Katie Taylor, pictured, 50, from London, was forced to cut short her career aged 43 because her GP had failed to correctly identify her menopausal symptoms over the course of four years
People often say there’s never been a better time to be a modern, working woman. The gender pay gap is half what it was 20 years ago, maternity leave packages are more generous than ever and more women are gradually emerging in senior management.
Obviously, there’s still room for improvement, yet career-wise, it’s probably fair to say things are better than ever. But not for all women. In fact, for the estimated 4.3 million working women over 50, slap bang in the middle of the menopause, it’s arguably tougher than ever.
Not only are they plagued by constant fatigue, painful joints, mood changes and memory problems but, as recent surveys reveal, employers are ill-equipped to deal with them. As a GP and founder of the UK’s first ever GP-led menopause clinic in Stratford-upon-Avon, I’ve seen the condition destroy the careers of hard-working women, from bankers to hairdressers.
My colleague Katie Taylor, a 50-year-old former high-flying marketing executive in the charity sector from London, was just one – at 43 forced to abandon her dreams of working her way up to a director role on account of her symptoms.
‘I’d be in important meetings, looking at budgets and it seemed like it was all in another language,’ she tells me.
‘I’d have anxiety, low mood and be utterly exhausted. I couldn’t tell anyone because my managers were all men.’
Katie suffered in silence for four years, consistently misdiagnosed by her GP, before abandoning career hopes completely.
According to a recent report, 14 million working days a year are lost to the devastating effects of the menopause.
Ms Taylor said: ‘I’d be in important meetings, looking at budgets and it seemed like it was all in another language’
In my own survey conducted this year of 1,100 menopausal women, 94 per cent said symptoms made working life tougher and half were forced to take time off, dramatically limiting career opportunities.
Now, politicians are finally beginning to take notice. In May, Conservative MP Rachel Maclean raised the issue in the Commons, calling on employers to adopt a specific menopause policy.
But it could be decades before there is concrete action. So don’t wait.
I’ve spent the past two decades helping menopausal women reach their professional peak. Here, I detail 20 of the most important tips and tricks I’ve learned, that will keep you at the top of your career for years to come – from sick pay, to office tweaks, to medical treatments, this is the only resource you need to keep you thriving during and after your menopause.
Don’t ignore classic signs… or other symptoms
First things first – recognise your symptoms for what they are.
I’ve lost count of the women who, still having regular bleeds, incorrectly think their agonising symptoms are nothing to do with the menopause.
That’s because doctors rarely diagnose the menopause until a woman has not had a period for a year.
Yet women can suffer a collection of symptoms and still have monthly bleeds for up to a decade before diagnosis.
The gradual depletion of sex hormones – oestrogen, progesterone and testosterone – during the perimenopause (just before the menopause) and menopause account for a host of familiar symptoms, including hot flushes, foggy head, joint pain and bloating.
But other symptoms are less well known so if, from 45 onwards, you suffer any of the following, it could be the start of the menopause.
A strange taste in your mouth?
Hormone changes can trigger a hot sensation affecting your tongue, lips, gums or the inside of your cheek. According to the Oral Health Foundation, the exact cause is unknown, but it is more common in menopausal and postmenopausal women.
Tingling, itchy skin
Oestrogen helps build collagen, a connective protein that gives your skin strength and structure, and is key in maintaining blood supply to the upper layer of your skin and keeping it hydrated and elastic. Skin gets thinner as oestrogen levels fall, and some women experience tingling, prickling or a crawling sensation called formication.
Palpitations, a feeling that the heart is beating quickly, can sometimes accompany hot flushes. Palpitations are usually harmless but if they are frequent or accompany symptoms like shortness of breath, see your doctor as this could be a sign of something more serious.
As oestrogen levels fall, androgens (hormones such as testosterone) become more prominent and can cause excess hair around the lip and chin.
Altered sense of smell
Oestrogen can affect the pathways in the brain that control sense of smell, and some women find they have a heightened sense of smell during the menopause.
Next, get the right treatment
A spot on the career ladder can still be yours with the right treatment. But only half of women seek help from a health professional for their symptoms. It’s tragic, considering hormone replacement therapy (HRT) is recommended by every international health body, as it’s hugely effective.
The 50-year-old mother-of-four said HRT was a game changer: ‘Within four weeks I felt like a new woman, like the clock had been turned back 20 years’
For Katie, HRT was an immediate ‘game-changer’. ‘Within four weeks I felt like a new woman, like the clock had been turned back 20 years,’ says the mother-of-four.
‘I immediately started a new business from scratch – a website called The Latte Lounge that supports women in midlife – which has gained 16,000 members in just three years. I can cope with any challenge thrown at me and feel like I have more brainpower than I did in my 20s.’
Many women tell me HRT – usually a combination of oestrogen and progesterone – gives them back their life.
Hot flushes and night sweats should subside within weeks, and other symptoms like vaginal dryness and urinary symptoms within a few months.
Recently, a series of alarming headlines have linked the drugs to health conditions such as heart disease and breast cancer.
But this is far from the whole truth. And you don’t have to pop pills at your desk every day, either – try a gel or patch instead.
So don’t shy away from drug treatment, as for most women it’s nothing short of life-changing.
Know your rights and tell your boss
There is no specific legislation covering how those going through the menopause should be dealt with at work but under the Equality Act 2010 employers can risk claims for sex, disability and age discrimination if they don’t properly support their female employees.
You can persuade your boss to makes the changes you need by…
- Checking if your workplace has a menopause policy in place and, if not, suggesting one. You’ll be surprised at how many businesses do have one.
West Midlands Police, for example, introduced a flexible working policy for menopausal women and some NHS trusts provide counsellors to help with menopause-related anxiety and stress.
If a policy doesn’t exist, the Faculty of Occupational Medicine website has a helpful guide.
- Bringing examples of how your menopause is affecting your work. Do conference calls in stifling rooms trigger a hot flush, or are you struggling to meet deadlines due to poor concentration? Managers may ask for evidence before granting a change to your working environment.
- Asking for sick leave if you need it. If you earn at least £118 per week, you are entitled to Statutory Sick Pay. That’s at least £94.25 a week for up to 28 weeks. After one week, you’ll need a doctor’s note. If you are self-employed and need time off, try to claim Employment and Support Allowance, or Universal Credit. Visit the Government’s website, gov.uk.
- If you feel you’re being unfairly dealt with, speak to your HR department or contact the Citizens Advice Bureau at citizensadvice.org.uk, for free, impartial advice.
Ask for a desk fan… and mornings off
If you have worked continuously for the same employer for 26 weeks, you have the right to request flexible working to cope with your symptoms. It may be that your joint pain is particularly unbearable first thing in the morning, or you suffer from post-lunchtime hot flushes.
Try to tailor the working day around the times you feel strongest, or negotiate a later start time or working from home if you struggle with concentration.
So why not request a simple desk fan, or move closer to the window? Or consider swapping afternoon coffees for herbal teas and avoiding canteen curries that can trigger hot flushes
According to a recent survey by the Trades Union Congress, half of menopausal women found office environments made their symptoms worse.
So why not request a simple desk fan, or move closer to the window? Or consider swapping afternoon coffees for herbal teas and avoiding canteen curries that can trigger hot flushes.
If you wear a uniform, ask if they’re available in cotton – great for wicking away sweat.
Lifesavers… alarms and post-it notes
It’s a scenario familiar to most of my patients; your boss asks a question to which the answer is painstakingly obvious.
Yet, for some reason or other, you draw a blank.
Brain-fog is commonly associated with depleted oestrogen – the hormone plays a significant role in learning and memory.
Recent studies by researchers at the University of Georgetown in Washington revealed that a drop in oestrogen can cause a surge in anxiety, too.
But although it might feel like it affects our performance, it actually makes little difference to our achievements.
A six-year study involving almost 2,000 professional women found that, despite the reported brain-fog, anxiety and depression, they performed just as well on cognitive tests as their pre-menopausal selves.
The weariness is temporary too, the study found. The brain simply adjusted to the drop in oestrogen, causing the confusion to diminish roughly four years after the symptoms started.
So, there’s no need to let it blight your confidence, especially when a few neat tricks could help you to cope.
First, get a smartphone and use the reminder application to set alarms, notifying you of important meetings or deadlines.
Then write key points you don’t want to forget on sticky Post-It notes and place them next to your screen. Repeat them to yourself every morning.
Finally, schedule meetings or the most challenging tasks at the point of the day when you’re sharpest.
Walk in nature… for the sake of your eyes
Many women spend every waking moment in the office, hoping this will compensate for time lost due to dips in concentration.
Don’t be tempted. It won’t do your career any favours.
Studies have shown that just 15 minutes away from the desk, or engaged in a relaxation exercise, can boost your concentration and reduce stress.
Staring at a computer screen worsens symptoms too – menopausal women are prone to dry eyes as oestrogen is vital for keeping the front part of the eye, the cornea, moist and elastic.
The Health and Safety Executive recommends short, frequent breaks of five to ten minutes every hour, rather than longer breaks every few hours.
Better still, take your break outside. Not only can daily breaks in nature boost mood and creativity, it can reduce the risk of developing diabetes and heart disease too, according to research.
Fight the long-term health risks
Sitting at a desk all day, and coping with the stress of working life, isn’t ideal for reducing the overall risk of disease.
A sedentary lifestyle makes you much more likely to develop bone or muscle stiffness, as well as obesity-related illnesses.
This is especially concerning for menopausal women given their already heightened risk of osteoporosis and potentially fatal heart disease.
That’s because oestrogen helps keep blood vessels healthy, controls cholesterol and protects the bones from weakening.
Women lose ten per cent of their total bone mass in the first five years of the menopause. But there are things you can do to counter this.
Regularly practise weight-bearing exercises such as brisk walking, dancing or lifting light weights to strengthen muscles.
Eat plenty of calcium – found in dairy foods and leafy green vegetables – and be sure to get ample Vitamin D by exposing your skin to daytime sun.
Calcium builds bone and Vitamin D helps the body absorb it.
Sitting at a desk all day, and coping with the stress of working life, isn’t ideal for reducing the overall risk of disease. A sedentary lifestyle makes you much more likely to develop bone or muscle stiffness, as well as obesity-related illnesses
Don’t fall into the comfort eating trap. A balanced diet full of wholegrain foods and fruits and vegetables will reduce bloating and help you maintain a healthy weight.
Then there’s sleep – a lack of which is also associated with heart conditions and mental health disorders. Roughly two-thirds of menopausal women have sleep problems because dwindling progesterone means sleeping patterns become deregulated and hot night-time flushes can make it tough to get back to sleep.
Sticking to regular bedtimes, banishing phones from the bedroom and keeping it at a cool 18C can all help.
Katie says she’s now sleeping, and working, better than ever.
‘Four years ago, all I wanted to do was curl up into a ball. My CV reflected the type of vivacious, confident woman I was, but no one in the office ever met her.
‘I would have loved to have worked my way up to the top and to have made a real difference in the charity sector, but at the time I just felt it wasn’t possible. My body wouldn’t allow it.
‘Now I’m more than happy with my achievements and have found personal satisfaction in the work I do. I don’t plan to stop any time soon.’
- Haynes Menopause Manual, by Dr Louise Newson, is available from haynes.com (Haynes Publishing, £12.99).
Don’t panic… HRT’s benefits far outweigh its risks
Last week, a new study about the safety of Hormone Replacement Therapy alarmed millions of British women.
The research, published in The Lancet, said that the risk for women taking the most common form – combined daily oestrogen and progestogen – of developing breast cancer was twice that previously thought.
One in 50 women on pills for five years will develop breast cancer, scientists said.
The NHS says there is a small risk of breast cancer with taking combined HRT but the risk returns to normal five years after you stop taking it
But these conclusions may not be entirely accurate.
They are based on previous observational studies involving 100,000 women – rather than a gold standard randomised controlled study that could establish precise cause and effect.
There are many different reasons for increased breast cancer risk, including obesity, not exercising and drinking alcohol.
The NHS says there is a small risk of breast cancer with taking combined HRT but the risk returns to normal five years after you stop taking it. Some women also worry about an increased risk of womb cancer.
Taking oestrogen alone, without progestogen (the synthetic form of the hormone progesterone), has been seen to have this effect.
But most women take the combination of hormones, and topical treatments such as gels and patches carry much lower, almost negligible, risk.
In my view, the benefits of taking HRT outweigh these risks. Countless, robust studies show the risk of heart disease, osteoporosis, osteoarthritis, type 2 diabetes, bowel cancer and dementia are all reduced in women who take it.
And don’t forget, the National Institute for Health and Care Excellence watchdog – as well as several other medical bodies – are still recommending HRT for debilitating menopausal symptoms.