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Menopause guide 

Everyone's experience of menopause is different. Some may not experience too many problems; others experience more difficult symptoms which can present significant challenges. 7 in 10 of our female workforce are at the age where they will be approaching menopause, or experiencing it right now. Research shows that some women are unwilling to discuss menopause-related health problems with their line manager or ask for the support or adjustments they may need.

We want:

  • Every staff member to feel heard, supported, and empowered to navigate the menopausal journey with dignity and confidence.

  • Menopause to be recognised as something that can impact mental and physical health and wellbeing.

  • Individual experiences to be respected and valued.

  • A culture of open dialogue, where employees can confidently seek assistance from colleagues and managers without fear of judgement or stigma.

  • Everyone to know what support is available.

The aim of this guide is not only to support those who may be experiencing menopause, but also to equip and support those around them – whether that’s colleagues and managers at work, or partners and family members at home.

Menopause is defined as a biological stage that occurs when hormones change and eventually menstruation stops. The average menopause age is 51, however it can be earlier for some, due to surgery, illness, or other reasons.

When we refer to menopause, we are referring to perimenopause, menopause and postmenopause, which are defined below:

Perimenopause is the time leading up to menopause when hormone levels are changing which can cause symptoms. This can be years before menopause. Menopause is usually defined as having occurred when someone has not had a period for 12 consecutive months (not the case for medical menopause when certain surgeries cause immediate menopause). The following day is classed as menopause.

Postmenopause is the time after menopause has occurred, starting when someone has not had a period for 12 consecutive months and for the rest of their life. When we talk about menopause in this guide, we are referring to any of these stages.

More information about the menopause, symptoms and treatment can be found on the NHS website (external link). 

Menopause before 40 is known as premature ovarian insufficiency (POI). Surgery and medical conditions, such as a hysterectomy, fertility and hormone treatment, and cancer treatments can cause menopause symptoms. In these cases, symptoms can be severe as hormone production is abruptly ceased.

Anyone with ovaries can experience menopause regardless of gender or gender identity. Hormone therapy as part of someone’s transition to a true gender can also bring on menopause symptoms.

Experiences of the menopause may also differ in relation to disability, age, neurodiversity, race, religion, sexual orientation or marital/civil partnership status. Some factors may make coping with symptoms more difficult.

It is also important to remember that partners, family members and colleagues may need support living and working with someone who is struggling with symptoms.

Andropause (male menopause)

Testosterone levels fall very gradually from the ages of 30 to 40 for men, and this is unlikely to cause any problems. A sudden drop in testosterone in middle age, like hormonal changes in the female menopause, is uncommon, but can be tested for.

Some men develop depression, loss of sex drive, erectile dysfunction, and other physical and emotional symptoms when they reach their late 40s to early 50s due to andropause. It is important to find the underlying cause and work out what can be done to resolve it.

More information about andropause can be found on the NHS website (external link).

Our hormone levels change throughout our lives e.g. during puberty, pregnancy, as a result of certain health conditions or treatment, gender transitioning, and as we get older. The main ones changing during menopause are:

  • Oestrogen which has a myriad of functions including nourishing the tissues of the body, regulating bone turnover as well as keeping our liver, brain and heart healthy.

  • Progesterone which boosts feelings of calmness and aids sleep and can help to improve mood.

  • Testosterone which increases motivation and optimism, helps improve energy levels, supports bone health and boosts sex drive.

Hormonal changes can result in a wide range of symptoms, both physical and psychological. Research shows that 3 in 4 women experience some symptoms and 1 in 4 of those experience serious symptoms. Others may not notice any major changes.

Below is a list of symptoms that may affect work ability, however this list is not exhaustive. 

Symptom

Potential impact

Cognitive issues such as memory loss and reduced concentration (brain fog).

This can affect short term memory, concentration and attention to detail leading to worry about performance and loss of confidence in ability, including reluctance to apply for career development opportunities.

Difficulty sleeping.

Can lead to tiredness, irritability, memory problems and reduced concentration.

Psychological issues such as difficulties in regulating emotions, anxiety and/or depression, panic attacks, and loss of confidence.

May be unable to concentrate or feel motivated leading to performance issues and increased absenteeism or going to work when not fit (presenteeism). Mood swings may impact on relationships at work. Worry about job performance and work relationships could lead to concerns about financial wellbeing. In extreme cases, depression can also lead to thoughts of self-harm and suicide.

Hot flushes (brief, intense and sudden surges of heat usually felt in the face, neck and chest) and night sweats.

Can cause embarrassment and distress, individuals may isolate themselves from colleagues. Stressful situations can trigger hot flushes causing individuals to avoid these situations.

Irregular periods and/or periods becoming light or very heavy, more or less frequent.

Heavy periods can cause pain, anaemia, disruption, embarrassment and distress as people worry about bleeding through their clothes. If this is the case more frequent changes of sanitary protection will require more breaks and easy access to toilet facilities.

Other physical symptoms, such as muscle/joint pain, recurrent urinary tract infections, headaches and palpitations.

Could cause worry, lower productivity and performance, as well as increased sickness absence.

For more information, have a look at the NHS list of common symptoms.

Just as everyone’s menopause is different, so is their personal choice about how to manage symptoms and long-term health. The depletion of hormones carry on for the rest of life (postmenopause). So, considering the important roles they have, it's important to think about how we manage any impact of this hormone deficiency on our long-term health. 

When deciding on your personal approach, thought should be given to benefits and risks of the different options, as well as your medical history and lifestyle.

The Henpicked guide to managing your menopause includes a symptom tracker, questions to help you develop your personal plan, how to talk to your GP and your manager to get the help you need. 

Every manager should know what the menopause is, when it happens and how it can affect people in the workplace.

You have a crucial role to play in ensuring that anyone experiencing menopausal symptoms gets the same support and understanding as if they had any other health issue. Effective management of team members with menopausal symptoms that are impacting on their work will help you to improve your team’s morale and performance, retain valuable skills and talent, and reduce sickness absence. If staff aren't supported there may also be a reputational and legal risk as staff are protected under the Equality Act 2010 for disability, age and sex.

Line managers are typically:

The first point of contact if someone needs to discuss their health concerns or needs a change or adjustment to their work or working hours to enable them to perform to their full potential.

Responsible for implementing the policies and practices that can help someone experiencing the menopause to feel supported, and to be effective in their role.

Responsible for managing absence and keeping in touch if someone is off work ill or because of menopausal symptoms, as well as supporting an effective return to work.

Simple changes to your management style can make a world of difference:

Building relationships based on trust, empathy and respect will make it easier for an employee to feel comfortable about raising a health issue like the menopause.

Including health and wellbeing in regular and informal one-to-ones with members of your team can provide the forum for a conversation about any changes to someone's health or wellbeing situation, including the menopause. Here are some pointers on how to undertake a wellbeing check-in to support you to do this.

Asking people how they are on a regular basis will help to create an open and inclusive culture and encourage someone to raise any concerns.

Don’t make assumptions – everyone is different, so take your lead from the individual.

Maintain confidentiality in handling health information relating to the menopause, in line with the Gender Recognition Act 2004, where health information relating to the menopause reveals someone’s trans status.

It can be hard when you suspect someone is experiencing menopause symptoms but they haven't talked to you. Wait for your team member to share what they're experiencing. Bringing it up yourself could be viewed as confrontational or offensive and you are there to support not diagnose. Talking with your team about menopause and the support available can be a great way to demonstrate you want to support anyone experiencing symptoms. It's vital you don't shy away from the topic. The more you talk about menopause with your colleagues, the easier it will become.

Complete the Menopause for Managers training on Astute and read these tips from Time to Talk Day to help you prepare for a conversation about menopause or any other sensitive issue.

Here are some more tips:

Prepare for the conversation – make sure you understand LCC's approach to supporting menopause, including the suggested reasonable adjustments and risk assessments.

Make sure you have the time and space for a confidential discussion that allows the opportunity to raise concerns and steps forward. Remember, it can be difficult for some people to talk about their experience so not feeling rushed will help put them at ease.

Opening up the conversation - focus on the positive. A positive mindset and approach are essential for managers to ensure conversations are supportive experiences for you and your colleagues. When a colleague talks about menopause, make sure you communicate that it's not a problem for you or for the organisation.

Offer support - some employees may just want an empathic ear, while others may want something more formal. It’s also okay not to have all the answers during your first conversation, you can offer reassurance that you will find answers for your next conversation.

Develop a working plan and review it regularly. Menopause is a unique experience, and each person may need different support. Ask your team member what they feel might improve their symptoms at work.

Keep talking. Arrange a time to meet again to agree next steps or monitor progress. The effects of menopausal transition can change over time, so support may need to change to accommodate this. Reflect back on what you are seeing.

Do's

  • Do your research and understand the facts

  • Do talk about menopause

  • Do follow this guidance

  • Do keep an open mind and be flexible

  • Do provide support and focus on solutions

  • Do contact People Services

  • Do refer to Occupational Health if appropriate

Don'ts

  • Don't make assumptions

  • Don't shy away from talking about menopause

  • Don't share personal information without consent

  • Don't address performance issues without checking about health concerns

A risk assessment must be completed for any employee who expresses concerns about something that is affecting them at work. This includes employees who express concerns about the impact of menopausal symptoms on their work, performance or attendance. The risk assessment template in the documents section for this is the same for any health concerns, medical conditions, disabilities or impairments affecting their job role or work.

The risk assessment must also be carried out by the line manager and allows employees the opportunity to discuss the impact their symptoms are having on them and their work and for the manager to work with them to identify any workplace adjustments that may support them. Guidance  is available to support managers to complete the risk assessment. and identifies some of the control measures that may be appropriate to consider.

The findings of the risk assessment must be documented and reviewed on a regular basis or in the event of any significant changes.  Menopausal symptoms and their impact vary significantly between individuals and over time may deteriorate, improve or diminish completely at which time it may be jointly agreed that the risk assessment is no longer required.

NHS Pensions Scheme

NEST

The purpose of a temporary workplace adjustment is to remove barriers, where possible, that get in the way of an individual doing their job. It is important that they are tailored to address the issues experienced specifically by that individual and should be identified through discussions with the individual and other relevant experts (such as Occupational Health and your People Business Partner where appropriate). It is essential to avoid making assumptions as menopause symptoms vary between individuals.

Many may not need adjustments to be made but if they are needed, this is a positive way to keep valued employees in the workplace. It is important that we don't lose staff through sickness or as leavers through lack of understanding and support.

Temporary workplace adjustments are not limited to but may include:

  • Flexibility where uniforms are mandatory, providing additional uniforms to ensure individuals can change during the day. Natural fibres like cotton are preferable to synthetic materials if an employee is experiencing hot flushes and sweating.

  • Access to a personal fan that plugs into a laptop or portable neck fan (both available on Fusion to order) and good ventilation including windows which open and blinds that can be drawn.

  • Locating a workstation near an opening window or away from a heat source.

  • Where work requires constant standing or prolonged sitting, ability to take breaks to move about and access to a quiet restroom.

  • Access to a quiet room for a short break to manage a severe hot flush or other symptoms that may be overwhelming.

  • Access to cold drinking water including at off-site venues.

  • Flexible working.

  • Consider the impact of symptoms during professional discussions or interviews.

  • Identify a 'buddy' to support the person for emotional regulation, e.g. sense check emails before sending.

  • Consider length of meetings.

  • Adjusting start and/or finish times or allow extended breaks.

If, after initial discussions and adjustments, further support is needed, the line manager is advised to: 

  • Contact their People Business Partner, the Wellbeing Team (wellbeingsupport@lancashire.gov.uk) for further advice and guidance.

  • Refer the employee to Occupational Health for further advice.

  • Review Occupational Health advice, and implement any recommendations, where reasonably practical.

  • Record absences on Oracle as due to menopause symptoms where this is the case.

We know it might be hard to talk to your manager about how menopause is affecting you but your manager is there to help you be at your best at work. To help you both, it’s a good idea to prepare for your conversation, which will lead to a much better conversation and outcome.

Use the five steps below to help you prepare for your conversation with your manager and get the most out of it.

  1. Prepare

  • Complete a menopause wellbeing action plan (Mental Health UK)

  • Keep a diary of your symptoms and how they’re affecting you at work.

  • Think about what practical, reasonable adjustments might help address these symptoms at work, being flexible and ideally coming up with some different options. These may only be needed for a short period of time while you work to alleviate your symptoms.

  1. Ask for a meeting

This means you’ll have the time you need and a private space to talk and will be more likely to get your points across without feeling pressured or overheard.

  1. Explain your situation clearly and what support you may need

  • Talk about how menopause is affecting you at work, what you’re doing to manage your menopause and what your line manager could do to help. Of course, this can be purely for work arrangement purposes if you're not comfortable expressing your symptoms or going into detail.

  • Discuss what support you think would help, e.g. reasonable adjustments and timescales. Or sometimes just knowing someone understands and is there to listen can help.

  1. Agree next steps

  • Your manager may need time to think about your suggestions. This may be the first time they have heard about your symptoms, so allow them time to digest the information and seek advice if necessary.

  • Decide whether you want the conversation to be kept confidential or if you’re happy to discuss it with colleagues. It’s your choice.

  1. Follow up

At the end of the meeting agree a time to meet again, whether that’s to agree a way forward, to monitor progress or update.

Menopause can be isolating if you don’t talk to someone but remember all women go through menopause at some point, so you are not alone.

We all need to feel comfortable talking about menopause and feel able to ask for help and support if needed. Simply by being willing and open to talking about it can make a big difference to someone. If you notice a colleague struggling or not seeming themselves, ask how they are or if there is anything you can help with.

Here are some tips on supporting a colleague that you know, or suspect might be, experiencing menopause:

It’s important to appreciate that everyone is different, so don’t make assumptions. Whether that’s about symptoms (some don’t have any), how we manage them or how much we want to talk about it.

Some staff may want to keep personal information, such as their symptoms, private, and that's completely their choice, try not to ask questions that may be considered invasive.

The human approach is powerful, it shows you care, understand, and want to support. A simple ‘How are you?’ or ‘What can I do to help?’ is often enough. Small gestures can make a big difference. Even being able to be open up about it can be a relief.

Internal sources

Documents and policies

  • Flexible working policy (available on the intranet or ask your line manager)

  • Risk assessment template (available on the intranet or ask your line manager)

  • Guidance for completing risk assessment (available on the intranet or ask your line manager)

Wellbeing support and information

Training

Managers can also contact Lancashire Adult Learning for free training sessions for groups of eight or more. This includes menopause and nutrition, managing menopause, menopause and sleep, and yoga for menopause, as well as a wide range of general wellbeing sessions. Email wellbeingsupport@lancashire.gov.uk for more information.

External sources

About menopause, signs and symptoms

Connecting with others

Inclusive resources

  • Queer menopause - inclusive resources, podcasts, groups, research, book recommendations and much more for LGBTQIA+ and other groups that may be insufficiently represented in mainstream discussion

  • Science on the spectrum - inclusive resources for underrepresented groups including neurodivergent

  • ADHD and the Menopause – NHS advice on the impact of hormonal fluctuation of symptoms

Managers supporting staff

Introduction

Lancashire County Council is committed to supporting individuals experiencing symptoms of the menopause including those experiencing perimenopause and andropause. We are dedicated to providing the appropriate support and training for all employees in order to improve the wellbeing of those who experience menopausal symptoms. Whilst not everyone suffers with symptoms, supporting those who do will improve their experience at work.

This statement sets out our approach to supporting employees experiencing menopausal symptoms and to supporting managers to provide the right support to manage menopausal symptoms at work.

Our aim is to ensure individuals experiencing menopausal symptoms feel comfortable in discussing them with colleagues and managers so any workplace adjustments can be explored to support them in work and with carrying out their job roles. Furthermore, it is important everyone understands what the menopause is, feels equipped in having conversations about this topic and is aware of our approach.

Equality

Menopause affects a large number of people, and this can include those who are non-binary, transgender and those with differences in sex development (DSD). Likewise, individuals may experience medically induced menopause at any age. We therefore recognise that for many reasons people’s individual experiences of menopause may differ greatly, and as such, different levels and types of support and adjustments may be required.

Support

We are committed to supporting employees who are experiencing menopausal symptoms and helping colleagues and managers to understand the topic further. This includes how colleagues can support themselves and where managers can provide support. Our Menopause Guide promotes a greater understanding of the menopause and its symptoms and aims to create an environment in which employees can openly and comfortably hold conversations about menopause.

We recognise that there are many workplace factors which can make working life more difficult for individuals experiencing menopause and which may make symptoms worse. Due to the difference in experience of menopausal symptoms, workplace adjustments need to be explored on an individual basis. The guide gives examples of workplace adjustments and a risk assessment to record the adjustments agreed and implemented. This process should be a two way discussion, similar to conversations about other long-term health conditions.

If you experience menopausal symptoms, you are encouraged to inform your line manager at an early stage to ensure that adjustments can be explored and implemented. Managers should take a positive and supportive approach to discussions and where necessary signpost you to further support. You can also access support from the Employee Assistance Programme or the Wellbeing Team in People Services by emailing employeesupport@lancashire.gov.uk.

Menopause can be talked about openly in the menopause peer support chat forum, which enables a safe space for discussion between colleagues across the organisation. An annual menopause staff survey allows colleagues to share their thoughts regarding the impact of menopausal symptoms at work and what they find helpful. Regular events are hosted to encourage peer support and to learn more about the effects of menopause and different approaches to managing the impact.

Training for colleagues and managers

Training is available for all employees to increase their awareness of menopause, the symptoms and the impact it may have and how individuals can be supported. It is recognised that menopause may indirectly impact others such as partners, families, and colleagues.

We are committed to supporting managers in becoming aware about the impact the menopause may have on employees. A manager specific training session is available to increase knowledge and awareness of symptoms that affect individuals, how this can impact them within work and the support available.

Managing absences

We acknowledge that severe menopause symptoms may impact an individual's overall wellbeing and fitness for work, which may on occasion, lead to absence. Sickness absence due to menopausal symptoms will be treated sympathetically as with other long-term health conditions.

Andropause

We also recognise that individuals may experience symptoms of andropause, which is the term used to describe age-related changes in male hormone levels. Information on this is included within our guidance package available to all employees.