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24 HOW TO TREAT: MENOPAUSE AND WORK

19 SEPTEMBER 2025 ausdoc. com. au return to her normal duties, albeit with a degree of residual right wrist pain.

Given the nature of her role, including the risk of slips or trips, the physical or manual requirements of assisting with births and the need to work for extended periods in potentially awkward postures, it is important that the musculoskeletal implications of Miriam’ s POI are comprehensively assessed. Review with an endocrinologist was arranged, and, in addition to reinforcing lifestyle management, additional medical therapies were being considered.

Figure 13. Considerations may include temperature control and the availability of fans.

Lucien Monfils / CC BY-SA / bit. ly / 3Gb20Dm

Case study three

Rhonda is a 54-year-old woman working as a CEO in a large organisation. She works long hours, is required to travel frequently and has regular media and public speaking events. For the past 12 months she has been experiencing hot flushes that include significant redness to her face and neck. There have also been very intrusive psychological symptoms, including severe panic attacks prior to speaking engagements which she has never previously experienced, that she has associated with menopause.

She has been noticing increasing difficulty in maintaining media and public speaking events, reporting significant self-doubt and anxiety in the context of such events. Rhonda is also very consciousness of the facial flushing and gets distracted when this occurs in the context of speaking events.

Vasomotor symptoms, including facial and generalised flushing, are a very common manifestation of menopause. These may vary in severity, frequency and duration, and can last months to years. In Rhonda’ s case, these symptoms are having a significant impact on her employment.

There are a variety of lifestyle- or environment-based strategies that are trialled in Rhonda’ s case, including

How to Treat Quiz.

1. Which THREE menopausal symptoms have the most negative impacts on women’ s working lives? a Fatigue. b Difficulty focusing or concentrating. c Hot flushes. d Menstrual irregularity.

2. Which TWO statements are correct? a Most women will experience similar menopausal symptoms. b Symptoms of menopause last for 2-3 years on average. c Menopause most commonly occurs between 45-50. d The employment-to-population ratio for women is much higher at 50 than at 65.

3. Which THREE statements regarding the impact of menopause on work are correct? a Recent research shows a relationship between the type of occupation and the likelihood of menopausal symptoms causing more difficulty in the workplace. b Women with a disability leave their jobs more often because of menopausal symptoms than do women without a disability. c There are increasing numbers of women employed full-time in the mining industry. d While many women work in sedentary, office-based roles, some do work in industries requiring more physical tasks.

4. Which THREE may be appropriate in the management of the vasomotor symptoms of menopause? a Hormonal treatment. b Beta blockers. c Avoiding potential triggers such as alcohol and caffeine. d Layering clothes.

5. Which TWO statements regarding the genitourinary symptoms and vaginal bleeding of menopause are correct? a In most cases, vaginal bleeding will not affect work. b The genitourinary symptoms usually resolve spontaneously. c Genitourinary symptoms affect up to 50 % of working-age women at some point. d The loss of exogenous sex steroids causes the genitourinary syndrome of menopause. identifying and avoiding triggers, layering of clothes and climate control of areas where she is working. She is started on medical therapy, including hormonal therapy and SSRIs( particularly noting the coexistent psychological symptoms).

The intrusive psychological symptoms also require comprehensive assessment. They have the potential

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6. Which THREE statements regarding sleep and fatigue during menopause are correct? a The aetiology of sleep disruption associated with the menopause is poorly understood. b Exclude other causes before menopause is determined to be the sole cause. c Sleep disorders are rare in menopausal women. d Hormonal treatment has been shown to improve sleep quality in menopause.

7. Which THREE statements regarding‘ brain fog’ during the menopause are correct? a The changes may be subtle for some, but others may find the severity of their symptoms impacting on work productivity. b Women may experience problems with recall, concentration and working memory. c Cognitive performance is impaired in most women during menopause. d Women may experience difficulty switching between tasks.

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Figure 14. Belinda is a 52-year-old woman working on a fly-in fly-out basis on a mine site in remote WA.

MENOPAUSE AND WORK

to markedly impact her quality-sensitive work as a CEO, and her high-level public speaking tasks. While there is an increased frequency of new-onset psychological ill-health after menopause, there are many other potential contributing factors to psychological ill-health in a 54-year-old woman. Thus, establishing an accurate diagnosis and aetiology is critical to institute appropriate

8. Which TWO statements regarding psychological changes during menopause are correct? a It is safe to assume that psychological changes during later life are all a result of menopause. b Low mood and anxiety are common in later life. c Women with previous episodes of depression are most likely to develop major depressive symptoms during perimenopause. d Antidepressant medications are not indicated.

9. Which THREE conditions may result from the musculoskeletal changes during menopause? a Increased lean muscle mass. b Increased risk of injury. c Carpal tunnel syndrome. d Osteoporosis.

10. Which THREE actions can workplaces implement to support women during menopause? a Menopause training or a briefing session for all staff. b Shared information about menopause with staff( eg, via intranet or noticeboard). c Advising staff not to share private health information in the workplace. d A support network for menopausal women.

management and enable Rhonda to continue her role as a CEO.

After excluding alternate causes of the psychological symptoms, a multimodal approach is implemented, continuing the hormonal management, SSRIs and cognitive-based therapies.

CONCLUSION

MENOPAUSE occurs when ovarian function ceases in mid-life. The condition affects large numbers of the working population, and the associated symptoms vary in type and severity.

Some people will have few symptoms and may be relatively unaffected in the workplace, while others may have intrusive symptoms. The latter may affect their day-to-day functioning and impact on their ability to perform work tasks safely and without worsening their symptoms.

The GP can provide a comprehensive medical assessment to ensure that appropriate treatment can be initiated and is able to offer follow-up. GPs can also educate and empower patients regarding their own symptoms, reduce the stigma regarding menopause and, where possible, liaise with employers to assist with individual workers. It is important to remember that GPs are themselves often employers or have influence in healthcare organisations; this enables them to improve the working situation for women with menopausal symptoms in the workplace.