Written evidence from Professor Jo Brewis [MEW0018]
I am supplying this evidence having researched menopause at work since January 2016. I am lead author of the 2017 Government Equalities Office report ‘The effects of menopause transition on women’s economic participation in the UK’[i]. I have also co-written several academic journal articles on the subject as well as presenting to/ on behalf of a wide range of UK organizations on the importance of menopause as a workplace issue. These span all three sectors and include GlaxoSmithKline, the RSPB and various universities. I am also a member of the expert panel for Menopause Friendly Accreditation[ii], and have authored an Advance HE briefing[iii] and co-authored a Business in the Community toolkit[iv] on the subject. I draw on all the research I have done during this period in the evidence I submit.
I should note before proceeding that I have deliberately used non-gendered terminology where appropriate in this evidence: I am very mindful of queer menopause expert Tania Glyde’s advice that “if you are writing … around menopause, please remember that it is not just cis women who experience it. Let’s get people used to saying ‘people in menopause’, including everyone who experiences it”[v]. As the terms of reference for this enquiry make clear, people in menopause include some transgender men and other gender-diverse people. However, research on populations other than cis women is very rare indeed. I am certainly no expert and would strongly recommend that the committee ask Ms Glyde for both written and oral evidence as to how people who experience the menopause but do not identify as women can be supported in relation to menopause and the workplace.
Great strides have been made in the UK since I began investigating menopause at work, including on the basis of the excellent consultancy services offered by Henpicked: Menopause in the Workplace[vi] with whom I have a close professional relationship. However, research suggests that people in menopause still face discrimination at work whilst going through this reproductive life transition. The BUPA/ CIPD survey cited in your preamble is very telling, and there are also important findings from Evandrou et al.’s (2021)[vii] analysis of the two most recent waves of the National Childhood Development Study. These data suggest that 23.2% of the women in the relevant data set had reduced their working hours by 5 or more a week and a further 11.2% had left employment altogether between the ages of 50 and 55. Those reporting very problematic symptoms were much more likely to take one of these routes. These findings did vary depending on whether the woman’s partner was employed – suggesting that some women with severe symptoms are forced to remain in work to maintain household financial stability – and whether they were taking HRT, which also reduced the likelihood of employment status changing because of its likely ameliorative effects on symptoms.
These and other available data (see for example the Health and Her survey findings, cited in Andrews, 2019[viii]) are strongly suggestive that we still have a lot of progress to make in supporting people in menopause at work. Not only are those in the relevant age group a very significant part of the UK labour force, but creating menopause-friendly workplaces means they are much more likely to stay at work for as long as they wish, which has very clear financial benefits for them. These are likely to also have a positive knock on effect in reducing the gender pay gap, which is presently largest between men and women in their 50s, as well as the gender pension gap. Moreover, it allows people in menopause to continue to derive self-esteem and social support from work, and guards against employers losing their accumulated knowledge, skills and expertise. Thus menopause-friendly workplaces also have a positive impact on wider society.
Relatedly, if we consider Oxford Economics statistics from 2014, we see that the economic impact of replacing someone who earns at least £25 000 per annum (which is substantially less than the median UK salary) is £30 614[ix]. This is made up of the direct costs of recruitment and selection as well as any effects on productivity due to new staff learning the ropes and others having to support them while they settle in. Then there are the intensive margin costs of people in menopause working whilst trying to cope with problematic menopause symptoms and the effects on their productivity this might entail. Research cited in Forbes magazine[x], for example, estimates that “menopausal women experiencing hot flushes and night sweats have nearly 60% more work productivity loss days compared to women without symptoms”, and the total cost is over $150 billion globally.
Employers can factor in the needs of employees going through the menopause and address workplace discrimination in a variety of ways. First and foremost, what is implemented should work within the context of that organization – what is suitable for a corporate multinational may well not succeed in a university, for example. And within-sector cultural differences mean something that has yielded positive results in one organization won’t necessarily do the same for their competitors. Second, the most important step in moving towards menopause-friendly workplaces is raising awareness about menopause as a workplace issue, and one that affects those going through it but which might also have knock on effects for their colleagues, managers, customers/ clients/ students/ end users and indeed their family and friends. Menopause is still something of a taboo in UK society, and it is also widely misunderstood, so accurate and evidence-based training for all employees is really important. This will also go a long way to shifting the culture in an individual workplace so as to make discussions about menopause easier to have, especially where people in menopause choose to disclose symptoms to their line managers (and this should always be a personal choice).
Other workplace mechanisms which can be used to support menopausal staff include:
• Line manager training in having sensitive conversations as well as the kinds of adjustments that can be made for individual staff members – the latter is important because everyone’s menopause journey is unique.
• Any occupational health and/ or Employee Assistance Programme staff should be fully trained in the issues around menopause at work, where relevant.
• Absence policies need to take account of situations where people in menopause need to be absent on very symptomatic days, perhaps on a recurring basis, to avoid these being categorized as a performance issue.
• Informal support groups like menopause cafes[xi] and Yammer groups are also very helpful for people in menopause to share their experiences and ask for advice, as well as allowing non-menopausal staff to learn more in a relaxed environment.
• Flexible working arrangements including home-working support can allow menopausal staff to continue to give of their best even on bad days – and of course we have learnt a great deal about home-working in particular during the COVID-19 pandemic.
• Fans, good ventilation and temperature control are useful for people in menopause who suffer from hot flushes – and, if the right awareness raising and education has been put in place for the whole staff composite, temperature adjustments in shared office space can be easier to facilitate. Cold drinking water stations are beneficial for the same reason.
• Clean, comfortable, well-equipped toilets are important, with free supplies of sanitary wear if possible so people in menopause experiencing heavy and/ or erratic menstrual bleeding are provided for. Access to showers is also ideal, where possible.
• Care should be taken around workplace furnishings – Butler (2020: 703[xii]) reports women in one of her focus groups commenting as follows:
“Whoever decided to buy office chairs with pale grey cushions wasn’t a woman on the change or any woman, to be honest. Bleeding and it coming through onto the seat, like hasn’t that happened at some time to every woman[?], but whoever buys furniture doesn’t get it. They just don’t get it. They’ve got no common sense. It’s not the sort of thing people want to talk about, is it? I understand that, but it’s the reality of life, isn’t it? We can’t all be young and healthy and have light periods, can we? We’ve all bought cushions. In all shades of black”.
The same is true of the bottom half of uniforms.
• Equally, ergonomic support for people working on site but also at home (appropriate chairs, standing desks, footrests, wrist supports and so on) is beneficial because muscle and joint pain can be a symptom of menopause.
• Staff should be able to choose lighter, layered, non-synthetic uniforms or workwear where appropriate, and to select this without being ‘marked’ by others as menopausal. So these options could be available for all employees without any explanation being required.
• Rest areas where employees with troubling symptoms can take a short time out to relax and reset are also a good idea, as is allowing exposure to natural light wherever possible.
• Provision of food which has been proven to be beneficial for people in menopause in workplace cafes and restaurants is a welcome addition – like food containing phytoestrogens (found in soy products, for example), decaffeinated drinks and ‘eat the rainbow’ type fruit and vegetable offerings.
• Reduction of noise exposure (which could be as simple as allowing someone to wear noise cancelling headphones in an open plan office) can be helpful where people in menopause are experiencing loss of focus or memory lapses.
• Finally, extra-curricular workplace exercise, yoga, meditation and/ or CBT sessions can be beneficial for menopausal staff.
The extremely impressive efforts made by HSBC UK, First Direct, M&S Bank, ATOS and Aster Group, the first recipients of menopause friendly accreditation, give some examples of best and most inclusive workplace practices, in three very different organizations, in this regard[xiii] [xiv].
Turning to how well current legislation protects against discrimination in the workplace associated with the menopause, my first observation has to do with the Equality Act (2010). As the committee will know, to date there have been three successful UK employment tribunals about menopause at work. The first – against British Telecom in 2012 - was based on direct sex discrimination, the second – against Scottish Courts and Tribunals Service in 2018 - on direct disability discrimination and the third – against Bon Marche in 2019 - on harassment on the basis of sex and age. Despite the fact that Section 14 of the Act, which would have allowed claims of direct discrimination on the basis of more than one protected characteristic, never being brought into force, the third case succeeded because it was based on harassment. Multi-characteristic claims are also allowable for indirect discrimination and disability discrimination.
As such, one way to further strengthen protection for people in menopause would be to enforce Section 14. This would then allow claims on the basis of, say, direct sex and age discrimination or indeed direct gender reassignment and age discrimination. Menopause is a fundamentally intersectional phenomenon since it mainly affects cis women, transgender men and other gender diverse people in mid-life. Enforcing Section 14 would recognize this in law and provide a stronger disincentive for employers to discriminate against people in menopause. I would, further, counsel that the Health and Safety Executive need to raise employer awareness of the Health and Safety at Work Act of 1974 and its attendant regulations as to menopause as a workplace issue. The two points which concern me here are that, first, harm need not have occurred for a case to be brought under this Act – risk of harm is sufficient. The second is that risks commonly identified under HSWA for other categories of staff include standing or sitting for long periods; long working hours; temperature; workstation and posture issues; work-related stress; and non-ergonomic workplace equipment like chairs or desks. All of these risks can also exacerbate menopausal symptoms. Therefore it is conceivable that a case will be brought against a UK employer in future on this basis, either by an individual employee or the HSE for a breach of their duty of care in this regard.
Next, to the question of what further legislation is required to enable employers to put in place a workplace menopause policy to protect people going through the menopause whilst at work, I would suggest this needs to be done with due care. My point here is that policies are not always the best way forward in supporting menopausal staff, given my earlier observations about the need for any intervention to be suited to the relevant organization. In some workplaces, a policy is necessary because they are very rules-oriented and bureaucratic, thus only by introducing a policy will the relevant provision ‘stick’. Elsewhere, policies may be routinely disregarded in favour of custom and practice, or ignored as ‘just a piece of paper’. In smaller organizations in particular, a policy might even be seen as overkill. Instead I would advocate for a legal expectation that all employers pay due heed to best practice around menopause at work and implement recommended measures as appropriate in their organization, with the expectation that these will be reviewed and revised where necessary a regular basis. The bare minimum should be awareness raising and education around menopause. I would add that menopause at work interventions straddle equality, diversity and inclusion and health and well-being, so need to be signposted accordingly in organizations.
I will finish with commentary about how effective Government action has been at addressing workplace discrimination related to the menopause and how well the GEO is working across Government to embed a strategic approach to addressing the impact of menopause in the workplace. I will say that, since the publication of our GEO report in July 2017, I am not aware of any significant progress across either of these areas. There has of course been the APPG on women and work’s focus on well-being, but its various outputs are arguably too recent to have had tangible impact. Then there was the Women’s Business Council Staying On Action Group, of which I was a member and which produced the Age of Success: Staying On toolkit, but of course the WBC has now been reconfigured to concentrate on the gender pay gap. As such I welcome the current call for evidence and look forward to practical and concrete actions from government as a result to support the growing number of people in menopause in the UK labour force and their colleagues and line managers.
[i] Brewis, J., Beck, V., Davies, A. and Matheson, J. (2017) The Effects of Menopause Transition on the Economic Participation of Women in the UK, London: Government Equalities Office. Online. Available at: Menopause transition: effects on women’s economic participation - GOV.UK (www.gov.uk).
[ii] Menopause Friendly Accreditation (n.d.). Online. Available at: Menopause Friendly Accreditation | About accreditation.
[iii] Brewis, J. (2020) Menopause Awareness and Higher Education: Guidance on Menopause in Workplace Settings, Primarily Higher Education, York: Advance HE. Online. Available at: New guidance for HEIs on how to support staff during menopause published by Advance HE | Advance HE (advance-he.ac.uk).
[iv] Watson, A., Brewis, J., Beck, V. and Davies, A. (2020) Menopause in the Workplace: A Practical Guide for HR, Wellbeing and Occupational Health Practitioners, London: Business in the Community. Online. Available at: bitc-age-toolkit-menopauseintheworkplace-jun20.pdf.
[v] Glyde, T. (n.d.) Queer/ LGBTQIA+ Menopause. Online. Available at: Mission — Queer / LGBTQIA+ Menopause (queermenopause.com).
[vi] Henpicked: Menopause in the Workplace (n.d.). Online. Available at: Menopause at work training, eLearning and resources | 5* rated (menopauseintheworkplace.co.uk).
[vii] Evandrou, A., Falkingham, J., Qin, A. and Vlachantoni, A. (2021) ‘Menopausal transition and change in employment: evidence from the National Child Development Study’, Maturitas, 143 (January): 96-104.
[ix] Oxford Economics (2014) ‘The cost of brain drain: understanding the financial impact of staff turnover’, February. Online. Available at www.oxfordeconomics.com/my-oxford/projects/264283.
[x] Das, R. (2019) ‘Menopause unveils itself as the next big opportunity in Femtech’, Forbes, 24th July. Online. Available at: Menopause Unveils Itself As The Next Big Opportunity In Femtech (forbes.com)
[xi] Menopause Café (n.d.). Online. Available at: Gather to eat cake, drink and discuss menopause (menopausecafe.net).
[xii] Butler, C (2020) ‘Managing the menopause through ‘abjection work’: when boobs can become embarrassingly useful, again’, Work, Employment and Society, 34 (4): 696-712.
[xiii] Garlick, D. (2021a) ‘Meet the UK’s first accredited menopause friendly employers’, Menopause Friendly Accreditation, 18th July. Online. Available at: Meet the UK’s first accredited menopause friendly employers | Menopause Friendly Accreditation.
[xiv] Garlick, D. (2021b) ‘HSBC UK, first direct and M&S Bank are the UK’s first accredited Menopause Friendly employers’, Menopause Friendly Accreditation, 19th July. Online. Available at: HSBC UK, first direct and M&S Bank are the UK’s first accredited Menopause Friendly Employers | Menopause Friendly Accreditation.