Written evidence submitted by Professor Katherine Sang, Edinburgh Business School, Heriot Watt University [MEW0002]
Background and research design: There is very little extant research on menopause, menstruation and gynaecological health conditions at work. Most of this is quantitative and does not take into account the lived experience. Further trans and non-binary people are omitted from the limited extant work. The existing research is largely focussed on developing economies.
We therefore addressed this gap with qualitative work with two research projects. Our research aimed to understand how women, trans men and non-binary people navigate employment while living with the menopause, as well as gynaecological health conditions. This research was inspired by our work on disability at work (www.disc.hw.ac.uk) which revealed gynaecological health conditions (such as endometriosis) as a potential barrier to remaining in a scientific career.
In 2017 an electronic survey was distributed via social media (convenience sampling) exploring the experiences of menstruation and menopause in scientific careers, noting the difficulties many women report in accessing a science career. The survey elicited 627 responses across a range of academic disciplines. The data revealed a range of concerns by participants. It is important to note that we also surveyed trans men and non-binary people. Follow up interviews were conducted in 2019 (n=23), again with those pursuing a scientific or research career.
In addition to experiencing menopause, respondents also reported conditions covered include endometriosis, PCOS, interstitial cystitis, infertility, abnormal uterine bleeding, lichens scleroses, vaginismus, continence, PMDD.
Below we summarise the key findings of the data will illustrative quotes from the interviews and survey
Findings Our data shows the following concerns at work
For women (and trans/non-binary people)with underlying conditions, the menopause can exacerbate the effects of these conditions and a number of participants reported being unable to work full time (with serious financial and career consequences). While unpredictable menstruation was an issue (see below) there were also continence problems and mental health conditions associated with menopause and made employment difficult.
Many women reported that their GPs were poorly informed about menopause and frequently denied women’s own narratives of their health and dismissed concerns about menopause. This will then be associated with problems accessing medication and other treatments but also would have knock-on effects on accessing support to remain in work.
‘when periods become really heavy towards sort of approaching menopause, that kind of, it became a bit unpredictable’
‘That's not an issue, it’s just the tiredness really I suppose, so I, it's difficult to say. I've got through all the teaching, so it’s been fine, but it's just that feeling of more increased anxiety overnight, unnecessarily kind of thing … While teaching’
While access to hormone replacement therapy can help to manage effects and symptoms of menopause, not all respondents were happy with HRT. One participant reported that anti-depressants helped managing the distress and this was helpful at work:
‘It [antidepressant] just absolutely helped massively because it just meant like, like I slept much better and it did actually elevate my mood. I wasn't feeling that I had a low mood, but it did elevate my mood which made, sort of made me aware of the fact that I was possibly a little bit more affected by that than I thought I had been.’
Women who experienced a cliff-edge menopause for example due to cancer treatment reported considerable difficulties as they were not allowed to take up HRT
One participant’s story illustrated this stigma, as she had experienced brain fog associated with cliff-edge menopause and as a result was removed from her senior management position:
‘I think it’s, certainly since menopause, it’s knocked my confidence. Because like l say when you get brain fog and stuff. My confidence had completely gone and I would say my self-esteem and I could be talking about, so I’ll give an example. I was participation champion for our department, and I was talking about statistics and in my brain it just really went really muddy and foggy and I just got it all back to front and stuff, and I couldn’t get myself out of it even though I knew I was wrong. I should have just said ‘look, I’m really sorry, I’m just having a bit of a brain fog moment.’ But when you’re with your senior management that’s not so easy so I kind of muddle my way through it. And anyway the role’s now been taken off me.’
Rather than being given support, the employer decided to remove the position which will have detrimental effects on the respondent’s future career and earning potential.
Generally survey respondents had not disclosed menopause to their employer due to shame and embarrassment. Participants reported that they felt menopause trigged discrimination which is the result of ageism and sexism and they would be laughed at or ridiculed at work when their menopause become known
‘You can also feel undermined because of ageist attitudes amongst colleagues, - in particular younger members of staff, and your male colleagues of similar age, but less so from female colleagues of similar age’
Our data shows the need for: