How can perimenopause impact me at work?

Oh, let me count the ways!

Are you one of the 31 million women in the US workforce who are between the ages of 40 and 65? Eighty percent of these women will experience symptoms related to perimenopause. Of that 80 percent, as many as 25 percent will experience symptoms so severe that they will consider leaving their position or quitting work altogether.

Because menopause has been such a taboo topic, many women don’t know enough about menopause to be able to identify it when it starts and therefore, don’t know how to manage the symptoms when they do start. In fact, many women are concerned/confused about what they are experiencing and fear that there is a serious medical problem.

In addition, most general practitioner MDs are not informed at all about menopause and are ill-equipped to provide adequate support. Many OB/GYNs are more attentive and knowledgeable about pregnancy and childbirth and know much less about menopause.

The workplace is often a veritable hotbed of sexism, bias, and stigma about age and menopause. Experiencing symptoms of perimenopause can feel like a crisis and can, actually, have a negative impact on your career.

What is a woman to do?

Let’s take a look at perimenopause:

• How to recognize when it starts
• How to find the best support
• How to manage in the workplace

Perimenopause is the time your hormones start to shift until 12 months from your last period - which is defined as menopause. Perimenopause can start as early as your late 30s and can last all the way to the typical age of menopause which is 51. For most women, it starts somewhere in their 40s. Some women experience no symptoms at all, some women are suffer many and severe symptoms. Some women experience early menopause because of a medical condition or medical treatment such as chemotherapy or surgical removal of some or all the reproductive system as the result of a medical condition.

Perimenopause itself is not a medical condition, it is a natural process of maturation of the woman’s body. Anyone born with a female reproductive system will experience menopause.

What signals the onset of perimenopause? Usually, the initial signs are irregular periods.   Periods may get heavier and last longer, may be lighter and shorter and may skip months. As your hormones dip more, you may experience any of the 40-plus symptoms. And, because estrogen impacts just about every system in our bodies, a woman can experience symptoms as varied as hot flashes, joint pains, mood swings, dry eyes, and heart palpitations.

Your best sources of support are certified menopause practitioners. You can find one on the North American Menopause Society website ( https://www.menopause.org/for-women/find-a-menopause-practitioner ). You can also get a lot of information about symptoms there as well.

Now, let’s talk about being at the office!

Hot flashes tend to be the most visible and potentially embarrassing of the symptoms. They can happen at any time and can vary from a simple increase in temperature that can feel uncomfortable and may cause your cheeks to flush to a full-on shift to your own tropical microclimate with sweat dripping down your face and from the ends of your hair. Imagine that you are presenting to your team, to leadership or to the board of directors and further imagine what your audience may be thinking. “She’s so nervous, she must not be prepared.” Or “She doesn’t know her numbers.” Or “She can’t back up what she is saying.” Or “She’s not ready for leadership.” Ouch!

I will get to how to speak to your boss about perimenopause a bit later. In the meantime here’s how to deal with those pesky hot flashes:

• Be mindful of how you dress – dress in layers
• Don’t wear silk anything – dresses, blouses, scarfs – as silk holds in body heat. When you’re feeling cold, that’s great. When you are having a hot flash, it can be a disaster.
• If you are doing a presentation, always have a glass of ice water handy. It is great to hold in your hand if you are experiencing your own little microclimate hot spell, as it can help to cool you down. Also, sip the water to cool yourself from the inside out.
• Stay away from spicy foods and coffee as they will tend to bring on hot flashes.
• Get a small, battery-operated fan for your desk or ask your employer to provide one.
• You want to give some people a “heads-up” so they understand that you are experiencing something normal and natural rather than thinking that you have become a problem employee.

On the more serious end of the continuum is anxiety that may get as bad as panic attacks, crushing fatigue, depression, lack of ability to focus or concentrate, memory problems, mood swings, and irritability all the way to outright moments of rage.

Take good care of yourself. Take time off from work, take breaks, go for a walk outside of the office. For many of these symptoms, you can get some immediate relief by taking several slow deep breaths and also reminding yourself that this will go away and you are not a weak or a bad person for having these experiences. Exercise is paramount and a good habit of exercising daily in your favorite way will help a lot. If you are experiencing debilitating symptoms, call that menopause specialist and get some clear advice. A few women will benefit from a short trial of medications for anxiety, mood and depression but it is not the be-all and end-all. However, they aren’t often the “go-to” for the typical doctor. At any rate, get out of the office for a while of for the day if you can.

You may want to consider hormone replacement therapy ( HRT ) and that is a very personal decision that you should discuss with a menopause therapist. In the meantime, there are many non-estrogen approaches to addressing your symptoms and may be able to provide some immediate relief.

The potential impact at the office is that your peers, your leadership, your direct reports may imagine that something job related is happening: you are feeling detached from your job, you are on your way out the door, or you have something really bad going on in your personal life. This can have a negative impact on your career.

However, times are changing and some companies (or at least individuals within companies) are aware that menopause is “a thing” and deserves consideration just as pregnancy, family illness, or other crises do. This doesn’t make you a bad person! It is a temporary state of being with an endpoint (and yes, there’s an endpoint, thank goodness).

Here are some suggestions:

• Try to find someone you can talk to: an understanding manager – perhaps an understanding HR professional – female or male. (Don’t forget that men have mothers and may have wives or girlfriends who have experienced what you talking about! Many of them ”get it.”)
• Make a specific time for a meeting and come prepared with a description of what you are experiencing. Keeping a diary is helpful.
• Practice what you will say with a supportive friend so that you sound natural and comfortable while you are speaking.
• Ask about some flexibility in your schedule so that you can come in late if you’ve had a sleepless night or work from home if irritability has you trapped in a volatile state or a fan for your desk or to have access to cold water or move to a desk with better assess to fresh air.
• Assure the person you are speaking with that you are working on your own solutions such as working with a specialist to help alleviate your symptoms.
• Don’t forget to follow-up as this may be the first time your employer has had to deal with this and may not have an immediate response. At the end of the meeting set a date for a follow-up meeting.

The bottom line is that you need to pay attention to what you are experiencing and take good care of yourself. Breathe, exercise, eat well, take some quiet “me time”, get out in nature. By all means, tell yourself that you are awesome and that you will feel better. Maybe get some acupuncture, a massage, a good talk with a close friend or a trusted advisor like a therapist or a coach familiar with menopause. And, try some natural, non-estrogen based treatments.

This too shall pass!

For decades Barbara Mark, Ph.D., an elite executive coach, has worked with professional women in midlife to listen, guide, support and cajole them to clarity and decisive action as well as attaining deep professional and personal fulfillment and satisfaction. She is a recognized expert on the psychology of women, the stages of adult development and how these stages impact career development and leadership in women.

Navigating menopause while you work? We created an encompassing guide to help.

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