The Menopause

The Menopause

Introduction: Supporting a Positive and Inclusive work environment

Most women will go through the menopause at some point in their working lives. We are only beginning to have meaningful and proactive conversations about this natural and normal life stage. The information in this resource page provides basic information on understanding the menopause and the stages that lead up to it. It also signposts self-care suggestions for women at this time. There are also suggestions for managers around supporting and promoting positive conversations which support women in the workplace.

What is the Menopause?

The menopause is a natural process and an unavoidable part of life for all those who experience periods. It is the time in a woman’s life when she experiences her last menstrual period and her ovaries have lost their reproductive function. It is influenced by hormonal changes and finally a decline in hormones, which are primarily produced by the ovaries. The average age for menopause in Ireland and Europe is 51 years old. At this point, the monthly cycle has stopped completely so there are no more periods and no more pregnancies. The actual definition of menopause in a woman over 50 years of age is when a woman has not had a menstrual period for one whole year.

• Menopause is a Greek word which means the end of menstruation

• It is important to recognize that it is not a once off event but a process which happens over a number of years

• It can be useful to think about it as a transition

• The menopause is a personal experience for women and not just a set of symptoms

• Menopause is a very individual experience. Some women may have very few symptoms that last for a short while. For some women their symptoms are severe and enduring



The beginning of the menopause happens long before the final menstrual period. The phase leading up to the menopause is called the perimenopause. Perimenopause means “around menopause” or “menopause transition”.
This phase can last several years. On average this phase begins around age 45 but can begin up to ten years before the actual menopause. This phase is marked by fluctuations in female reproductive hormones. Women start experiencing symptoms of hormonal imbalance. Women are still having menstrual periods whilst they are perimenopausal. They may experience physical and psychological symptoms particularly associated with the fluctuation in oestrogen and other hormones. The perimenopause can be a good time for a woman to review her lifestyle. It is important to know what the signs and symptoms of the perimenopause are. As hormone levels change, symptoms can come and go.

Common symptoms include:


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As a woman moves towards the menopause, there is a gradual decline in oestrogen, which results in the end of the menstrual cycle. If the menopause occurs when a woman is under 45 years of age, this is called early menopause. If a woman is under 40 years of age, it is known as premature menopause or Premature Ovarian Insufficiency (POI). When a woman has had a hysterectomy with her ovaries removed at the same time, she will immediately become menopausal. This is known as surgical menopause. I. If on average a woman experiences menopause at age 51 years, this means that most women spend at least one-third of their lives post-menopausal.

Menopause is marked by a spectrum of physical and psychological symptoms. Symptoms vary significantly in duration and severity. For some women, this can be a distressing and anxious time. Some women may experience more psychological symptoms and others may experience more physical symptoms. Some women have very few symptoms. The most common symptoms associated with menopause are related to the decrease in the body’s production of oestrogen. Hot flushes are the most common symptom of the menopause occurring in three in every four menopausal women. Flushes and sweats are known as vasomotor symptoms. Other common symptoms include night sweats, sleeplessness, vaginal dryness, irritated skin, more frequent urinary incontinence and UTI’s, low mood and a reduced interest in sex (Women’s Health Concern Fact Sheet, British Menopause Society, November 2020).

The list below encompasses the whole spectrum of potential symptoms that may be experienced. Some may be familiar, and others may be not so much. It is vital to be aware of the potential symptoms so that a woman may recognize when she is experiencing menopausal symptoms.
The image below captures the spectrum of symptoms associated with the menopause

Long term postmenopausal health consequences include the risk of developing osteoporosis and cardiovascular disease.

How long does the menopause last?

Symptoms tend to change over time. Most women experience symptoms for at least four years after their last period. One in 10 women can experience symptoms for up to 12 years.
Post menopause is the time in a woman’s life after she has not had a period for 12 consecutive months.


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The psychological and emotional symptoms associated with menopause are often less spoken about. Psychological symptoms can include anxiety, irritability, panic attacks, feeling low, feeling frustrated, tearfulness, loss of self-esteem and loss of confidence.

Mood changes are very common symptoms during perimenopause and menopause. Many women experience anxiety which impacts significantly on their lives. This often appears out of nowhere and can be frightening. Menopausal brain fog encompasses difficulties with concentration and memory which can have a significant impact on personal relationships and work life. Many women suffer these symptoms in silence. These cognitive and emotional symptoms can be treated. Cognitive behavioral therapy (CBT) can be effective for many of the psychological symptoms particularly anxiety and can also help with hot flushes. When we are very anxious, we can move into anticipating the worst case scenario or catastrophic thinking. This often adds to the stress response and increases the feeling of anxiety. New strategies and helpful coping mechanisms are developed which can help in many situations. “CBT for hot flushes focuses on the links between physical symptoms , thoughts, feelings and behaviours” CBT can help develop a more calm approach to hot flushes .The link to the leaflet on CBT and the Menopause is in the resources at the end of the article. This will explain how CBT works and what you can expect. Your GP can provide you with a referral to a CBT therapist.
CSEAS: Health and Wellbeing Resource page
Women’s Health Concern – Cognitive Behaviour Therapy (CBT) for Menopausal Symptoms


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It is vital that we are all educated and informed about menopause. Many women are not prepared for the many changes that their bodies and minds go through in this natural transition. Having knowledge gives power and informs good choices. There are some very useful articles and fact sheets at the end of the article which will provide evidence based information. If a woman is experiencing distressing physical and /or psychological symptoms, it is important to reach out and get help. An appointment can be made with their GP. There are a number of GPs in Ireland who specialize in menopause who are members of the British Menopause Society. To prepare for the visit, keep a record of symptoms in as much detail as possible. Make a note of how long symptoms have been experienced. Keep a note of the date of the last menstrual period. Be informed about the different treatment options. HRT is a form of therapy which replaces the declining hormones. Write down any questions about benefits versus risks. Ask what other treatment options are available; There are highly successful localised treatments for vaginal dryness and urinogenital symptoms which vastly increase quality of life for many women.

Some Lifestyle Changes to consider

• Regular exercise benefits both physically and psychologically

• Relaxation and mindful breathing can help reduce the stress response and help with hot flushes

• Monitoring spicy food intake/alcohol which can precipitate hot flushes

• Lose the duvet, use light layers at night

• Build in some resistance exercises in addition to cardiovascular exercise. This supports muscle mass which is lost in menopause

• Eating a healthy diet which supports bone health and cardiovascular health

• Talk to others

• Learn the accurate facts and be informed

• If symptoms are causing distress, reach out and get help


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If the average age of perimenopause is around 45 years, this means that most women have at least another 20 years or more in the workplace. It is only quite recently that we have started to have more open conversations about menopause. Menopausal symptoms can have a significant impact on women in the workplace. Creating a culture of openness and inclusiveness facilitates conversations which help break the stigma around talking about the menopause in the workplace. This is an issue which impacts on both age and gender. The work context presents a more significant challenge for women in managing their menopausal symptoms. The most frequently reported symptoms which affect women at work include fatigue, poor memory and difficulties concentrating, low mood and loss of confidence. A number of studies have shown that women who experience more difficult hot flushes are linked to a higher intention to leave their employment.

Managing the Menopause at Work
Consider talking to your line manager. This is a personal choice for women in the workplace. This could be an important step in securing the support you need at work. It is also breaking the silence around this. It can be difficult to disclose sensitive and personal information to a younger manager or a male. You might consider talking to your employee assistance officer. They can provide you with a safe space to discuss your concerns and identify how this might be best approached.


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• List the symptoms which impact you most at work. Write down workplace examples of how this impacts on you

• Try to identify what adjustments might support you at this time

• Consider talking to a manager that you trust

• Seek further advice and support

• Try to use any flexible working arrangements to your advantage

• Look at how your desk area is set up. Would a fan help or being near a window?

• Does your workstation need to be closer to the bathrooms?

• Make a note of things and set reminders to support your memory

• Notice when you are at your best and plan your most demanding tasks around this

• Try to get a walk out in the fresh air at lunchtime

• Do a three minute relaxation exercise once a day. This can help with easing stress.

• Incorporate Mindfulness Techniques at home and at work

• Identify any lifestyle changes that will support you

• Do you need to reduce alcohol or stop smoking?

• Build in more exercise and a healthier diet

• If you are suffering with anxiety or low mood, it could be worth considering CBT

• Consider talking to supportive work colleagues. Some may be at a similar life stage and could create support for each other.

• Avail of additional support from your employee assistance officer

This time can be an opportunity to re-evaluate and look at what positive changes you might like to move towards in your life.

Tips for Managers

• Creating an open and inclusive work environment based on trust and empathy supports staff in discussing sensitive issues that may be impacting on them in the workplace

• Make time to check in with staff and asking how they are helps create an open and supportive environment

• Provide information and raise awareness for all staff about the menopause. It is a normal transitional stage in life that all women will go through in their personal and working lives

• Consider developing a menopause policy

• Additional support is available to managers through the CSEAS


Tel: 0761 000030
Monday – Thursday: 9am – 5.45pm
Friday: 9am – 5.15pm
Email: cseas@per.gov.ie

Appointments are available evening and weekends if required. Video conferencing is also available.



References and Resources
– Ready to be Real Podcast by Sile Seoige: Menopause Part 1 and Menopause Part 2
– Real Health Podcast with Karl Henry :The Menopause – everything you need to know with Dr.Deirdre Lundy
– Newson, Louise, Dr, (2019) Menopause, Haynes. UK
– Newson, Louise, Dr, (2021) Preparing for the Perimenopause and Menoapause, Penguin. UK
– Mosconi, Lisa, Dr (2020) The XX Brain. Allen&Unwin. UK
– British Menopause Society, (2021) Women’s Health Concern Fact Sheet


 
 
 

CSEAS Resources

CSEAS Video: Anxiety
CSEAS Health and Wellbeing resources
CSEAS Information for Parents of Children Who May Be Experiencing Anxiety
CSEAS Good-Mental Health in the Workplace leaflet
CSEAS Understanding Stress booklet
CSEAS Anger Management leaflet
CSEAS Building Personal Resilience leaflet
CSEAS Introduction to Mindfulness leaflet
CSEAS Counselling Psychotherapy Psychology how do I choose

External Resources

Women’s Health Taskforce: www.gov.ie/en/campaigns/-womens-health
Aware – Lets Talk About Menopause: www.aware.ie/webinars/lets-talk-about-menopause
www.wellnesswarrior.ie
HSE: Early Menopause
HSE: Postmenopausal Bleeding
HSE: A – Z list of resources
Women’s Health Concern: www.womens-health-concern.org/help-and-advice
www.menopausematters.co.uk