“For two years I didn’t sleep well. Never a full night. No peace. Restlessness and heart palpitations were my steady companions at nightfall. This was back when I was 48 to 50,” wrote American talk show host Oprah Winfrey in the October 2019 issue of her <i>O, The Oprah Magazine</i>. “And, after my menstrual cycle stopped for good, at 53, I wasn’t prepared to have such difficulty concentrating. Reading, my favourite pastime, became a chore. Suddenly my attitude toward most things was ‘whatever’. I wasn’t vibrant. My whole world dulled down a couple of notches,” Winfrey narrated, of her experiences with the <a href="https://www.thenationalnews.com/lifestyle/wellbeing/hot-flushes-and-hrt-everything-you-need-to-know-about-the-menopause-explained-1.972722" target="_blank">menopause</a>. Women make up half of the world’s population, and every menstruating woman experiences the menopause, usually between the ages of 45 and 55 – the time marking the end of a woman’s menstrual cycle, 12 months after her last period. Incidentally, the menopause also coincides with the age when a career woman is in her prime and likely to take on leadership roles. But the range of symptoms – hot flushes, erratic periods, anxiety, depression, mood swings, poor concentration and loss of interest in intimacy – can recur for four to 12 years, according to the NHS, both before and after the attainment of menopause. These symptoms can turn life on its head for many, as one in four women experience “serious symptoms”, according to a 2019 study from the Society for Endocrinology. Unsurprisingly, the menopause can significantly affect a woman’s quality of life, engagement, performance, motivation and relations with employers, according to a report in the international journal <i>Maturitas</i>, and it is one of the most under-recognised factors contributing to attrition. Almost 900,000 women in the UK quit their jobs over an undefined period of time owing to menopause symptoms, according to a 2019 survey by international healthcare company Bupa, while a Bloomberg article published this June reported global menopause productivity losses to be $150 billion annually. To turn the global focus on menopause as a gender and age-equality issue, the European Menopause and Andropause Society last month released global recommendations to make workplaces supportive of women during this time of their lives. In the recent past, experts in the West have been working to educate and engage with employers on the menopause, and retain valuable staff. Dee Murray, an advanced psychotherapist, human behaviourist, and founder and chief executive of health information platform Menopause Experts Group, is one of them. She offers free training to employers in Britain to address issues such as staff retention, menopause policy, the risk of being taken to tribunal and its cost to their business. Murray finds employers are not proactively involved in providing menopause care because of their ignorance on the issue. Historically, poor education on the menopause has been a problem everywhere, Murray says. “Creating an inclusive culture, breaking down taboos among colleagues by having open discussions will help,” she says. “Menopause has been the subject of humour in the past, and this must not be the case as we move forward.” Dr Donald Grant, a general physician with an OB/GYN diploma, suggests that listening to the personal concerns and experiences of staff can not only “offer organisations guidelines for future approach, but also highlight blind spots they might have otherwise missed”. Murray says companies should “put a robust menopause policy in place”. It should include flexible working hours and the opportunity to work from home as women often experience sleep disturbances. “Be sure when recruiting that people are made aware of your core values, which include diversity and inclusion.” Given that some women face anxiety and depression, they would need time to recover from the emotional burden caused by the menopause. “Granting wellness days as a no-judgment recovery time, over and above paid sick leave, can be useful for employees in avoiding uncomfortable and distressing situations within the workplace,” Grant says. Wellness days can be used confidentially, with HR or team leads the only ones to know that an employee is availing those rather than sick leave. Offering a confidant of choice from the team, who could be trusted to manage a woman’s workload in her absence, can be encouraging, Grant says. On a more tangible level, desk fans can help women experiencing hot flushes. So can a relaxed approach to uniforms. “Allowing layers women can easily remove and colours that hide sweat patches is a great way to keep employees healthy and help them avoid potential embarrassment,” Grant says. Finally, Murray says organisations should make it clear they value every employee and will provide extra support when they most need it. “Women do not want to let their employer down, they just want to feel supported and heard and know that their employer cares.”