Menopause and mental health: addressing the invisible symptoms

In its 2022 report on Menopause and the Workplace, Parliament’s Women and Equalities Committee explored menopause from three perspectives: as a health issue, a workplace issue and an equality issue. Supporting those experiencing the menopause – and perimenopause - at work requires employers to consider this issue through each of these lenses. And implementing effective support strategies can be beneficial on each front.

Whilst each woman’s experience is different, the menopause can often have significant mental and physical health impacts. We look at what these symptoms might be, what support employers should consider, and why the recent Employment Rights Bill brings this closer to the top of the corporate agenda.

What is the menopause?

The NHS defines menopause as occurring when periods have stopped for more than 12 months due to lower hormone levels. This usually takes place when individuals are between the ages of 45 and 55 but some will experience menopause, and associated symptoms, earlier than this.

Perimenopause is the transitional phase leading up to menopause, characterized by hormonal fluctuations and various physical and emotional symptoms. This stage can last for a number of years.

As we discussed in our detailed article on this topic, during menopause and in the run up to it, people can experience a range of physical symptoms from hot flushes to palpitations to reduced muscle mass. But it is the mental health symptoms - which also have the potential to have a significant impact on someone’s performance at work – which we are focussing on in this article.

Mental health impact

Mental health symptoms of menopause (and perimenopause) include:

• Low mood
• Anxiety and heightened stress
• Depressive symptoms
• Cognitive difficulties, such as problems with memory and concentration (often referred to as “brain fog”)
• Sleep disturbances.

All of these could impact on someone’s day-to-day functioning, and could have a significant impact on someone’s performance at work. For example:

• Mood changes can affect interpersonal relationships and team dynamics.
• Anxiety and depression can lead to decreased motivation, absence, and lower productivity
• Cognitive difficulties can impact decision-making, problem-solving, and the ability to focus on tasks.
• Sleep disturbances can have a similar impact and exacerbate other mental health symptoms.

The impact on work can, in turn, could lead to a loss of confidence. Also, many women with these symptoms may be highly functioning, masking the true extent of the symptoms. This can result in heightened anxiety for the individual, and can also make it more difficult for employers to recognise the underlying issue.

Perhaps exacerbating “invisible” symptoms such as these is the stigma and misunderstanding that still surrounds menopause. Research suggests that women often feel unprepared for the psychological effects of menopause and may feel dismissed or misunderstood by healthcare professionals.  By extension, a failure to understand or acknowledge the challenges that menopause and perimenopause could bring at work could also result in a similar sense of isolation and frustration.

Menopause action plans

As set out above, the Employment Rights Bill, published on 11 October 2024, includes a provision that could require employers with 250 or more employees to develop equality action plans. These must show the steps employers are taking in relation to gender equality, including the support provided for employees going through the menopause.

Prescribed information will need to be published and frequently refreshed. Key details, including the required content, frequency and form of publication, remain to be determined in future regulations.

Regardless of the finer details, this shines a spotlight on menopause in the workplace and elevates the importance of openly addressing this issue. Introducing specific, supportive measures, tailored to the business in question, will have to be standard practice.

Published equality action plans are unlikely to be required before 2026 but employers should start to consider what steps they can take, and engaging with their workforce, now.

Support Strategies

Although there are currently no proactive obligations for employees to take steps supporting those going through the menopause, introducing support can not only mitigate legal risk, but reduce stigma and create a more supportive culture.  We explored in this article that menopause has the potential to form the basis of an employment tribunal claim, primarily through a sex and / or age discrimination claim. Some of the physical or mental health symptoms could also amount to a disability (although menopause itself will not automatically qualify as a disability).

Taking tailored action now can also prepare the business for producing a considered equality action plan in due course. Steps to consider include:

• Creating a formal menopause policy

  The CIPD recommends developing a framework to manage menopause at work and ACAS suggest introducing a specific menopause policy. We are more frequently seeing employers introducing this type of policy to help educate staff, set out manager and colleague responsibilities and outline the support and resources available. The policy could designate a menopause specialist within the business who can deal with menopause-related queries. These could be any wellbeing champions or somebody within the HR team.

  If a specific policy is not produced, employers should review their diversity and inclusion policies, as well as flexible working and absence procedures to ensure menopause is covered.

• Promoting open conversations

  Crucial for fostering a supportive environment is encouraging a workplace culture where employees feel comfortable discussing mental health issues without fear of stigma. By hosting "safe space" conversations, organisations can provide a platform for employees to share their experiences and seek support. These initiatives also help to normalise discussions around mental health and the menopause, perhaps making it more likely that they access the help that is available. Creating this culture can benefit your DEI strategy generally, but hosting these conversations on specific topics would also educate colleagues who are not themselves experiencing either menopause or perimenopause.

• Training for HR and managers

  Training should ensure that managers understand and are able to recognise mental health issues generally, but also specifically related to menopause. Earlier this year Acas published guidance on mental health reasonable adjustments – demonstrating the particular sensitivity that’s needed around this issue. Training should equip managers with the skills to handle sensitive conversations and to consider appropriate adjustments. 

• Employee Assistance Programs (EAPs)

  EAPs are potentially valuable resources that often provide confidential counselling and support services. Employees may not be aware of the resources available to them, so promoting the use of EAPs could help equip women with the tools to better manage their mental health and its impact on their working life.

• Private health care

  If applicable, employers should highlight what menopause specific support their private healthcare provider offers. This may be access to specialists or private GPs, advice on HRT, or programmes to help women manage their symptoms.

• Mental health resources

  Other mental health resources, such as online platforms, helplines, and support groups, can offer convenient and immediate assistance. Also, promoting specialized apps like 'balance’, which offers health and wellbeing support specifically for menopause, could offer more tailored information and support.

• Workplace adjustments

There is no one size fits all answer to this question: whether adjustments are needed, and what they should be, will depend entirely on the individual. Regardless of whether the legal duty to make reasonable adjustments is triggered, there are a range of supportive measures that could foster a more inclusive and understanding workplace. For example, flexible and remote working options could provide a range of benefits - for example, allowing options for remote work and flexibility in start and finish times could help employees manage symptoms like hot flushes or sleep disturbances; and, in the office, providing quiet, private spaces can help those struggling to focus. The benefits of open conversations means that managers would be better placed to understand the support that particular individual might benefit from.

Why is this important?

Supporting women through this period of their lives is critical and can lead to better retention of women who may otherwise choose to reduce their hours or leave the workforce. This issue is going to increase in importance over the coming years as the number of women aged 50 and over participating in employment rises. Recent statistics indicate that women make up nearly half of the UK workforce and this is expected to grow.

To make the biggest difference, however, employees of all genders, not just women, need to step up to help break down taboos and stigmas. Everyone has a part to play in this effort. To assist with this, employers should consider signing the Menopause Workplace Pledge and take positive action to make sure everyone going through the menopause is supported.

See other key planned reforms in our Employment Rights Bill dashboard and our comments in our Labour policy impact hub.