Menopause is a topic for everyone at work

Our newsletter this week is focusing on menopause in the workplace. Menopausal employees are the fastest-growing workplace demographic with 1 in 4 considering leaving employment. It is vital that employers are putting the right support in place and creating cultures that are conducive to everybody’s wellbeing.

It just so happens that my stepmom is a GP and Transformational Coach, Dr Rachel Reset Coach.

She suggested that we talk to each other about the menopause at work and this is the result:

Ollie Kasper-Hope

Okay Dr Rachel, tell me about yourself, who are you and what do you do?

Dr Rachel

So, I’m a GP with special interest in the menopause.

And I also happen to be your stepmom?! I've known you since you were nine years old. So, we've known each other a long time you’ve mostly known me as a traditional GP all that time.

Ollie Kasper-Hope

That’s right, I think you were still training when I met you.

Dr Rachel

Oh yeah - I had just left Medical School, it was 1994, it was so long ago. I had always thought that being a partner in a GP practice was the epitome of any GP career. Being a partner had meant that you had “made it”.?

After a few career and family changes; I ended up remarrying and relocating down to Oxfordshire, where I became a GP partner. Long story short; I moved to a local, rural practice, which I figured I would stay at until I retired. However, I found myself very much feeling unsupported by the management there, then COVID hit and I ended up going off work due to burnout for 6 months.?

During that time, I scratched my head and thought “I can’t carry on like this”, so I decided to do some self-development, as part of that I sat in on a menopause clinic.??Interestingly I was sat there thinking, “hang on a minute, this is me!”?

I'm in perimenopause, I am this patient that they are describing. This was a moment of clarity. After discussing with my doctor, I started discovering my own menopausal journey.

I got some medication and during my time off, I had some very good healthcare through an organisation called Practitioner Health, which has been set up for people in the health service. It was a brilliant service and enabled me to have access to a therapist.?

My therapist guided me to experience another light bulb moment; they made me see that I might also have ADHD! So, there I was with burnout, feeling menopausal and at the starting line of an ADHD diagnosis. And I sort of sat with that thinking, “Well, do I do anything with that? Because, I'm nearly 50 years old and I've managed this far, so do I have to address this?” As we all know, NHS waiting lists are very long for these types of things. But I did pursue it and I got my diagnosis.

I decided to leave GP partnership and then become a GP locum (which is like a freelance or supply GP), and this gave me my freedom to pursue my interest in women's health and menopause.?

The more I looked into this, I learned a number of really interesting things, such as;

●??????Many people don't realise menopause is like a continuum and it creeps up on you.??

●??????Menopause is identified when your periods stop, so it’s a retrospective diagnosis, because you don't know about it until sometime down the line.?

●??????Post menopause is deemed 12 months after your last period stops.?

●??????Perimenopause is the period running up periods pausing. So, people can experience this in their mid 40s, to mid 50s. Some people can start earlier, but some people can, for example, still have hot flushes when they're in their 70s. So, it’s not a set thing, everybody experiences it differently.?

●??????It's a normal, natural experience for all that experience it.

Of course, there are loads of things to discuss, like how everybody will know somebody that's going through the menopause, either through work or a relative. Also, this isn’t an issue exclusive to women and can directly impact transgender and non-binary people, we must make sure that we are inclusive and discuss this for everybody.

My interest grew when I realised that this was a real niche area. I also did six months training as a transformational coach. I’m now finding myself setting up in private practice, and I help menopausal women. My company is called Dr. Rachel Reset Coach, because it's basically about resetting and restarting on a different journey, I don't want to just limit it to women, but that's that's my niche to start with. I'm also using my skills and helping people with??medical weight loss management services. I'm considering adding in services for men too e.g. looking at the Andropause and the role of testosterone amongst other things.?

Ollie Kasper-Hope:

Wow, thank-you, that was so interesting to hear! Mainly because I've known you for a long time, you are my stepmom after all. I've known the various different milestones within that narrative, but I never appreciated the full story and whole journey. It is so powerful when you can look at people you know and love through a different lens.

Dr Rachel

I was just thinking, it's actually also about practising what I preach, I was stuck behind a desk for 20 years and now I'm actually trying to live a life that I would recommend to other people, which is full of variety and pursuing my interests. I try to take a holistic approach to my own life rather than just being chained to a desk! I am also aiming to become an accredited reformer pilates teacher.?

Ollie Kasper-Hope

Yeah, it's difficult: practising what you preach. I’ve recently had to cut down my desk time for health reasons and this is really challenging but must be done.

Okay. Well, our next question was “what is menopause?” But have we already answered this?

Dr Rachel

Yes, probably. But if you wanted the diagnosis, or the definition, it's the end of the menstrual cycle. So, interestingly it's diagnosed retrospectively and the average age is 51 years.

Ollie Kasper-Hope

And that's the clinical definition?

Dr Rachel

It is, yeah.

Ollie Kasper-Hope

Great. Alright, so tell me a bit more about the symptoms of menopause and how that may impact someone at work.

Dr Rachel

As mentioned, menopause can creep up on people and at the same time people can be somewhat in denial or just not aware that it’s happening. People can struggle to put it all together.

Also, people must be given space to process menopause in their own time. For example; I was talking to a friend of mine who is a coach, they have a friend who is in her mid 40s, and she could see that she was developing numerous symptoms , but that person had to come to it in their own time.??Attached to menopause are a whole mix of issues. Do you want to have children? Have the symptoms of menopause crept up before you've had children?

Coming to terms with losing your fertility can be hard.

Then there's the impact of the symptoms and how people experience them. I use menopause symptom questionnaires for patients. This is useful as there are mild, moderate, or more severe symptoms, so it's much more about being??on a journey with a patient and helping them tackle those symptoms in a positive way. It's not all about HRT by any means. Lifestyle changes are hugely important.?

The main symptoms are physical or psychological. There's a huge amount of psychological distress around the menopause, some of which is what we've just mentioned about coming to terms with the end of fertility. But there's also lots of problems with things like anxiety, low mood, brain fog, etc. These things occur because the hormones are fluctuating and particularly oestrogen is starting to reduce. Brain fog can be a really big problem. It's where you have this feeling of a “cotton wool head”. People sometimes fear that they may be developing dementia, because, they have problems remembering things, recalling names or switching-off mid-sentence, which I do regularly. You can lose your train of thought, or you can have problems finding words and things like that. So that can be a big problem, especially, in the workplace. People can be used to presenting or speaking well and then all of a sudden, they may have struggles doing something that they have always found easy.

Ollie Kasper-Hope

Oh wow, so there’s a risk this could be interpreted as almost like a drop in performance?

Dr Rachel

Yes, it absolutely could.

Ollie Kasper-Hope

Or that’s how it could present itself for observers and colleagues who perhaps are not as mindful of menopause?

Dr Rachel

Yeah, definitely. We're looking at how it impacts the individual, but also maybe how it impacts the workplace. Colleagues in the workplace and crucially, employers, obviously have to be fully aware and mindful of menopause. You must look for reasons why somebody's performance may suddenly drop. So, you need to look for an underlying explanation and say, “what's the reason behind that?” Don’t simply be punitive and be sure to open a supportive dialogue with that employee.

Ollie Kasper-Hope

I think one of the challenges is how you would approach having that discussion with somebody in the workplace? You could be experiencing or presenting symptoms of perimenopause before you've had a diagnosis, right? So, if someone was to think, as an employer, oh, maybe that person is menopausal? How would you approach that sensitively and supportively without knowing where someone is on their discovery of menopause?

Dr Rachel

I think the important thing is, is an awareness of it, and then facilitating a conversation. We want to normalise this, right? So, there's an organisation called ' pausitivity' , for example.??They provide resources to shine a light around workplaces on menopause and seek to normalise those conversations and considerations.

Ollie Kasper-Hope

Normalising these conversations is crucial, are there any other practical things workplaces can do?

Dr Rachel

Flexible working can help. The menopause is a normal part of ageing. So, it shouldn’t need to be a protected characteristic, but it does need to be navigated??sensitively and given important consideration. Employers should have a menopause policy, or better yet, embed menopause in a number of different policies. But you need a policy that actually works and is not just sitting on the shelf, you know??

Here’s a question for you: what age do women in the UK get invited for a woman's health check on the NHS?.., is it 35, 45 or 51??

Ollie Kasper-Hope

Well, I'd like it to be 35. But I think it’s probably 51?

Dr Rachel

Well, it doesn't happen. So, it's a trick question.

Ollie Kasper-Hope

That proves your point really well.

Dr Rachel

But the fact is that in the US and Europe, a lot of people have access to an annual gynaecology appointment - they often go straight to a specialist rather than a GP. So, it's more normalised, having the conversation on an annual basis will prepare people to talk about menopausal symptoms. In the UK, we don't have that, therefore, what we need to do is be more individually empowered to know how to seek help, but also, that's where the workplace and colleagues come in, because we all have a collective responsibility to help each other and the implications are such that if you leave things and let things get really bad, then the chances are, that person will have a lot of time off work, trying to sort themselves out, performance may drop to a point that is detrimental to them, but also to the workplace. So, it's really important that things are picked up early enough to get help, because if people could get help earlier they won’t struggle as much with mental ill health for example, and we can give people access to support before the problem gets larger.

Ollie Kasper-Hope

So, as with a lot of complex challenges in wellbeing it's about prevention and more upstream interventions.

Dr Rachel

That's it, before the wheels fall off.

Ollie Kasper-Hope

Well, as you know, Dr Rachel: I am a white, cisgendered, straight man, but I'm also the CEO of a growing company. I'm very conscious and aware of the need to be a supportive ally in the workplace and to have a culture of belonging for Alkhemy.?

So, this question is about men really and I was wondering if I?should?ask it. A lot of people, mainly cis-gendered men may not see this as a prevalent issue in the workplace, or something that they are not particularly conscious of.??The more I learn, and the more I read, I see gender inequality at play in the workplace in many different forms. How can, men in particular, be supportive allies to colleagues experiencing menopause in the workplace?

Dr Rachel

Firstly, this is everyone’s issue, not just the people experiencing it. We have to be inclusive to absolutely everybody. It starts by having conversations like this, and Alkhemy’s newsletter, and it's amazing that we're having this discussion, because it does make it more normalised. Having that debate and allowing dialogue between everybody so that people feel comfortable with the language to use, and not frightened to talk about symptoms – this shows it doesn't have to be a scary topic. So, this is amazing to have this opportunity to talk to you. I’m also taking part in a show on YOWAH Radio, (Your Wellness and Happiness Radio), “Putting the Men in Menopause”. This raises the profile of menopause symptoms and sort of role-models men moving into spaces with menopausal people to discuss and debate the menopause.

Ollie Kasper-Hope

So, I guess really, for men in the workplace, it's about being supportive, raising consciousness of the fact that this might be happening with colleagues that might be going through these symptoms, and just being just being a nice person! Anything else?

Dr Rachel

But also, I think there's a responsibility for people to educate themselves. I did a webinar for leaders and managers last week. 66 people attended, and only one of them was male. Male leaders and managers were obviously missing from that webinar, but it was open to everybody, which I found interesting. There’s something to say about how you market things like that, or how people will see the relevance of these events. So, it's kind of like, if they don't want to come to something like that, it's still important that people would do their own research and learning about it. It might be that half a dozen guys might feel more comfortable, sat around with a coffee talking about it, than in a group with their female colleagues, you know, so you might have to facilitate something like that.?

Ollie Kasper-Hope

Yeah. There's a personal responsibility to educate yourself. But there's also learning for those people who are trying to do the education piece as well in making inclusive spaces for men.

Dr Rachel

Yeah, the other thing I was going to mention was, I had a patient the other week saying to me that she was really struggling with the menopause. And I said, “Well, have you talked to your manager about this?” And she said, “Oh, no, no, no, I can't possibly talk to my manager.” And then she said, “but there's another manager coming in. So, I'm going to talk to them when they come in”. So, I asked “why can't you talk to the manager?” “Oh, because he's male, and he says to me “I don't do tears”. If we're doing tears, you go to see that other person.” It doesn’t matter what your gender identity is you should be a good manager – so, saying you don't do tears? It's not great really, is it?

Ollie Kasper-Hope

So, if there's anybody reading this newsletter today, and they want to reach out to you for more information, where would they find that?

Dr Rachel

I would love to hear from people. You could just email:?[email protected]

Dr Rachel on?Facebook ?and and?Instagram