“We found a lot of staff were in the dark about the menopause, what its symptoms might look like and what treatments are available,” says Debby Holloway, member of the RCN Women’s Health Forum and gynaecological nurse.
Debby had been hosting monthly wellbeing webinars in her trust, with the help of colleagues in occupational health, to discuss women’s health – from perimenopause to periods.
“In the webinars, people began disclosing quite a lot of information about menopause,” says Debby. “It was obvious they needed someone to point them in the right direction.”
Debby and colleagues from the menopause clinic decided to pilot an in-house clinic offering tailored guidance and support.
Menopause in the workplace
Menopause occurs when someone’s periods begin to stop and they develop related symptoms, which are usually present for four or five years. But for some people, it can last for up to 20 years past their last period.
Symptoms of the menopause can affect the mental and physical health of nursing staff.
“Hot flushes can be uncomfortable, particularly if working in uniform or in an environment that doesn’t allow you to go outside and cool down,” says Debby. “Anxiety is very common. People might once have felt confident in their role and suddenly, they don’t.”
Joint pain can cause issues for those working in more manual roles, vaginal dryness can make it uncomfortable to sit or walk around, and increased urinary frequency can be stressful to manage.
A few people say they feel like their personalities are completely different
“Brain fog is very disruptive, as are mood swings – we’ve had a few people say they feel like their personalities are completely different,” she says. “Angry outbursts and crying for no reason can also affect how staff conduct themselves at work.
“Trouble sleeping is a significant concern. If you don’t sleep, then you don’t feel good the next day and it’s more difficult to perform.”
According to Debby, it’s not about short-term solutions – although they can be beneficial – but long-term, adaptive changes. Lifestyle and diet changes, and prescriptions for hormone replacement therapy (HRT) can significantly improve symptoms.
Efficient and effective
The in-house clinic runs on minimal staffing with fairly low administrative efforts. Staff can self-refer to book an appointment, which are 15-minute telephone conversations.
Prior to an appointment, staff are sent a questionnaire to send to the team to give an idea of how they can help. From there, they would speak to the staff member directly.
“In the clinic, we have a few options for what we do: give general advice, give advice on what we think the GP should prescribe, or ask the GP to refer to a women’s health clinic,” says Debby.
You can self-refer for physiotherapy, so why not for the menopause?
“Working with occupational health has been key. People can book appointments via their department, but they can also self-refer. You can self-refer for physiotherapy and other health support, so why not for symptoms of the menopause?”
Debby points people to resources and information for them to take to their GP.
“Quite a few people have successfully been prescribed HRT as a result,” she adds. “There have been a few positive comments from people who say they feel more confident, more like themselves, and ready to get on with their jobs.”
Open to all
The self-referral aspect was important to Debby. All members of staff, from nursing staff to porters to physicians, who work in the trust can arrange an appointment.
So far, the clinic has helped staff from band 2 all the way to band 9.
“People come with all kinds of questions,” she says. “Some are as simple as ‘How do I know if I’m going through the menopause?’ to ‘These are my menopausal symptoms, what would you suggest I do?’
“There is a stigma attached to talking about the menopause, but it goes both ways. Some people are suffering and don’t care who knows about it because they just want some help, but there are also people who wouldn’t say anything in a group.”
The clinic has helped people feel more confident, more like themselves
Going through the menopause can feel overwhelming. Debby advises people to take a moment when they’re feeling more settled to write down their symptoms and the problems they cause, what they want to happen and potential outcomes.
“Some people go through the menopause and don’t have any problems at all, so it’s very difficult for workplaces to introduce a menopause policy because it’s not one size fits all,” she says. “You must treat each individual case as it comes.
“People should remember to be kinder to themselves, take the time to recognise their symptoms and decide how they want to manage it.”
Create your own clinic
“To anyone thinking of creating something similar to our clinic, look at what’s already out there,” says Debby.
The first step is to see if there’s an existing workplace policy, and from there, look for health information on your trust or health board’s intranet and make sure people know where to find it.
“Then I’d say you should contact occupational health and see what they might already have in place,” she says. “If you link up with other departments, it’s much easier to do. Maybe there’s an option to bring in an external service or provider to help. It might depend on the expertise in your trust.”
There may be some networks in your trust already, she adds. Consider talking to your union reps who might be interested in helping.
“It is an emotional thing to go through,” says Debby. “But the more you know about menopause, the more you can think about the symptoms, and the more you know about the treatments.”
More information
There are several websites, networks and societies that offer support to those going through the menopause.
- The British Menopause Society has a series of short videos covering some of the key topics in menopause care.
- Menopause Matters is an independent website providing up-to-date information about the menopause, menopausal symptoms and treatment options.
- For people under 40, the Daisy Network provides information and support to those diagnosed with Premature Ovarian Insufficiency, also known as premature menopause.
- Women’s Health Concern provides a confidential, independent service to advise, inform and reassure.
- Read Looking after our menopausal workforce: A model for NHS staff from Post Reproductive Health.
The RCN has an online clinical subject guide on the menopause, with links to guidance and resources, as well as academic articles.
Debby and her colleague Katherine Gale hosted a break-out session on the impact of menopause in the workplace at RCN Congress 2022. Take a look at their presentation slides here and part two here.
