Menopause and work – how 'the change' presents a real opportunity for change
I started writing this post in response to the UK government’s current call for evidence as part of a public consultation on women’s health, which includes the impact of menopause on work. This is the first time I have responded to a public consultation from both a professional and personal perspective - it doesn't fully grasp the complexity of the issue, but the opening sentence got my attention:
"For generations, women have lived with a health and care system that is mostly designed by men, for men"
As a menopausal woman, this is the exact sentiment I wanted to convey, but also extend it to work. Because I see important parallels between this current consultation, and one I have previous experience of helping to produce, that present real opportunities for change. If government joins up their thinking.
During 2016-17, I was seconded from my academic post to the Department for Work & Pensions as a Policy Fellow. My role was to help UK government produce evidence-based policy, and as part of this, I was involved in the preparation of the Improving Lives: Work, Health and Disability Green Paper. A joint publication with the Department of Health & Social Care (joined up thinking!), it received around 6,000 responses from individuals and relevant organisations across the UK during its public consultation.
As a result, government announced an ambitious strategy in 2018 to reduce the disability-employment gap, pledging to see 1 million more disabled people in work over the next 10 years. In line with the Equality Act 2010, a disability also includes long-term health conditions. This means the vast majority of work disability is avoidable - the evidence shows one of the most effective ways to achieve this target is to prevent people becoming part of the statistic in the first place and help them to remain in work.
What was missing from this strategy was the recognition that menopausal women are the fastest growing demographic in the workforce. And it’s somewhat ironic now to realise that during the time I was helping to prepare this policy, I was perimenopausal. Like many women, I was unaware that what I was experiencing – unexplained anxiety, chronic pain, hair loss, frequent bouts of insomnia and headaches – are classic symptoms. I suppose without the more characteristic symptoms (hot flushes, night sweats - although these have now made an appearance!), I didn’t once ask myself, ‘is this menopause?’
I just accepted it was the health ups and downs of life. Apart from seeking healthcare for the debilitating pain of two frozen shoulders in the last 5 years (another classic symptom apparently!), I was rarely at my GPs and I didn't even think about taking time off work. This in itself isn't necessarily wrong - but the lack of knowledge about what was going on in my own body meant I felt powerless about what was happening to me. I thought I was being weak by having so many symptoms. It was only after developing frequent migraines, confusion, stomach problems and fatigue over the past year that I went for some routine blood tests, which identified I was menopausal.
I know it isn't just menopausal women that experience these health problems over the course of a working life. But all working lives are not equal. In common with many other working women my age, I also do the lion’s share of parenting on top of playing career catch-up ever since taking maternity leave followed by a few years part-time working. Sure, having children is a choice, but one that seems to limit the choices for one working parent more than the other. This is because policy has not caught up with our advances in the workplace – parenting and caring is still chronically undervalued.
We are the generation of women that were told we could ‘have it all’, only to realise that this largely translates to ‘doing it all’ (for less or no pay). Never has this invisible labour been so important. It underpinned the economy during the pandemic, with the schools closed and our usual care and social support systems unavailable. Yet these same women will be returning to work in fewer numbers. Decades of inequality are now being felt in our exhausted menopausal bones.
So, I welcome the recent public discussion and government consultation. It’s totally unacceptable that women don’t have access to accurate information about what we will all experience at some point in our lives, and what we can do about it (and there is a lot!). But I hope this debate doesn't get dominated by the view that menopause is purely a healthcare issue, a collection of symptoms to be treated. I understand how debilitating those symptoms can be, and every woman should have access to appropriate healthcare. But to me, this misses the point.
Because this view promotes an ongoing denial about the huge, sustained, and natural life transition that menopause is - it side-steps the long-term solutions and collective responsibility required. And unless we have a 'whole-systems' approach, menopausal women will be the group that significantly widens the disability-employment gap. Conversely, this means menopause presents a real opportunity for UK government to meet their ambitious target and ‘build back fairer’. Yes, healthcare and employers need to do more, but government needs to make sure they can. Pre-pandemic, healthcare wasn't largely work-focused, and employment wasn't always health-supportive - it's unlikely they will be more so now.
Perhaps what would be more helpful is for government to produce policies that support women in redefining what successful and productive working lives look like. Historically, these have been defined by one half of the population only. Similar to the bigger questions currently being asked about our unequal healthcare system, we need to ask the same questions about work. We have the power in numbers to start asking (and demanding answers to) these bigger questions. I would urge all women aged 16 and over to contribute to the current government consultation - instead of getting signed off, let’s start speaking out.