Menopause in the workplace

• Could you tell us about your experience of menopause, and how it affected you at work?

My menopause started right at the beginning of the pandemic and it has taken some time for me to identify the symptoms as menopause related. I had a massive bleed on a flight, and first dismissed it, thinking it was related to the trip itself. Then, from never having any issues with periods in my life, I started to have irregular periods. But there was the pandemic and I did not want to bother my GP with such a “minor” issue. In the end of 2020, there were a lot of people living in our house, so I thought I was just generally stressed.

But the symptoms got worse, with more bleeding, more fatigue even after things got calmer at home after lockdown ended. I had been having headaches, migraines, mood changes and was not being able to sleep well, but I didn’t have any hot flushes during the day — so I didn’t realise that it was the menopause. I worried that it was endometrial cancer or a neurological disease, so I decided to go to the GP to get it checked.

The GP required some tests, which discarded cancer and confirmed the start of menopause. It was a relief, and I was able to deal with the problems with less stress.

I decided to return to the office to resume cycling, as I thought that the exercise would help. Exercising regularly has helped with my energy levels and mood but it hasn’t helped with the periods/bleeding and cramps. Not knowing when they are going to happen has been difficult. Also, having a more regular sleep routine was good, but not enough to help with night sweats, that always wake me up. I have spoken to the GP about HRT and she has reassured me that you can stop if you want to and if there are any side effects — this helped me decide to ask for HRT.

• Did you change anything about your way of working, as a result of, or to help with, your symptoms?

With regards to work, I am lucky that my manager supports me and I don’t have strict clock in times, provided I work the same hours every day. The flexibility allows me to start sometimes later and sometimes earlier, depending on the appointments I have and also the symptoms and the night before!

• What advice would you give others, both those going through the menopause and their colleagues, managers?

My advice to other women would be to get help, knowing what is going on brings you peace. Let’s raise awareness about the menopause as something as common, normal and natural as periods. Men and women need to know more about it. It has real effects and they aren’t just hot flushes, there are more than 30 symptoms registered as related to menopause — if I had known them at the time I started I might have been less concerned about what I was going through. People speak about brain fog as covid-related... but it happens with menopause too! Brain fog is real! For example, I managed to put all my bike equipment inside and locked the garage yesterday but left the bike itself outside! Now I know why this happens, I just laugh and carry on.

• Could you tell us about your experience of menopause, and how it affected you at work?

Looking back, I can see that my perimenopause started 11 years ago but at the time I had no idea what it was.  I had mood swings, changes to my menstrual cycle, lack of sleep (I can’t remember the last time I slept all night) and for the last 2 years, awful hot flushes. On top of that I had, and still have, lethargy and aches from head to foot, as well as awful bloating.  I found my body shape changing although my eating and exercise patterns hadn’t changed.  There are such a lot of physical and psychological symptoms that I feel like everything is affected.  I had really bad brain fog - it’s got a bit better now but it makes you start to doubt yourself.  I often felt very anxious, and felt I was acting out of character but I didn’t know how to stop it – and because I felt alone and unsupported I would feel very emotional.

Before menopause I always felt that I was very efficient: I was able to work fast, and anticipate the needs of those I work for and I have always been proud of the service I could deliver. When my menopause symptoms were at their worst I found I would be making silly mistakes that were out of character for me, and then I would get anxious about what the outcomes of that would be – would I be performance managed, for example? I ended up being signed off work with stress for a while, as a result.

 I have spoken to friends about what they are going through.  A couple of them tried HRT but found it wasn’t for them, and I’m concerned that it will cause me to gain weight and cause my periods to restart so I haven’t had any treatment for my symptoms. I worry about what long term effects there might be.

The first time I talked about menopause and how it was affecting me at work was a few years ago.  I was working in a different job in a different department at the time. The reaction I had from the department was really negative: the two colleagues that I spoke to, a senior manager and an HR person told me that the University offered no support to those going through menopause.  Worse than that, I felt that they were sniggering at me, and ridiculing my concerns and I felt very alone.   It felt so different to how other issues, such as mental ill-health, were treated.  As I was getting no support at all, my symptoms got worse and I also ended up feeling less tolerant of others going through other difficulties, which is not how I normally react. 

I have recently moved to a new department and one day I started to have a hot flush during a meeting with the senior administrator and HR manager.  I explained what was happening and they immediately told me that there is a lot of new support within the University for those going through menopause.  It was so different to my last experience - they were very encouraging that it was OK to talk about this and to ask for help.   

• What would you have changed if anything?

If I had known what I know now I would have been more open and asked for help earlier, likely from Occupational Health.

• Did you change anything about your way of working, as a result of, or to help with, your symptoms?

With New Ways of Working I work from home 2 days a week, but the rest of the time in a shared office – this is exceptionally difficult because I find I have different ‘environmental’ needs to my office-mates.  I have a desk fan but it makes my eyes very dry so I’m hoping that something else could be provided.

• How would a greater awareness in the workplace have helped you?

If there had been a greater awareness the first time I asked for support it would have made all the difference.  It’s been a lonely and stressful time, and I would have found it much easier if I had felt that I could talk about it in the workplace and know that I would get a positive response.

• What advice would you give others, both those going through the menopause and their colleagues, managers?

To colleagues I would say, talk about it, seek help, find someone you can trust whether it’s a colleague or an HR manager and explore what options are available.  To managers I would say, try to be kind and listen and don’t judge.  Make sure that you are well-informed, particularly if you are a male manager, so that you understand that this is real and understand how it might be affecting the individual.  Kindness is key. 

• Could you tell us about your experience of menopause, and how it affected you at work?

The big ‘M’ was never discussed or referred to in any of the previous organisations I worked in or in my personal life.  In fact the first time anyone mentioned it publicly was when I joined Saїd Business School and a couple of colleagues mentioned they had been experiencing symptoms.  From the little I knew about it, the menopause seemed to mean “hot flushes”, “irritability” and of course the end of the likelihood of falling pregnant.  Looking back, I first experienced peri-menopausal symptoms just prior to joining the School 6 years ago.  At the time I probably just Googled the symptoms and then thought no more about it – until of course the symptoms really started to kick in….. 

Goodness it was tough.  I was maxxed out with work, leading a growing team, commuting daily between Central London and Oxford plus dealing with family issues.  Some days I could barely drag my continuously aching bones out of bed.  I felt totally exhausted all the time.  I used to hold a weekly in-person stand-up meeting with my team (pre-pandemic) and found I couldn’t remember any of their names.  I could barely string a coherent sentence together – which is not great when you are the communications lead.  I just felt so miserable, tired and concerned that I would lose any respect I might or might not have built up.  I managed to get an appointment with my local GP and ended up embarrassingly crying my eyes out in front of them but they just told me that I needed to take more iron supplements.   

It reached the stage that I seriously thought I’d have to stop working as my body and mind seemed to be falling apart.  Of course I never dreamt of confiding in anyone at work – I didn’t want to be viewed as being unable to do my job.

My turning point came when I visited a therapist (for a constant migraine I was also suffering from) in Oxford one lunchtime.  The therapist took one look at me and gave me the name of a specialist consultant that she had visited in Wimpole Street in London.  After humming and hawing I took the plunge and made an appointment.  That turned out to be a lifechanging decision for me.  My debilitating symptoms virtually vanished by simply buying a big bottle of Vitamin D capsules and being prescribed HRT.  I realise that this solution is not for everyone and there are still concerns about HRT, but I have been very fortunate (so far) and rapidly started to get back on track and felt normal again.  I still need to have a quick occasional snooze on the train on the way home from the office and working with Zoom/Teams for the last couple of years has not necessarily cured me of forgetting of people’s names when I see them in person, but I feel I am able to do my job again and cope with whatever life throws at me.

• What would you have changed if anything?

So many things!  I would have actively looked for more information, challenged my GP, attended webinars/talks on the topic, joined support groups, spoken about the topic openly.  Importantly, I would have had far more appreciation of what women are undergoing at this point in their lives and have been more supportive.

• Did you change anything about your way of working, as a result of, or to help with, your symptoms?

Before I was prescribed HRT, I foolishly didn’t – I just soldiered on.  However, I would recommend that women do spend time thinking carefully about how to adjust their working patterns and talk to their line managers about what would work for them e.g., a later start time if they have experienced a really restless night or working in short activity bursts rather than sitting at a desk all day.  Exercise, fresh air and looking after yourself is so important.  We are also very fortunate that the new ways of working are actually helpful in that tiring commutes back and forth to the office everyday can now be minimised.  I also write everything down now in a paper notebook to prevent me from forgetting what I’ve promised or need to do!

• How would a greater awareness in the workplace have helped you?

Immeasurably.  I felt a bit of a freak and that I was the only person who wasn’t coping.  Sadly, many women experience similar disinterest from their GPs and although the stigmas surrounding this life stage are now being more openly discussed, workplaces need to be supportive and a safe space where women can be open and honest about the symptoms and challenges they are experiencing.  It is such a challenge to recruit and retain experienced women that workplaces should do more to support them by making adaptions where necessary.

• What advice would you give others, both those going through the menopause and their colleagues, managers?

Recognise it is a normal ‘condition’.  Most women will experience symptoms of some sort.  Be kind and forgive those who might snap without knowing they have or are seemingly forgetful.  Allow women to adjust their working patterns where necessary and don’t expect them to sit through hours and hours of meetings without breaks.  Plenty of cool ventilation is also a good idea.  Encourage everyone of every gender to talk about the topic openly and respectfully and attend training on how to be supportive.  It does pass and women don’t go through it forever.

• Could you tell us about your experience of menopause, and how it affected you at work?

With the menopause, there are so many symptoms that you may not realise are because of your drop in hormones. I got a few hot flushes, they were mild and maybe occurred after having a cup of coffee, so easy to deal with, by dinking de-caff tea and coffee. Sweating at night was worse and is more like a burning feeling.

When I was in my early 50’s, I went to the GP as I thought I had thyroid problems (my mother has underactive thyroid, so not entirely random), as I was always feeling tired, my nails were flaky and breaking, my skin was very dry and I had hair loss both on my head and body. The doctor gave me tests for thyroid deficiency, I had tests for iron deficiency, tests on my hands and feet as they were sore and tender, even x-rays for arthritis. They all came back negative and there was no mention by the GP that these issues could be connected to the menopause.

There are so many symptoms that you have that you don’t realise are related to the menopause. For example, another symptom I had was dry eyes, which the optician thought was to do with me wearing contact lenses, even though I have been wearing them since I was 15. I also started with hay fever. Some of the worst symptoms were not remembering things, getting a lot more anxious about things that never used to bother me and losing confidence. I got nervous about driving on the motorway, for no reason and scared of flying, when I used to love flying. I can thoroughly recommend the EasyJet ‘Fear of Flying’ course which was amazing and really works.

The other thing that was very difficult was waking up in the early hours of the morning, I bought a 100% wool mattress, tried lots of herbal remedies, gave up caffeine, diary, sugar, took up yoga, everything I could think of to try and get more sleep. I’ve since found out that this is due to the release of different hormones, so anything I did would only help slightly.  For me, these symptoms were gradual and crept up on me.

I eventually read something about a menopause clinic in Stratford upon Avon, they were brilliant and I had an initial 45 minute consultation about my menopause symptoms and the options that I had.  Following this, I started taking HRT. After 2 days on HRT if felt as though my brain was lit up like the lights on a Christmas tree, and I slept through the night for the first time in ages. I stopped feeling so old and my quality of life is so much better.

At work I hadn’t really said anything about the poor sleep and just carried on. I didn’t realise that this was connected to the menopause. If I had have known then I would have asked if I could have come in later and worked later, on those days that were particularly exhausting.  Fortunately, I have a supportive line manager and colleagues, so I have discussed symptoms with them since I’ve been on HRT.

• How would a greater awareness in the workplace have helped you?

We need to talk about the effects of the menopause and that it is not just hot sweats and needing a fan. If people knew it would make such a big difference. It was 4 years before I went to the GP, it is a creep of symptoms and things creep up on you.

• What advice would you give others, both those going through the menopause and their colleagues, managers?

My advice to others would be – talk to someone about your symptoms and the menopause - your partner, a friend, a colleague, your mother and daughter. Find a GP who is a specialist, the Balance App is good for logging symptoms to take to your GP. Read up on the other symptoms, for example the anxiety, loss of confidence, brain fog, it is not just hot flushes.  Read the University menopause policy and watch the online training session and talk to your manager, to see what can help you at work. I chose to take HRT and I found that extremely helpful, so that may be an option for you.

• Could you tell us about your experience of menopause, and how it affected you at work?

I am peri-menopausal at the moment. In the last 2-3 years my monthly cycle has become very heavy for the first 2-3 days. I get very heavy bleeding and have to change my sanitary wear every 1-2 hours. It is so heavy that I don’t feel comfortable leaving the house which can be very isolating. I’m normally a very active person and having to restrict my activities, e.g. swimming, is frustrating.

I am now under the care of a gynaecological team and they have found a large fibroid. I don’t yet know what my options are regarding treatment, other than that I can’t use HRT or hormone therapy. There may be a possibility that I will need surgery. It has impacted my iron levels, so I am now taking iron tablets on a daily basis.

My line manager is understanding that there might be days when I would ordinarily be in the office, but instead need to work from home as the commute is just too difficult when I have heavy bleeding.

The only other menopausal symptom I have is low level anxiety.

I talked to my mother about her experience of the menopause. She didn’t have any major symptoms so I can’t follow her experiences. I have met other people in the area where I live who also have fibroids, and it’s been helpful to share our experiences of this condition. There is apparently a menopause specialist at our local surgery but my GP hasn’t referred me to them yet.

• Did you change anything about your way of working, as a result of, or to help with, your symptoms?

Nothing has changed dramatically other than that, occasionally, when I’m supposed to be in the office, I will request to work from home instead. Post-Covid, the increased flexibility to be able to work from home has enabled me to be able to work from home when I need to. This way I can still continue to work. Without this flexibility, if I had to come into the office every day, I guess I would have had to take sick leave.

• What advice would you give others, both those going through the menopause and their colleagues, managers?

Be as open as possible with the people you work most closely with, so that they can be more understanding about your situation and can work with you to find a working arrangement that works best for you.

• Could you tell us about your experience of menopause, and how it affected you at work

In my late thirties I started to suffer from mood swings, exhaustion and low mood. At the time I thought I had chronic fatigue or depression. I managed to keep working but the rest of my life ground to a halt for six months or so. My doctor was supportive, and I was treated for anaemia; at this time my periods also started becoming irregular, but I didn’t immediately associate this with peri-menopause because I was so young.

My colleagues at my then-employment were supportive and allowed me to change my work patterns as needed (eg to go home if I was completely exhausted, or do shorter days).

• What would you have changed if anything?

I wish I had known more about peri-menopause and realised that this could have been what was causing the problems I was experiencing. Eventually I had a conversation with my mother (not so easy as she is of a generation where such things tended not to be talked about) and discovered that she too had had an early menopause. So I then got some books out of the library and everything started clicking into place.

I was lucky that I had a very supportive (female) GP, who arranged for blood tests to confirm the onset of peri-menopause. We discussed HRT but I decided not to go down that route as my symptoms were manageable.

• Did you change anything about your way of working, as a result of, or to help with, your symptoms?

What changed more than my actual way of working was my mindset. I realised that I needed to start looking after myself better and getting a better work/life balance (I was working very hard in a fairly stressful environment at the time). This was one of the reasons I left that job and ended up at the University. I learnt to prioritise my sleep, healthy eating and lots of exercise. This helped me manage my mood and my energy levels, which in turn enabled me to continue working well and positively.

• How would a greater awareness in the workplace have helped you?

Luckily the place I worked at the time was very open and supportive – there were several women going through these experiences at the same time and we were able to laugh about the hot flushes and brain fog, and about the fact that the men wanted the windows in the office closed and we wanted them open! This made a huge difference as we didn’t have to hide what we were going through or try to explain away how we were feeling and reacting to things.

• What advice would you give others, both those going through the menopause and their colleagues, managers?

To those going through the (peri)menopause I would say: get all the help you can – including getting referred to a Menopause Clinic if appropriate; don’t feel that you have to apologise for what you are going through – it isn’t your fault, it is natural and although it can be a horrible experience and a real challenge, there is life on the other side. Link up with other women going through the same thing so that you can talk to people who really understand it.

To female colleagues not yet at that age: read up on it! If you can, talk to your mother or to older sisters about their experience. Forewarned is definitely forearmed.

To colleagues and managers: menopausal women should be given the same respect, support and space as anyone else going through life changes (eg think about how we treat – or should treat – pregnant colleagues). Read up on it (especially if you are a man or have not had direct experience of menopause yourself) so that you can be sympathetic and offer appropriate support.

• Could you tell us about your experience of menopause, and how it affected you at work?

It is difficult to say when my symptoms started. I was on antidepressants and in retrospect I wonder if I should have been on HRT instead.

I really started to notice symptoms during the lockdown.  It was a stressful time work wise, and I didn’t know if I was stressed and anxious due to that or something else. I started to piece it all together a bit more as the menopause was in the media more and I realised that was what I was going through.

For me it coincided with the lockdown, I might have had a few hot flushes pre-lockdown but they weren’t as bad as some women. It all increased during the lockdown, I had an increase in stress and anxiety, memory issues and I wasn’t able to sleep. I couldn’t think clearly and it felt like I was losing myself. I also started to have extreme fatigue, which is partly sleep deprivation but it is more than that and not like anything I experienced in the past.

I went to occupational health, and they were really helpful and reassuring. We made some adjustments to my work when I returned to the office. Normally people are in 3 days a week since returning to the office, but on their recommendation I am in 2 days now which really helps.

After discussion with occupational health I decided to go to the GP as well. They were actually really helpful. I had been preparing myself for a battle based on what I had heard from other women.

One of my other symptoms is very heavy periods.  I always used to have painful periods, but they started to get so heavy I couldn’t leave the house for the first 2 days a month due to the bleeding. This was during lockdown and I really worried about going back to the office. The GP recommended I have a coil fitted which has helped. The GP also recommended taking a low dose of oestrogen for my high anxiety. The anxiety levels are much less now and it has helped with the fatigue. The oestrogen made a noticeable difference almost overnight.

I always read a lot about women’s bodies and health issues, but I still wasn’t aware of the perimenopause until a few years ago.  Most of the time when we are talking about menopause issues we are really talking about the perimenopause as the menopause is a year after periods cease.  For me the perimenopause has been going on for at least 3 years already.

• What would you have changed if anything?

I might have gone to the GP sooner and tackled that, rather than antidepressants I might have gone for HRT. I had a bias against HRT, like a lot of women my age I think, because there was one flawed study which caused a lot of anxiety about the danger of taking HRT.  I also avoided it as I had bad experiences being on the pill and the contraceptive injection. It does depends in a large way how receptive your GP is though, and I was lucky.  I have moved and now go to a smaller GP practice which is great. When I started the perimenopause I was at one of those large practices where you are unable to get an appointment and you don’t feel listened to by any of the GPs. I understand that GPs are under a lot of pressure but it doesn’t make things easy if you have limited time or aren’t sure what is going on.

• Did you change anything about your way of working, as a result of, or to help with, your symptoms?

I changed to working only 2 days in the office, post lockdown. I also start and finish early which makes a  difference for the commute.

• How would a greater awareness in the workplace have helped you?

I suppose for me, I worried about seeming unviable. I felt quite vulnerable raising it. My colleagues were great and very supportive, but I worried that I was presenting as being unable do the job any more due to what I was experiencing. I know a lot of women resign at this point. My department were sympathetic and are finding ways of dealing with it, when other workplaces they might not and may write a woman off.

• What advice would you give others, both those going through the menopause and their colleagues, managers?

Listen to people; everyone’s experience of it is going to be different .

If you think you might be going through it, look into it go to occupational health and your GP. Hopefully the GP support will get better but it can still be a bit hit and miss read up on it too, in case your GP is not supportive or helpful.
Find out about what is going on, it isn’t just you and there are other women going through similar things. We need to get better at talking about these things, we tend to suffer in silence about it. There is a very Victorian attitude about it, we have started talking more about periods in the offices as we have a lot of field work and we need to talk about it and the access to toilets so staff can be supported in their field work. Hopefully that is breaking down the barrier for talking about periods and women’s health.

• Could you tell us about your experience of menopause, and how it affected you at work?

I’ve been experiencing symptoms for about 18 months.  Mainly, these include joint pain, fatigue (due to waking in the night or waking very early), occasionally forgetfulness!  It got to the point where I would get out of bed in the morning and my ankles were so stiff and painful I couldn’t walk properly across the bedroom or down stairs, and I was finding that I couldn’t unscrew lids on jars because my thumb joints were painful, this is the main thing that prompted me to speak to my GP as I’d never experienced this before.   I also wake more often at night, something I’ve never really struggled with, and that means by mid-afternoon I can struggle with concentration through a long meeting!  I get out most lunchtimes to walk the dog, this really helps as it’s a good break from the desk and fresh air.  Days where I can’t do that, I really notice the effect of tiredness!  Occasional forgetfulness may come mid-sentence, or not being able to recollect a conversation I had last week for example.  Irritating at best.   

• What would you have changed if anything?   

I haven’t spoken to my manager about this in depth, however, our team recently introduced Wellness Action Plans and I felt able to write down ‘I’m peri-menopausal, and these are the things that affect me and what would help me…’ it made it an easy thing to say. 

• Did you change anything about your way of working, as a result of, or to help with, your symptoms? 

Working from home is really helpful – as mentioned, I can get out for a purposeful bit of exercise at lunchtime, something I do less when I’m in the office.  I use OneNote for all my meetings now, it’s superb with having my meeting notes so well organised, so if I do forget anything, it’s captured.  And it’s better than a note book, because I can use the Tasks function to just add things to my to do list so I don’t forget anything.   

• How would a greater awareness in the workplace have helped you? 

I am glad to see the Menopause Policy and guidance which has come out.  I think more needs to be done at a University level to raise awareness of Menopause as it’s still not widely talked about much.  The University should take the lead here, particularly as one of its aims is attract and retain senior women.

• What advice would you give others, both those going through the menopause and their colleagues, managers? 

If you are experiencing symptoms, reach out for support.  I think everyone should watch the two Davina McCall documentaries [Available from All4 Sex, Myths and the Menopause and Sex, Mind and the Menopause]!  They will inspire you to seek support, they will also help others understand the broad range of symptoms associated with menopause, if you can be empathetic and understanding, this really is the best you can offer to start with.  I went through my GP to obtain HRT, it took a while but she was really understanding and helpful.  I have only just got it and hope that it will help with my symptoms (and perhaps avoid some that I haven’t experienced yet).  Don’t suffer in silence.  Speak to your manager, or HR team, your GP, a trusted friend, if you are struggling with symptoms

• Could you tell us about your experience of menopause, and how it affected you at work?

I started late 2019 with the symptoms. They were mild to start with, then I was not sleeping, getting hot flushes but the worst thing for me was the mental aspect and the memory. I found this hard to manage at work. In my role I am talking to people all the time and conversations will continue after that day, I was struggling to remember the conversations and I started to feel I was going a bit mad. My memory had always been fantastic and that felt so strange to me to lose that part of me. I felt like a failure in my job and was I stressed at work.

I have a great line manager, who I can be open with and she’s slightly older so had been through it all and she was very supportive and understanding. I felt that I wasn’t doing a good job and completely failing at work, she reassured me that this was not the case.

I wasn’t sure that it was the menopause after my symptoms started, it got very busy with the pandemic. I just kept telling myself it was just stress and I was too busy. When I spoke to my doctor, they said that I was definitely perimenopausal. The symptoms were just after I had turned 40, so quite early. I spoke to my mother and she had been considered young when she went through it but she was older than I am now.

People said to me 'you are far too young for that' but we should all be aware it can affect you at any age. In my mid-30s I had been tested for early menopause, so had that awareness in the back of my mind. I just didn’t join it up fully.

I have been taking HRT since April and the doctor was great. She said you don’t have to have HRT, there are lots of things available, especially for perimenopause. I was not hesitant at all about trying HRT, I know some people feel that they don’t want to take any HRT. For me it’s going very well so far, I feel like I have my brain and memory back! It’s amazing. It helps with the sleeping as well. HRT has helped more than I expected.

• What would you have changed if anything?

I would have spoken to my doctor earlier. If there was more general awareness, I think I would have realised earlier what was going on, and I would have gone earlier.  If it was discussed the same way we do with mental health then there would be greater awareness and understanding.

• Did you change anything about your way of working, as a result of, or to help with, your symptoms?

I took some time off work on days that were difficult. If the anxiety became too much and I became emotional and started struggling. My manager was great, she would quickly tell me to take time off and take myself away for a bit. I have also changed my working pattern to do a 9 day fortnight, this time away from work really helps.

• How would a greater awareness in the workplace have helped you?

Yes it would have helped. I did discus it in the rest of the team once I felt comfortable doing that, some of my colleagues are the same age or older but my younger colleague didn’t know what the symptoms were. They had no awareness really for the symptoms and they were interested to hear about it, we should be ensuring that we raise awareness for people at all ages.

It’s going to happen to all women and some men, so everyone should be aware of the menopause as they get older. It is very important as line managers that they are able to spot it in their staff. It is important that everyone is aware of it and that it’s ok to talk about it.

• What advice would you give others, both those going through the menopause and their colleagues, managers?

To anybody going through it; talk to your GP as soon as you can and talk to others. Usually somebody is going through what you are going through. For line managers; just be aware that this thing happens to people and that its ok to talk to somebody about it if you think that they are suffering with symptoms.  Even just acknowledging that it happens removes some of the stigma.

• Could you tell us about your experience of menopause, and how it affected you at work?

After years of good health, suddenly being diagnosed with intermediate prostate cancer in 2019 was a shock. I chose the treatment option of hormone therapy and invasive radiation, as it meant I would need the least time off work; rather than undergo a hi-tech surgical operation requiring protracted recovery. Cancer of the prostate feeds on testosterone; blocking testosterone through hormonal injections reduces the prostate in size, making it easier to zap with pinpointed radiation. However, the hormone treatment induces symptoms that are very similar to menopause (see Side effects of hormone therapy | Prostate Cancer UK) so I knew that there would be these side-effects but not quite what that would bring.

I adopted a stoical resolve to the very real prospect of an early death, which friends were surprised by and admiring of, but I was only to learn that it is all too easy to fool ourselves. I suffered hot flushes but, because I worked outdoors in a physical job at the time, I was able to manage these at work.  But at home or when out at indoor venues I would have to sometimes remove many layers of clothing and would feel very conspicuous.   I suddenly found myself having to pee every 40 minutes, which was really challenging at work but I was lucky that colleagues were supportive.  My emotions were often heightened, although I concealed this - blokes will be blokes whatever is happening to their hormones. Much of the time I was fine, but when things became too much at work, I went and cried alone in the toilets. Nights were regularly tearful and I know I often seemed like a lonely lost child to my wife. The hormones caused other physical changes which were really distressing. The loss of testosterone changed my temperament everywhere but, more positively, I became more accommodating and less rigid.  However, the treatment was effective and I was to make a good recovery in every respect.

• What would you have changed if anything?

At the time I felt I didn’t want pity or additional consideration from co-workers and so I only told my manager about my cancer, and I didn’t mention the corresponding menopause-like symptoms and their impact on  me at all. In retrospect, I should have made the briefest potted announcement to all work colleagues, requesting understanding (although NOT sympathy which I didn’t want).  This might have helped prevent some unnecessary “unfriendly fire”, when colleagues didn’t understand my changed behaviours and I found myself facing a nasty spurious allegation at work. I was so deeply upset by this; life does not stop to accommodate ill health.

• Did you change anything about your way of working, as a result of, or to help with, your symptoms?

After falling off a pair of dodgy steps and fracturing my pelvis, I realised that I needed more protein and calcium to make up for the testosterone loss. I had a physical, outdoor job which required strength and so I revolutionised my diet, substituting carrots for bread at lunchtime and I ate a daily tin of sardines, which I hated! I cut out sugar almost entirely, even now I almost never eat biscuits, cheap chocolate or confectioned cake. I learned that my fatigue was effectively combatted through exercise and not rest. I joined a Pilates class which made muscles fit that I did not know I had. I ran a mile every day. I started soul dancing again - first for 30 minutes and then for an hour every day – it kept me so fit and took my mood upwards. I walked in beautiful landscapes and this nature derived centring was deeply beneficial.

• How would a greater awareness in the workplace have helped you?

When I was shown kindness at work, this went a very long way. After work one evening, a colleague who had lost her husband, shared her philosophy with me of looking to be happy above all else in life, this raised my spirits and heartened me. Given my outdoor job the hot flushes didn’t matter at all at work but in indoor environments if I overheated during a ‘flush’ I felt very conspicuous when I had to take my top half off, down to my white underwear T' shirt. My wife spontaneously bought me stylish T’ shirts that I could wear under my shirts and that left me presentable when needing to strip down to them. I often think back on this single act:  it is this type of practical kindness, from any quarter that made such a difference.

• What advice would you give others, both those going through the menopause and their colleagues and managers? 

To those going through major hormonal changes I would say that whilst we no longer talk about ‘the change’, for me it was completely ‘a change of life’. It was really challenging but the positives are that I don’t hide my intelligence any more, nor feel the need to display it. I began writing. My marriage is very different now and I am infinitely closer with my wife.

To colleagues and managers I would say simply stand back, be kind, supportive and patient, whilst continuing to affirm your own space. If you are invited to become a confidante, share your own heart - but most of all - like a pot plant in the corner of the office , water it, add nutrients occasionally and ‘let it grow’... enjoy your new colleague as they mature and develop. Not only will they remember this, but they will remain endeared to you afterwards.

• Could you tell us about your experience of menopause, and how it affected you at work?

I have already had 2 menopauses as a result of medical treatment for endometriosis: one in my 20s and a second in my late 30s.  And now that I’m in my 40s I am en route to a 3rd natural menopause.

In my 20s I was diagnosed with endometriosis and, after exhausting all other treatments, my doctors put me onto a drug called Zoladex.  This is a hormone therapy, and when used for endometriosis (it’s also used to treat prostate cancer in men) it works by essentially stopping your body from producing oestrogen, therefore putting your body into what’s called a medical menopause. As a result, I experienced the vast majority of the 40 or so known symptoms of the menopause!

During my first menopause I didn’t talk to anyone at work about it.  I was not anywhere near the age group where anyone would expect that this was what I was going through, and it wasn’t something that was talked about so it was a lonely experience. 

By the second time I went through menopause I was doing my current teaching job, here at Oxford.  Anxiety and hot flushes are really problematic when you have a role where you can’t easily adjust your work plans at short notice, and where you are really visible all the time.  When teaching I am often at the front of a room standing by a screen which pumps out quite a lot of heat so that can be really uncomfortable.  It’s difficult for people who haven’t experienced them to understand what a hot flush is like and that it isn’t just being hot.  Normal heat is something that usually affects your body from the outside in – so you can move away from the source of the heat.  With a hot flush it’s like it comes from the middle of your body, so it’s much harder to deal with and much more uncomfortable.

• Did you change anything about your way of working, as a result of, or to help with, your symptoms?

By my second menopause I was more prepared to deal with the symptoms.  This coincided with the pandemic and the move to remote working which actually made things so much easier for me.  For example, if I was having bad hot flushes I found I could set myself up to teach from my kitchen which has a tiled floor that stays really cold, so I could stand on the floor in bare feet or change into lighter clothing or keep ice close to hand to help manage hot flushes. So being able to teach virtually was a real godsend for me. 

I have also got more skilled over the years at finding tactics to make things easier for myself. For example, if my brain fog means that I know the answer to a question but just can’t grasp the right word in that moment, I will say ‘excellent question – we’ll come back to that later on’.  And where I used to teach without notes, I now know that I sometimes need to work in a different way. So, I have drafted speaking notes, prompts, or lists to make sure that I don’t put myself in the position where I might lose my thread.  I have also found it really helpful to work with a colleague, or colleagues, who I can talk to in advance and explain what I find helpful and supportive.  For example, I’ve talked to the two male colleagues I teach with most regularly so they know that if I dry up because I’ve temporarily lost a word I need, I will welcome them stepping in to fill in the gap for me. That makes it a supportive and stress-reducing thing, rather than a stressful situation where they might worry that I would find it intrusive if they jump in. We also have a back channel in the meeting where I can ask them confidentially for help, or they can offer it.

In addition to causing the full range of symptoms of menopause, Zoladex also drains calcium from your bones, so I took up a variety of exercise paths to help improve my bone density. I was fortunate to have some gym equipment at home and found weightlifting really beneficial, for both my physical and mental health.

• Looking back, what would you have changed, if anything?

The first time I went through menopause I wish I had known more, and that there had been more information. Even just about things like tactics for managing hot flushes, such as wearing natural fibres and layers. It would have been good to be more prepared, and to have a network of other women to talk to and share experiences. Also, I would definitely have talked to my colleagues and managers about this much earlier on! Having supportive colleagues who might then know what to say or not to say would have been great. For example, because of my age colleagues would sometimes ask me if my symptoms were because I was pregnant - which was upsetting.

The second time I told everyone! Even though a lot of my work as a teacher is done alone, knowing that my colleagues know what’s going on and can offer the right support is much better.

After my second menopause I had a hysterectomy and found a support group on Facebook and that was really good – being able to talk to people going through the same thing is really powerful so I would definitely look out for menopause support networks and groups.

• What advice would you give others, both those going through the menopause and their colleagues, managers? How would greater awareness in the workplace have helped you?

To those going through it I would say tell people, but in a way that works for you. I found that I got, and still get, very emotional when talking about it, and that talking face to face can be harder than maybe writing an email.  Also, if you want to talk to someone about it, letting them know in advance what you want to talk about can be easier than having to find the words to broach the subject face to face. It also gives them a chance to prepare for the discussion themselves. I would say, try to be open to offers of support – such as discussions about how you would prefer to be supported on a bad day – as this will make things easier for everyone, not least yourself.

To colleagues and managers, I would say that, as well as being informed about who might be affected and supportive, it’s great for colleagues and managers to try to be a bit proactive. People are often really supportive but they frequently ask ‘what can we do?’.  For someone going through menopause, it can be difficult to be expected to come up with the solutions. With symptoms like brain fog, anxiety, loss of confidence, it can be difficult to really work out what you need, so it can be helpful for managers or colleagues to really listen to what your symptoms are and how they are affecting you and suggest solutions too. For example:

• ‘Would it help if we got you a fan or put some ice packs in the fridge?’ 
• ‘Would it help if you worked remotely when your symptoms are bad?’
• ‘If you want to leave your camera turned off in meetings if you are having a bad day, that would be OK’

 And, to perhaps suggest things in a way that doesn’t target individuals.  For example, making sure that there are breaks in longer meetings might be important for many people for lots of different reasons. 

• Tell us about your experience of menopause and how it affected you at work?

I'm 44 and for about 18 months had been experiencing symptoms which were having a major effect on my work and family.  The main symptom was crashing fatigue. At sudden notice I would feel like my batteries had been taken out and I needed to lie down (including mid-way through a 2 hour seminar for 40 students which I had to halt, as I simply couldn't continue). My energy levels were so low that I couldn't cycle any more (despite being generally fit and many years of cycling).  My husband had to drive me to and from work, and I had to take a nap when I got home in order to have enough energy to make supper for my kids.

On top of that, having been someone with very high drive and energy, I lost my confidence.  I developed anxiety, low mood, and most devastatingly, as an academic with a tenured role in a field I love, I started to feel I was losing interest in my work. 

My GP diagnosed burnout and I made major lifestyle changes to try to tackle this.  I tried yoga therapy, more exercise, more rest, and managing my workload but despite all this many of my symptoms persisted, and some new ones started or got worse. Most worrying (for me) were cognitive symptoms such as brain fog / poor concentration / memory lapses. On bad days, I simply couldn’t write sentences: drafting a short email would take enormous energy / effort. I couldn’t concentrate enough to read a page of an academic article. I would lose my train of thought or even ability to spell or add up in the middle of teaching a group of students.  Fortunately, I have enough teaching experience to be able to mask this by making a bit of a joke about it with my students, so these episodes didn’t affect them, but it really shook my confidence.  My symptoms weren’t continuous - some days were 'normal' but on many others I just couldn’t work. It was really unnerving.  

Eventually friends suggested I read up on perimenopause.  It had not occurred to me that what I was experiencing might be related to menopause but, as I read, I found other women's stories super helpful and I recognised myself in them.

Armed with this knowledge I went to see a different GP.  After tests to rule out other causes, she agreed perimenopause was likely to be driving my symptoms and that I should try HRT. At this point I had been experiencing symptoms for about 18 months and after just a couple of months of HRT I have found an absolutely enormous reduction in my worst symptoms and feel that I am getting myself and my life back.  And my family and partner are also getting me back.

• Did you change anything about your way of working, as a result of, or to help with, your symptoms?

Before I knew the real cause of my symptoms I was forced to change lots about how I worked and managed my work-life balance, just to keep functioning.  My husband and I had to organise our day so that he could drive me to and from work.  Having been someone who would always rise early and get a couple of hours work done before the family and work day began I became someone who had to take lots of naps, and I found I needed to spend a good 12 hours a day in bed, and would find that by the afternoon I was literally counting the hours before I could go to bed and sleep. I had to push through even simple tasks and felt like I was fighting my body at all times.

I found myself in discussion with a senior colleague about progressing my career and although my ‘normal self’ would have been delighted at this, my new self felt there was no way that I could consider something I had worked so hard to achieve because my energy levels were so severely impacted.  I felt so low that I had actually got as far as looking up the long-term sick pay arrangements thinking that I might need to call on them as I was not sure that I could carry on working, and not sure that I would ever feel well enough to do the job properly again.

Now that the HRT is starting to take effect I am seeing really positive effects – and my normal home and work patterns are being re-established. My energy levels are returning and I’m recently back to cycling.  More importantly, my cognitive abilities are returning to normal, and I am thinking about the future positively.  However, whilst generally things are improving, I do still have bad days and these are unpredictable so I don’t yet feel I can rely on my body and brain in the way I did before. So now I plan to allow myself space in case of a bad day - for example I plan a bit of extra ‘rest and recovery’ time into work trips to make sure that I’m functioning at my best at a conference or meeting.

• Looking back, what would you have changed, if anything?

I just wished I had known was it was much sooner.  The fact that I didn’t get a proper diagnosis for my symptoms meant that I felt I lost myself for 18 months, and also lost a crucial period of career development.  If I had understood that perimenopause can bring so many cognitive as well as physical symptoms I would been in a better place to seek the medical advice and treatment that I needed much earlier.  And I wouldn’t have had the deep worry that I might never get better.

• What advice would you give others, both those going through the menopause and their colleagues, managers? How would greater awareness in the workplace have helped you?

For individuals, managers and colleagues, awareness of menopause and all the symptoms is key.  We need to get the message out there as much as we can to make sure that women are able to recognise their symptoms, and get a proper diagnosis and treatment as early as possible.  But we also need to dispel some of the myths that talking about menopause makes women look like a workplace problem, so that we can ask for the support we need.  Look at what women have achieved without support on this, and imagine how much more we can achieve if we are properly supported! If I had understood that I was perimenopausal earlier I wouldn’t have lost 18 months, both personally and professionally.  The more we talk about it the better!

For those going through it I would say get as much information as you can. I have joined the University’s menopause network and sharing experience and knowledge really helps.