Menopause Wellness Toolkit

Menopause and Endometriosis - A Practical Guide for Kaimahi

The purpose of this toolkit is to help retain valuable talent by supporting women through menopause.

We wish to acknowledge other world views around this topic. If you would like to contribute to this page or have a question please contact PeopleandCulture@op.ac.nz

Endometriosis

Endometriosis is a condition that occurs when cells similar to those that line the uterus are found in other parts of the body.

It most commonly occurs in the pelvis and can affect a woman's reproductive organs. Causes, symptoms, diagnosis and the options to manage and treat endometriosis, including lifestyle, pain-relief medications, hormone therapy and different types of surgery, are all discussed here.

Often women have questions about the effect of endometriosis on their bladder and bowel, fertility, emotional health and relationships. Knowing where to go for advice and support is important. Reading and listening to the personal stories of women who have endometriosis is helpful, too, particularly in reminding you of the importance of not giving up hope.

For more information and resources have a look at Endometriosis

The Four Phases of Menopause

1	2	3	4
Pre-menopause	Peri-menopause	Menopause	Post Menopause
Having regular periods	The beginning of the transition and onset of symptoms	A single day after 12 consecutive months without a period	Generally, 2-3 years after the last period
First menstrual cycle -- first signs of menopause	Estrogen levels decline -- period fluctuates.	End of woman's reproductive life.	Stage following menopause for duration of life.

Perimenopause

Perimenopause means “around menopause” and refers to the time during which a woman’s body makes the journey to menopause. Also called the menopausal transition, it is the years leading up to menopause and the time for the onset of symptoms. Perimenopause can start at different ages. This period can be more chaotic than menopause itself and can last for years.

The symptoms of perimenopause, taken on their own or collectively, can directly impact the experience and performance at work. The impact of perimenopause on the work experience depends on a variety of factors including severity of symptoms, workload, environment, and attitudes of colleagues and formal leaders.

The level of oestrogen - the main female hormone - in the body rises and falls unevenly during perimenopause. Ovulation becomes irregular, progesterone is not produced if ovulation does not occur, periods become irregular, and the thickness of the uterine lining varies according to the hormone levels in the body.

Premature and Early Menopause

Premature menopause and early menopause are conditions where a woman goes through menopause at an earlier age than is typically expected. Both conditions can result in people being unable to become pregnant. If there is no obvious medical or surgical cause for the premature menopause, this is called primary ovarian insufficiency (POI) or premature ovarian insufficiency.

Genes, some immune system disorders, or medical procedures can cause premature menopause. Other causes include:

Premature ovarian failure: This is when the ovaries prematurely stop releasing eggs, for unknown reasons, and the levels of oestrogen and progesterone change. When this happens before 40, it is called premature ovarian failure. Unlike premature menopause, premature ovarian failure is not always permanent.

Induced menopause: This happens when the ovaries are removed for medical reasons, such as uterine cancer or endometriosis. It can also happen when radiation or chemotherapy damages the ovaries.

Menopause

Menopause itself is one day in a woman’s life. This is when oestrogen levels decline and periods cease, reaching the end of natural reproductive life. Once a woman has not had periods for 12 continuous months, she has gone through menopause. However, it is important to ensure that the lack of periods is not due to another reason, like abnormal thyroid function or the use of birth control pills. Menopause is when the ovaries no longer release eggs and oestrogen levels become very low.

Post Menopause

Post menopause refers to the time after menopause. Post menopause is generally two to three years after a woman’s last period when some of the symptoms subside. The symptoms of post menopause continue to impact people’s experience in the workplace, despite the severity of cognitive and physical symptoms subsiding. The symptoms reported to be most problematic for people in this stage are osteoporotic symptoms such as joint and muscular discomfort.

Hormone levels will remain at a constant low level and the woman will no longer be able to become pregnant, nor experience monthly menstrual cycles. Critically – post menopausal people will be at increased risk for:

Osteoporosis: This is a condition that causes the thinning of the bones. This change in bone density increases following menopause, particularly in the first few years after the period stops and is due to the loss of oestrogen in the body. A woman may lose up to 25 percent bone density following menopause up to age 60. Osteoporosis makes a woman susceptible to bone fractures, particularly in the hips, spine, and wrists.

Cardiovascular disease: Menopause does not directly cause cardiovascular disease, but it may increase a woman’s risk. The shift in hormones as well as changes to blood pressure, “bad” cholesterol, and triglycerides (a type of fat found in the blood) can also occur following menopause. It is important to note that energy levels may increase, and cognitive and physical symptoms often subside.

Symptoms

Menopause can cause a wide range of symptoms, both physical and psychological that can last for a number of years. However, symptoms can fluctuate and be felt to varying degrees, everyone is different.

Common symptoms can include (and are not limited to):

Psychological issues such as mood disturbances, anxiety and /or depression, memory loss, panic attacks, loss of confidence, and reduced concentration
Hot flushes (brief and sudden surges of heat usually felt in the face, neck, and chest)
Fatigue (sleep disturbance can make people feel tired and irritable)
Night sweats (hot flushes that happen during the night interfering with sleep)
Irregular periods and /or periods can become light or heavy
Muscle and joint stiffness, aches, and pains
Recurrent urinary tract infections (UTIs) including cystitis
Headaches
Weight gain
Palpitations (heart beats that become more noticeable)
Skin changes (dryness, acne, general itchiness)

Research indicates some individuals have positive experiences from menopause, which can include increased confidence and a sense of authority; speaking one’s mind more often; no longer willing to tolerate inappropriate behaviour in the workplace and less concerned about others’ opinions.

Why do these symptoms occur?

Symptom	Why?	Why?
Foggy brain	Awkward & embarrassing word and name ‘gaps’, general mind storms, and difficulty concentrating. It can feel like your brain is full of cotton wool, or as if you are driving with the brake on.	The lowered levels of oestrogen essentially create an imbalance in the brain chemistry, affecting how it works and how well the different parts of the brain communicate with each other.
Anxiety	A persistent and nagging feeling of tension and nervousness, which can manifest as palpitations, dry mouth, chest pain, nausea, headaches, or even panic attacks.	With less oestrogen going to your brain, this can reduce levels of serotonin (the ‘happy hormone’) and increase cortisol levels (the hormones of stress).
Mood Swings	You can experience a whole spectrum of emotions, from feeling unexpectedly, tearful right through to irrational anger.	As with anxiety, this is driven by reduced levels of serotonin, but also increased levels of norepinephrine (also known as noradrenaline), which increases heart rates and blood pressure and can create fluctuating emotions.
Hot Flushes	Unexpected and sudden rushes of heat, often in the face, neck, and chest, making your skin red and sweaty.	These are known as vasomotor symptoms (and one of the more commonly known effects of menopause). They are created by a sudden increase of blood flow, usually to the face, neck, and chest. Normally the body is good at regulating internal temperatures, but the decrease in oestrogen levels can affect the body’s ability to self-regulate.
Night Sweats	Unexpected and sudden rushes of heat, often in the face, neck, and chest, making your skin red and sweaty.	Also, a vasomotor symptom, lowered oestrogen levels affect the body’s temperature regulation, which is exacerbated by bed covers at night.
Chilly	It might sound counterintuitive, but you can also get a surprising onset of chills, and no matter what you put on, you can’t seem to warm up.	As with hot flushes, the hypothalamus part of the brain responsible for heat regulation is affected as oestrogen levels drop, and can misinform your body that it is overheating, and try to compensate by shedding heat.
Insomnia	Despite feeling tired, a persistent state of awareness or regularly waking up, leading to further exhaustion.	This can be driven by a number of factors, including the night sweats, but also general anxiety, joint pains, bladder issues, brought on by hormonal fluctuations.
Bladder Issues	Urinary infections, occasional leakage (made worse by coughing, sneezing, or laughing) and needing to go to the loo more, particularly during the night.	The decrease in oestrogen levels can weaken the pelvic floor, affect bladder tissue and the urinary tract, making it harder to control your bladder.
Itchy Skin	Many people experience itchy skin during menopause.	Low levels of oestrogen reduce the production of collagen and the natural oils that keep your skin moisturised. This can cause the skin to become dry and irritated.
Skin Crawling Sensation	Some people can experience uncomfortable sensations that feel like there are insects crawling across their body, when there is nothing there (also called ‘formication’).	Fluctuating hormones, along with the consequent impact of thinner and drier skin can lead to this unpleasant sensation.
Pins and Needles	Occasional unpleasant sensations or numbness in hands and feet.	Oestrogen impacts the central nervous system and circulation. Any oscillation can create an imbalance that causes tingling or numbness, particularly in the extremities.
Joint & Muscular Pain	This is called ‘menopausal arthralgia’ and can be an uncomfortable feeling of soreness, swelling and stiffness around the joints. It can often be worse in the morning.	Lowered oestrogen can affect cartilage (the connective tissue in joints) and the production of collagen (a fibrous protein that gives the skin strength and flexibility) which together provide a kind of scaffold for the skeleton.
Breast Tenderness	Sometimes this can be a dull throbbing, tenderness, and soreness, but can also feel like sudden stabbing pains.	As with joint pain, this can be caused by the weakening of connective tissue supporting the breasts. As with periods, it can also be hormonal fluctuations creating the tenderness.
Bloating & Weight Gain	Many people complain of weight gain, and difficulty in losing weight. There can also be a general feeling of bloating, tightness and swelling in the abdomen.	This can partly be down to the fact that fewer calories are needed during menopause because calorie-consuming muscle mass is waning. So, if eating volumes are maintained, weight gain is likely. It is fluctuating hormones that cause the bloating effect.
Headaches & Migraines	This can partly be down to the fact that fewer calories are needed during menopause because calorie-consuming muscle mass is waning. So, if eating volumes are maintained, weight gain is likely. It is fluctuating hormones that cause the bloating effect.	This is an effect of oestrogen withdrawal, as the normal hormonal balance is disrupted. Other symptoms, such as anxiety, lack of sleep and hot flushes can also contribute to headaches.
Burning Tongue	Apparently experienced by up to 4 in 10 people you can feel as if your tongue is burning, tender, tingling, or numb.	Dwindling oestrogen levels can reduce saliva production, cause a metallic taste in the mouth, and activate pain-sensitive nerve cells at the back of the tongue.
Changes to Taste & Smell	Apparently experienced by up to 4 in 10 people you can feel as if your tongue is burning, tender, tingling, or numb.	Dwindling oestrogen levels can reduce saliva production, cause a metallic taste in the mouth, and activate pain-sensitive nerve cells at the back of the tongue.
Hair Loss	Hair can become more brittle, fall out all over and be replaced by finer hair, making it look and feel thinner than previously.	Hair loss is normal for everyone. But oestrogen and progesterone help to keep hair in the ‘growing’ phase, making it grow faster and stay on the head longer. As these hormones decline, hair growth can slow, and hair loss speed up.
Heart Palpitations	It can sometimes feel as if your heart is pounding or racing, almost as if you’ve been running. The feeling can also rise up through the neck and throat.	These can be an effect of other symptoms (anxiety, stress, and particularly hot flushes), but can also be the result of lower oestrogen levels.
Period Pandemonium	Early or late, ridiculously heavy, or almost pointlessly light, short, or long. The problem is you never know.	The various chemical messengers fall out of sync as the levels of oestrogen rise and fall unevenly, creating an equally unpredictable menstrual cycle.

Endometriosis

Endometriosis is a disease characterised by the presence of tissue resembling endometrium (the lining of the uterus) outside the uterus. It causes a chronic inflammatory reaction that may result in the formation of scar tissue (adhesions, fibrosis) within the pelvis and other parts of the body. It causes pain and, in extreme cases, infertility. Unlike a period, as this endometrial tissue grows and sheds, there is no way for the tissue to leave the body – which can cause chronic pain and other symptoms. The variable and broad symptoms of endometriosis mean that it is not easily diagnosed, and it is often hard for people suffering from it to have a comprehensive awareness of the disease. This can cause a lengthy delay between onset of symptoms and diagnosis.

Symptoms associated with endometriosis

Symptoms vary, are often severe and life impacting, and can include any or all the following:

painful periods
heavy periods
chronic pelvic pain
painful urination, bowel movements
fatigue
depression and/or anxiety
abdominal bloating and nausea

How it affects people at work

Endometriosis is a painful often debilitating disease and often decreases a person’s quality of life due to severe pain, fatigue, and depression. Global studies demonstrate that endometriosis has significant social, public health, and economic implications. A significant majority with endometriosis experience debilitating endometriosis-associated pain that prevents them from going to work.

Your Role as the Person Going Through Menopause

Talking about any part of menopause may be extremely stressful and embarrassing for some people. It can be a time of isolation and confusion about what is happening physically and emotionally. During the phases of menopause, we may feel tremendous confusion, self-doubt, and severe anxiety for several years, which can severely impact our career.

Many of us recognise that menopause often intersects with a critical career stage, in our 40’s and 50’s - the age bracket during which people are most likely to move into top leadership positions. Some of us may not be aware that we are going through menopause. It is critical to talk to your GP or a specialist support provider about how you feel and to get blood tests to validate the change in your hormones.

What are the symptoms and why do they occur?

Eight out of ten people will experience several of these symptoms, though not necessarily all at once as the symptoms will typically change over time. Below is a description of some the symptoms and why these occur.

Looking after yourself at work

Every woman will have a different experience of menopause, but these are some helpful tips and tricks to help manage some of the symptoms. It is advisable that you visit your GP or use some of the resources on the resources page if you are struggling. Consider the following and talk this over with your formal leader:

Flexible working – OP has a Flexible Working Policy but you might like to discuss with your formal leader some more specific arrangements, which might include:

Later start times to compensate for disturbed sleep
Later in the day lecturing - timetabling changes
Reduced work hours if symptoms are problematic
Walking meetings to get exercise and calm some of the symptoms
More breaks to provide time for composure and mindfulness

Comfortable clothes – It can often be better to wear natural fibres, and looser fitting clothes.

Cold drinking water – Drink cold water throughout the day and take this to meetings with you.

A cool working environment – Contemplate getting a desk fan. Showers are provided at OP, consider having a cool shower if you get too hot. See if you can have a desk that is near a window that can be opened. Another option would be to hold your wrists under a cold tap.

Time off – If you feel unwell due to menopausal symptoms which may come on during the course of the day, and you feel the need to go home on sick leave, tell your formal leader and feel free to be open about the reason why.

Sleep – Not sleeping throughout the night is a very common problem, with regular waking periods due to body temperature, rest in bed. Consider your bedding, try a gel pillow which keeps your head cool, cooling sheets, and a cooling mattress protector. Try having a cool shower before you go to bed, this sometimes helps.

Bedsheets – Ideally use more natural fabrics, like cotton, bamboo, and linen. Keep a towel next to your bed. Loose bed clothes also help to keep air flow going, keeping you cooler, and reacting less to sweat. Think about having a spare set of bed clothes on hand.

Diet – Eat a healthy balanced diet and avoid sugary or processed foods where possible. Some people find it helpful to cut down on alcohol and caffeine, as that can exacerbate some of the symptoms.

Exercise – Can be helpful for a number of symptoms – it can reduce stress levels, increase wellbeing, and even help manage some of the overheating. Even a short walk is better than nothing.

Relaxation – This is such an important thing to make time for. Try and find a way to switch off – go for a walk, read a magazine, do some cooking. Whatever works to help you find a good place to relax.

Yoga – The stretching and flexibility required for yoga can help with aching muscles and can also improve strength and posture.

Keep your brain active – Think about stuff that can keep your brain active – reading, quizzes, crosswords, puzzles. It all helps with brain stimulation.

Practical Coping Strategies

Talk about it – There is nothing to be embarrassed about. It is much better to talk about being menopausal than to overtly struggle in a meeting and be traumatised by it. You will find that people are remarkably supportive.

Take control of the sweat – Try a regular half an hour of sweat-inducing exercise in the day and you might be less affected by night sweats.

Make a food diary – There are some trigger foods that will make the physical symptoms worse, and it is different for everyone. It is worth making notes of what you have eaten that is ‘different’ when you have a particularly bad night – and you will collate a list of food and drinks best to avoid. There are apps you can use, and Health Navigator have a list of these and reviews on these.

Vitamins and boosters – Herbal remedies may be helpful. It may be worth looking at options that have the THR mark (Traditional Herbal Remedies), which means they have been through safety, efficacy, and ingredient checks. However, you should always check for any potential side-effects, and understand about pre-existing conditions or allergies that you might have which could create issues. Chat with your Pharmacist, Doctor, or Naturopath for options.

Stigma and Support

It is up to all of us to remove the stigma of menopause. It is a natural occurrence that happens to 50% of the population, and the more we talk about it, the more normal, and less embarrassing it will become. We encourage you to talk to your formal leaders and your colleagues about how you are feeling and how they can help support you. Help people understand the troublesome symptoms for you.

If you feel uncomfortable talking to your formal leader, please talk to a trusted colleague, one of the leadership team, or someone from People and Culture (P&C) so that we can help you navigate the discussions.

It is very important to be honest about the impact on both our minds and bodies and seek appropriate support and help. It is also paramount to appreciate how hard it often is to talk about menopause at work. At OP, we are eager to support you and ensure you have the care and consideration you require during this time. Conversations you may have with formal leaders or P&C are confidential and will not lead to discrimination and negative outcomes. We firmly believe that any taboo topic loses power when someone with authority addresses it openly. Trying to normalise your challenges may feel awkward but often has the ripple effect of empowering those around you.

How to have a conversation

Having a conversion about ourselves and what is happening physically and cognitively is not easy. It is important that you are comfortable about what you share and with whom you share it. It might be a good idea to think about who you want to share this with, and what you want to get out of the conversation.

If you are thinking about having a confidential conversation with your formal leader, you may wish to practice with a colleague, friend, or someone from P&C to start with. Framing that conversation is important - take the time to work out what you would like to get out of the conversation as well as what you want to say. It is ok if it is not perfect - and you should feel free to reach out to P&C, Employee Assistance Programme (EAP), or find a support network.

Engaging at work

Consider:

Reaching out to the EAP to assist you in getting support for your symptoms.
OP is working with formal leaders to ensure you will have access to support. If you are not comfortable speaking with your formal leader, speak to someone from P&C.
As part of a conversation with P&C or your formal leader you could discuss reasonable accommodations that may be able to be made for you.

This can include:

Having a comfortable working environment which may include a temperature-controlled environment, access to water, and access to a quiet room for rest and privacy dealing with symptoms.
Flexibility to take breaks when needed e.g., a walk to ease pain, or to take medication at specific times to maintain health and wellbeing.

Accessing support

Think about speaking with your GP or specialist support service.
Knowing you are not alone. Change is difficult and can be isolating and confusing. For some it is a time of empowerment, for others it is less so. It is good to remember you are not alone. There are online resources available, have a look at the resources at the end of this toolkit.
Reaching out to someone else who is also going through or has gone through menopause. It is not always easy reaching out, but the benefits can be rewarding. There is power in sharing information and experience. Sometimes our family members mean well but do not have first-hand experience.
Researching menopause. Knowledge is power. The right knowledge is even better! There is lots of information about menopause on the internet. It is good to look at accredited sites as well as ones that will support you on your journey. This can be done online, at a time that is comfortable for you.
Recording your symptoms and their frequency will help you inform your GP and/or specialist support service and help you to frame an understanding of the kind of support you require at this time, including at work. You may wish to use this as a framework for future conversations.

The Role of the Formal Leader

Every formal leader should know what the menopause is, when it happens and how it can affect staff. It is likely that you currently manage or will manage in the future, at least one person who is transitioning through the menopause. How confident do you think a member of your team would feel to talk to you about the menopause?

Menopause need not be an awkward or embarrassing topic. Often a few simple changes to someone’s working environment can make a world of difference, enabling someone experiencing menopausal symptoms to continue performing and contributing to their full potential. Even just talking about it openly can reduce the impact of someone’s symptoms. As a formal leader you are responsible for our people, their performance, and any occupational health and reasonable accommodations required. Menopause affects everyone and is not just a women’s issue. Getting information about what menopause is, how to respond, and how to support our people is critical to break the taboo, retain top talent, and create an inclusive, thriving, and healthy workplace. Those of us who are supporting people going through menopause are often uncertain how to do this. Menopause does not necessarily lead to poor performance or increased absenteeism or presenteeism. It is not necessarily a negative time of life. It is important not to ignore staff by simply hoping ‘it’ goes away or dismissing it as a ‘women’s issue’ is not realistic, or supportive.

Menopause often strikes when someone is in the prime of their career. This can have a distressing effect on someone’s self-confidence. Normalising the subject of menopause and being able to have an open conversation fosters empathy and understanding. Menopause is a sensitive subject and when communicating about this the OP values should be front of mind.

It is also important for us to understand how symptoms may affect people at work. Everyone recognises hot flushes as a symptom of menopause, but research results suggest that fatigue, difficulty focusing or concentrating, anxiety and worry, and insomnia were the symptoms people said affected them most at work. It is critical to remember, like most issues facing our staff, the workplace should be a safe space. We have a role to play to support our colleagues. Supporting your staff experiencing menopause transition is crucial. When a person comes to work it is not just one part of them that comes to work. We all bring our whole selves with us - which may include both challenges and brilliant parts of our lives considered ‘personal’ or ‘outside of work’. If our child or parent is ill, it will weigh on our mind; if we are experiencing sleeplessness or fluctuations in how we feel this may be part of who we are. Effective management of team members with menopausal symptoms that are impacting upon their work will help you improve your team’s morale, retain valuable skills and talent, and reduce sickness absence. Your role as a formal leader is to have supportive conversations with all of your staff.

Simple tips and having a conversation

Building relationships based on trust, empathy, and respect will make it easier for staff to feel comfortable about raising health issues, including menopause.

Like any conversation you have, supportive and ‘human’ conversations make all the difference. Here are a few strategies that may help:

Learn the facts about menopause and how it may affect our people at work. Some of our people will speak with you about themselves, others perhaps about family members.
If a member of your team comes to you, ensure you make the time for them and you are available. Find a private place where both of you are comfortable. Make sure both of you have water - this is good practice when having a potentially emotive conversation. Create an environment where menopause can be talked about openly without embarrassment.

Regular and informal one-to-one conversations with members of your team can provide the forum for a conversation about any changes to someone’s health situation. Having frequent check ins with your colleague makes it easier to build trust and talk openly about issues at work and home. Genuinely asking people how they are on a regular basis will help to create an open and inclusive culture and encourage your staff to raise any concerns.
If you need to address issues of performance or how menopause is affecting a member of your team, remember that every person’s journey is unique to them and symptoms can fluctuate and be felt to varying degrees, so take your lead from the individual.
Recommend the use of EAP if required, also point them in the direction of the resources on the Menopause Resources page.
Discussions could include confidentiality, potential reasonable accommodation being requested, support required around leave for appointments, flexible working hours and/or working from home.
You may consider taking notes during conversations you have and agree what actions can be taken. Set a time to check in if the person - it can make them feel more supported. Again, each affected person should help guide the conversation.

Remember that providing the right support and communicating openly enables all people - and teams - to perform at their best.
OP has an open and inclusive culture and have a trans and non-binary supportive culture, recognising people of diverse gender expressions and identities who experience menopause.

How to approach a sensitive conversation

It is important to set the right tone when opening a conversation about any sensitive issue. However, try not to worry too much, being over-sensitive will stop you from addressing the issue. Review this checklist before approaching a sensitive conversation which has suggestions for differing symptoms:

Sleep disruption and/or night sweats	Recognise someone may need to take a short-term absence if they have had a difficult night. Offer a flexible working arrangement, for example either a later start time or an earlier finish time.
Hot flushes	Look at ways to cool the working environment, for example provide a fan, move the desk close to a window, adjust the room temperature, if possible.
Heavy or irregular periods	Acknowledge there will be more frequent breaks. Allow staff to leave work at short notice, and temporarily work from home if they have very heavy bleeding, headaches, or fatigue.
Headaches and fatigue	Consider a temporary adjustment to work duties and flexible working hours. Provide a quiet area to work where possible or they could use noise cancelling headphones. Acknowledge more frequent breaks if required.
Muscular aches and bone and joint pain	Make any necessary temporary adjustments to work, and flexible working hours. Encourage movement and stretches if that helps. Encourage the staff member to undertake an ergonomic workstation assessment. Explore the provision of a close carpark to work for a period of time.
Psychological issues (for example loss of confidence, poor concentration, anxiety etc.)	Support your staff member to discuss concerns with you. Discuss possible adjustments to tasks and duties that are proving a challenge. Allow time out from others when needed, to have some quiet time or to undertake relaxation or mindfulness activities. Have agreed protected time in their diary to catch up with work. Encourage staff member to visit their GP for support, also EAP. Ensure your staff are not disadvantaged if they take leave for their wellbeing.

Some other suggested for conversations:

If a team member raises concerns about a colleague who appears not to be their normal self, a leader could approach the colleague by saying “I have noticed ….”, “How are you feeling? Are you sleeping ok?”
Avoid interruptions – switch off phones, ensure colleagues cannot walk in and interrupt.
Ask simple, open, non-judgmental questions and avoid patronising responses. Questions like – how may we support you, how do you feel, what would you like to see happen?

Speak calmly and maintain good eye contact.
Listen actively to gain a better understanding of what their symptoms are.
Encourage your staff member to talk and give them ample opportunity to explain the situation in their own words.
Show empathy and understanding and be prepared for some silences and be patient.
Avoid making assumptions or being prescriptive.

For further information you could refer to The menopause at work - a practical guide for people managers

Information for Colleagues

Menopause affects everyone - whether experiencing it first or second hand as a colleague or partner. Therefore, it is important to have an open mind, be sensitive to the issues and not make any assumptions. You can help by breaking the silence – even just talking about menopause with our colleagues can make the world of difference to a woman’s ability to cope with menopause, especially in the workplace. This will also encourage a more open and inclusive environment, which is essential to helping people going through menopause and to get the support they may need.

How to have a conversation

Given the taboo nature of menopause, people who may wish to support colleagues affected by menopause are often uncertain of how to approach the topic. Adopting some of the following strategies to help break the stigma and provide support:

Brush up on the facts on menopause and how it may affect people.

Ask how the person is - be patient if there are silences.
Keep an open mind and be flexible. Do not make assumptions about what someone may be going through.
Signpost to helpful information – remember that you are not the expert. Suggest speaking with their GP, reaching out to a specialist support service such as our Health and Wellbeing Partner, or recommend EAP.
Consider joining a community to learn more about support. Knowing colleagues are not alone can be hugely beneficial for people experiencing the debilitating symptoms of menopause.
Create an accepting environment for our people - an open, supportive culture making use of positive language can help people dealing with menopause symptoms such as memory and concentration lapses.

Information for Family and Friends

Menopause is a journey every woman takes.
Learn the symptoms. One of the frustrations of perimenopause (the stage of life where hormonal fluctuations and menopause symptoms start) is it is unpredictability.
Keep lines of communication open. Listen. Sympathise. Be patient. Do your best to understand an experience you may not ever share. Do not push. This is such a sensitive and highly personal subject, many people may not want to talk about it, but just knowing you are there and supportive can make a huge difference.
Give them free range over the heating, and whether the bedroom or office window is open or closed. Do not call attention to their symptoms.

Help to build their self-confidence. With the sensitive topic of menopause, self-confidence can be diminished at menopause.
Do not doubt or diminish their experience. Menopause is real, and possibly the worst thing anyone can do is deny their experience or tell them “it’s all in your head.”
Emotional symptoms are also very real. Support them, provide a safe space, know they are doing the best they can, and help them continue to be the best they can be.
Get the support you need, too. Find ways to take care of you so you can be there for

Resources

Websites

Tippi Endometriosis Tips for Living
Heretaunga Women's Centre - Follow Dr Samantha Newman's menopause journey
NZ Early Menopause Support Group An information website with news, links, discussion groups and support groups.
Australasian Menopause Society Provide educational information for both health professionals and women, links to the latest research, information sheets and resources and a directory of doctors who specialise in women’s health and menopause.
Whaea-power and the mentalpause... - Collective Intelligence member and staffer, shares her experiences of the ‘mentalpause’ and reflects on Collective Intelligence’s newly-minted ‘Menstrual and Menopause Policy.
MPowered Women This website has real life stories and offers some help.
Health Navigator - Menopause NZ based not-for-profit website backed by the District Health Boards which provides information and key links.
International Menopause Society - The International Menopause Society (IMS) brings together the world’s leading experts to collaborate and share knowledge about all aspects of aging in women. The IMS advocates evidence-based treatment options that optimise mid-life women’s health and promotes best practice in women’s health care.
My Menopause Centre After experiencing their own challenging menopause journeys, GP and registered menopause specialist, Dr Clare Spencer, and women’s wellness champion, Helen Normoyle, knew something needed to change to stop other women from going through the same thing. Clare dedicated time to qualifying as a menopause specialist and then joined forces with Helen to create My Menopause Centre – a website that provides evidence-based information and advice on the menopause (what it is, the symptoms and how to treat them) as well as on online menopause clinic run by Dr Spencer where she and the other menopause specialist doctors take a holistic and personalised approach to treating the symptoms of the menopause. Take their menopause questionnaire to receive a personalised assessment that will help you see if and where you are on the menopausetransition, as well as an explanation of any symptoms and a range of treatment options.
Sexy Aging – This website has books, articles, podcasts, courses and blogs. It is a resource for midlife women with all the tools you could ever need to gracefully move through menopause.
Balance - This UK website are on a mission to make support with the menopause inclusive and accessible to all women, and trans and non-binary people.
Join the Menopause Awareness & Action Community on Linkedin (you need to be a member of Linkedin to join this).
Jean Hailes - Creating a healthier future for all women - this website has some delicious recipes and lots of different information on women's health.
Jean Hailes - Greene Climacteric Scale this scale provides a brief measure of menopause symptoms, it can be used to assess changes in different symptoms.
CPID - The menopause at work: Guidance for people professionals
MenoDoctor - Dr Linda Dear works as a Menopause Specialist in Tauranga and lives with her husband and two energetic young boys and runs this website
Menopause ma' lady? - This site includes a webinar from Professor Bev Lawton who talks about disparities that exist for Māori and Pacific women
Māori: Menopause what are the symptoms? - This website includes a poster in Te Reo around the symptoms of menopause.
Heretaunga Women's Centre

Apps

Peppy App Have a look at the web site and download the Peppy app, which provides access to instant messaging with expert practitioners, 1-2-1 and group video calls, programmes, podcasts, and webinars.
Balance Get information and fact sheets about menopause.

Podcasts

Visible Women 45 mins
Understanding Menopause 2020 74 mins
Breaking the Silence on Menopause 2022 24 mins
Showy Ovaries (Series) Penny Ashton
Breaking the Silence on Menopause Kate Billing and Anna Thomas 2022 24 mins
Visible Women Power Pause Vanessa Baxter and Jeanette Kehoe-Perkinson 2021 (Series)
The Hormone Rollercoaster Dr Beverley Lawton(Series) 2015
Perimenopause, breaking the cycle of silence Shelly Horton 23.53 mins
NZ-based leading expert on women's health and fitness, Dr Stacy Sims, to discuss all things nutrition, hydration, food and gut microbiome.

Webinars, TED Talks, Videos, Documentaries, Podcasts, and Interviews

Pause for Thought: Menopause & Employment Law 2022 54 mins
The Link Between Menopause and Gender Inequity at Work Andrea Berchowitz 2021 8 mins
Dr Jen Grunter's Menopause Manifesto Kim Hill 2021 52 mins
Menopause Dr Anna Fenton 2019 24 mins
How Menopause Affects the Brain Dr Lisa Mosconi 2020 13 mins
Why More Women Get Alzheimer's Dr Lisa Mosconi 2020 24 mins
The Truth About Menopause Mariella Frostrup 2019
Why We Need to Talk About Menopause The Project on Newshub 2019
Pause for Thought S2 Ep1: Dr Linda Dear & The NZ Menopause Survey 53 mins 05/04/2023
Videos from the British Menopause Society - lots of information here on all different aspects of menopause
Public Talk: Women's health in mid-life: Happiness and hormones - University of Otago 1 hour 6 mins
The Dr Louise Newson Podcast - a variety of podcasts in this website
Menopause: A sisterhood of indigenous women gather to rant, laugh, and share stories 18mins 29 secs

Books

Niki Bezzant – This Changes Everything
Nicky Pellegrino – Don’t Sweat It
Tracey Minnoch Nuku – My Menopause Memoir
Laura Briden – Hormone Repair Manual
Dr Jen Gunter - The Menopause Manifesto
Dr Lisa Misconi - The XX Brain
Caitlin Moran - More Than a Woman
Darcey Steinke - Flash Count Diary
Miranda Sawyer - Out of Time
Avrum Bluming MD, Carol Travis PhD - Oestrogen Matters
Kate Codrington - Second Spring

Fact sheets

Articles

People and Culture acknowledge the contribution of the staff involved in the Menopause Forum. People and Culture would also like to acknowledge the following sources of information which this site is based on:

Vodafone Menopause Toolkit