Why Aren’t We Talking About Menopause at Work?
Hot flashes and brain fog can wreak havoc on your productivity. But you shouldn’t have to suffer in silence. Help is here.by Sarah Ellis Health Writer
We need to talk more about menopause. Despite its ubiquity—literally every menstruating woman on the planet will go through it—the stigma is all too real. Cultural myths and stereotypes about aging discourage women from sharing this normal reproductive transition. Many choose to keep it secret, suffering through hot flashes and sleepless nights for years without relief.
Not only is this silence demoralizing, but it can also add serious stress to one’s work life. A new study in Menopause examines the impact of menopause symptoms on a woman’s career, finding that an increase in symptoms—hot flashes, night sweats, and insomnia, to name a few—correlates with poorer on-the-job performance levels. This may sound like a no-brainer to anyone who has gone through menopause (like, hello, just try working when your body feels like it’s on fire!), but it’s a challenge that’s so rarely discussed that it’s almost shocking. And according to leading reproductive health experts, we really need to bring it to the forefront.
“Imagine being on your A-game, as most working women in their fifties are, and being distracted by these symptoms that you have no control over,” says Heather Hirsch, M.D., clinical program director of the Menopause and Midlife Clinic at Brigham and Women’s Hospital in Boston. She notes that women with untreated symptoms often choose to retire earlier. “There is a portion of women we are losing out of the workforce,” she says. “Our jobs are so vitally important, not just for finances, but for a sense of purpose and motivation, a reason to get up in the morning, friendships, experiences, growth, and learning. So, this is a huge problem.”
Despite what you may have been told, you are not helpless when it comes to managing your menopause. And you shouldn’t have to just “suffer through it.”
Menopause Symptoms & Their Effects
Symptoms can invade your life in sneaky ways, often when you’re least expecting it. Vasomotor symptoms (hot flashes, night sweats, and other sudden temperature changes) are the most common, affecting up to 75% of menopausal women, according to a study in Nature Reviews Endocrinology. Other symptoms include sleep problems, mood changes, and brain fog or chronic fatigue. They happen because of changes in your hormone levels—specifically, a major decrease in estrogen. This is a natural, albeit uncomfortable, part of the menopause transition.
“It’s not surprising that menopause symptoms can impact job performance, as they can impact almost all aspects of a woman’s life,” says Stephanie Faubion, M.D., medical director of the North American Menopause Society. Here’s how they can disrupt your hustle:
Hot flashes – “Hot flashes in and of themselves are really bothersome,” Dr. Hirsch says. “But not only are they bothersome, they’re distracting and embarrassing, especially when they happen at a meeting or during a presentation.” Hot flashes can be triggered by nerves or anxiety, so they tend to come up at inconvenient times when the pressure is on at work.
Sleep disturbances – There’s nothing worse than trying to be productive after a sleepless night. Around half of women report insomnia during menopause, which can seriously hamper their ability to function normally during the day.
Brain fog – You know that feeling when you just can’t seem to think clearly, almost like your mind is underwater? That’s brain fog. “It could be related to sleep, [or] it could be related to the estrogen imbalance; it’s hard to say,” Dr. Hirsch explains. But as you can imagine, brain fog is the last thing you want to deal with at work, especially if you’re scared to tell your boss why you haven’t been working to your potential lately.
Joint aches – Dr. Faubion notes that joint aches are a common but little-discussed menopause symptom, and one that can seriously rattle your everyday life. Especially if you work in a job that requires you to be up and moving (shoutout to teachers!), soreness and pain are unwelcome disruptions.
What You Can Do
First, let go of that voice in your head telling you to just suck it up and push through. “What women can do is arm themselves with education and change the mindset that there is nothing they can do about this,” Dr. Hirsch says. A study in Post Reproductive Health found that only 54% of symptomatic women sought input from their doctor to get some relief.
You should not have to stay silent. “Women should understand that menopause symptoms are treatable, and there are a number of hormonal and nonhormonal options for managing symptoms,” Dr. Faubion says. They range from medications to simple lifestyle shifts.
Talk to a Doctor
Consider seeing a specialist to help you understand your options. “Seek help,” Dr. Hirsch urges. “And think about it initially.” Too often, women wait years to address their symptoms, thinking they will last only a year or two. But according to research in JAMA Internal Medicine, menopause symptoms frequently last seven years or more. That’s way too long to just surrender and feel miserable.
Finding a doctor is as simple as using the search tool at Menopause.org, the website of the North American Menopause Society. There, women can “find a certified menopause provider in their area who can help them understand what their options are for management of bothersome symptoms,” Dr. Faubion says. They’ll help you figure out a plan that works for you.
Try Prescription Therapy
Hormone therapy isn’t for everyone, but it can be a life-changing intervention for some women. “It can be so efficacious and helpful, particularly when women are really suffering,” Dr. Hirsch says. She urges women to take it seriously and not to be fearful about safety. “[It’s] so much safer than initially thought.”
A broad coalition of evidence-based experts, including the North American Menopause Society, the American Society for Reproductive Medicine, and The Endocrine Society agree that hormone therapy is the most effective treatment for symptoms like hot flashes and vaginal dryness. It does have side effects, including slightly increased risk of blood clotting and breast cancer, so talk to your doctor to determine whether you are a good candidate.
Your doctor may also suggest non-hormonal alternatives like certain antidepressants. They might also refer you to specialists for cognitive-behavioral therapy and other mind-body approaches to reduce stress, which can have the added benefit of helping minimize your hot flashes.
Open a Dialogue at Work
Say it with us now: Don’t be afraid to speak up! “A lot of women feel alone,” Dr. Hirsch says. “A lot of women still don’t talk amongst each other about this” or talk to their bosses. She suggests talking directly with your supervisor or HR representative if you are dealing with menopause symptoms that affect your work. “It can be scary to admit that you’re a little hazy, but I think it’s better than them not knowing why and coming to you later,” she says.
Go in with a clear purpose in mind. What do you want to communicate to your boss, and what outcome do you hope to achieve? Dr. Hirsch suggests arming yourself with resources if need be (you could even send them a link to this article!). If you have other women in your office going through the same thing, this could also be an opportunity to address the issue as a group. “Have a conversation about what is going on and what you plan to do about it, so you’re not just sidestepped over at this point in your career,” she says. You deserve the chance to make the adjustments you need.
Change up Your Workday Routine
Speaking of adjustments, here are a few easy ones you can try. Work during the hours when your brain is clearest. “Is it better in the morning? Be present in the morning, do the job in the morning,” Dr. Hirsch advises. “Leave everything else for the afternoon. Or maybe your brain fog gets better with the day, so then be productive from noon to six. Whatever you need to do.”
Of course, some people have no control at all over their workplace hours or surroundings, so that will require a little creativity. Dress in layers at work and bring a handheld fan with you to cool your body temp down when needed. “There are cooling mists and sprays you can put in your purse and spray on in the bathroom,” Dr. Hirsch says. Take your breaks in the coolest room you can find. (It’s okay to spend an extra second standing in front of that open break room refrigerator. We won’t judge.)
Develop a Sleep Routine
Sleep hygiene may not totally cure your insomnia, but it can certainly help. Dr. Hirsch suggests keeping your room cool and dark, going to bed at the same time each night, and reserving your bed for sleeping and sex only. Try not to watch TV or look at screens too soon before your head hits the pillow. If your partner’s snoring tends to wake you up, consider sleeping in a different room, especially on nights before a big day at work.
Track Your Symptoms and Triggers
Hot flashes are often brought on by stress, caffeine, spicy food, or a warm environment. The sooner you can figure out your triggers, the sooner you can start trying to avoid them. “Journaling and tracking are huge,” Dr. Hirsch says. “If you start tracking your triggers, you might realize it’s stress from that one person at work, or that coffee you used to enjoy in the morning.” You may not recognize the patterns until you outline them on paper.
Make a Personal Pledge to Yourself
Perhaps most important is the grace you give to yourself. Dr. Hirsch urges women to be their own advocates, to take time off when they need it, and to be honest about what they’re going through. “I can take the day off, I can open up if I’m having sleep issues or anxiety issues or brain fog,” she encourages women to tell themselves. “I am not superwoman. This is physiologic and there is nothing I have done wrong.” Know that there are people out there to help you, whether they are your doctor, your friends, or your supervisor. Don’t wait until you feel miserable to speak up and get the support you need.
The best way to manage menopause at work is first to talk about it. Whether you’re dealing with hot flashes, insomnia, or brain fog, be confident that you are not alone and what you are feeling is normal. Together, we can work to end the stigma and keep smashing glass ceilings as usual.
- Menopause & Job Performance: Menopause. (2020). “Relationship between number of menopausal symptoms and work performance in Japanese working women.” pubmed.ncbi.nlm.nih.gov/33235035/
- Prevalence of Menopause Symptoms: Nature Reviews Endocrinology. (2018). “Symptoms of menopause — global prevalence, physiology and implications.” nature.com/articles/nrendo.2017.180
- Seeking Menopause Treatment: Post Reproductive Health. (2016). “Behaviours and attitudes influencing treatment decisions for menopausal symptoms in five European countries.” ncbi.nlm.nih.gov/pmc/articles/PMC5019289/
- Duration of Menopause Symptoms: JAMA Internal Medicine. (2015). “Duration of Menopausal Vasomotor Symptoms Over the Menopause Transition.” jamanetwork.com/journals/jamainternalmedicine/fullarticle/2110996
- Hormone Therapy Safety: North American Menopause Society. (n.d.). “The Experts Do Agree About Hormone Therapy.” menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/the-experts-do-agree-about-hormone-therapy
- Non-Hormonal Treatment: Ecancermedicalscience. (2019). “Non-hormonal strategies for managing menopausal symptoms in cancer survivors: an update.” ncbi.nlm.nih.gov/pmc/articles/PMC6445536/