Review articleMenopause in the workplace: What employers should be doing
Introduction
Reflecting the increased participation of women and the aging profile of labor markets in many industrialized nations, a growing number of women aged 45 years and over have taken up paid employment over the past two decades [1], [2].1 This trend is likely to continue as national governments and employers tackle the challenges of an aging population by seeking to retain and increase the number of mature-aged women at work [3]. In consonance with these demographic and economic imperatives, a large and, in some nations, ever-growing number of women are transitioning through menopause whilst in employment [4], with the majority of women symptomatic between 45 and 55 years, and some likely to exhibit certain symptoms beyond [5]. However, the many specific and interconnected health, lifestyle, aging and work-related concerns of women aged 45 years plus (including menopause) which can influence women’s participation in paid employment, and engagement and performance whilst at work, are often overlooked. In most of the literature to date, ‘work’ has not been the primary focus of interest, sometimes even only as a single item on a survey [6]. This oversight is potentially costly for employers. In one study of 252,000 symptomatic employees, the incremental direct and indirect costs of their untreated vasomotor symptoms (VMS) for employers amounted to circa USD $370,000,000 over one year [7]. Despite the clear and significant business case for ‘managing’ menopause, organisations have been slow to respond. A survey of 500 UK health and safety representatives conducted for the UK’s Trades Union Congress (Paul, 2003) [4] found that only 1 in 5 employers provided information about menopause to employees; a mere 2% covered it as part of their health and safety provision.
This review summarizes the existing literature on menopause in the workplace. It pays particular attention to how menopausal symptoms affect and are affected by a woman’s working status, as well as key physical and psychosocial work-related factors that may exacerbate or ameliorate symptom experience. The review synthesises recommendations for employers on what they could best do to support employees going through menopause, notes limitations in existing studies, and concludes with directions for future research.
Section snippets
Search strategy
We conducted an initial search using the Ovid MEDLINE database from the fields of medicine/nursing/health sciences (no time range limits) using the keyword combinations: menopause/work (693 citations); menopause/employment (138 citations); and menopause/productivity (18 citations). Scrutiny of these references highlighted that ‘work’ was typically used as a synonym for efficacy (e.g., in relation to menopause treatments), or in a general sense, rather than to specifically refer to the workplace
Results
In most studies to date, ‘work’ has typically not been the primary focus of interest, often only included as a single survey item [6] (usually as the sociodemographic variable ‘employment status’) and tested for its potential association with symptom reporting (see Section 3.1 below). However, there is a trend over the last decade or so towards studies that place a primary and more systematic focus on menopause in the workplace. These recent studies (2000–2015) offer more detailed quantitative
Conclusion
It is only in recent years that peri-menopausal and post-menopausal women’s experiences in the context of paid employment have been systematically researched. The literature summarized above suggests that vasomotor, psychological and somatic menopausal symptoms can create difficulties for some women at work, and that physical (notably the temperature and spatial layout of the working environment) and psychosocial (notably work stress and job control/autonomy) facets of the working environment
Contributors
Professor Gavin Jack* declares that he helped conceive the form of the review, designed and participated in the literature search, wrote an initial draft of the paper and contributed to the final draft, and has seen and approved the final version.
Associate Professor Kathleen Riach declares that she helped conceive the form of the review, participated in the literature search, contributed to the final draft, and has seen and approved the final version.
Ms Emily Bariola declares that she helped
Conflicts of interest
None.
Funding
None.
Provenance and peer review
Commissioned; externally peer reviewed.
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Dr Schapper died in September 2014. She was an Honorary Researcher in the Department of Management, La Trobe Business School, La Trobe University, Bundoora, VIC 3086, Australia.