on their advice.

If you’re a woman going through the perimenopause or menopause, please consider talking about it and advocating for better awareness and treatment. Especially if you are a senior leader with a position of power in an organisation, you can set the tone for how an organisation handles this stage of female employees’ careers. As a society, we have made giant strides in our ability to openly discuss mental health. We also need to be able to openly discuss physical health as it relates to our reproductive organs. Our silence around this is prolonging agony and encouraging poor health and poor performance at work. This is true for both women and men. Many men also undergo physical and mental health effects as their reproductive hormones decline, and many men can benefit from testosterone supplementation, for example.

I use an app called Balance to track my symptoms. It helps me to see long-term trends in my symptoms and this helps me to know when I need a consultation with my specialist and when my HRT dosage may need to change. Blood tests are fairly unhelpful in this regard as our hormone levels fluctuate a lot day to day and depending on the time of the month. Most menopause specialists diagnose and treat based on symptoms alone, not blood tests, so keeping a diary is very helpful and Balance is specifically designed for this.

Finally, if you offer private medical insurance to your employees, make sure menopause is covered. Some policies inexplicably exclude it. Private menopause care is expensive. I estimate that I’ve spent around ￡1500 to ￡2000 on treatment, scans, blood tests and doctor’s appointments in the past 18 months.

Coda

I am not yet in a happy place with the menopause. Most days I have some sort of symptom that reduces my quality of life, and I can’t help thinking that menopause is something of a cruel joke. Fortunately, I have plenty of post-menopausal female friends who are thriving and who give me hope for the future. In the meantime, I want to try and reach out to those women who, like me, may be suffering in confusion or silence, or who are being denied information that could help them lead a better, healthier life. If you’ve read this far, please consider sharing this article with women you know, or sharing some of the resources below. Please always be kind to yourself, and to those around you. 

Resources

Menopause Doctor website (tonnes of useful, evidence informed articles)

Guidance on menopause in the workplace

Balance App (evidence-informed information, community support and symptom tracker)

Make menopause matter campaign