Dr Clare Wood( left) Specialist occupational and environmental physician, and adjunct senior lecturer at Monash University, based in Brisbane, Queensland.

Dr Andrew Lingwood( right) Specialist occupational and environmental physician, and adjunct senior lecturer at the University of Queensland, Queensland.

First published online on 12 September 2025

INTRODUCTION

WOMEN make up 47.9 % of the Australian

workforce, comprising 37.4 % of all full-time employees and 68.5 % of parttime employees. 1 The participation of women in the workforce is increasing. In 2020, the Australian Bureau of Statistics reported the employment-to-population ratio for women at age 50 was 76.9 % and 35.6 % at age 65( see figure 1). 2 This is compared with 70.5 % and 10 % in 2000, 47.1 % and 6.7 % in 1980, and 36.6 % and 9.9 % in 1966. 2

Menopause is defined as the last menstrual period. The diagnosis can only be made in retrospect, and as such we define women who have not had a menstrual period for 12 months as postmenopausal. 3 Menopause can be natural when occurring as part of the ageing process in biological females, or caused by surgical or medical procedures including bilateral oophorectomy or chemotherapy. 4 Most people experiencing menopause are women, but it can also occur in people with ovaries who do not identify as female. This article will refer to women throughout, using the term to also encompass these individuals.

Menopause is a result of lack of ovarian follicular function and most

commonly occurs between ages 45 and 50( see figure 2). Menopause that occurs before age 40 is called premature ovarian insufficiency( POI). The causes of POI include surgical removal of the ovaries, chemotherapy or pelvic radiation treatment, genetic predisposition, and some medical conditions such as autoimmune conditions and HIV / AIDS. 5

The effect that menopause has on individuals is varied( see figure 3). When considering symptoms, a recent Lancet series stated“ Experiences vary hugely. Some women have few or no symptoms over the menopause transition while others have severe symptoms that impair their quality of life and may be persistent.” 6 Symptoms that may impact on women at work include vaginal and urinary symptoms, muscle and joint pain, hot flushes and sweats, and insomnia with its resultant fatigue. 7 Affected individuals may also notice changes in mood or‘ brain fog’. There is a significant increase in new-onset depression during the menopausal transition. 7 Importantly, although experiences are varied, most women have symptoms and these last for 5-10 years on average. 8

A 2024 Lancet series indicated that prolonged or heavy menstrual bleeding affected 80-90 % of women, vasomotor symptoms affected up to 80 % and genitourinary symptoms between 10 and 40 %. 6 It is relevant to note that this series has been criticised by some specialists for referring to over-medicalisation of menopause, when many women do not have access to medical guidance during menopause. 9 A UK survey indicated that fatigue, hot flushes, difficulty focusing or concentrating, and anxiety or worry were the symptoms that had the most negative impacts on women’ s working lives. 9

From an occupational medicine perspective, any condition causing intrusive or persistent symptoms has the potential to affect people at work and requires consideration and management, particularly when affecting large numbers of workers. Work fulfils a number of important needs for an individual, including financial stability or independence. It can be linked to self-esteem, identity and community. Good work provides a number of benefits and is a determinant of health and wellbeing of employees, their families and the broader community. 10

This How to Treat reviews some of the most common menopause symptoms, addressing the possible effects in the workplace, and provides some examples of how these can be proactively managed. It aims to provide some insight into the impact of menopause in the workplace and the role of the GP in assisting with its management— both as healthcare professionals and, in many cases, as employers— to ensure the sustainability and continuation of work for older women.

IMPACT OF MENOPAUSE ON WORK

WHEN considering what the medical

profession can do to assist women experiencing menopausal symptoms at work, it is important to understand the types of work performed by women in Australia, and the effects that individual symptoms and symptom-combinations can have on a person in the workplace.

A 2022 UK report found that one in 10 women who worked during the menopause left a job because of their symptoms. 11 In addition, this disproportionately affected women with a disability, 22 % of whom left