Menopause and work - how 'the change' presents an opportunity for change

"For generations, women have lived with a health and care system that is mostly designed by men, for men" (UK government, 2021)

As a menopausal woman, this is something I have come to experience personally and professionally. Yet, because of these experiences, I see how the issue also presents a real opportunity for change.

During 2016-17, I was seconded from my academic post to the Department for Work & Pensions as a Policy Fellow. My role was to help UK government produce evidence-based policy, and as part of that, I was involved in the preparation of the Improving Lives: Work, Health and Disability green paper - a joint publication with the Department of Health & Social Care. It received around 6,000 responses from individuals and relevant organisations across the UK during its public consultation period.

As a result, an ambitious strategy to reduce the disability-employment gap was announced, pledging to see 1 million more disabled people in work over the next 10 years. The vast majority of work disability is avoidable - the evidence shows one of the most effective ways to achieve this target is to prevent people becoming part of the statistic in the first place and help them to remain in work.

What was missing from this strategy was the recognition that menopausal women are the fastest growing demographic in the workforce. And it’s somewhat ironic now to realise that during the time I was helping to prepare this policy, I was perimenopausal. Like many women, I was unaware that what I was experiencing – unexplained anxiety, chronic pain, hair loss, frequent bouts of insomnia and headaches – are classic signs. Because I wasn't experiencing the more well-known symptoms (hot flushes, night sweats - although these made an appearance later!), I didn’t once ask myself, ‘is this menopause?’

I just accepted it was the health ups and downs of life. Apart from seeking healthcare for the debilitating pain of two frozen shoulders in the last 5 years (another common symptom apparently!), I was rarely at my GPs and I didn't even think about taking time off work. The lack of knowledge about what was going on in my own body meant I felt powerless about what was happening to me. I thought I was being weak by having so many health symptoms. It was only after developing frequent migraines, brain-fog, stomach problems and fatigue about 5 years later that I went for some routine blood tests - these came back normal but identified I was menopausal.

Now I know it isn't just menopausal women that experience these health problems over the course of a working life. But all working lives are not equal. In common with many other working women my age, I also do the lion’s share of parenting on top of playing career catch-up ever since taking maternity leave followed by a few years part-time working. Sure, having children is a choice, but one that seems to limit the choices for one working parent more than the other. This is because policy has not caught up with our advances in the workplace – parenting and caring is still chronically undervalued and under-resourced.

But indirectly, it is a leading cause of work disability for women.

I am part of the generation of women that were told we could ‘have it all’, only to realise that this largely translates to ‘doing it all’ (for less or no pay). Never has this invisible labour been so important. It underpinned the economy during the pandemic, with the schools closed and our usual care and social support systems unavailable. Yet these same women will be returning to work afterwards in fewer numbers because decades of inequality are now being felt in our exhausted menopausal bones.

So, I welcome the recent public discussion - it’s totally unacceptable that women don’t have access to accurate information about what we will all experience at some point in our lives. But I hope this debate doesn't get dominated by the view that menopause is purely a healthcare issue, a collection of symptoms to be treated. I understand how debilitating those symptoms can be, and every woman should have access to appropriate healthcare. But to me, this misses the point.

Because this view promotes an ongoing denial about the huge, sustained, and natural life transition that menopause is - it side-steps the long-term solutions and collective responsibility required. And unless we have a 'whole-systems' approach, menopausal women will be the group that significantly widens the disability-employment gap. Conversely, this means menopause presents a real opportunity for UK government to meet their ambitious target and ‘build back fairer’ (or level-up).

Perhaps what would be more helpful is for government to produce policies that support women in redefining what successful and productive working lives look like. Historically, these have been defined by one half of the population only. Menopausal women have the power in numbers to start asking (and demanding answers to) these bigger questions. Instead of getting signed off, let’s start speaking out.