Menopause: breaking workplace taboos


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Audio time: 17:45

Talya Shaulov: [00:00:04] My name is Talya Shaulov. I'm a gynecologist. I work at the CHUM and at Ovo Clinic. My subspeciality is reproductive endocrinology and infertility. What I love most about my job is really working with women and following them throughout multiple stages of their life. I find that very special.

Sarah Beaudry: [00:00:23] Hi, my name is Sarah Beaudry. I'm an organizational development advisor at Beneva. I'm also responsible for the Health Awareness Program. I love helping people out so they can be happy at work and also in their personal life.

Voice-over: [00:00:38] You have questions?

Question: [00:00:41] What are the first steps in raising menopause awareness?

Question: [00:00:50] Is talking about menopause at work still taboo?

Question: [00:00:53] How can I help my employees going through menopause?

Voice-over: [00:00:53] We're here to answer them.

Catherine Duranceau: [00:00:56] Hi. Welcome to the Beneva podcast, Ask the Experts. I'm your host, Catherine Duranceau. A sensitive topic that is rarely an open discussion, but that every woman experiences is menopause. Ten million Canadian women are going through menopause as we speak, and it's still taboo. Gladly, we feel a shift in many companies that want to be more inclusive and start the conversation for the well-being of their employees. And that's exactly what we're going to do right now. Let's dive into the core of the topic. Talya, explain to us what is menopause exactly.

Talya: [00:01:29] So menopause is really a universal physiological phenomenon that a woman will go through around the age of 50 – that’s the average age in North America – which is defined precisely by the absence of menstrual cycles for a period of 12 months, but can be preceded with multiple changes, which we can discuss. And once a woman is in menopause, she is then in menopause for the rest of her life. So it's kind of, her status becomes menopause.

Catherine: [00:01:57] That is done. When we think of menopause, we think, okay, it lasts for years, but there's the pre-menopause, then the menopause, the post-menopause. Can you guide us through those different phases?

Talya: [00:02:08] Yeah. So there's a table kind of that we use to follow which divides the pre-and the menopause and the post- into multiple different stages. But essentially, menopause can be preceded by multiple years of premenopausal changes which can be very variable, so change in menstrual cycle pattern to physical symptoms like hot flashes, mood changes. You know, all the symptoms that we can also discuss. And those can precede menopause by about ten years.

Catherine: [00:02:37] So a couple of years could be actually ten years before hitting the menopause?

Talya: [00:02:42] Before hitting the exact menopause date. And then these symptoms can also last beyond – obviously, not the menstrual cycle changes – but all the other accompanying symptoms can last several years after the actual menopause date as well. So it's not a one-day phenomenon.

Catherine: [00:02:59] No, it's a transition for years, like you're saying. And some women could have a premature menopause. Now, I'm curious. I read that a Hollywood actress started to have those menopause symptoms around 36. When is it considered premature menopause?

Talya: [00:03:14] In kind of scientific terms, there's the term menopause, which is normal between the ages of 45 and over. Anything between 40 and 45 is considered early menopause. But it still happens. And then under the age of 40, it becomes more of a pathological condition which requires investigations and which really requires a treatment, so hormone replacement to protect the patient from complications like cardiovascular complications and osteoporosis.

Catherine: [00:03:44] It should be taken seriously. And what are the symptoms of a menopause?

Talya: [00:03:47] Okay, so the cornerstone of menopause is really hot flashes, whether they be daytime or nighttime; vaginal dryness, or the term we use to call it these days is genitourinary syndrome of menopause. So it encompasses all of the genital urinary tract symptoms.

Catherine: [00:04:03] Are those very common?

Talya: [00:04:04] Very common. About 50% of women will suffer from that during the menopausal transition and beyond, for which we have very good treatments, so it's important to talk about it. And other symptoms will be mood disorders, so anxiety, depression or just mood changes; joint pain; decreased concentration; sleep disturbances which can be accompanied, obviously, by fatigue and decreased energy; memory loss or memory changes. And I would say that pretty much covers most of the symptoms.

Catherine: [00:04:38] And it seems scary, but not all women have necessarily those symptoms.

Talya: [00:04:42] That's right. So it's a universal phenomenon, but the experience is not generalizable to everybody. So some women will go through the menopausal transition very smoothly from one day to the next, no more periods and no other symptoms, whereas some women will really have a tsunami of symptoms appear, you know, this wave of symptoms that kind of overtakes their life. So it's very, very variable.

Catherine: [00:05:06] And every woman has different job. We were saying every menopause has different symptoms because we're all, of course, different. Sarah, how does menopause impact women's work and also maybe their careers?

Sarah: [00:05:16] Well, there's a few ways that menopause can impact their professional lives. So like Talya said, there are physical symptoms, hot flushes, night sweats, sleep disorders, fatigue. But also we can have some concentration problems, so it can impact your work. There's also too, maybe decreased energy. So the fatigue that comes with symptoms of menopause can reduce your level of energy and your motivation, too, at work. There's also all the time management that comes with that because sometimes we have to go to the doctor, the clinic or something like that. So we need a little bit more time to go to medical appointments. There's the ways that menopause can affect work.

Talya: [00:05:57] I think women in the 45 to 55 age category are really in the peak of their careers. Their children are a little bit more grown up. They finally have more time to dedicate to their jobs. They hold more senior positions and senior roles in companies. And these menopause symptoms, this new wave of symptoms that all of a sudden, you know, kind of attacks them out of the blue can really hinder their professional development. It's not the case for everybody. So some women will go through it and their professional careers are not at all impacted, just like their personal lives are not impacted. But the ones who really feel the heaviness of the symptoms will definitely feel it in their professional lives, and so much so, that some of them have to cut back on work, have to decrease hours or completely change jobs, quit their job, change their jobs. So it's very well documented that it can have a serious impact on their career.

Catherine: [00:06:55] And do women still feel that it's an off-limit topic and are frightened to break the silence surrounding the menopause?

Sarah: [00:07:02] I think yes. It’s really going to depend on the work environment, too. So at Beneva, we try to do some education to have an open communication on this topic because it's really important for us. We have more than 60% of all employees that are women. So it's a big topic for us. I think with the education, like I said, the communication, maybe manager training too, that they can be able to give support and know all the symptoms that they're experiencing.

Catherine: [00:07:31] Yeah, because some women don't even know, so we can't blame the managers for not knowing.

Sarah: [00:07:35] That's right. So I think the best thing to do is start with that. And after that, you can maybe create like a support network. So yeah, but the first thing to do is really to talk about it just to break the taboos.

Catherine: [00:07:46] And I guess there are some small actions that employers can take to change the environment and help them go through the process. What could they do?

Sarah: [00:07:55] Yeah. Well, it can be really simple. It can be a little bit more flexibility on the remote work options. It can be also just to install fans or regulate the temperature. If you're in a room with a lot of persons, can I open a window? It can be as simple as that. And just to give information too, just to let know, what are you going to go through, if you have symptoms and everything. And at Beneva, we install rest cabins. It's like a big box. Inside of that, there's a couch that do massaging. Inside of the cabin, you have light therapy, too. You have meditation. 

Catherine: [00:08:38] Can  I go?

Sarah: [00:08:40] Yeah, you’re going to try it out? And you can be in a zero-gravity position on the chair. So you’re floating like astronauts in space. So it's really comfortable. So all the stress goes away and you can disconnect for like, 15 minutes. And you come back after that and you're like, oh wow, that feels so good.

Catherine: [00:08:55] That sounds amazing.

Sarah: [00:08:56] And that's offered to all Beneva employees. Everybody can go and that benefits everyone.

Talya: [00:09:01] So firstly, I think it's important to say that everything that Sarah mentioned is very well documented in the literature. These are not benign things. They're really important. And they can really change a lot for the women. As employers and managers, I think it's really important to sensitize these people. So through whatever it is, workshops and courses and educational tools, but for them to develop the empathy. You know, a woman who has a 25-year-old manager or a male manager, these are people who either don't know menopause themselves yet or will never undergo it themselves. So I think the empathy that a manager can feel to, for example, a woman who's pregnant or a couple going through a separation, it can make a world of a difference for that person. And I think it could really make a difference for the woman who's going through menopause and going through that transition to feel like a human support; you know, like a very humane support could really make a big difference.

And I just wanted to mention also that work is a really rewarding part of a woman's life, and it's a really important part of a woman's life. And I think for employers and managers, it's really important to remember that and to work from that. So menopause is not the time to tell a woman, okay, well, we're going to cut your hours by half, and come back when you're ready.

Catherine: [00:10:21] You don’t feel well? Stay at home and do 15 hours instead of doing 40.

Talya: [00:10:25] It's an opportunity to make her feel good, to make her feel like she's supported, to make her feel like there's going to be changes in place and policies in place to help them go through that. But to preserve their self-esteem is really important, and that also impacts their experience of menopause as well.

Catherine: [00:10:45] Can it change their symptoms?

Talya: [00:10:45] It could also change their symptoms. So a woman who's feeling less stressed out will feel more comfortable, can be less impacted by the symptoms of menopause. So it's kind of a two-way street. It's really important for this environment to be the case at work.

Catherine: [00:11:01] So to feel supported is not taking away responsibilities because, oh, you won't be able to work. That's not it.

Talya: [00:11:06] Exactly, exactly. It's really to promote professional development. And through that, you'll be building a woman's self-esteem. A woman who's suffering from hot flashes can often really feel like her self-image and self-esteem are affected.

Catherine: [00:11:21] Literally, they may be sweating because you feel different.

Talya: [00:11:24] Exactly.

Catherine: [00:11:25] And is there a difference with this socioeconomic background, also the cultural backgrounds? Could you tell us a little bit more about that?

Sarah: [00:11:34] Yeah, of course, there's still cultural taboos around menopause, so it's really going to depend on the culture. So that's the main idea to talk about it and to break some taboos and stigmas around that.

Catherine: [00:11:46] But I'm curious, are there some communities that see menopause as like an aura? It's impressive?

Sarah: [00:11:52] Yeah, yeah, there's some cultures that that's really like a big step. And when the woman is in menopause, they're going to help the young ladies to go through their first period and help them to go to that phase and give the tools, how they’re supposed to feel and everything. So they're really going to be there for her.

Catherine: [00:12:14] So you feel part of the community.

Sarah: [00:12:15] Yeah, yeah, they talk really about it. So it's really different in every culture.

Catherine: [00:12:19] Yeah, absolutely. We should be inspired by those cultures.

Sarah: [00:12:21] Of course.

Talya: [00:12:22] Different women will also of go through menopause very differently. There's different factors that will affect menopausal symptoms, the severity and the timing of it. So socioeconomic factors, ethnicity. We even see that women who work certain types of jobs will have different symptoms and earlier menopause. So for example, people who work night shifts like nurses who work night shifts for like, ten years.

Catherine: [00:12:46] And that are doing a job that’s so hard to do.

Talya: [00:12:48] Exactly. That's so important, will sometimes see symptoms appear earlier. So there's a big influence of environmental factors on our experience of menopause as well, for better or worse.

Catherine: [00:13:01] And how could they, let's say the hospital in the case of a nurse, help them out so that they have concrete actions to accept it?

Talya: [00:13:08] Yeah, I mean, I think all the things that Sarah mentioned are really important to all work environments. You know, the hospital happens to be one where it's sometimes a little bit more difficult to implement these things because of the high stress feature of the job. You know, like nurses and other health care professionals in the hospital are always on the go. There's no time for breaks. You know, your break is much less important than the patient who is having a heart attack right now. So I think there is work to be done, and there's huge leaps that are happening in this domain. But it's in all these domains where the job is extremely hands-on, it's not less important to really address the issue. It should be taken seriously.

Catherine: [00:13:48] It should be taken seriously and have those concrete actions even while working in a high-stress environment?

Talya: [00:13:52] Exactly.

Catherine: [00:13:53] Yeah, yeah, yeah. So Beneva did a survey and you got lots of great answers. Tell us more about that.

Sarah: [00:13:59] Yes. We did a survey on organizational health. So that showed us a lot of women were very interested in menopause. So we already did some intervention, like a conference. We put tools on our intranet, too. And we also have an Officevibe that they call which evaluates the level of wellness and happiness of our employees. So we can adjust our intervention according to this data, just to make sure we act on the right track to make sure we did the right thing to respond to the needs of our employees.

Catherine: [00:14:46] Absolutely. Talya, do you have an anecdote to share with us that really struck you?

Talya: [00:14:50] So in line with the topic today, I had one patient who came to see me a couple of years ago. She was going through a really tough menopausal transition, and she was having extremely big symptoms, substantial symptoms that were impacting her personal and work life. And she came to me saying, you know, I need a break from my work. I need to reduce my hours and need to work more from home. Can you fill out my insurance papers? And I was very taken aback by the fact that she brought me these, you know, that she wasn't even comfortable speaking to her employer about it. I kind of felt uncomfortable filling out this form. And, you know, the questions these insurance companies often ask are really specific to, like, physical limitations and mental limitations. And I didn't feel like she filled out any of those categories. You know, it was just simple things that she needed in her job to be able to help her do her job better, you know, in a time where she needed a little bit more support. And so that's when I kind of realized, wow, we have work to do in the workplace.

Catherine: [00:15:45] That is kind of strange. We should be able to have the conversation without saying, hey, I've got my doctor's note. Can you approve that I adapt my job?

Talya: [00:15:54] Yeah, exactly. It's funny because menopause is a medical condition, but it's not a disease. That's kind of what needs to be destigmatized in a way.

Catherine: [00:16:03] Did you have lots of patients like that?

Talya: [00:16:05] No. Thankfully, no.

Catherine: [00:16:06] Good. Thankfully, no. Absolutely.

We always like ending the podcast by having a short recap of our conversation. Sarah, can you sum up the most important points we discussed?

Sarah: [00:16:26] Of course. Well, as we said many times, the symptoms of menopause are different for every woman, which underlines the need to avoid any generalization or labelling of those going through this phase of their lives. Maybe to promote open-mindedness in the workplace and initiate an inclusive dialogue. Give some tools, information, resources that employees can work with. Deconstruct all the prejudices that can be there and show empathy and remember, all of the small gestures can make a difference.

Catherine: [00:16:58] Thank you, Sarah and Talya, for engaging in the conversation. Talking about menopause will break taboos and will slowly help women embrace it instead of fearing it.

Thank you all for listening. If you have any questions, please don't hesitate in contact us at [email protected]. If you would like to have more information about this topic and discover other episodes, we invite you to go on Beneva’s website in the podcast section. Stay tuned for another conversation that will guide you for future insurance and business needs. Until next time.

END OF TRANSCRIPT

Hot flashes, mood swings, trouble sleeping… although menopausal symptoms vary from one woman to the next, they can all in some way affect their performance at work. Dr. Talya Shaulov, member of the Department of Obstetrics and Gynecology at the CHUM and reproductive endocrinology, infertility and menopause expert, and Sarah Beaudry, Organizational Development Advisor at Beneva, and responsible for the company’s Health and Wellness Program, provide us with insight in the hopes of breaking down this taboo subject.


Animation : Catherine Duranceau


Guests: Dr. Talya Shaulov and Sarah Beaudry

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