When WH polled our community, 57% of those who struggle with a hormonal or gynaecological condition told us they believe it has harmed their career.
That’s why we’re taking a close, critical look at how female health issues - that’s everything from endometriosis, fibroids and PMDD to fertility treatment and (peri)menopause - affect our working lives.
How did we get here? What does it feel like? And how do we make meaningful change? This is Women’s Health at Work.
Call to mind, if you will, what’s holding you back professionally. Maybe it’s knackered technology long overdue an upgrade. Maybe it’s the IG reels wormhole that claims victory over your attention span more regularly than you’d care to admit.
Maybe it’s the child you’re raising who makes your heart swell while also making those long hours you used to pull when rising through the ranks completely out of the question. Whatever your current working theory, we have another one to throw into the mix: your biology.
You know, fluctuating hormones that seem to hijack your mental health for 10 days of the month. Or the dragging, vice grip-agony that consumes your lower abdomen as your womb lining breaks down.
Brutal menses; disabling PMS; a menopause that makes you feel like your world has been flipped; the visceral rollercoaster of trying, and failing, to become pregnant. These are the messy, inconvenient, unproductive - and, largely, intractable - occupational hazards that can come with the territory of occupying a female body.
They don’t care about your goals, or that your relationship could *really* do without being shoved into the premenstrual pressure cooker this month. And you’ll bet that they’ll follow you to the office, ward, shop floor - or WFH desk - wherever you earn your crust.
Lifting the lid on the women’s workplace health crisis
When WH polled women in our Instagram community, 57% of those who struggle with a hormonal or gynaecological condition told us they believe it has harmed their career.
While a minority of you told us your health condition had directly caused you to lose your job, the prevailing narrative was of these conditions and challenges chipping away at women’s professional identities.
Much like the impact of a daily swig of Diet Coke on your tooth enamel, just over half of you report female health issues holding you back, professionally, by corroding your confidence.
And this isn’t just a ‘past tense’ thing: 81% reported feeling like they couldn’t speak up and expect reasonable adjustments to be made by their employer. One in five believe they have been discriminated against because of their condition.
A key flashpoint is during the (peri)menopause. That’s when, if you need a primer, hormone levels drop, causing your periods to stop while also ushering in a host of symptoms from irregular periods to hot flushes, low mood and cognitive disruption.
Commonly occurring when women are between 45 and 55 of age, menopause can happen before, naturally or as a result of a the removal of reproductive organs, as with a hysterectomy.
While precise data on the topic is difficult to find, a survey conducted by BUPA and the Chartered Institute for Personnel and Development (CIPD) estimated that approximately 900,000 women leave their jobs each year due to (peri)menopausal symptoms. Online menopause community The Latte Lounge also found 42% of women had considered leaving their job because of such symptoms.
But problems arise before that. A parliamentary report found 28% of those with endometriosis have had to change or leave their job - with 27% believing they missed out on a promotion because of their condition. And despite over 50,000 people undergoing fertility treatment each year, one in four with fertility issues suffer negative experiences with employers, according to new research by Fertility Matters At Work.
Clare Knox (@see_her_thrive) is a business psychologist who works with organisations to help them become a more supportive employer for their staff with gynaecological conditions - or those experiencing the menopause - as well as with individual clients navigating female health issues in the workplace.
‘It’s not just about certain companies wanting to be seen to “do the right thing”,’ she clarifies. ‘When workplaces are hostile, either knowingly or unknowingly, to conditions that women face, research shows they will likely experience more sickness absence - and lose top talent.’
Indeed, a landmark 2019 study from Radboud University in The Netherlands pinpointed that working through period pain and other disabling premenstrual symptoms accounts for an average nine days lost productivity per person, per year.
On the flipside, interventions such as the option of paid menstrual leave can - according to a review of research led by the University of Sydney’s business school - have a transformative impact not only on the way women feel, but how they perform.
‘If you provide the right [services], women's productivity increases, their commitment and loyalty increases, and there are benefits to the firm,’ writes the university's professor of gender and employment relations, Dr Marian Baird.
Business psychologist Clare, like many women working in this area, has got skin in this game. Specifically, she wrestles monthly with the tyranny of premenstrual dysphoric disorder (PMDD).
She’s somewhat heartened to see the rise of companies adopting policies for how to better handle individual female health concerns - i.e. focusing on menopause or endometriosis. But, for her, it’s crucial that the wins in this fight don’t operate in isolation.
‘It’s the same issue at play across many of these scenarios: the working world, fundamentally, isn’t designed for women and the cyclical nature of our health,’ she explains.
‘It’s not set up for people who lose days to agonising period pain or mental distress. It’s not set up for those going through fertility treatment or for those experiencing menopause - naturally or following a medical or surgical procedure.’
And meaningful progress, in her opinion, needs to challenge this across the board, as opposed to being too neatly trained on one particular condition or experience. It also needs to be inclusive of those trans men and non-binary people who also experience these issues.
Supporting female health in the workplace: what are the challenges?
Short answer: there's a few. ‘I’m not entirely sure that thinking about these issues purely in relation to employers’ squeamishness [around female health] is constructive,’ says Dr Vanessa Beck, professor of work and organisation at the University of Bristol’s school of management, when WH put that theory to her. ‘That is not to say that such squeamishness doesn’t exist, it definitely does. But I would argue that the situation is more complex.’
Take the issue of the menopause, an area which Dr Beck's research has homed in on. From employers’ perspective (and assuming that they want to tackle menopause issues, which sadly, not all do) she says: ‘it's quite difficult to raise the subject matter in a manner that is seen as appropriate by all. Individuals and their menopause transitions are so varied that what is seen as “helpful” or “appropriate” also differs considerably.’ Women - even those encountering the same reproductive health challenges - are not a monolith. ‘Not all women want to talk about it.’
‘In our own survey of individuals who were willing to take part in research on menopause in the workplace, 45% of those currently or previously experiencing menopause had disclosed their situation at work,’ she tells WH. ‘The main reasons why respondents didn’t want to disclose included that “[menopause] is a private issue and I do not want to talk about it at work” and concerns that “my abilities would be questioned”.’
Such sentiment was present when we asked for our own community's take on paid menstrual leave. While 58% said they’d support this legal right (and a further 10% agree with it in principle but believe it should be down to individual employers to decide, as opposed to policymakers at a national level) a significant minority weren't keen.
While some (16%) deemed it ‘unnecessary’, 17% thought it could be actively unhelpful because it ‘signals that women need adjustments [in the workplace]’.
Charlie Thompson, employment solicitor and partner at law firm Stewarts, agrees that favourable policies enacted at a company level won’t function like a silver bullet, especially given the wider issue of UK workers not taking the leave that they’re already entitled to.
‘Many employees are highly likely to continue working while dealing with health issues. As an example, it appears that in many organisations that offer the benefit of “unlimited holiday”, people end up taking less time off.’
Playing the generation game
Several experts contacted by WH for this piece believe that as millennials and Gen Z occupy more senior positions, the sentiment they’ve brought with them to the workforce - a belief that you can’t separate a person’s health from how they show up in their working life - will become increasingly dominant.
You know, those leadership maxims that have become so clichéd: ‘bring your whole self to work’, for example. Cringe? Possibly. But the sentiment behind them has undeniably grown in influence.
And it’s hard to find a medic, legal or psychology professional working in this area who doesn’t believe these shifts are positive for women whose lives are routinely hampered by gynaecological or hormonal health concerns.
By our estimations, the shift could be powerful. Women redefining the boundaries of professionalism originally drawn up for a working world without them could usher in a paradigm shift.
And if this could nudge us closer toward a workplace culture more accommodating of the messy, repeated, sometimes unsurmountable biological challenges that can come with occupying a female body? That would be welcome - long-overdue - change.
Hope that elements of female health might become protected characteristics in employment law - under the Equality Act 2010 - were dashed when Baroness Stedman Scott, Parliamentary Under-Secretary of State for Women - and Work and Pensions - wrote to Caroline Noakes MP, chair of the Commons Women and Equalities Select Committee, stating that the UK Government will not make the menopause a new protected characteristic under the act.
There are no current plans to revise the law - though new guidance may be published in response to the increase of menopause being raised at employment tribunals - incidents of which increased by 44% between 2021 and 2022.
However, when contacted by WH, the Department of Health were keen to emphasise their support for women's wellbeing - specifically focused around menopause - within the workplace.
The Minster for Women's Health, Maria Caulfield said: 'Women’s health is not just an issue for women – we must all work together to ensure women of all ages are supported to reach their full potential.'
'The health service is here to help anyone experiencing perimenopausal or menopausal symptoms. But it’s also crucial organisations have policies in place to ensure women feel supported. This will not only help increase retention, improve productivity and wellbeing but ensure we keep expert women in the workplace for longer.'
'We recently launched a grant fund to ensure the voluntary sector can continue to support women experiencing menopause, as well as fertility problems, menstrual health and gynaecological conditions in the workplace.'
'We’ve also set up a UK wide menopause taskforce taking a whole society approach to menopause support, and we will shortly be publishing the first ever government-led Women’s Health Strategy.'
Of course, organisational change is slow - and, at present, all too often focused within those businesses with deep pockets and robust structures. We'll be sharing our own learnings about how to help women - including those with (peri)menopausal symptoms - feel more supported at work. Plus, not forgetting the sizeable chunk of British women who work for themselves, advice on navigating female health challenges while self-employed.
But, for now, what's left to say is a reminder that cultural shifts are powerful and so often come about from the bottom up. And, if you feel comfortable doing so, speaking up about your experience of a female health condition - to friends, family, colleagues, people you manage - means you're playing a part to destigmatise these experiences.
Experiences that have, for too long, been the elephants in the room. Fed on a diet of silence, these grow from small calves to monstrous beasts, their power fuelled each time they’re unacknowledged until they’re able to stamp all over dream jobs, solid working relationships and hard-earned professional respect. Often to devastating, confidence-crushing, livelihood-sabotaging effect.
We say: no more.
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