Commentary: Menopause - how to talk about something that’s mortifying for many women

SYDNEY: Menopause has really come into its own in 2023. From Microsoft to the National Basketball Association and British bank Standard Chartered, companies are implementing policies and offering benefits to women managing the symptoms of the natural ageing process.

This is obviously a terrific development that has been aided in no small part by a host of female celebrities who have come out publicly on radio, television and social media to describe what it’s like to deal with the hot flashes, the sleeplessness, the sweating, the brain fog, among the more than 30 other symptoms. They inspired other women to speak up. Credit to them.

Now, it’s time to dial it down. We must find a way to walk the tightrope between normalising something that will affect half of the population and encouraging company initiatives to support them, while stopping short of the oversharing so common in the TikTok generation.

WHY DISCUSSING MENOPAUSE IS MORTIFYING FOR WOMEN

Part of that is acknowledging why some women find the discussion of menopause so mortifying. Beyond the stigma, it’s because it tends to happen at a key time in our careers - between the ages of 45 and 55 - when we are most likely to take up leadership positions.

It remains a delicate subject, especially given women more than men tend to face gendered ageism at work.

A guest on Australian television recently was widely praised for stopping mid-sentence to admit that she was having a perimenopausal hot flash, a sudden, overwhelming feeling of intense heat accompanied by sweating and a rapid heartbeat. Not all women are comfortable being so upfront about something so private, especially in the workplace.

Not only will symptoms vary greatly, so too will how women deal with them: Publicly or discreetly. That has to be taken into account before we argue that the only way to change perceptions and yield results is to reveal intimate details about menopause at every opportunity.

What we need is a solid body of research to educate employers and ensure they implement policies to help destigmatise this period of every woman’s life. Anecdotes shared on socials run the danger of eventually losing their impact.

“There is work to be done translating the current wave of media awareness into rigorous research and, in turn, empathetic support that women feel safe to accept - or ask for when it isn’t available,” according to Belinda Steffan, a research fellow at The University of Edinburgh Business School who studies menopause in the workplace. 

IMPACT ON WORKPLACE STRATEGIES

The number of postmenopausal women globally is expected to rise to 1.1 billion by 2025, according to the North American Menopause Society.

Yet studies into the economic impact have been limited and the findings patchy. Mayo Clinic surveyed more than 4,400 participants aged 45 to 60 years in the largest study of its kind in the United States, and identified a major negative impact of the symptoms on work outcomes and the need to improve medical treatment to make the workplace more supportive. Released earlier this year, the study estimated the cost to companies annually from lost days at US$1.8 billion. 

But it concluded that there was “a dearth of literature on the impact of menopause symptoms on work productivity”, and additional examinations were needed to confirm its findings in larger and more diverse groups of women.

It also noted that other studies “have not reported a link between menopause and a compromised work experience”. In addition, the survey was conducted during the pandemic, when changes in mental and physical health may have been “erroneously ascribed to menopause symptoms”.

Further in-depth analysis presented alongside women’s experiences can only strengthen the case for workplace strategies. In the US, about 4 per cent of employers that offer sick leave are providing additional support for menopause such as access to hormone therapy and counseling, according to benefits consultant NFP. A third are considering adding them within the next five years. 

NORMALISING A PART OF THE AGEING PROCESS

We shouldn’t stop talking about it, but the focus now should shift to how we tackle a still-taboo subject for many women. While there is a view that normalising menopause can help the retention of mid-career females, many are concerned about a potential backlash at a time when the path to gender parity is by no means smooth. 

Among the 1,000 women in the University of Edinburgh survey, there was concern that “pulling the menopause card” might set the gender equality movement back, and that an increase in awareness might lead to greater stigmatisation at work. Drawing attention should be done “with a note of caution that is sometimes absent from current conversations”, Steffan wrote.

“Presenting menopause as a problem might not be welcomed by all women,” she said. “While many organisations have started to put workplace adjustments in place, our data suggests women might need time to embrace these.”

The point is particularly important at a time when diversity programmes in the US are coming under fire and policymakers from the United Kingdom to Australia are figuring out how to address menopause. Raising awareness in a climate increasingly hostile to equality can be bolstered by stronger evidence of the financial cost to employers if the issue is not addressed. More show, not tell is the key going forward. 

The unabashed sharing of menopause symptoms from the likes of Oprah Winfrey, Michelle Obama and Naomi Watts has paved the way for a more open discussion. The next phase to normalise what is normal should be about research to quantify the economic impact, while respecting that not all women are eager to be so outspoken.