Change of life? Tackling the menopause culture to retain senior doctors

by Helen Fidler

The workplace must recognise and make reasonable adjustments for people going through the menopause.

Location: UK
Last reviewed: 6 August 2020
Busy hospital with blurred figures moving through a reception area

Sometimes the culture in which we work is helpful, and sometimes it is a massive barrier to career progression.

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 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 per cent 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?

Helen Fidler is BMA consultants committee deputy chair