AusDoc 19th Sept | страница 21

HOW TO TREAT 21
ausdoc. com. au 19 SEPTEMBER 2025

HOW TO TREAT 21

considered and addressed where
appropriate.
Of note, OSA is more common
in older women, and women may also gain weight during menopause, thus increasing their risk of OSA. The mainstay of treatment of OSA is CPAP( see figure 7), which is effective in reducing sleep disruption.
Brain fog
Mood disorders( anxiety and depression)
In addition, some women experience
fatigue without specific sleep
disruption during menopause and the effect of fatigue in the workplace also needs to be considered. 25 The causes of fatigue are extensive. Exclude other causes before menopause is deter-
Thinning hair
Dry eyes and mouth
mined to be the sole cause, as treatment
recommendations for fatigue
will vary depending on the cause.
If no other cause is found, or the problem persists despite appropriate treatment, hormonal treatment has been shown to improve sleep quality in menopause, which may reduce the negative impacts in the workplace. 24
Hot flushes
Sexual dysfunction
Concentration / focus /’ brain fog’
Many women transitioning through menopause may experience cognitive symptoms including problems with recall, concentration and working memory( see figure 8). Maki and Graff provide the following definition for menopause-related brain fog:“ The constellation of cognitive symptoms experienced by women around the menopause, which most frequently manifest in memory and attention difficulties and involve such symptoms as difficulty encoding and recalling words, names, stories or numbers, difficulty in maintaining a train of thought, distractibility, forgetting intentions( reason for coming into a specific room) and difficulty switching between tasks.” 26
The changes may be subtle for some, but others may find the severity of their symptoms impacting on work productivity. 26
Cognitive performance remains within normal limits for most women during menopause. However, women who are more affected may find tasks at work requiring attention to detail or memory more challenging.
Bone loss
Genitourinary symptoms
Figure 3. Symptoms of menopause.
Weight gain
Dry skin and nails
Psychological symptoms
Psychological symptoms including
low mood and anxiety are common in later life. 27 Alterations in hormone levels may be associated with
a change in symptoms, and exacerbations
of pre-existing mental health conditions. 28 Women with previous episodes of depression are most
likely to develop major depressive
symptoms during perimenopause
( see figure 9). 29
There are other psychosocial factors
that increase the risk of depression
and anxiety at this time of life;
it is important to ensure that menopause
is considered and treated where appropriate, but also important not to attribute all changes in mental health during ageing to the menopause.
The symptoms of depression and anxiety can impact at work during
Figure 4. In 2024, 71.8 % of clerical and administrative workers were women.
menopause, as they can at all other
times of life. It is essential to ensure
considered, either alone or in com-
can thus have a significant impact on
injury. These effects have potential rel-
association between menopause and
that appropriate support mechanisms
bination with antidepressant med-
musculoskeletal function. 30
evance for individuals working in roles
the development and progression of
are available for those workers who are most significantly affected.
ications( such as SSRIs, which may also be considered for vasomotor
Lower oestrogen levels lead to a decrease in lean muscle mass and
with significant physical demands. Fluid retention related to meno-
32, 33 osteoarthritis. The hormonal changes of meno-
Important considerations are the location of the job, whether the worker is away from home and if they have access to support, both from healthcare professionals, family or friends and work. In terms of man-
symptoms). 7
Musculoskeletal changes
Reduction in oestrogen levels has
impacts on bone, muscle, joint, tendon and ligament physiology. The
muscle strength. Lower levels of oestrogen also affect the collagen structure in tendons and ligaments, making them stiffer and contributing to tendinopathy. These changes may manifest as increased musculoskeletal aches
pause increases the risk of carpal tunnel syndrome( see figure 10). 31 This can result in symptoms that may impact roles which require frequent, forceful use of the hand, use of vibrating hand tools, or frequent keyboard use.
pause result in more rapid progression of loss of bone mass( that by the typical time of menopause will already be occurring in a physiological age-related manner). 34 Subsequently, women are at greater risk of developing osteo-
agement, hormone therapy can be
hormonal changes of menopause
and pains and an increased risk of There also appears to be an
porosis( and associated low trauma