A British Medical Association survey shows that 90% of doctors in the relevant age group believe that menopause has affected their work performance. Yet it remains a taboo workplace subject that is leading to an unaffordable loss of senior doctors.
Sometimes the culture in which we work is helpful, and sometimes it is a massive barrier to career progression, writes Helen Fidler, British Medical Association (BMA) consultants committee deputy chair. This is particularly the case for senior doctors with menopausal symptoms where a “just-get-on-with-it” approach affects doctors taking up leadership positions and providing the UK’s National Health Service (NHS) with their valuable expertise. And with 30,000 doctors at risk of menopausal symptoms in the 45- to 54-year age group right now, we need to make sure their needs are met.
Especially as this number is going to rise as the demographic of the workforce changes and, of course, we already have a senior doctor shortage. On average the menopause lasts four years – and that could be four years where experienced doctors may leave the NHS or take a step back from leading their teams. If the menopause is properly recognised as a workplace issue, and the right support is given, we will retain doctors the health service cannot afford to lose.
Yet discussing the menopause and its effects on our working lives is something we just don’t do. I can imagine the expression on the face of male colleagues and managers if I brought up the subject. Most would be embarrassed and frankly, so would I.
Men and women are totally unprepared for how to deal with talking about menopause in the workplace – because it is a pretty taboo subject and trusts rarely have a menopause policy or training in this area. Add to that the problem that doctors find it very hard to talk about anything that affects their performance and we just ‘shut up, and put up’.
So how is the menopause affecting our colleagues? The BMA has surveyed nearly 2,000 doctors in this age group who have told us that 93% have had symptoms, with two thirds of these having physical and mental symptoms. And alarmingly 90% felt it affected their work, with nearly two fifths finding it significant. Predictably, given the lack of education for managers, nearly 40% had wanted to make change but couldn’t and nearly half had wanted to discuss the problem with managers but felt uncomfortable doing so.
And it is relatively simple to make adjustments for this relatively short period of a doctor’s working life. Gender-sensitive risk assessments, access to cold water and fans and toilet facilities, sanitary products and cotton scrubs go a long way to help. Flexible working to help with sleep deprivation and a non-judgemental attitude to menopause-related sick leave are needed to reverse the earlier retirement age of older doctors at risk of menopausal symptoms.
The Equalities Act 2010 and the Disability Discrimination Act are relevant here – if menopause is causing an impairment to how you work you are entitled to reasonable adjustments but this is rarely offered.
We simply have to change the culture of sniggering about “forgetful tearful women of a certain age”. Older doctors are pivotal for caring to patients and we have to retain them. To do that we must start talking about menopause openly and without gendered ageism. After all, if we can discuss sex and death without embarrassment why shouldn’t we ditch this last taboo and make life better for our colleagues?
The findings will concern the nine out of 10 hospital bosses in England who fear under-staffing across the service has become so severe that patients’ health could be damaged: there are currently more than 30,000 female doctors aged 45-55, when menopause typically occurs, reports The Guardian. This number will rise significantly as the new cohort of medical students progress, almost 60% of whom are female.
“It is extremely concerning to find that some women may be permanently stepping back from senior positions in medicine – a key cause of the gender pay gap – and the health service may be losing highly experienced staff because of inflexibility and a lack of support during a relatively short phase of life,” said Dr Helena McKeown, BMA representative body chair.
“The health service is under immense pressure and we cannot afford to lose experienced doctors because of a lack of flexibility and support,” she added.
Professor Neena Modi, president of the Medical Women’s Federation, added: “The menopause affects more than half of the population, many to a debilitating extent. We hope this report will help employers provide appropriate support for their employees and end the taboos around a normal physiological process.”
A spokesperson for the NHS said: “The vast majority of women will experience menopausal symptoms at some point in their lives so it’s important that people come forward to get the help they need, while it’s right that employers do what they can to recognise the health impacts of menopause.”
A Health and Social Care Department spokesperson said: “The health and wellbeing of all of our NHS and social care staff is our absolute priority. It is incredibly important that staff feel that they work in a safe and supportive environment where they are able to raise any issues which may affect their work with managers or colleagues.”
[link url="https://www.bma.org.uk/news-and-opinion/change-of-life-tackling-the-menopause-culture-to-retain-senior-doctors"]British Medical Association material[/link]
[link url="https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/workforce/challenging-the-culture-on-menopause-for-working-doctors-report"]BMA survey[/link]
[link url="https://www.theguardian.com/society/2020/aug/06/female-doctors-in-menopause-retiring-early-due-to-sexism-says-study"]Full report in The Guardian[/link]