REASONABLE ADJUSTMENTS IN THE WORKPLACE FOR MENOPAUSE
Author: Victoria Howell Menopause Nurse, RNA, PG cert Healthcare Leadership, BSc, DipHe Nursing Adult, DipHe LCW, DipHe Coach Mentor Practitioner.
So, why do you need to ensure Reasonable Adjustments are in place at work for people going through the peri or post menopause? As an employer, manager, equality and diversity or HR professional you need to be aware of and follow good practice to provide the right support to your workforce. You have a Duty of Care to all your employees’ health and wellbeing at work.
Let’s take a step back and look further at the menopause, what it is and who it affects. The norm range for menopause occurs between the ages of 45-55. If it occurs between the ages of 40-44, this is known as an early menopause. Any time before 40, is known as premature ovarian insufficiency or POI. Women may also go into premature menopause following surgery or radiotherapy/chemotherapy. You will need to consider the needs of trans men and non-binary people also enduring symptoms of the menopause. People may not feel confident raising the topic of menopause with managers for fear of being judged or discriminated against. A trans man may not wish to disclose he is trans and peri menopausal, a woman in her 50’s may not wish to disclose she has symptoms of perimenopause as she fears younger women may laugh about her. Equally a young woman may not wish to disclose, as she may be struggling coming to terms with what it means for her in terms of fertility. Which is why awareness in your workplace needs to be aimed at all employees in addition to training and awareness for managers.
The menopause itself is literally 12 months after the last menstrual period, so it is one day, then is termed as post-menopausal. The phase before this is commonly known as the peri menopause. This may last a few months or up to or over a decade. So, people still have periods during this time. Oestrogen starts to fluctuate and can cause periods to be unpredictable, closer together, further apart, lighter bleeding or extremely heavy bleeding. The many symptoms of the peri menopause are varied; while some women experience lots of symptoms, some hardly experience any at all. Some appear to breeze through this transitional phase in their life, while others really suffer to the extent it impacts on their home and work life.
Envisage this scenario:
You have been kept awake at night worrying about something at work, it is ruminating in your mind. You eventually fall asleep, only to be woken up by extreme stomach pain, hip soreness, and the feeling of being extremely hot and sweaty. You fall asleep for short periods of time during the night, only to be woken again. The alarm goes off for work and you are already tired. Imagine going through that most nights. How do you think you would feel?
It will not surprise you to consider how these impacts on your work life, feeling tired and groggy before the day begins. It can often lead to lack of concentration and can affect memory. Imagine yourself in a meeting feeling this way and being asked questions, that usually you would have no problem answering but due to the above, it is a problem for you. You feel embarrassed, and this will ultimately impact on your confidence to fulfil your role efficiently. You will be worried about what your colleagues and manager think of you.
Let’s look at the Law.
The Law around reasonable adjustments is covered in more detail in other Chapters. Reasonable adjustments are for employees with disabilities or health conditions (ACAS). The Equality and Human Rights Committee say that “Equality Law recognised this may include changes to the way employment is structured. For example, removing barriers or providing extra support of resources”. This is the Duty to make reasonable adjustments, as employers we are responsible by law to provide a Duty of Care to all employees.
So now you know how the peri menopause can impact on a diverse age range of employees, how can you ensure you provide reasonable adjustments? How can you help as an employer or manager with regards to menopause in the workplace? Let’s look at what you can do.
Consider your environment
What type of culture does your workplace radiate? Do you have open values that all staff are encouraged to adhere to? Your values could include integrity, respect, trust, transparency, or support to name a few. Is your workforce aware of the values and do you practise these as a manager? Or are people afraid to confide in managers, afraid their issues will be discussed with other members of staff, or do they anticipate ridicule or discrimination?
Ensure you are approachable and professional, if staff do not trust you, they will not confide in you. Promote values of trust and excellence in your professional conduct. Raise the profile of an inclusive culture of wellbeing at work. Mental Health is now considered under the wellbeing umbrella, many organisations have Mental Health First Aiders to support the workforce. The introduction of Menopause Champions could help you to help your staff, perhaps a dual role for the Mental Health First Aider.
Training and awareness
Menopause policy – to include menopause sickness, this will assist accurate auditing, rather than generic ‘gynae’ reasons for sickness. Ensure all managers have read, understand, and refer to the policy. Easy access to all staff (in different languages), on your local intranet. If you do not have an intranet, in the Staff Handbook. Supply different formats for those with sight and hearing impairments.
Risk assess your work environment for people experiencing symptoms of the menopause, including a workstation assessment, as you would for mental health and pregnancy.
Hold menopause awareness sessions for all your employees.
Provide menopause awareness and support training for all managers. Arm them with a manager’s menopause pack, something they can easily refer to when required. (Victoria Howell Health & Wellbeing provides these workplace services, contact to discuss your requirements).
You may wish to commission the services of menopause specialist speakers/trainers if your workplace does not have the level of knowledge required. A trainer unknown to the workplace can help achieve better outcomes. They may be able to offer 1-1 support for people experiencing problematic symptoms of the menopause, as part of an occupational health report recommendation.
Incorporate the importance of lifestyle factors into your generic wellbeing programmes which all your workforce can benefit from. Introduce awareness around nutrition, hydration, exercise, and selfcare. You may have a member of staff who can provide yoga classes or other shared activities before or after work hours.
The more people in your company/corporation that is aware of menopause, the further it will help eliminate the unnecessary taboo around this topic. People enduring menopause will feel better supported and more likely to share the problems that they encounter, which may impact on their ability to fulfil their job role.
Provide a safe and confidential place to speak about symptoms, problems, and the impact it is having on the individual.
Workplace temperature – Hot flushes can occur any time, if possible, ask if the person would like to sit/work closer to an aircon unit, or a window.
Fans- provide fans at face and leg levels. During the peri menopause, and the person is having irregular periods, the temperature will fluctuate too. During menstruation, body temperature is slightly raised, so that combined with hot flushes can make one feel incredibly uncomfortable and hot.
Anytime access to toilet facilities. Some call centres, manufacturing companies only allow toilet breaks at set times. For employees that travel to other sites or visit your site, make information available at the onset of their arrival to the whereabouts of the facilities. You could incorporate that into a welcome process for all, so people do not feel they are being singled out because of their peri menopause (or any other health condition, disability). Natural cooling sprays available in facilities can help, something with peppermint or other essential oils that help with cooling, these can be extremely effective.
Quiet space/room- somewhere undisturbed and safe for someone to go and deal with a hot flush or anxiety, dizzy spell or other symptoms necessitating a quiet place.
Uniforms- Review the composition of uniforms, do they have natural fibres? Polyester and manmade fibre garments will contribute further to feeling hot and exacerbate a hot flush, causing sweat to drip and pool. Cotton or moisture wicking fabrics are readily available.
Cool water on tap – There are inexpensive units that deliver fresh cool water. These can be plumbed in so not to run out. Other types are available via contract, where large bottles are provided as spares. When people are hydrated, it may help reduce the severity of hot flushes, it can also help enhance concentration levels.
Flexible working hours- People who have been awake during the night may need to start later, or prefer to start early, as they are already awake and prefer to finish earlier. Listen to what will work best for your employee. If the role permits, offer working from home.
Shower facilities where available- Many companies have shower facilities for staff, for example those who cycle into work and shower before starting their day. Awareness of facilities will be beneficial to those suffering extreme hot flushes, having a shower and change of clothes can make all the difference to the ability to perform duties for the remainder of the day, instead of someone having to go home and lose a half day of work.
When periods are irregular and unpredictable, maintain staff dignity and avoid embarrassment by providing somewhere private away from an open plan office to store these products. Personal storage space, for sanitary ware, change of clothes, deodorant and, or medication.
Vending machines- healthier options like fruit, nuts and seeds.
If work duties require long periods of sitting or standing, provide access to rest room.
Many of the above need to be in place for general mental and physical health requirements.
Consider the cost
You may wonder how much will this cost? Well, consider the costs of someone leaving and the advertising, recruitment, and training of a new person and the impact this could have on service delivery.
Women’s health has attributed to the Glass Ceiling effect, where gender imbalance is seen, due to pregnancy and/or menopause, and has caused inequality in promotional prospects and pay. Nuffield Health reported in 2017 that “72% of female workers said they feel unsupported at work. One in five said their symptoms had a detrimental effect on their work. One in ten said they had considered quitting their job”.
By accommodating the needs of your current staff, you will evidence Duty of Care, staff will feel valued and engaged. Sickness and attrition will reduce, and your company will demonstrate an inclusive culture of valuing their staff. The corporate reputation will be one of excellence and this will engage the interest of further stakeholders and customers. You will have a clear return on investment and ability for succession planning safe in the knowledge you are protecting your employees and your company.
Do you provide health insurance as part of your employees’ benefits package? Include menopause consultations and care with this.
Menopausal symptoms do not last forever, this is a transitional stage in a person’s life. When the right support and care is provided for your staff, the less impact it will have on your service delivery.
As mentioned before, with the right awareness and training in place for the entire workforce, the menopause be a subject that can be discussed openly, comfortably and viewed as a norm and will help people be treated fairly.
The menopause can be a time for people to assess and review their life, and to look forward to positive change.
Put yourself in your employees’ shoes to enhance your understanding and be a role model of excellence.
‘The Menopause at Work – A Practical Guide for Managers’, Chartered Institute of Personnel and Development. March 2019. www.cipd.co.uk
Menopause at Work, ‘The NHS Staff Council Working in Partnership’. March 2020