Take this hot flash and shove it!

These concerns are probably shared by women
around the globe. Each year, an estimated 1.3 million US women, typically those
in their early 50s, enter menopause — meaning that they have not had a
menstrual period for at least 12 months. Millions more each year begin
perimenopause, the period before menopause when a woman’s body begins producing
less estrogen.

It is during perimenopause — which can last
for four to eight years — that many women experience potentially debilitating
symptoms, such as changes to their menstrual cycle, hot flashes, sleep
problems, migraines and mood swings, which are driven by hormonal changes and
can make women’s lives in the workplace more challenging.

“It’s definitely very hard to work with
symptoms,” said Dr Wen Shen, a gynaecologist and the co-director of the Women’s
Wellness and Healthy Aging Program at Johns Hopkins Medicine. The implications
are dire, she added, considering that there are over 60 million women over the
age of 50 in the United States, according to the US Census Bureau.

Other research backs up the new survey findings.
In a study that has not yet been published, Dr Stephanie Faubion, director of
the Women’s Health Clinic at the Mayo Clinic, surveyed more than 5,000 women
between the ages of 45 and 60 who receive primary care from the Mayo Clinic.
“We were shocked by the number of women that said they reduced their hours
because of menopause symptoms, or were missing workdays because of menopause
symptoms,” she said. “Think about the women’s lost wages. Think about the
companies’ lost profits. This is an economic problem.”

Experts and women who have had menopause or
perimenopause symptoms clash with their work duties shared workarounds and
potential job accommodations that may help women stay in the work force while
experiencing these common changes.


As the coronavirus pandemic has endured, many
women have said that they prefer to maintain some of the workplace flexibility
that came with it, such as remote work, for reasons related to parenting,
health and productivity. It makes sense that women who are having menopausal
symptoms in particular would consider leaving their jobs if they’re now
required to resume working in-person, Dr Shen said.

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“When you’re home, nobody sees that you’ve got
three fans pointing at you while you’re on Zoom or that you have shorts on
under the desk,” she said.

In the workplace, on the other hand, women
have to come up with creative solutions: Laura Lindberg, a scientist who works
for a nonprofit institute, said she used to stick her head in the company freezer
when she had hot flashes. “How sad was I when they switched to a fridge with a
bottom freezer — didn’t work the same,” she said.

At home, women also have more time and space
to compose themselves after experiencing something emotionally triggering. Mood-related
issues — which affect about 40 percent of women in perimenopause — can pose
problems at work. “I’ll have patients tell me, ‘It’s really impacting not only
my personal relationships, but my professional career, too, because I am
responding in a way that I would not have before, and it’s not appropriate,’”
said Dr Monica Christmas, the director of the Center for Women’s Integrated
Health at UChicago Medicine.

Menopause can also affect women’s sleep, and
the ensuing exhaustion can lead to mood swings, too. Symptoms such as hot
flashes and night sweats can drastically reduce how much sleep women get at
night, with sleep loss affecting an estimated 40 to 60 percent of menopausal
women. “Patients are just totally fatigued,” Dr Shen said, “by not having gotten
a full night of sleep for months, if not years.”

Jeannine Ouellette, 53, a writer from
Minneapolis who is in perimenopause, is grateful that she gets to work from
home most of the time because she often sleeps poorly at night and benefits
from short cat naps during the day. “If I just close my eyes for 10 minutes, I
can come back to that task and get it done three times faster than trying to
struggle through it on a sleepless brain,” she said.

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Another major problem is that menstrual cycles
change in perimenopause, so women don’t always know when they will start
bleeding, Ouellette said. “To have that, combined with potentially very heavy
bleeding, is very stressful in a professional environment,” she said. “That
feeling that every woman knows — that gush — you’re like, oh my God, how am I
even going to get out of this room?”


Nicola Green, a consultant in Britain who
advises employers on how to support workers going through menopause, recommends
that workplaces provide free menstrual products in their bathrooms and access
to cold drinking water. If workers are required to wear uniforms, employers
should have extra uniforms available so that people can change if necessary.
She also advises workplaces to allow employees to work from home, or have
flexible hours, when they are experiencing menopause symptoms.

People who “are completely sleep deprived, or
may be suffering from the most horrendous periods that make them really
struggle to leave the house, they can manage that so much better by working at
home,” she said. When workers aren’t given these accommodations, she added,
they may instead call in sick.

Fran Poodry, 51, who works in customer service
at an educational technology company in Portland, Ore., recalled a time several
years ago when she woke up and couldn’t stop crying. “I explained to my
supervisor that it was perimenopause since I was not sad or upset,” she said.
“I just was helpless to turn off the tears and snot due to hormones,.”

She told her supervisor that she might need to
come into work late or work from home when symptoms were bad, and he told her
that was fine. “I really am very lucky that my workplace is so accommodating,”
she said. “Nowadays, with Zoom, I can attend a meeting from home if I needed.
Or I can work from home entirely.”

Ultimately, employers should educate
themselves about menopause and communicate that they want to be supportive to
staff going through life transitions or other health issues, experts said. “A
more flexible schedule allows room for the employee to work when they’re most
attentive and productive, which benefits both the employee and employer,” said
Emily Klover, an organizational psychologist in Sacramento. “It really does
work well for all.”

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Dr Faubion, from the Mayo Clinic, said that
one of the biggest tragedies of menopause was that many women — and even many
doctors — didn’t realize that there are lifestyle changes and treatments that
can ease their symptoms. During perimenopause, for instance, a low-dose birth
control pill can control bleeding issues and ease hot flashes and night sweats,
she said. Simple dietary changes — like avoiding alcohol and caffeine — can
also reduce hot flashes in some women, Dr Faubion noted, while cognitive behavioural
therapy and mindfulness meditation have been shown to make hot flashes more
tolerable and improve sleep quality.

Women who don’t get relief through lifestyle
changes might want to consult a qualified menopause practitioner, Dr Shen said.
Prescription medications also could help, such as antidepressants for mood
issues and antiseizure medications, such as gabapentin, for hot flashes.

After menopause, low-dose hormone replacement
therapy helps many women, too, Dr Faubion said. Although the therapy can increase
cancer risk, the risks are minimal among women under 60, she added. “For the
majority of women who are under the age of 60 and within 10 years of their last
menstrual cycle, the benefits outweigh the risks,” she said.

Thankfully, women today may be more
comfortable than women in past generations talking to their doctors about
symptoms and asking their employers for accommodations, Dr Faubion said. Women
who are menopausal now “want to talk about it,” she said. “They’re not going to
shove it in the closet.”

Melinda Wenner Moyer is a science journalist
and the author of a book about child rearing

© 2022 The New York Times Company

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