Menopause

Why menopause matters

All women and other people who have a menstrual cycle will experience menopause and symptoms can impact home life and work life, so it's important that we have an open and honest conversation about the menopause and the support that's available. Here's some other reasons why it's important for us to talk:

• Women make up 51% of UK population.
• The Office for National Statistics puts UK life expectancy at 83.1 years for women.
• There are around 4.4 million women aged 50 and over in work, a 72% rise since 1994.
• It can significantly affect a woman’s work life, their family, and friends.

Right now, there are still too many who suffer in silence or are left frustrated and let down by medical professionals that either don't recognise menopausal symptoms when presented or refuse to prescribe the most appropriate treatments. Too many are told that being menopausal is just a natural phase of life - and while that's true, that doesn't mean we can't treat what can be the debilitating effects on the individual.

We want to break the stigma, and to ensure that everyone know what options are out there to support them through the transitions of menopause.

Menopause symptoms

There are many symptoms of the menopause, these are the most common:

• hot flushes – short, sudden feelings of heat, usually in the face, neck and chest, which can make your skin red and sweaty 
• night sweats – hot flushes that occur at night 
• difficulty sleeping – this may make you feel tired and irritable during the day 
• a reduced sex drive (libido) 
• problems with memory and concentration 
• vaginal dryness and pain, itching or discomfort during sex 
• headaches and migraines
• mood changes, such as low mood or anxiety 
• palpitations – heartbeats that suddenly become more noticeable 
• joint stiffness, aches and pains 
• reduced muscle mass 
• recurrent urinary tract infections (UTIs)

The menopause can also increase your risk of developing certain other problems, such as weak bones (osteoporosis).

Menopause Support have a useful symptom checker available, and the app provided by Balance is also useful for tracking symptoms.

Stages of menopause

In simple terms, menopause is the end of the monthly periods as the body stops producing eggs and levels of the hormone estrogen drop.

Leading up to menopause is the perimenopause. During the perimenopause, hormone levels start to fluctuate but monthly periods continue, but may be disrupted. Around 75% will experience some symptoms during this time and for some the effects can be debilitating for them and those around them. Many start to experience perimenopausal symptoms in their late thirties and early forties although they may not recognise them at the time.

Post menopause is everything after twelve months and one day without a period. Some will continue to feel the effects of menopause during this period and can continue for many years.

Early menopause

A small percentage will experience menopause at an early age - what is referred to as premature menopause. It's important to understand that there is no minimum age for the menopause and those in their thirties, twenties and even their teens may be affected.

Medical intervention may result in a woman experiencing the menopause, such as hysterectomy surgery. This is known as medical menopause. Some forms of chemotherapy and radiotherapy may also have the same effect on the body.

Experiencing menopause early in life, whether occurring through medical intervention or naturally, may have far reaching mental and emotional impacts, and support and understanding is important.

Treatments for menopause

It can be a scary time, especially when you don't know what to expect and what support is out there. The good news is that there are effective and safe treatments to alleviate the symptoms of menopause and you can access them easily through your GP or other healthcare professionals.

There are some important facts you should be aware of:

• Blood hormone tests for women and other people who have a menstrual cycle over the age of 45 are not appropriate and menopause should be diagnosed on symptoms.
• Periods do not need to have changed to indicate perimenopause or stopped entirely to access Hormone Replacement Therapy (HRT).
• Premature menopause effects 1 in 100 under the age of 40, 1 in 1,000 under the age of 30 and 1 in 10,000 under the age of 20.
• HRT can protect your long-term health and should be first line treatment for menopause.

You'll find more useful information in the information sheet provided by Menopause Support on the things you and your doctor should know about menopause.

A little about HRT

Hormone replacement therapy (HRT) is the most effective treatment for menopause symptoms, but it's been the subject of some scary headlines which may get some people a little nervous. It's important for us to talk about the facts and not rely on myths and tabloid headlines to guide the treatments that we have.

There are some important facts you should be aware of about HRT:

• It improves symptoms.
• Reduces the risk of osteoporosis.
• Reduces cholesterol.
• Lowers risk of Type 2 diabetes.
• Lowers risk of heart disease.
• For the majority under 60 HRT is safe.
• Those under 45 should take hormones to protect their hearts, bones and brain health.
• HRT is the most effective treatment for the relief of vasomotor symptoms (e.g. dizzy spells, hot flushes, palpitations etc.).
• The right HRT preparation, in the right woman, has very low overall risks and has significant benefits.

It's also important to know that there isn't a single HRT treatment, there are several types :

• Oestrogen only, or combined
• Sequential or continuous
• Tablet, patch or gel
• Testosterone
• Mirena Coil

Read more about HRT and some answers to frequently asked questions.

From the 1st April 2023, HRT will be available on a Prescription Pre-payment Certificate (PPC) - costing £19.30 for 12 months treatment. Full details available on the Government website.

Menopause & mental health

Psychological and emotional changes are extremely common during perimenopause and menopause. It's often one of the main reasons that someone is prompted to visit their GP. It's clear to see why these feelings could be mistaken for depression and why a doctor might prescribe antidepressants, but can taking antidepressants help?

Common symptoms include:

• Feeling down, or sad
• Frequently becoming upset
• Low self-esteem
• Reduced motivation or interest in things
• Feeling anxious or having panic attacks
• Increased irritability
• Mood swings

Menopause guidelines are clear that antidepressants should not be used as first line treatment for the low mood associated with the perimenopause and menopause. This is because there is no evidence that they actually help psychological symptoms of the menopause.

Despite this clear recommendation, many women and other people who have a menstrual cycle are offered antidepressants when seeking help from medical professional about their menopausal symptoms. In some situations, some medications can be of benefit, but it's important to know how and when antidepressants should be used.

Balance provides a useful factsheet on the use of antidepressants for menopausal symptoms.

Having a menopause conversation with your manager

Talking about the menopause has been taboo for way too long. We’re working with your employer to break down barriers to normalise conversations that should lead to positive change. 

Here are some tips we think will help when you need or want to have your own meaningful conversation with your line manager:

1. Think about what you want to say, and what you want to happen. Being prepared with a few notes will help you get the best out of the conversation.

2. Rehearse the conversation if you’re feeling unsure what to say – close friends or partners offer a safe space to practice.

3. Book a suitable time – don’t spring the conversation on your manager, and don’t make assumptions about their knowledge or comfort with the subject. Book a room if you’re in an office, even if you’re having the chat online. A private space gives you safety from being overheard and avoids embarrassment.

4. Keep a diary of your symptoms – jot down how they’re affecting you both physically and mentally. Try and mention specific examples wherever possible. This gives you a good basis to explain to your manager how you’re being affected and will help identify the types of support that may be useful.

5. Be clear and don’t feel embarrassed to open up. Explain what is happening, the situation and how it’s affecting your work. Remember that every woman will go through the menopause at some point, and that there are estimated to be 4.4 million women over the age of 50 in work… what we’re saying is you’re not alone.

6. Offer a solution – make suggestions on what would help manage your symptoms at work. Take a look at the support that’s available to you as a colleague or use our menopause guidance page to find out about what support is available outside of your employer.

7. Follow up – give your boss time to digest what you’ve said. They are unlikely to be an expert on the subject and may need to refer to guidance or support themselves. So, suggest a time to have a follow-up meeting to talk about next steps.

Having a menopause conversation as a manager

If you’re a line manager, you can help normalise conversations about menopause too. Research has shown that 70% of women and other people who have a menstrual cycle feel uncomfortable talking about menopause at work. Here are some tips we think will help you to make it easier for colleagues to talk openly about menopause and help identify the support need:

1. Ask questions – simple, open and non-judgemental questions will help someone open up.

2. Avoid judgemental or patronising responses – this will cause someone to close up.

3. Speak calmly and maintain good eye contact.

4. Avoid interruptions – switch off or mute phones and other distractions.

5. Give the colleague ample opportunity to explain the situation in their own words.

6. Be patient – silent pauses don’t need to be filled, let the colleague tell you what they need to in the way they feel comfortable.

7. Focus on the person, not the problem.

8. Show empathy and understanding.

9. Encourage the colleague to talk – if you can see something is wrong, don’t just ignore it.

10. Listen actively and carefully.

11. Make a note of any actions agreed and share these with the colleague or ask them to share a note of actions with you.

12. Read up on menopause and the sources of support that are available.

General support from employers

Most employers have started to wake up to the needs of those experiencing the menopause and have developed specific policies and support. Most of our members are covered by some form of menopause policy, so we'd direct you to take a look at the specific support that's available which will be clearly signposted on your employer's intranet. 

These are some of the more general things that employers can do to support.

Making smaller changes

You won't always need a big change to the way you work, and you may only need some changes for short periods of time - yet these can make a huge difference:

• A temporary change to your working pattern – this might include later start or finish times, or additional breaks. This simple change can help those experiencing extreme fatigue or who experience night sweats and have disrupted sleep.
• Working at home – being able to work from home at short notice can help following a disrupted night or through heavy periods. Being able to switch your camera off in online calls provides some control back during hot flushes.
• Helping you keep cool – for example, allowing you to move to a cooler desk or area, or having desk fans available can really help you stay in control. You might find that being close to toilets and drinking water quickly and easily also works. There are also cooling sprays that are available that can help you keep cool.
• Moving about – being able to stand up and walk about where possible can help with aches and stiffness. Being able to move away to somewhere more private can help you feel more in control if you have a hot flush.
• Managing stress – many experience loss of confidence; worries about memory loss; anxiety about the unpredictable nature of hot flushes and heightened emotions any of which can make activities feel impossible! Talk with your manager and colleague about how you would like to manage stress levels. It's also important for managers and colleagues to think carefully - if you know someone is going through the menopause and they might be finding things, ask them if they feel able to take on that presentation rather than just assuming.
• Adjusted travel – being able to avoid public transport at peak times can help manage anxiety.
• Uniforms – where you have a business uniform, make sure you have enough items so that you can change as often as you need to. Some businesses are moving to more breathable materials which help reduce sweating and the feeling that you need to change clothing - but where that's not available additional items can be provided. Your employer should also provider a locker that you can use - ideally close to the toilets so you can quickly change when you need to. If you're an LBG employee, check out the menopause friendly garments that are available to you. You can also find further information about the support that's available to you from LBG Careerwear here.

This is not an exhaustive list, and the key is to have open conversations to help you identify what will work for you.

Download our 'Let's talk about menopause' leaflet for further tips on how to have menopause conversations at work and for things your employer can do to help support you.

Support in Lloyds Banking Group

We've been working with Lloyds Banking group on improving the support and information that's available to colleagues around this topic. You can find some of the useful support that's available in LBG on this page. Some of these links will only work if you're logged into your LBG account:

• Lloyds Banking Group have a policy – called the menopause promise – aimed at normalising conversations around menopause, educating line managers and ensuring the right support is available at the right time.
• A free dedicated menopause helpline provided by Bupa on 0345 608 9984 is available which gets you through to a specialist menopause nurse.  Lines open 8am – 8pm, 365 days a year with no limit on the number of times you call. Once you've obtained a pre-authorisation code from Bupa you'll be able to speak to a Menopause GP on 0800 917 8636 (Option 1).
• Find out about the support you can get through your Bupa Private Medical Insurance provided by LBG.
• Work in a branch? Check out the menopause friendly garments that are available to you. You can also find further information about the support that's available to you from LBG Careerwear.
• Join the conversation, ask questions, share your experience or get support and information through the Menopause Yammer group.
• There's training and support for line managers – including an e-learning tool and guidance to help you learn more about the effect of menopause in the workplace.
• A dedicated menopause hub on the Group Health & Wellbeing site.
• You'll find lots of past menopause events hosted on the Menopause - Let's talk page
• Use [email protected] to order items such as desk fans (a USB-C adapter may also be needed - product code R67893), and cooling sprays to help you stay cool.

Get support from Accord

• Find one of our trained Menopause advocates
• Find and contact your local Accord rep or your local Accord officer
• Check out this guidance from Acas for more information on discrimination
• Considered using your employer's private healthcare scheme? You may be entitled to claim back 50% of the excess you pay. Check if you're eligible and make a claim online
• Download and share the 'Let's talk about menopause' poster to raise awareness of the menopause symptoms in your workplace
• Download our 'Let's talk about menopause' leaflet for further tips on how to have menopause conversations at work and for things your employer can do to help support you.

Menopause advocates

We’re building a network of menopause advocates across our membership who can offer support and guidance for those going through the menopause, or those seeking advice. It's a useful way to ensure everyone gets the support they need in work, and know what support and treatments are available from medical professionals.

Advocates need to be knowledgeable about menopause and have a good listening ear. To become an advocate, you must have either attended the training session run by Menopause support or watched the recording. We'll provide additional resources so that you have the tools needed to have supportive conversations.

Accord's menopause advocates are available for both members and non-members to talk to.

Mental health contacts

There are many sources of support available to you:

• LBG’s Employee Assistance Programme (Validium): 0800 9700 100
• TSB's Employee Assistance Programme: 0800 0856 348
  
• Bank Workers Charity: 0800 0234 834 or https://www.bwcharity.org.uk/
• Mind mental health charity: https://www.mind.org.uk/
• Samaritans: 116 123 or https://www.samaritans.org/
• NHS Every mind matters

Menopause related support

• Bupa menopause helpline (LBG only): 0345 608 9984 - you'll need to obtain a pre-authorisation code from Bupa before you'll be able to speak to a Menopause GP.
• Balance: Mental health & wellbeing during perimenopause and menopause
  

And remember, if you’re an Accord member and need a chat about support at work, call the helpline on 0118 934 1808.

Find more mental health related articles on our website.

Other sources of support

There are many sources of support - here are some of our favourites:

• Most employers we work with have guidance available for you on your intranet, including details on how to access medical support.
• You'll find a wealth of support on the Bank Workers Charity menopause page.
• Bupa has a range of information available on their menopause support page. Not a member of Bupa or another private healtcare plan? Bupa have a pay as you go option too.
• Menopause Support have a range of resources on their website, including; videos, posters, symptom checkers, ten things your doctor should know about menopause, understanding menopause for partners, and how to prepare for your doctors appointment.
• Menopause Support also run a private (i.e. request to join) Facebook community called The Menopause Support Network.
• The app provided by Balance is a NHS approved app for advice and guidance on supporting your wellbeing during menopause, tracking your symptoms, and access to personalised content.
• The Daisy Network is a support group of women who have experienced early menopause.
• Women’s Health Concern is part of the British Menopause Society (BMS) offering factual, evidence-based information.
• The CIPD has guidance and webinars available on its website.
• The TUC have developed a toolkit for reps and advocates with even more information and support.
• Dr Louise Newson’s Newson Health – Menopause & Wellbeing Centre