Breaking the silence about the menopause

Like the rest of society, universities have largely failed to consider the specific needs of menopausal women. Here, one scholar describes how this can lead to marginalisation and bullying – and why the issue is as important as the fight for maternity rights

January 16, 2020
Image from Tacuinum Sanitatis, Medieval Health Handbook, dated before 1400
Source: Getty

I recently noticed that the issue of the menopause was completely absent from the Athena SWAN discussions within our faculty. When I pointed this out to the coordinator – a leading academic specialising in related theoretical issues – she admitted that it had not even crossed her mind that this might be something relevant to good gender practices. Evidently none of the other women on the committee, all in their thirties and forties, had thought about it either.

Perhaps this is not surprising. The best-selling feminist manifesto of the decade, Lean In: Women, Work, and the Will to Lead, by Facebook chief operating officer Sheryl Sandberg, which teaches women to be assertive about their specific needs at the workplace and with their partners, doesn’t mention the menopause once.

This silence about the menopause has very damaging effects on women. Many find themselves unprepared when menopause hits, in terms of physical and mental health. Hence the popularity of blogs such as the one by June Girvin, emeritus professor of nursing at Oxford Brookes University, eloquently titled “Everything I needed to know about the menopause…No One Told Me”. This describes the exasperating search for reliable strategies in a context of a “taboo” issue and an “information gap” and has elicited more than 50 comments from readers.

The menopause raises many issues around work, retirement and finances, some of them specifically relevant to universities. Here I want to draw on my own experiences to show how the academy often fails to support menopausal women in getting the help they require and so ends up pushing them to the sidelines.

I entered menopause in my early fifties. Nearly a decade later, I feel great – I am healthy and look good. That is because l spent a good deal of time educating myself to make informed decisions on managing the menopause (despite the limited amount of help and information available from the NHS) and chose to be assertive rather than ashamed.

I do not feel the need to be apologetic about “the change”. Every stage of life has its satisfactions and pleasures. As a senior academic, however, I cannot help noticing that my working life is now more difficult than it used to be. I can no longer work the 60-hour weeks that I have been putting in for more than 20 years, day in and day out. I need to convert some of this time into taking care of myself, to sleep enough and to exercise daily. Once this is done, I am perfectly fit to work – within the hours that my contract stipulates.

Unfortunately, academia now demands a commitment far beyond the contractual. It seems easier for the system to chew me up and spit me out rather than provide respect and support.

We might make a comparison with pregnancy and motherhood. In the past, working women were in essence on their own. Female academics who wanted children faced a significant struggle. Many opted out. This led to a public outcry, discussion and eventual consensus on what needed to be done. After years of battles, things changed. Today, there is a legislative framework to support women’s special needs relating to pregnancy and motherhood. Employers are liable if they do not comply.

Unlike having children, reaching menopause is not a matter of personal choice: all women get there if they live long enough. Yet there is next to nothing in place to help those with a chronically impaired hormonal balance and its associated conditions. Thus, between their early fifties (the average age for the onset of menopause in the UK is 51-52) and the time they are set to retire at 65, menopausal women are faced with difficulties similar to those faced by pregnant women and new mothers in the past. Finding a new job is out of the question for most of them, and there is no enforceable framework in place to accommodate any special needs.

Particularly in the cut-throat world of the academy, women who experience adverse symptoms of the menopause are not normally asked what support they need to continue working. (At my own place of work, administrators offer a workshop to teach women how to manage themselves, but not to teach those in managerial positions what menopausal women may need.) Instead, they are encouraged to switch to a part-time contract or to seek early retirement – with the strong implication that they are no longer “delivering”. That is certainly what happened to me.

Once I got to grips with the menopause, I sought accommodation at work. This was related to specific periods of absence that I would compensate for. It was not about reducing my duties but rather arranging my duties in a way that allowed me to stay healthy. My proposed arrangements were accepted, temporarily, but surrounded in silence. By the time I realised that the rationale for such accommodation was hushed up rather than communicated to colleagues, it was too late. Younger colleagues could see that special arrangements had been made for me, yet no one would openly say why. I found myself in the unenviable position of the elephant in the room. I imagine that the women who pioneered the struggle for pregnancy and maternity rights must have felt the same.

Then there was a change of management. Under my new boss – a younger man of great academic repute – bullying became the new normal. I would be omitted from planning for sabbaticals, for example – and had to complain to senior management to get back on the list. When I asked for a period of unpaid leave to treat menopause-related conditions, I received a suggestion (supposedly coming from senior management): why don’t you just change your contract and go part-time?

I currently enjoy an excellent academic reputation in the outside world and feel perfectly fine working full-time, as long as I can ensure that this is not damaging my health. At my place of work, however, I found myself treated like someone who is arrogant in her demands and standing in the way of the young. I am not keen to keep complaining, since the negative emotions that come up only do further damage. If I want to stay on, I have to shut up and be grateful for being tolerated.

Edited image from Tacuinum Sanitatis, Medieval Health Handbook, dated before 1400
Source: 
Getty (edited)

So why would I want to continue working in a place where I am made to feel that I have overstayed my welcome? What about the option of early retirement? To answer that question, we need to look at the detail of the pension scheme for those working in British universities.

For academics, according to guidance from the Universities Superannuation Scheme, it is possible to retire as early as 55 (with various strings attached). This sounds like a scenario that is perfect for menopausal women who are perceived to be unable to “deliver”. However, it is not until the age of 63.5 that the full benefits one has accumulated can be accessed. If a woman opts to retire before then, this translates into a permanent reduction in the benefit. Universities that want to encourage them to leave early do not seem empowered by the USS to offer them a fair pension payout.

As a senior academic, I experience this quite clearly: why not leave and make way for younger academics? Because if I retire now, I will not only exchange a good salary for a small pension, I will also lose a significant part of my projected pension. This lose-lose scenario is the only one available.

I have devoted a good deal of effort to learning about these things. I hardly seem to be alone in this. In a recent conversation with other senior academic women, we observed that, since the age of 50, we have spent approximately the same amount of time reading about health, finances and employment legislation as about our specific academic subjects.

In a blog written for Wonkhe in 2019, “Time to talk about the menopause”, Lizzy Woodfield, a policy adviser at Aston University, explains why this is “a higher education issue”. Most obviously, this is because “universities employ thousands of menopausal women” (and also welcome many mature female students). Her hope is that “In an open and supportive working environment, it is more likely women will be able to secure the adjustments they need.” Yet she also cites a briefing by the University and College Union that notes that “the menopause is still not recognised as a workplace issue, which results in many women being unable to access the adjustments they need”.

It is only fair to acknowledge that things have begun to change in recent years and that the menopause is no longer considered just “a niche issue”. Yet emerging policies are severely limited by an approach that sees the menopause solely as a period of transition. There is recognition that symptoms vary widely, yet the menopause is still treated as “a bad patch”, an annoying hiccup that may require temporary support while it passes. In reality, women do not just bounce back from the transition. While the most active symptoms manifest over a two- or three-year period, the menopause leaves women with a chronic hormonal imbalance that often means significantly reduced energy, impaired sleep and low tolerance for stress, and sometimes the onset of other ailments and mental health difficulties.

If the menopause is a transition to old age, the transition beginning to be recognised by employers lasts only two or three years and so takes the woman to the age of 54-55, whereas the officially recognised “old age” for retirement and a full pension is set at 65 or 66. It is as if a woman was given support during pregnancy but no account was taken of the difficulties facing young mothers.

When I look back at my own academic career, I can see three moments when I needed support as a woman.

The first time was when I got pregnant. It was in the US, and my colleagues commented on how lucky I was that the birth would take place out of semester time, since I was not eligible for leave under the terms of my contract. I was also lucky to be in employment and so to receive medical assistance during pregnancy and birth. There was no maternity leave and I had to run home between classes to breastfeed.

Motherhood in the UK was somewhat better provided for (although pre-school childcare expenses were my biggest outlay and took up 50 per cent of my salary). Colleagues were supportive in allowing me to work from home as much as possible. When I asked for assistance, I received it.

The second time I needed support was when, a few years into my career as a full professor, I found out that a male colleague (or “comparator”, to use the legal jargon) was paid significantly more than me for doing the same job. This proved emotionally difficult, especially after it emerged that the situation was known about but not considered a priority that needed to be fixed. I took a deep breath and went to the top of the university to demand that my pay be brought in line with the pay of my male colleague.

This paid off and the anomaly was rectified. In retrospect, I discovered that I had done what few other women find the strength to do. The vice-chancellor herself commented on this. “Women don’t ask,” she said. This was the title of a 2004 book by Linda Babcock and Sara Laschever, subtitled “the high cost of avoiding negotiation – and positive strategies for change”, which she had read some years back and which had influenced her own approach to difficult situations. I had been one of the few women who asked, she added.

The third time I needed support came when I felt I needed some adjustments to my pattern of work to allow me to manage the menopause, stay healthy and continue working. As I have described, the arrival of a new manager meant that I started being treated like a freeloading member of staff – one whose demands were disproportionate and contributions insignificant. Assertiveness, openness and courage became irrelevant. This time around, I am on my own, and the fact that women often fail to ask is no longer relevant. One cannot ask for something in a context of illiteracy, where what I regard as reasonable and necessary is treated as extravagant and outlandish.

As things stand, the cost of menopause is borne by those who suffer it (unlike the cost of pregnancy, where substantial proportions are absorbed by society). The cost of maintaining ourselves in good health is borne by us. So, too, is the cost of taking early retirement. Since universities are knowledge organisations, one might hope for them to be more enlightened than other employers, but there seems little evidence of this. Both their particular pressures and pensions schemes may even add to the problem.

It is a simple fact that, through the menopause and beyond, a woman has special needs. For as long as this is not recognised, opportunities for shaming and bullying at the workplace are rife. In my own case, only two options are available: to accept the fact that I am treated like a parasite, hide away in shame and feel grateful for being tolerated – or to take the financial penalty of early retirement. I will soon settle on one of them.

The author, who teaches in the humanities faculty of a Russell Group university, wishes to remain anonymous.

POSTSCRIPT:

Print headline: Wise women, not pariahs

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Reader's comments (13)

Interesting article, and definitely good to talk about these issues and improve practice. But as a Post menopausal woman myself , I am uncomfortable with the idea that this makes me into some sort of invalid who needs special treatment. Personally I found menopause a bit of a non-event and the negative symptoms were far outweighed by the benefits of not having to cope with periods and contraception. Many of my friends had a similar experience. Of course women who do experience problems - I know some do, and some don’t - should be given the adjustments and consideration that are needed in their specific circumstances. As with any other long term health problem or disability. But I am worried that labelling all older women as “post menopausal” and expecting reduced performance or odd behaviour may be harmful.
It isn't about labelling all older women as "post menopausal" and I really don't feel that is what this article is asking for. Aside from the fact that the author appears to be an extremely committed academic that is under-appreciated and who would be better supported by many other Institutions, it is clear that as with the support legally required to be offered to pregnant women (a choice as is mentioned) there is a need for policies to be introduced that offer a similar level of empathy to those going through the menopause, if medically required. In addition to this for younger women there also needs to be an understanding from managers that for many there are times each month where our performance can be affected through no fault of our own.
Thank you for this article. Yes, not everyone has problems pre-, during or post-menopause but some of us do - and it's even more of an issue when you get past 55 and it still hasn't occurred. My institution have been very good and my schedule is pretty flexible - I can usually take a rest when needed (helped by the fact I moved to be nearer my place of work) and I have had support from occupational health. But the most important section of the article is this: why should anyone be penalised for working a full contractual load and eating, exercising and sleeping normally? In my case, I can only manage an average of around 40-45 hours a week, with less travelling around, than the 60 hours a week including lots of travel I was doing 5 years ago. The trouble is, this means I helped to sustain the current practices that now make it so difficult to change the whole environment. It's a condition with an end point (I really wish it would end - this is too many years of symptoms and treatments) and personally I get frustrated that fatigue and 'brain-fog' prevent me doing as much writing as I want too. I'm assured that too will change, with or without medical intervention (the latter won't work for everyone either). We not only need to campaign for support for menopause where it is needed but also use it to call out the work practices that push academics at all ages and levels into habits where they don't eat, sleep and exercise in a perfectly normal way.
Unlike having children, reaching menopause is not a matter of personal choice Please remember that there are many women who do not have children and that was not their choice.
“breaking the silence “ is one thing, making menopause out to be some form of inevitable chronic disease or handicap needing special accomodation quite another. Menopause is a physiologic phase in any woman’s reproductive cycle ... perhaps even more so than pregnancy . Of course it may not come without some stormy moments for some women ( for no fault of theirs ) and appropriate adjustments must be made both within work and outside of it in such ‘ extra physiologic ’ exceptions, menopause should nevertheless not be added ( wittingly or unwittingly ) to the growing list of “ Disabilities” and expected to be routinely handled as such or as a matter of course ... and that is because it (often) is not. A ‘disability image’ ( overt or implied ) is neither fair to menopause nor to the many women who go through that phase very uneventfully if not very happily . It is almost impossible to go through this piece not seeing menopause as a disability needing all of the special facilitations every disability demands. I still hope I’m wrong about that surmise of the piece ... for the sake of menopause at least. Basil jide fadipe.
interesting article, whilst a number of women go through life, periods, pregnancy etc. etc. with little difficulty others have chronic pain during periods, migraine headaches, nausea and really should be in bed for 3 days of the month. Instead they are taking very strong pain medication and dragging themselves to work. Some women are required to rest during pregnancy have complications and suffer ill health while others have none of these symptoms. Menopause is very similar some suffer chronic physical symptoms other psychological some both and some not at all! Therefore in society all phases of life should be respected and supported. One would think in this day and age that there is respect, tolerance and support for women to stay in the workforce as long as they wish. longer working lives is a reality for most and the labour market actually needs women to actively stay in the labour market contributing to society. Menopause can indeed be incredibly debilitating, for a number of women, just look at the statistics of how many women are so terrified to stop taking HRT incase they symptoms return that they take it for 10/15 yrs. l have never found labels to be useful, at various points of life we all need support to get through, there is no one out there who will not at some point experience this, its part of being human. Therefore we need work environments and HR policies to proactively ensue all staff are supported, respected and treated as a full human being not just a worker!
Having a background of working with organisations on their gender diversity and having had a number of leading universities in the UK as part of my client portfolio, my experience is that, generally speaking, the academic world is way behind other sectors in terms of diversity. So this article did not come as a huge surprise. What did surprise, however, were some of the comments (from women) that no 'special treatment' should be provided. It is true that not every woman will have a negative experience. Only around 25% of women are 'on the edge' during this natural life transition. Around 25% sail through and around 50% have a mild to moderate to sometimes severe experience. However, for the women who suffer, it can be utterly devastating. Combine that with basic business sense. Why would an organisation (public / private / education sector) invest time and money in anyone at the beginning of their career and then abandon them when they have 2, 3 or 4 decades of experience, knowledge and expertise? This is a basic bottom line issue, not a 'fluffy / nice-to-do' idea. We represent 52% of the population, so this is hardly a minority issue. What is actually needed is for this natural rite of passage for all women to be celebrated rather than feared and for the power and potency of 'midlife' to be recognised: by women and all of those around them, both personally and professionally. As a 60 year old post-menopausal woman I am busier in my professional life than I have been, more visible than ever and have considerably more confidence than when I was 30. The world benefits enormously from the power and potency of women at 'midlife', let us celebrate rather than forget them.
Like the first poster, I am ambivalent about this subject. More information and awareness is a good thing - I went through an early menopause ( I was 42 when periods stopped...) and it took me somewhat by surprise. I was actually relieved when I realised that's what it was rather than ( a) being pregnant ; ( b) being incompetent or lazy - I suffered from what I subsequently realised was 'brain fog' , struggled to concentrate and thought it was all my own fault and ( c) something more serious wrong with me - boy was I sweaty at night ! But all in all I didn't have a bad time, once I realised what it actually was. Not having any more periods was wonderful. But it was a little bit of a shock that I could have been better prepared for - and more awareness of it would have helped ME adapt better, and not blame myself for forgetfulness or bouts of vagueness. I would be very wary ( perhaps this is my generation showing, when throughout my career as a woman you could not admit to any 'female'issues,' period pains etc lest it was used against you; I never had children but my sisters who did minimised or lied about their child care commitments for the same reason... ) of making a big deal about menopause and needing adjustments (please tell me what kind of 'adjustments' would help anyway?) because this could be yet another thing that would disadvantage women - presenting us as weaklings, incompetent or incapable because of our" female issues." I know some women have a really bad time and can understand that there should be awareness of that (so if they need time off, say some sick leave, they shouldn't be dragged through some humiliating 'return to work' interview and all that ) . But it happens to all of us , is an inevitable part of aging - and being exhausted and no longer able to put in 60- hour weeks is an inevitable consequence of aging ( for both women and men.) So I wouldn't want to make too big deal of it - ALSO making too much of a deal of it will make younger women think it will always be dreadful and awful and a time to be dreaded when that is not the case for many (most? ) . I wasn't lucky going through it as early as I did ( eg it was painful to accept the finality of it all, that any chance of children was now gone) but I was lucky in that I had older sisters to whom I could talk and with whom I could compare notes. But as a work issue I would really want to be careful about that...
As a 51 year old PhD student looking to work in academia, I'm feeling very nervous...
Sorry, but why? There could be many reasons to be (e.g. precarity, possible age discrimination etc ), but certainly issues surrounding the menopause should not be putting you off, among the least of your worries...
Isn't it interesting how this has generated so many 'it wasn't that bad for me' responses? Well good for you . . . but I think many of the respondents have indeed missed the point of the article. They perhaps need to read it in conjunction with the article on the need for a re-think about caring responsibilities: https://www.timeshighereducation.com/news/careers-intelligence-supporting-academic-carers-care-full-approach As the nature of HE changes, as the HE workforce changes, and as we face an inevitable crisis in social care, we need to ensure that women are supported when these worlds collide . . . and that these issues are part of everyday conversations . . . not hidden beneath the worry of presentee-ism, alpha behaviours and jostling for career progression.
Oh, of course.! Women should remember that talking about their actual experience is less important than the need to conform with the party line ... Sorry about telling it truthfully. If we are to talk menopause as " part of everyday conversations" one would have imagined that account needs to be taken of its reality across the board, not for experiences to be dismissed with a snarky "good for you" if they don't match the "correct" narrative . One definite benefit of being an older post menopausal woman is that such ideological posturing and suggestions for the need to further educate ourselves "about the need for a re-think about caring responsibilities" just makes me laugh...
This issue, while not consistent with my me experience of menopause, shows me how grateful we in the US should be for the Americans with Disabilities Act, which would allow for specific accommodations to handle a challenging medical condition. Along with the accommodation, however, is the difficult area of confidentiality. The author mentioned that colleagues were not aware of the reason for her special schedule and that this caused resentment, but in the US, as an employer we would not be able to share the confidential reasons for the accommodation. Perhaps this should be addressed when the accommodation is granted. As the person needing that assistance, how would you like for the confidential information to be shared? Not sharing it may have consequences, as the author noted.

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