Abstract
This Statement was endorsed by the Academy of Medical Royal Colleges
The British Menopause Society (BMS), Royal College of Obstetricians and Gynaecologists (RCOG), Royal College of General Practitioners (RCGP), Faculty of Sexual and Reproductive Healthcare (FSRH), Faculty of Occupational Medicine (FOM) and the Faculty of Public Health (FPH) have issued this Position Statement in response to the British Medical Association’s (BMA) report ‘Challenging the culture on menopause for doctors’ published on 6 August 2020.
The BMA report included recommendations based on the findings from a survey of 2000 BMA members carried out to understand the specific challenges faced by doctors working through the menopause.
The BMA report concluded that there is a ‘fear to speak out about the menopause’ among the doctors surveyed. It also highlighted that many doctors felt that support was lacking and there was huge reluctance to discuss the problem with managers and colleagues. Symptoms such as insomnia, fatigue, loss of confidence and debilitating hot flushes were reported by 90% of the doctors surveyed who felt this affected their ability to work, with 38% describing the impact as ‘significant’. More than a third of doctors in the survey indicated they wanted to make changes to their working lives as a result of their menopausal symptoms but couldn’t, and almost 50% mentioned they wanted to discuss the topic with their manager but did not feel comfortable. Only 16% of respondents had discussed this issue with their manager.
The report highlighted that there were over 30,000 women doctors between the ages of 45 and 55 on the GMC register. The survey found that a significant number have reduced their hours, left management roles or intend to leave medicine altogether, despite enjoying their careers, because they were struggling to cope with their menopausal symptoms and did not feel they had the support they needed to help them manage this.
The BMA recommended that employers take a pro-active approach to the menopause, to make it easier for employees to talk about the menopause and to ensure staff are offered support and sign-posted to information and advice. Other recommendations in the report included the need to enable doctors to work flexibly, making suitable adjustments in the workplace and providing support for mental health and wellbeing.
We recognise that the menopausal transition can have a significant impact on many women. In addition, symptoms may last for a number of years (seven years on average), and a third of women experience long-term symptoms. It is therefore important that support and advice is available to guide women through their menopause and help them cope with it.
Data published by the Office for National Statistic showed that 70% of women in the UK are in paid employment and that women comprise 47% of the UK workforce. It is estimated that 4.3 million women aged 50 and over are in employment. Further, over the last 30 years, the proportion of women aged 55–59 in UK employment has gone up from 49% to 69% and for women aged 60–64 from 18% to 41%.
Recommendations of the BMS, RCOG, RCGP, FSRH, FOM and FPH in response to the BMA report ‘Challenging the culture on menopause for doctors’
The BMS, RCOG, RCGP, FSRH, FOM and FPH fully support the recommendations made in the BMA report.
The findings from the BMA report are very concerning, especially when doctors should have knowledge of, and access to, information about menopause and treatment options. If doctors, who often need to advise their patients about menopause, find this stage difficult to discuss and struggle with the impact of symptoms, then it is not surprising that other women do so too. In addition, health services in the UK are under significant pressure and we cannot risk losing experienced doctors because of the lack of support offered to employees to help them cope with the menopause.
We believe there is an urgent need to raise menopause awareness among all managers and staff, including the NHS. This can be achieved through the following:
Employers should ensure that policies are in place to help employees who are experiencing menopause-related symptoms and support them during their menopause transition. Women should be encouraged to seek help for managing their menopausal symptoms and should be made aware of resources available for guidance. Information should also be provided to women on how they can access menopause advice and to make an informed decision on their management options. Employers should have defined pathways in place such as online training for employers and educational webinars on the menopause. This should be offered to managers, supervisors and team leaders. Employers should also include working flexibly (where possible) and adjustments to the workplace environment as part of such pathways. There is also a need for such processes to be rolled out nationally and to be included in local health service policies. The incorporation of menopause support in workplace culture, policies and training should be in accordance with all legislative requirements in particular the requirements of the Health and Safety at Work Act 1974, the Management of Health and Safety at Work Regulations 1999 and the Equality Act 2010. Both individual- and organisational-level interventions are therefore recommended in order to meet the needs of working menopausal women.
Footnotes
Declaration of conflicting interests
HH: No conflicts of interest. EM: One off Advisory Board – Gedeon Richter, 2019, Exploratory research funded by Chugai Pharma. Trustee to RCOG, BMS and Group B Strep Support. Advisor to Pfizer, 2017 and 2018. MM: No conflicts of interest. AK: Has been paid Lecture fees by Bayer. AdB: No conflicts of interest. MR: No conflicts of interest.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Contributorship
HH wrote the first draft of the manuscript. All authors reviewed the manuscript and approved the final version of the manuscript.
