|
their job because of menopausal
symptoms. 11
The role of women in the workplace
has changed in recent years. In 2010, just three industries( healthcare and social assistance, education and training, and retail) accounted for 44.4 % of female employment. Women made up 56 % of all casual employees, more than 75 % of clerical and administrative workers and just 8.7 % of machinery operators and drivers. 12 In 2024, 71.8 % of clerical and administrative workers were women( see figure 4). 13 Thirteen point two per cent of the work-
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Australian Bureau of Statistics / CC BY 4.0 / bit. ly / 42rDOE7 |
force in construction are women. 13 From 2002 to 2022 the number of |
women employed full-time in the |
mining industry increased from 8700 to 45,000. 14 This includes an increase in technical, operational |
and leadership roles, but women are |
still over-represented in clerical and |
|
administrative positions. 14A
So, while many women work in
|
Figure 1. Employment-to-population ratio. |
sedentary, office-based roles, some |
do work in industries requiring more physical tasks, including manual handling and shift work or reduced access |
Oestrogen deficiency
Oestrogen level
|
to toilet facilities. These are all important |
considerations when looking at |
the impact of menopausal symptoms |
on work. However, a 2022 UK study |
did not show a relationship between |
the type of occupation and the likelihood |
of menopausal symptoms causing |
more difficulty in the workplace. 15 |
|
Vasomotor symptoms
The reduction in oestrogen that begins
| ||||
at perimenopause affects hypothalamic | ||||
thermoregulation and can lead | ||||
to dysregulation of body temperature | ||||
. This is most commonly experienced | ||||
as flushing, skin reddening and | ||||
sweating( see figure 5). Vasomotor | ||||
symptoms in peri- and postmenopausal | ||||
women are common, and usually | ||||
peak about one year after the final menstrual period. 16 These vasomotor symptoms vary in severity, frequency | ||||
and duration in affected individuals, | ||||
and can last months to years. Some | ||||
affected people may prefer to try lifestyle | ||||
changes including exercise, |
cool drinks, layering clothes, lowering room temperature and avoiding |
Figure 2. Declining oestrogen levels with menopause. |
|||||||
|
potential triggers such as alcohol and caffeine, while others may try medication. 16 Options include both hormonal treatment and non-hormonal treatment, the latter including SSRIs, gabapentin and clonidine. 17
In regard to considering the impact at work, the severity of the
|
those working outside in hot regions, underground, in industrial areas with heat generation such as furnaces, or in those roles requiring high levels of physical activity in the heat.
The better the GP’ s understanding of the role being performed by
|
The loss of endogenous sex steroids causes the genitourinary syndrome of menopause, encompassing any combination of genitourinary symptoms experienced, and, unlike vasomotor symptoms these symptoms rarely resolve spontaneously and |
seating options, access to private areas and toilet facilities.
Vaginal bleeding
In perimenopause, bleeding may
change in frequency, regularity, duration or volume. Menstrual
|
Sleep / fatigue
Sleep disorders are common in the
general population. Their frequency increases with age and sleep disorders can affect up to 60 % of menopausal women. 24 Sleep disorders are a major complaint in menopausal
|
symptoms is associated with both |
the worker and the potential impacts |
are often progressive over time. 22 |
bleeding ceases after menopause, |
women. Symptoms include difficulty |
absenteeism and presenteeism. Pre- |
of the symptoms and / or the treat- |
Genitourinary symptoms may not |
but there may be abnormal bleeding |
falling asleep, frequent awakening |
senteeism is defined as attending |
ment, the better able they are to |
be disclosed to health professionals for |
associated with the genitourinary |
and / or early morning awakening. |
work in spite of health problems, |
ensure a worker’ s safety and wellbe- |
a variety of reasons and are unlikely |
syndrome of menopause. 23 |
There are multiple possible causes |
resulting in suboptimal employment |
ing in the workplace. |
to be reported to an employer. The GP |
It is important that practition- |
of sleep disorders in the postmeno- |
functioning and lost productivity. 18 |
ers consider and exclude other |
pausal woman, including vasomo- |
In addition, there are associations with overall work impairment in employed women. This may be explained by the effects of vasomotor symptoms on sleep, and the resultant sleep disturbance. Treat- |
The reduction of oestrogen that begins at perimenopause affects hypothalamic thermoregulation. |
potentially important causes of vaginal bleeding in perimenopausal and postmenopausal women. Consider benign and malignant neoplasia( including endometrial polyps or uterine fibroids), infec- |
tor symptoms, hormonal changes, restless leg syndrome, periodic leg movement syndrome and obstructive sleep apnoea( OSA).
The aetiology of sleep disruption associated with menopause
|
|
ment of the vasomotor symptoms may reduce their severity or frequency, and therefore reduce their |
Genitourinary symptoms
Genitourinary symptoms associated
|
may, therefore, be in the best position to initiate the discussion. |
tions, trauma( including from sexual intercourse), and medication side effects. |
is poorly understood, but may be related to changes in the levels of oestrogen and melatonin, vasomo- |
impact on the person’ s work capacity |
with menopause include a number |
A variety of treatment options |
In most cases, vaginal bleeding |
tor symptoms directly affecting |
and performance. 19 |
of conditions that may impact on |
are available, including lubricants |
will not affect work. For individuals |
sleep, or a result of the impact of |
It is also important to consider the |
work, such as vaginal dryness( see |
and moisturisers, hormonal treat- |
with very heavy bleeding, dysmen- |
psychological symptoms. 24 |
potential effects of treatment in the |
figure 6), vaginal wall prolapse, vul- |
ments and laser treatment. 22 |
orrhoea or anaemia however, the |
An understanding of the indi- |
workplace. Some of the antidepres- |
val irritation or itching, recurrent |
Genitourinary symptoms may |
symptoms may impact on their work |
vidual’ s experience will help to |
sant medications used to treat vasomotor symptoms( including SSRIs) can reduce a person’ s tolerance to heat. 20 This may be relevant for workers in certain industries, including |
UTIs, urinary urgency and urge or stress incontinence. 21 These symptoms affect up to 50 % of working-age women at some point, and this increases with increasing age. 21 |
affect multiple aspects of a person’ s life, and their impact in the workplace should not be underestimated. Consider factors such as the location of work, uniform requirements, |
performance or attendance. Relevant workplace factors may include access to toilet facilities, uniform requirements, leave policies and flexible scheduling. |
direct possible treatment options, and it is important to ensure that all other sleep disorders and chronic illnesses unrelated to menopause that may affect sleep are |