Menopause in the workplace: One in four women consider quitting due to symptoms
One in four women considers quitting their jobs due to menopausal symptoms, yet human resource and employment policies, in Kenya and globally, lack an elaborate clause to address this reality.
What you need to know:
- Globally, most workplaces lack policies for menopausal women, but some companies like Standard Chartered Bank are embracing menopause support.
- Studies say four women consider quitting their jobs due to debilitating symptoms of the condition, according to research.
- From heart palpitations to memory lapses, many women silently grapple with diverse challenges.
This is the second of a four-part series on menopause
At the beginning of May, 2024, Hollywood award-winning actress Helle Berry made headlines, globally, after she shouted that she is in menopause.
“I’m in menopause, okay?” Helle shouted amid chuckles from the crowd.
“The shame has to be taken out of menopause. We have to talk about this very normal part of our lives that happens. Our doctors can’t even say the word to us, let alone walk us through the journey.”
She was accompanying Senators Patty Murray and Lisa Murkowski, and a group of other bipartisan senators as they introduced the Advancing Menopause and Midlife Women’s Health Care Act at the US Capitol.
If passed, the act will garner an unprecedented $275 million (about Ksh36 billion) towards research, care and acute treatment for menopause. The National Institutes of Health (NIH) would receive $25 million (about Ksh3 billion) annually for five years, to increase data collection and review chronic symptoms associated with this transitional period in a woman’s life.
Recently, the 57-year-old leading actress has been candid and vocal about the painful symptoms she experienced while going through perimenopause. Her doctor initially misdiagnosed her with herpes, a sexually transmitted disease that both Berry and her partner tested negative for.
As millions of women navigate these life-changes each year, many find themselves without proper guidance from the medical community on the menopause transition.
Talia* from Nakuru County is a retired teacher who started experiencing menopausal signs about 10 years ago.
“I remember suddenly becoming moody and angry — the complete opposite of my jolly nature. I suddenly hated interactions and would cry myself to sleep on most nights, not knowing exactly what was happening to me,” offers the mother of three adult daughters.
Admittedly, Talia lost quite a number of friends during this phase, as she would ignore them or just became harsh towards them for no apparent reason.
“Seeing people avoid me made things worse for me and at some point. I contemplated suicide. I felt worthless and misunderstood even by my immediate family members,” she shares.
Around the same time, her menses were very heavy and quite inconsistent. “Within a month, the days that I would have my menses were more than the days I didn’t. This was strange because previously, I had pretty regular menses with no cramping. But this phase presented serious cramping as well as large lumps of blood. I would use up to 12 pads per day.”
The irregular and painful menses are what prompted her to confide in a doctor friend, as they were interfering with her productivity.
“I was still practicing as a teacher and these painful and irregular menses were costing me my productivity. When I spoke to a doctor friend about it, she casually asked me if I was having hot flashes or mood swings as well. I had never experienced the hot-flashes. On the mood swings, however, I recounted how I was even struggling to maintain relationships.”
“She went ahead to explain to me that I was in my peri-menopause era and that whatever I was going through was quite normal. I was relieved. I got to understand more about this phase. The doctor advised me against taking any medication, as this would only retard the symptoms and they’d later re-recur bigger or more confusing. She advised me to rest adequately as well as control myself during anger bursts.”
The mood swings and suicidal thoughts would fade out after a few months. But that was not the end.
“When I was almost turning 49, the worst symptoms I have had to deal with yet, manifested. I started experiencing long-dry coughs. I would cough for up to seven minutes straight and the coughs would be so intense that I would piss myself off. This greatly dented my self-esteem,” she recounts as her voice trails off.
Experts say the same way there are globally-accepted policies around maternity, the same should apply to menopause.
She says she resorted to wearing maxi- dresses, afraid that the piss smell would be detected. She also started wearing pocketed-sweaters to carry extra pants around because she would often change them after a coughing episode.
“This lasted for about seven months. I am glad I had the doctor friend walk with me through this phase. Otherwise, I doubt I would have made it out on my own.”
The last couple of years have, however, been smooth for the 59-year-old. She no longer has her menses and is more intentional about her rest as well as maintaining healthy relationships.
Judith*, a communication specialist and media/podcast trainer, is in the middle of her peri-menopause phase. She is 49, and at her career-prime as she aspires to take her professionalism abroad. Judith is childless and so, all her life, could predict her menses, up until she turned 47.
“First, I started having funny headaches, and then very bad fatigue started setting in in my 47 going to my 48. I immediately sought medical help but unfortunately, I observed that even doctors haven’t grasped this phase just yet and the chances of a misdiagnosis are quite high,” she opines.
She observes that she suddenly became grumpy when she woke up around 5am or 6am and never wanted to talk to anyone until around 7am or 8am.
Read also: When menopause knocks on your door early
“I then started having heart palpitations. I am a plus-size and my first thought was that I was in pretty bad shape in terms of weight or was suffering from a heart-condition. Other times I would wake-up in the middle of the night with a stomach ache. I would also continuously experience a fainting feeling,” she reflects.
“It was a roller-coaster for me as one extreme symptom after the other hit and I wasn’t getting any concrete help from the hospitals.”
“I remember one day casually telling an older friend that I thought I would die. Having the casual conversation with my friend, however, changed everything for me,” Judith says.
Her friend explained that she was going through menopause and that she needed not to worry.
“She introduced me to a fibre-rich diet to subdue the symptoms and guided me on the best exercises. She further pointed me to an organic supplement that I have used to date. It eased out all the weird pains, leaving me to battle the extra-heavy menses only.”
“Sometimes I change one-pad per hour- translating to 24 pads a day. This is not only costly, but when I am having these menses, I hardly leave the house. I do not even go to church,” she says with a distant look in her eyes.
Pre-menopause and perimenopause
According to a Healthline study, menopause officially marks the end of female reproduction. It officially occurs when women stop menstruating. Perimenopause, on the other hand, means “around menopause.” It’s also known as the menopause transitional phase, occurring before menopause.
Pre-menopause and peri-menopause are sometimes used interchangeably, but technically, they have different meanings. Pre-menopause is when you have no symptoms of peri-menopause or menopause. You still have periods — whether they’re regular or not — and are considered to be in your reproductive years. Some hormonal changes may be occurring, but there are no noticeable changes in your body.
On the other hand, perimenopause, onsets the symptoms of menopause. They may include changes in the period cycle, hot flashes, sleep inconsistencies, and mood swings, and weight gain, among others.
Dr Grace Kanyi, a consultant obstetrician and gynaecologist based in Meru County, sys menopausal symptoms start manifesting in mid-to late 40s, when women are in the prime of their careers. For some, the symptoms can also occur in the early 40s.
Worryingly, one in four women considers quitting their jobs due to menopausal symptoms, according to the Wellbeing of Women survey in 2016. Ironically, human resource and employment policies, in Kenya and globally, lack an elaborate clause to address this reality.
Group Human Resource (HR) expert, Danson Maina, says he has never heard of any policy relating to menopause.
“I have been in HR for 14 years now and I have never heard of a policy that addresses menopause. We treat menopause like any other illness catered for under the sick-off policies in employment.” He also admits that he does not know the extent to which menopause could affect a woman’s productivity at work.
Standard Chartered Bank
“This could be because even the affected women choose to be silent about it. Menopause is still a taboo topic and probably that is why they opt not to share. It is a good thing that the topic is now coming up as it would be important to know how to adjust employment policies to accommodate this demographic.”
Standard Chartered Bank is among the pioneering organisations that has a comprehensive menopause cover for all its employees in place, globally. The bank also trains male staff so that they have an equal understanding of this phase. The institution promotes workplace adjustments for menopausal colleagues, by providing them with fixed desks or cooling fans, and recognizing the importance of creating an environment that accommodates their unique needs.
Evans Munyori, the Head of Human Resources for the bank in Kenya, says the initiative reflects a deep commitment to addressing the challenges faced by women navigating the overlooked transition of menopause.
“In collaboration with the Financial Services Skills Commission (FSSC), our bank has undertaken a deep dive into understanding how menopause affects women in the workplace. Our findings are shocking: 75 per cent of women experience menopausal symptoms, with 25 per cent facing severe challenges that adversely affect their perceived quality of life and work. Further, one in four women even consider leaving their jobs due to the severity of these symptoms. Sadly, a prevailing culture of silence and misunderstanding surrounds the topic in the workplace,” he offers.
Munyori laments that there is limited data on the effects of menopause on work productivity.
“It is sad but we can always borrow from global studies. Having a localised view would encourage more companies to create more inclusive policies. Breaking the silence around the menopause in the workplace is not just a matter of social responsibility; it is an economic imperative,” he opines.
Jane Muiruri, the Head of Human Resource at Nation Media Group (NMG), agrees with Munyori, adding that the menopausal phase should be handled with the same seriousness and emphasis as the child-bearing phase.
“The two phases are pretty similar. They are hormone-related and affect every aspect of the woman. The same way there are globally-accepted policies around maternity, the same should apply to menopause,” she says.
She also echoes the importance of training all employees in an organisation to understand and support their menopausal colleagues.
Demistify condition
“Some women in employment suffer in silence when they are going through this phase because they might be viewed as old and no-longer capable. We need to break this stigma and stereotypes. Due to lifestyle changes, some women experience peri-menopausal symptoms as early as 35 years.”
“Demystifying menopause can be managed if we openly talk about it. Awareness for all goes a long way. Even women who are going through the phase need to be self-aware so that they can know best how to relate with those around them. The male colleagues and the younger women in employment should also be sensitised to know how to support and co-exist with their menopausal colleagues.”
Jane further advises affected women to join support groups, of people who are in the same phase as them such as in WhatsApp. This, she says, would make the journey easier as they become vulnerable with each other. It also provides the comfort and reality that they are not walking that journey alone.
A huge champion of women in menopause, Jane highlights the importance of employers adjusting their medical coverage to cater for menopausal symptoms. “Perimenopause and menopause symptoms are different for different women. They present in different ways, ranging from migraines, heart palpitations, depression, insomnia and everything in between.
Read also: Normalise talk about menopause
Women in this phase often see different doctors for different treatments, a potential to exhaust their medical benefits. Exhausted medical benefits would mean that the loss ration of the organisation goes up. To counter this, employers need to come up with elaborate medical covers to exclusively cater for menopause,” she says.
Supporting people in this life phase at work can benefit women and companies. Missed workdays related to menopause symptoms may cost companies in the US roughly $1.8 billion (about Ksh230 million) annually, according to a study by the Mayo Clinic.
How does menopause affect the brain functionality of women?
According to a post by the Washington Post, brain imaging studies of women — conducted before and after menopause — reveal physical changes in structure, connectivity and energy metabolism. The neurons in the brain that were once essential for menstruation and pregnancies are no longer needed, so the brain goes through a “renovation,” US-based neuroscientist Lisa Mosconi notes.
Neuroscientist Mosconi and her colleagues have been imaging women’s brains and have found that during menopause, the grey matter volume is reduced in areas of the brain involved in attention, concentration, language and memory. There are also declines in brain energy levels, meaning the brain pulls glucose from the bloodstream and does not burn it as fast as it used to. Further research is needed, but some of these changes could help explain some of the symptoms of menopause.
For most women, symptoms tend to be temporary and then improve or dissipate after menopause, suggesting that “the brain is adapting to its new biology,” Mosconi said. These “intelligent adaptations,” she says, allow women to live up to a third of their lives after this transition.
“Every time we talk about menopause, it’s always doom and gloom but I’m hoping that we can break the stigma and make menopause an accepted and welcomed part of a woman’s life.”
Tips to help menopausal women improve their health
Dr Mary Claire Haver, an obstetrics and gynaecology doctor and a menopause specialist in the US has three recommendations for menopausal women:
Diet: She advocates for menopausal women to get adequate fibre in their diet every day. Fibre-rich foods are good for the gut microbiome, help one stay full for longer, and are good sources of vitamins, minerals and nutrients.
Limit added sugars – Those that are added in cooking and processing – to less than 25g per day. Women who do that consistently have less visceral fat. Visceral fat is tied to increased risk of chronic inflammatory diseases.
Don’t just focus on cardio for your movement- Women in menopause need to keep their muscles strong. For at least two days a week, she recommends that they pick up some weights. Multiple studies in menopausal women show better outcomes for osteoporosis with resistance training.
Even women without symptoms need a menopause plan - A study published by the Washington Post emphasised that even women who are lucky to sail through menopause with few or minimal symptoms should not ignore the phase. At menopause, the body stops producing oestrogen and that has ripple effects such as vulnerability to bone loss, heart diseases and metabolic issues.
Avoid misinformation and hyped products - There is a lot of talk currently about menopause. It is a trendy topic and while this is helping demystify the phase, this has come about with too much misinformation. Women should be careful about their sources of information.
Further, as Jen Gunter, a gynaecologist and author of “The Menopause Manifesto’ cautions, menopause is becoming a massive business and everyone is getting in on it. As such, there are many products flooding the market all with the promise of making the transition easy. Women should consult their gynaecologist before buying these products.
*Names hidden to protect the women’s identity.
