On 5 May 2021, Irish radio show host Joe Duffy invited women to share their stories about menopause. The response was so overwhelming that the anticipated five-minute phone-in turned into a five-day marathon.

“Suddenly, menopause was all over the media in Ireland and the UK,” says Dee France, manager of the Thrive wellbeing hub and CA Support at Chartered Accountants Ireland. “No-one could believe that suddenly everyone was talking about it.”

The menopausal transition – perimenopause, menopause and postmenopause – is a natural stage in the life of every woman, as well as many trans, non-binary and intersex people. In New Zealand, the age of onset ranges from 42 to 56 years, with an average 51.5 years, though it can also occur much earlier, often as a consequence of illness, surgery, radiotherapy or chemotherapy. Yet, despite affecting about 50% of the population, it remains shrouded in mystery.

During the transition, fluctuating hormone levels can trigger physical symptoms including hot flushes, insomnia, night sweats, fatigue, joint and muscle pains and headaches. They can also cause anxiety, depression, mood swings and the cognitive challenges known as brain fog.

“I pride myself on being articulate, professional and great at what I do, but I would often lose a word or even an entire sentence in meetings and presentations,” says Rae Gunn FCA, chair of the Local Committee for CA ANZ in Hamilton and a certified coach.

Women have a lot to lose

Some women sail through menopause symptom-free while the majority experience symptoms considered to be ‘moderate’. However, in 2023, The Menodoctor Survey New Zealand found that one in six women experiencing menopause have considered resigning from their job, while one in 12 actually did.

“This reduces their income, threatens their financial independence and impacts New Zealand’s gender and retirement pay gaps,” says Claire Stuart who, in partnership with Robyn Fausett, established the international organisation Menopause Friendly in New Zealand. “The current gender retirement gap is an atrocious 36%.” This disparity of voluntary contributions favouring men was highlighted in a 2023 study, Distributional Analysis of KiwiSaver Contributions from the Te Ara Ahunga Ora Retirement Commission.

Stigma and discrimination can compound the challenge by causing embarrassment, shame and lack of confidence. These can all interfere with career development and opportunities for promotion, leading to under-representation of women in leadership roles.

“In New Zealand, 70% of the CA ANZ workforce is female and around 38% of them are aged between 40 and 60,” says Shona Tarrant, group executive, People and Culture, at CA ANZ. “Menopause often intersects with a critical career stage when women are likely to be entering senior leadership.”

The high cost for organisations

Ignoring menopause can be very costly.

“There’s the financial cost of finding and training replacements for those who leave, if you can find them at all,” says France. “The accountancy profession is already in crisis in terms of recruitment. We can’t afford to lose women who could have years of experience and high levels of skill.”

There is also a legal imperative. The Health and Safety at Work Act 2015 requires employers to provide a safe work environment as far as is reasonably practicable, including reasonable adjustments to accommodate health conditions such as menopause. Menopause is covered under the New Zealand Human Rights Act 1993 and the New Zealand Bill of Rights Act 1990 on the grounds of sex, age or disability discrimination. In the UK, law firm Irwin Mitchell has identified a rising trend in the number of employment tribunal cases citing menopause as a contributing factor. And research by Menopause Experts found that of 23 employment tribunals citing menopause in 2021, 16 cited disability discrimination, 10 sex discrimination and 14 unfair dismissal.

What needs to change?

In a survey for the New Zealand Institute of Economic Research (NZIER), the organisation’s deputy chief executive (Wellington) and principal economist, Sarah Hogan, asked about the workplace changes women would like to see. The most common were flexible start and finish times, reduced hours, support for emotional and mental health and a controlled temperature in the workplace.

“I believe that period products in employee bathrooms and appropriate uniforms should also be a priority,” says Stuart. “But perhaps the most important thing is being able to have a conversation about menopause without feeling ashamed or embarrassed or stigmatised.”

Some women fear that being open about the challenges of menopause would give employers more ammunition for discrimination.

“I understand that point of view, but not talking about menopause hasn't helped women for generations,” says Niki Bezzant, author of This Changes Everything: The Honest Guide to Menopause and Perimenopause. “Menopause is not an illness, or a disability, or a reason to avoid promoting women, it’s simply a transition where some women may need support. The more we talk about it, the less it can be weaponised into another way to hold women back.”

An outsider can often help to get the conversation started.

“They can speak very frankly and openly in a non-confrontational or non-serious way,” says Bezzant. “When I do a webinar or an in-person talk I always encourage the organisation to include everyone in the workplace because everyone needs to hear and understand.”

Ethnicity and culture must also be taken into account.

“In pre-colonisation Māori culture, wahine [women] were honoured and respected during this life stage for all that their bodies had done, which is a beautiful perspective,” says Stuart. “Other ethnic communities may see menopause as a taboo subject. Not having English as a first language can also limit access to knowledge and treatment.”

Hogan found that, when women approached their GP, they were most likely to be offered advice on diet, exercise or other lifestyle adjustments. They’re also just as likely to be offered sleeping pills, antidepressants, pain medication or other medicines as hormone replacement therapy (HRT).

“I believe it’s really important to educate yourself so you can have an informed conversation with your GP,” says Gunn. “Along with the brain fog, I suffer really badly from sore joints, hot flushes and sweats, but my doctor refused to prescribe hormone replacement because of my medical history. When I researched this myself I discovered that, in my case, the increased risk is very small compared with the improvement to my quality of life. I've been on hormone replacements for a couple of months now and I really wish I'd known that 10 years ago.”

A movement gaining traction

Some people question the need for a workplace menopause policy but Stuart believes that a formal commitment to providing support is reassuring for women.

“It will also enhance the company’s reputation for inclusivity,” she says.

CA ANZ New Zealand has a menopause policy on the work plan.

“We have invested time in normalising the conversation,” says Tarrant. “We also have the MenoMe portal – a dedicated intranet wellbeing hub with articles, podcasts and support material. We’ve had great feedback from our females and also from male people leaders who now feel equipped to support employees experiencing menopause with options including access to our EAP, flexible working, and personal and carers leave.”

Stuart is encouraged that all things menopause are finally gaining traction.

“I think we’re on the brink of long-term positive change for women and the organisations they work for,” she says.

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How menopause friendly is your workplace?

Menopause Friendly Australia offers a range of training and resources to empower organisations to actively support menopause at work across five key areas (environment, culture, policies and practices, training and engagement).

Organisations can download a free checklist to determine how ‘menopause friendly’ they are and where there could be improvements.