In conversation: Menopause in the workplace

MRA Search

Firstly, I think you touched on this in the initial webinar, but what kind of treatments are there for menopause? Particularly regarding the stigma historically around HRT and whether that stigma has shifted more recently.

Lauren Chiren

I’ve done a lot of training on the medical side, but I’m not a medic, so please be aware that nothing that I say is advice. Treatments for the menopause are many and varied. The NICE guidelines state that, pending no contraindications, HRT (hormone replacement therapy) is the first line of treatment for menopause.

The stigma came from a Women’s Health Initiative study done in 2002 that made links between HRT and breast cancer and heart problems. As a result, the study was stopped midway through, and globally, the press jumped on it. Literally overnight, women came off their HRT, and for the last 20 years, doctors have not been routinely prescribing HRT because they, understandably, wish to do no harm to their patients. Now, we know that in the study, the women were largely over 60, and many were obese. If you’re 10 years postmenopausal or obese, these are considered contraindications for taking HRT. So that study was based on the wrong sample to start off with. And secondly, it was oral HRT. Nowadays, it is far more common to receive oestrogen as a patch, gel, or spray. Modern oestrogens are typically body-identical, subject to safety testing and quality control, and regulated by the Medicines Regulatory Agency.

Other approaches that should be considered are based on good self-care: eating well, hydrating, moving properly, strength work, good downtime, good sleep hygiene, and good morning and evening routines. All the things we should all be doing in our lives anyway.

MRA Search

In the webinar, you also spoke about embracing the menstruation cycle. Would you be able to expand on this and tell us who should take the lead on this?

Lauren Chiren

What’s interesting to me is that, as a person in business for years, I never ever questioned my gender. It wasn’t until I went through an early menopause in my late 30s that I suddenly started thinking about how many women have times of the month where they might be more reflective, more sociable, or more analytical. And there are times when they actually want to withdraw and have some quiet time, which is quite normal. When I reflected on it, I realised that most working women, and transgender and non-binary colleagues, are typically going into environments that have been set up for men and by men. This is not a criticism, but a fact.

It’s only in the last couple of decades that women have gone into the workplace en-masse and have tried to fit in along the way. So, when I started doing some research on this, I realised there’s a natural ebb and flow to menstrual cycles, just as there’s a natural ebb and flow to our hormone levels. When you recognise that someone is more creative or more analytical, or more reflective or more sociable, you can work with that. Companies that have embraced that approach have seen an increase in productivity. It’s fascinating to watch how much more you can achieve when you’re not pretending to be something that you’re not, biologically.

In terms of who’s responsible for it, it’s everyone’s responsibility. There’s a big tie-in to the culture you’re working in and the people you’re working with, so it’s going to be unique to each organisation. More traditional or older organisations may need the younger generations to start to speak up and demonstrate why change needs to be made. The most progressive companies are talking about health, wellbeing, and diversity & inclusion under one umbrella as opposed to separate pockets of the organisation.

MRA Search

How can the wider team try to identify whether someone is experiencing symptoms of menopause or if it’s something unrelated? Is it the responsibility of the organisation to do that?

Lauren Chiren

It should be the responsibility of an organisation to create a safe, healthy working environment for their people – that’s the most important thing. It’s not just about menopause or women’s health awareness training; it’s about getting to know our people better.
In many organisations, people are elevated up the ladder because they’ve been great at their job. It means they also end up being in managerial roles and don’t necessarily have the people skills, so there’s a big chasm, especially now that many organisations work in a hybrid model. If a manager or teammate understands how a colleague behaves, and then that behaviour starts changing, that’s the time when you need to intervene. If you’re responsible for one-to-ones, make sure that you know as much about their wellbeing as about their work. The closer you get to people, the more you can identify if something is bothering them. Some people do want to talk about it, and some people absolutely don’t. But if something’s impacting the performance, as an organisation, there is a responsibility to create an environment where people feel psychologically safe to open up. As an individual, they need to have that conversation. And if they don’t, you can’t make them, but if they still don’t perform, then you’ve tried everything you can as an employer. That’s my personal belief.

MRA Search

Expanding on the employer’s responsibility, what is their role in terms of signposting and how it fits into the organisational culture?

Lauren Chiren

When it comes to women’s health at work, if you know someone has had a miscarriage, or has period or menopause issues, it’s easy to send them off to occupational health. Depending on your internal processes, an algorithm may then assess that they are stressed and depressed and put them on antidepressants, or maybe give them six weeks’ worth of cognitive behavioural therapy. It might be helpful, but most of the time it’s a sticking plaster. If it’s menopause, or menstruation, often there’s a root cause that’s not being addressed. Then it looks like you’ve got an employee who’s not playing ball, and it looks like you’re doing everything in your power to help and support, but the reality of the fact is you’re not signposting to the right help and support. So always make sure that your third parties are set out to do what you would think yourself to do. It’s been very normal for organisations to get Mental Health First Aid trainers; I’m a big advocate of menstruation, fertility, and menopause champions as well. Nominate some people in the organisation who have an interest in the topic and can be the go-to people to listen and to signpost in the right direction. This could be the HR team, managers, volunteer champions or upskilled mental health volunteers.

MRA Search

Journalist Celia Walden recently wrote in an article that “forcing staff to attend ‘menopause awareness’ courses will be an albatross around women’s necks… and that… Such a heavy-handed approach only perpetuates the ‘stigma’ that, at various points of their lives, women are incapable of doing their jobs”. How would you respond to that?

Lauren Chiren

When I started doing this eight years ago, I got this a lot. And it’s interesting. Over the years, I have worked with more female C-suite people including CEOs, and they don’t want to be associated with working with the menopause coach. So, it’s all done very hush-hush because they don’t want to be seen as being weak or vulnerable, as that is what they personally see the menopause as. They fought hard for their careers. They’re at the peak of their career. They don’t want to be associated with anything that they perceive as making them incapable of doing their job. I understand where that comes from. There’s often someone in an organisation that really doesn’t want menopause to be discussed. And it’s interesting, it’s about perception. However, if we’re serious about gender parity, if we really want to close gender pay gap and we want more women coming through from our early mid-management roles through to senior roles, we need to create an environment or a culture that is conducive to having these conversations.

We need to acknowledge that women over 50 are now the fastest-growing economically active group in the UK and the US. We are now using the voice we’ve always had, but in a very different way to create an environment that means that we can flourish, and we can continue to work much longer and later into life in a way we’ve never done before. So, for people who feel that it’s an albatross around women’s necks, then I believe there are conversations that they need to have.

I often invite people to consider what they’d do if they had a blank canvas when it came to women’s health. What if we acknowledged that because of women having menstrual cycles and going through menopause, we could see those things as enhancing the workplace when listing people’s performance, rather than it being seen as a weakness? What if we could change that perception? If we could switch up how we think about someone ageing—not getting old, but recognising that they come with skills, knowledge, and experience, and they’ve got so much to give—what if we could embrace that and work with it?

MRA Search

What would you say to those women who might be nervous to be the person embracing female wellbeing issues at work?

Lauren Chiren

It’s understandable. In industries where I come from, financial services largely—especially at the top, where it’s male-dominated—women don’t want to do anything to stand out. Except to be exceptionally good at their job. There is currently an inquiry in Parliament around menopause in the workplace. As part of that inquiry, there has been a parliamentary committee subgroup survey of 2000 women of roughly menopausal age. The results, released on the 23rd of February 2022, were not surprising at all. 81% of women declared sleeplessness and sleep problems, and 70% declared memory, concentration, and cognition issues – all the usual things that are associated with menopause at work.

After years of lobbying, the fact that we finally got a parliamentary committee together to look at this is brilliant. Recommendations will be made in late spring, including the consideration of making menopause a protected characteristic under the Equality Act 2010. From a legislative regulatory point of view, it is a monumental shift in the same way as pregnancy was back in the 1970s or the 1980s. However, we’ve got a cultural environment that hasn’t recognised menopause ever; we’re at the beginning of that journey currently. If there’s that shift of menopause being a protected characteristic assigned in law, then it will start to open the conversation. For example, as general counsel working with legislation, hopefully, this shift will speak to them; they have a practical thing they can hang their hat on. I also don’t think there will be many FTSE 250 companies left within the next three years that won’t have menopause or women’s health policies. However, you can have as much structure and framework as you want but it’s the cultural change that needs to happen. It will naturally shift as perceptions change, so it will be a process.

MRA Search

The parliamentary inquiry is obviously UK-specific. Does that mean that the UK is a pioneer? Or are we behind the times?

Lauren Chiren

We’re actually leading the way globally. Sweden have had a huge shift too. In the UK, MPs Caroline Noakes and Carolyn Harris were in Parliament a couple of months ago talking about the menopause inquiry that they have been instrumental in pulling together. All of a sudden, change is starting to happen, and people are taking it seriously. That was a powerful moment because many of us have been fighting for this a for a long time. Finally, we have our parliamentarians talking about it, and then we’ve got whole group lobbying medical schools. We’ve also got a change to PSHE education in secondary school, adding menopause as a topic. I think that’s exciting.

MRA Search

One of the things you said earlier is that you’ve been doing this for eight years. Have the attitudes of the C-suite people that you coach changed in keeping with what seems to have evolved during that time?

Lauren Chiren

Very much so. I work with professional women, and a lot of the work I do is around changing mindsets and perceptions. In my coaching sessions, I focus on how we get to choose our thoughts and choosing how to interpret them. When I’m working with someone and they’re stripping away all those limiting beliefs, they realise that this is just who they are. I think why a lot of women don’t want to speak up is because they don’t feel safe. So, they don’t want to speak up in their families or their communities or their workplaces because they don’t want to lose their position in their social circle, or how they’re perceived. I run an annual Mastermind where woman meet with other senior professional women and over a year, they get to trust each other and have their moments where they can just be human and share how they’re really feeling. And that’s wonderful.

MRA Search

Have you noticed a general shift in attitude in recent years? It feels like there’s been a sort of explosion in the last six to 12 months of media coverage and attention on the menopause for us as an organisation. We’ve talked more about the menopause in the last two months than we ever had before. Presumably all these things are helpful in facilitating this change and and taking away the awkwardness, the sensitivities and the stigma that might previously have surrounded discussing the menopause in the workplace?

Lauren Chiren

Yes, it’s made a massive difference. I get more inbound leads now than I’ve ever had before. Before COVID, I would speak at conferences and leads would come in from there. Now, you have an article in the newspaper and suddenly my inbox is filling up.

Mariella Frostrup did a programme a couple of years ago and that raised a little bit of an eyebrow here and there, but the Davina McCall programme was the one that really sparked something because she linked in with many of us who have been working in the space for a long time. Her latest programme has once again raised the level of debate. I spoke to the production team earlier in 2022 about how many women are being exited through NDAs and settlement agreements and how many employment tribunals have successfully cited menopause, using the Equality Act. There are over a million women who have, or know someone who has, left work due to lack of support through menopause. We anticipate another million in the coming year or two, which is staggering.

MRA Search

Is there anything in particular that you think has triggered the increased publicity that the topic of menopause has had in recent times? Can you trace it to one particular thing, or has it just evolved?

Lauren Chiren

I think it’s evolved over time. World Menopause Day kicked off in the 1970s and it kind of bumbled along in the background for a while. Since then, more of us have been using our voice to lobby and try to get changes in medical schools and the workplace. The media and the parliamentary inquiry have helped. I also think simply because more women are working longer and later into life, they are using their voice in a way which hasn’t been done before.