NEW YORK (AP) — It took five years for Crystal Burke to put a name to the symptoms that haunted her.
Heart palpitations. Insomnia so severe she slept only two to four hours a night. A newfound struggle to make decisions in her job as a nurse. Confusion when dealing with statistics, which she used to handle with ease.
“It affected my work, it affected my relationships, it affected everything,” Burke said. “I felt lost. I didn’t talk to anybody about it.”
Then Burke saw an advertisement about a face cream which contained estrogen, one of the two hormones ovaries produce less and less of with aging. She began talking with friends about her symptoms. And she connected the dots: menopause.
At just 38, Burke had thought she was too young to be going through the life stage when menstrual periods stop and women no longer can become pregnant. But menopause is more than the pop culture stereotype featuring women in their 50s having hot flashes. Symptoms can start much earlier — during perimenopause, the time leading up to menopause — and go well beyond hot flashes.
The many manifestations include insomnia, migraines, brain fog, loss of concentration, memory problems, mood swings, depression, anxiety, heart palpitations, hair loss and weight gain. If that wasn’t enough, some people experience heavy, painful periods or recurring urinary tract infections.
Chronic insomnia can make it difficult to concentrate. Brain fog leaves the afflicted struggling to find words during meetings. But social stigma and a lack of information have left menopausal people dealing alone with severe symptoms that may impact their work. Many stay silent, fearing they’ll be viewed as underperformers or weak.
This article is part of AP’s Be Well coverage, focusing on wellness, fitness, diet and mental health. Read more Be Well.
Some women in senior leadership positions leave their jobs or reduce their hours as a result of debilitating side effects from menopause, said Lauren Redfern, executive director of Hormonally, a nonprofit that provides workplace training and education about women’s health. But those who feel supported by employers during the transition are more likely to remain at work, she said.
“When you open up a space to talk about these things, people are desperate to have a conversation,” Redfern said. “The symptoms are so diverse and so far-reaching and so prolific they impact every area of someone’s life.”
Promoting changes around ‘the change’
Menopause affects about half the world’s population at some point in life. Yet due to the epidemic of silence around it, women, nonbinary people and transgender individuals often don’t recognize the onset of unpleasant physical and emotional changes as side effects of declining hormone levels.
Finding health care providers who are trained to identify and treat their symptoms can be challenging. Some startups have sought to change that by providing access to referrals or telehealth appointments with doctors or therapists who specialize in treating menopausal patients.
“When you don’t know that something can get fixed, it’s very scary,” said Midi Health founder Joanna Strober, whose company connects women with professionals who understand menopause. ”If you think, ‘For the rest of my life I’m going to have brain fog and not remember anyone’s name, and I’m going to keep losing my car in the parking lot and I’m going to keep gaining weight,’ then it’s very demoralizing.”
Burke found relief when she began hormone replacement therapy. Inspired to help others, she co-founded The Menopause Clinic in Louisiana to offer telehealth services focused on menopause.
“The biggest thing is for women to know what perimenopause is, what menopause is, and that there are options,” Burke said. “The suffering isn’t necessary.”
Hormone replacement therapy is not an option for those with certain medical histories, and some doctors are unwilling to prescribe it. Some experts recommend acupuncture, dietary changes and exercise to help manage symptoms.
The Mayo Clinic estimates that menopause symptoms lead to $1.8 billion in lost work time per year in the U.S. About 5% of employers offer menopause benefits or accommodations such as the ability to work from home or a cool room, according to benefit consulting company NFP.
Here are some steps you or your employer can take to make the workplace more hospitable for people experiencing menopause.
Start a support group
Finding supportive colleagues can help bridge knowledge gaps. If your organization doesn’t have a menopause support group, you can start one. Once established, the group or human resources department can bring in facilitators to teach the entire workforce — not just women — about menopause.
Sarah Daniels, a communications manager, started a support group called “Menopause Matters” at Arriva Group, a U.K.-based public transportation company. The male-dominated company already had a gender inclusion group, so Daniels joined and organized the menopause group as an offshoot.
The group’s monthly meetings are held online during business hours. Participants swap notes on supplements, teas, treatments and beauty products. Daniels believes the group improves productivity because it gives members a sense of belonging within the organization.
“I know how lonely it is when you are going through these things, because you think, ‘Is this just happening to me?’” she said. “I had a UTI (urinary tract infection) that was so severe that I fainted on a train. My periods were so heavy that I couldn’t leave the house.”
Arriva has a policy that says bosses must listen to and make reasonable adjustments for employees struggling with menopause. That could mean more restroom breaks, uniform adaptations to help with hot flashes or flexible working hours, Daniels said.
Push for benefits
People working for employers who do not subsidize menopause-related care and programs can model requests for similar benefits after the small percentage of companies that do.
When Shevonya Noble joined biotechnology firm Genentech as a principal quality and compliance leader, she was connected with a care advocate who helped her find a nutritionist, wellness coach, career coach, mental health provider and physical support coach to address her menopause symptoms.
Appointment costs were covered through a benefit provided by Maven, which partners with employers and health plans to deliver care targeted to women. Genentech’s benefits also include menopause-specific classes and support groups.
At a former employer, Noble felt she had to hide the hot flashes that interrupted her sleep and disrupted her concentration while giving presentations because she didn’t see anyone else furiously fanning themselves at their desks.
“The conversation about menopause needs to be broadened to include men, not just men in our lives but in the workplace as well,” Noble said. “It’s important that we not shy away from the topic but include it in our conversations and to just take the mystique away from what goes on with women at this stage in life.”
Take ownership
Speaking up about symptoms also may help. When women experience hot flashes and brain fog at work, they’re often seen as less competent, but if they say, “It’s menopausal, I’m getting treated for it,’” the discrimination goes away and they’re seen as powerful leaders again, according to Midi founder Strober.
“You have to call it out. You have to say, ‘Oh, that’s a hot flash,’ not just look sweaty in a meeting, because then they just discount you,” she said. “But if you call it out, you can take your power back.”
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