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Menopause – breaking the taboo

Suzanne Banks, former chief nurse at Sherwood Forest NHS Foundation Trust, describes how she worked to raise awareness and understanding of the menopause.

Menopause is a natural transition in every woman’s life and is experienced differently for each of them. It typically occurs between the ages of 45 to 55, with the average age of onset being 51 years.

Symptoms of the menopause typically include hot flushes, night sweats, insomnia, problems with recall, fatigue, brain fog, loss of confidence, anxiety and joint aches/pains. The workplace can exacerbate these symptoms and for some women can influence their decision to stop working earlier than previously intended. 75% of women experience mild or moderate symptoms, which typically last between 4 and 8 years. Yet despite affecting most women during their working lives, the menopause is a topic that is not often discussed and can be regarded as taboo.

During my early 50s I experienced many of the symptoms while working at Sherwood Forest Hospitals NHS Foundation Trust (SFH). I was also concerned about several members of my team who were going through the menopause. They felt they were no longer at the top of their game, were constantly tired and questioned their credibility and competence. They spoke of feeling easily distracted and having to focus more intently on conversations and doing day-to-day tasks.

This led to me wanting to break the menopause taboo and make some changes at the trust. I had discussed the issue of menopause awareness with a colleague previously and started to explore whether other trusts were doing anything that we could adopt. Despite contacting several people, I found no other trust addressing this issue. As an employer of a predominantly female and ageing workforce (akin to the NHS as a whole), this underlined the need to do something.

SFH employs approximately 5,000 staff. 81% are women and 35% are over the age of 50. Nearly one in three workers in the UK are aged 50 and over, and this is set to grow in the next decade with many more people working into their 60s and beyond. Around 75–80% of women of menopausal age are in work so a large number of women will transition through the menopause and experience symptoms while at work.

I pulled together a group of interested women, including specialists in women’s and sexual health, HR and occupational health colleagues, comms, trade union colleagues and a project lead, and enlisted the support of Henpicked, a charity that provides education and support for women over the age of 40.

In order to break down the taboo and remove the stigma associated with the menopause we aimed to:

  • develop resources for staff to access on the trust website so they could become menopause literate
  • have conversations about the menopause without embarrassment and removing the stigma associated with it
  • raise the profile using #menoPAUSE4Thought
  • develop key guidelines for managers to support staff going through the menopause
  • start to address simple environmental changes
  • provide an ongoing education and peer support programme
  • raise the profile of menopause within the trust and more widely across the NHS
  • start to influence nationally and champion for changes to the electronic staff records system.

The enthusiasm and commitment for taking this agenda forward was palpable. So far, we have run three conferences to coincide with World Menopause Day on 18 October. We have also set up a menopause support group to provide monthly education and peer support sessions and undertaken an evaluation of menopause intervention, due to be published soon.

At the trust the menopause is now talked about more openly and the monthly sessions are well established. Feedback has highlighted the value of the training and support, and staff have commented on feeling better informed and supported and also more confident to approach their GP or other healthcare professional.

This is great progress but we recognise that there is more to be done and are aware that we represent just one organisation in a big NHS.

Many women enter the menopause at the peak of their productive lives. We should ensure we help them to navigate this natural stage of the ageing process and support them at work so that we retain their skills within the NHS.

Further reading

Banks S. Menopause and the NHS: caring for and retaining the older workforce. British Journal of Nursing 2019;28:1086–90.

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The RCP’s Mental health and wellbeing resource aims to support physicians to stay well and seek help when needed by opening up the conversation about mental health issues and their impact.