ABDO Guidance on Menopause

Introduction

The Association of British Dispensing Opticians (ABDO) is committed to ensuring the health, safety and well-being of its members, employees and the patients we care for, ensuring everyone is treated with dignity and respect.

With this is mind, the organisation is committed to supporting members who are affected in any way by the menopause and to support and inform their managers and ensure that people reporting issues are treated fairly and given appropriate support.

This policy is inclusive of all gender identities, including trans and non-binary employees as they can also experience menopause symptoms if taking hormonal treatments.

The menopause is a natural process and for many can be positively managed through lifestyle adjustments. However, we recognise that for some the menopause is not always an easy transition.

We are providing this guidance to support members, both employers and employed, who are going through the menopause process. Consideration of this content can also be used when supporting employees who may be going through the transgender process where they are receiving hormone therapy.

Some employees may need additional considerations to support and improve their experience at work. 62 per cent of the DO workforce is female, 19 per cent is aged 45–60 years. Therefore, many employees will be working through the natural age of the perimenopause period and beyond. Approximately 1 in 100 affected people will experience menopause before 40 years of age. The average age in relation to menopause is 51 years.

Symptoms

According to the National Institute for Health and Care Excellence (NICE), the most reported symptoms of menopause, namely hot flushes and night sweats, occur in approximately 75 per cent of cases, with 25 per cent being severely affected.

Symptoms are associated with a decrease in the body’s production of the hormone oestrogen. Other factors such as diet and exercise, lifestyle and medication can also influence the symptoms.

It is important to note that not everyone will notice symptoms or need help and support. The most common symptoms include:

• hot flushes
• night sweats
• sleep disruption
• fatigue
• difficulty concentrating/memory problems/loss of confidence
• mood disturbances including anxiety and depression
• headaches
• irregular periods/heavy bleeding
• bone and joint problems

Symptoms on average continue for two to four years, however some individuals will experience symptoms for longer.

The nature of symptoms will vary from mild to severe. These symptoms can have a significant adverse impact on the quality of both personal and working life.

Legislation

The Health and Safety at Work Act 1974 requires employers to ensure the health, safety and welfare of all workers. Within this, employers are required to perform risk assessments, which should include any specific risks to menopausal employees.

The menopause is also an equalities issue. Under the Equality Act 2010, employers have a duty not to discriminate in terms of age, sex or disability. Detrimental treatment related to the menopause or transgender could represent direct or indirect sex discrimination on any or all of these protected characteristics.

Employee and Employer Responsibilities

All employees are responsible for:

• taking reasonable responsibility and care for their own health and well-being
• being open to having conversations with managers. If for any reason they feel unable to speak to their manager, they can also speak to occupational health, human resources or trade union/professional organisations.

All employers are responsible for:

• upholding a positive working environment treating others with dignity and respect. It is also important to note that the onset of menopause symptoms can also coincide with other health issues as well as potential caring responsibilities for elderly parents/other relatives/children.
• familiarising themselves with the above information on the menopause and symptoms.
• being willing to have open and protected discussions with employees about changes in their health including issues relating to the menopause, treat the discussion sensitively and recognise that each individual’s experience may differ.
• forming an agreement with the individual on how best they can be supported.
• using the form in Appendix 1 to record a summary of the discussion and any agreed actions or adjustments.
• ensuring ongoing communication and agree a plan for review where appropriate.
• implementing agreed adjustments. If adjustments have not been successful and/or a member of staff is reporting ongoing difficulties or concerns about their health at work, consider a referral to occupational health or human resource department for further advice.
• promoting awareness-raising activities for employees and managers.
• providing flexible working where possible.

Guidance for Managers’ Discussions with Employees

Regular, informal conversations between manager and employee can enable discussions about issues related to menopause. One of the most valuable things a manager can do is listen and respond sympathetically if issues relating to the menopause are reported. These conversations can assist to identify support at work that can make a real difference to how employees cope with menopause.

This will enable them to continue working well, productively and to remain at work. It is important to note that employees experiencing menopausal issues (directly or indirectly) may feel uncomfortable or embarrassed to approach their manager. However, if a manager is aware of the symptoms associated with the menopause and how this can affect a person, this can greatly assist in promoting an environment where employees feel more confident to approach their manager and seek support, if required.

If an employee wishes to talk about changes in health including symptoms of menopause it is important to:

• encourage the employee to discuss any relevant health concerns with their GP practice
• maintain confidentiality when handling health information (seek a private room/office and ensure any records are stored in a safe and confidential manner)
• allow sufficient time to have the conversation and encourage the employee to be open and honest when discussing any difficulties they may be experiencing
• explore with them ways in which they can be supported
• agree an action plan, record the outcome of the discussion and agree a review timeframe (please see Appendix 1 for a discussion template)
• provide details of support and external services available (Appendix 2)

Suggested Adjustments to Consider

Hot flushes can result in employees feeling uncomfortable and less tolerant of workplace temperatures.

• Review control of workplace temperature and ventilation. Consider a desktop fan in an office or locate desk closer to an opening window or away from a heat source.
• Provide access to drinking water.
• Provide access to washroom facilities (take into consideration employees who travel or work in multiple locations).
• Avoid tight-fitting uniforms. For staff who are not required to wear a uniform, recommend loose-fitting layers and cotton fabrics rather than man-made fibres.
• Provide access to a rest area/room for breaks if work involves prolonged periods of standing or sitting.
• Provide access to a quiet room/area for a short break to manage a severe hot flush.

Night sweats/sleep disruption can result in increased tiredness and fatigue.

• Consider flexible working hours or temporary shift changes to accommodate difficulties and recognise that performance may be affected.
• Offer regular supervision/review with manager for additional support.
• Review task allocation and workload.
• Consider flexibility in working pattern or shift pattern, for example if concentration is better or worse at certain times of the day.
• Offer a quiet place to work if feasible, for example in office environments.

Low mood/depression/anxiety/panic attacks/loss of confidence can make work tasks more difficult to carry out and performance may be affected.

• Provide opportunity to openly discuss any concerns/difficulties.
• Offer regular supervision/review with manager for additional support.
• Provide access to a quiet area for a short break if required (allowing time for simple relaxation and mindfulness techniques).
• Encourage the member of staff to discuss symptoms with their GP practice.
• Signpost to sources of support (Appendix 2).
• Consider referral to occupational health.

Headaches.

• Provide access to drinking water.
• Provide access to a quiet space or area for a short break and to take medication if required.

Irregular/heavy bleeding.

• Provide access to toilet and washroom facilities.
• More frequent short breaks may be required.

Bone and joint problems – certain moving and handling tasks may be more uncomfortable.

• Provide local risk assessments and moving and handling assessments, if required.
• Consider temporary adjustments or modifications to work tasks.

Personal/intimate issues.

• Advise to attend GP practice for advice.

Appendix 1: Confidential discussion template

Appendix 2: Sources of information and support

References

• The British Menopause Society (BMS). BMS Tools for Clinicians. Available from: https://thebms.org.uk/publications/tools-for-clinicians/ [Accessed 9 January 2023].
• Equality Act 2010. Available from: https://www.legislation.gov.uk/ukpga/2010/15/contents [Accessed 9 January 2023].
• Faculty of Occupational Medicine (FOM). Advice on the menopause. Available from: https://www.fom.ac.uk/health-at-work-2/information-for-employers/dealing-with-health-problems-in-the-workplace/advice-on-the-menopause [Accessed 9 January 2023].
• Health and Safety Executive (HSE). Health and Safety at Work etc Act 1974. Available from: https://www.hse.gov.uk/legislation/hswa.htm [Accessed 9 January 2023].

Last updated January 2023