From depression to anxiety and chronic pain, it can be debilitating to go through the menopause. The Cable spoke to women about their experience and support at work.
Photos: Izzy de Wattripont
Angela* is an experienced senior manager in Bristol’s public sector, who is known for getting results and being ruthless in a male-dominated environment. But for the last four years her menopause symptoms of chronic pain, anxiety and brain fog have peaked resulting in her being diagnosed with burnout.
She’s currently on sick leave from her job and feels unsupported by her manager and HR department. “There is a menopause policy in place but every time I have raised the subject of reasonable adjustments I have been met with resistance and made to feel as though I am making a fuss,” she tells the Cable.
Angela says her line manager turned down her request to compress her working hours because it would “set a negative precedent for other managers”. Still experiencing symptoms and trying to get her hormone replacement right, she doesn’t feel ready to return to work.
“I just feel so let down and with nowhere to go for support,” she says. “After years on the wrong type of HRT [hormone replacement therapy] I am only just beginning to get myself well. I can’t afford not to work but I don’t feel like I am being supported to return,” she says.
Sadly her story isn’t unique. Some women seem to cruise through with very few side effects but for others, menopause is an all consuming, life changing process forcing them from the workplace and leaving them in a financial crisis.
I hadn’t slept for years and I was consumed by anxiety and fear. I turned up for work everyday masking these feelings. I honestly thought I had dementia at 37
Legal changes may have to wait. But in the meantime, the Cable spoke to women across the city about their experience of the menopause and what needs to be done to support women in the world of work.
Getting employers to offer support
“I fell down the menopause black hole,” says Becky Batt, a Unison union rep at Bristol City Council. Becky had worked at the council for years when in 2016 she found herself experiencing a devastating depression with no obvious trigger.
“I was experiencing suicidal thoughts and felt as though I couldn’t continue in work.” Becky, who was in her early forties at the time, visited her doctor who pointed out the likelihood of her symptoms being related to menopause.
“I wrote to the council’s HR department to ask what policies were in place for women like me, only to find out there were none.” Becky says it was her caseload of women, all of a similar age who had either been reprimanded for long-term sick leave or had left their roles entirely, that made her push for the council to provide better support.
“There were just too many women of a similar age who were having long-term health issues, departmental grievances and leaving their roles, for it to be coincidental,’ she says. “It really broke my heart.”
Becky’s campaign for better menopause care at work was met with enthusiasm after she went on a training course and set up focus groups within the council. “The response was great, 120 women all in the same situation came forward saying they needed more support.”
Off the back of training and research Becky went on to work with the council’s HR department to set up health and wellbeing plans and menopause training.
So how well are these working in practice? “I am proud to say the Health and Wellbeing Plan is an effective and robust way to drill down into what women need in terms of support,” she says. “It’s fluid and not fixed, meaning it can be updated regularly.”
“My caseload was previously 75% menopause-related and is down to less than 5% a year. Our menopause group now has over 400 members who support each other, and offer advice on things like symptoms and HRT shortages,” Becky says.
“Asking employees what they need and working with them to ensure they get the right support really works.”
Professor Vanessa Beck with University of Bristol began researching menopause and its social and economic impact back in 2017. Since then she has helped create and cultivate what a good menopause policy looks like, including advising the council on its health and wellbeing plan.
“I have somewhat changed my mind about what a good policy looks like over the years,” says Beck. “A policy stipulates something must be implemented by a line manager and in hindsight without women driving these policies forward and championing them, they have the potential to collect dust on shelves.”
“What really drives a good policy and holds businesses accountable is the culture surrounding menopause,” she adds. “Making it person centred and less of a taboo subject while also allowing for nuance.”
However, Angela’s case shows that menopause policies may exist but need to be put into practice.
Using personal experience to support others
Lauren Chiren’s symptoms were so severe she would pass out at work. But now she runs free training to help others cope.
The Cable spoke to women who have used their experience to support others. One is Lauren Chiren, now 53, who walked out of her job in Bristol as a financial executive aged just 37. At the time of leaving her job, with no idea how she would pay her mortgage, Lauren says her symptoms were so severe she would pass out at work.
“I didn’t know what was wrong with me and couldn’t remember anything.” she says.
“I hadn’t slept for years and I was consumed by anxiety and fear. I turned up for work everyday masking these feelings. I honestly thought I had dementia at 37! And by the time I found out what was causing it, I was out of work and post menopausal.”
Since being alerted by her GP to the driver of her debilitating symptoms, Lauren has dedicated the last 17 years of her life to improving her knowledge on reproductive health and now supports women and girls with theirs. In her role as a menopause coach she supports businesses in providing better training and support for their employees. She also offers a free training course to anybody who wants to learn more about the impact of menopause.
Hazel Hayden used her own experience to found Bristol Menopause Clinic
Hazel Hayden, founder of Bristol Menopause Clinic, had been working as a nurse for eight years when she left her job because of suicidal thoughts brought on by menopause.
“I was working in a role supporting patients with menopause symptoms and nobody was supporting me,” says Hazel, who felt her request for support was ignored.
“Working in the NHS you expect to be supported with your health, but unfortunately I wasn’t. My husband and I had to adjust our lifestyle completely so we could afford to live until I got support and found a job with more flexibility.”
Both Lauren and Hazel have since used their experience to build their careers around the menopause. Hazel offers private menopause care in her Bristol clinic including supporting women to remain in work and manage their symptoms. She hopes to offer community interest services at the clinic in the imminent future that would provide low-cost support.
With waiting lists for outpatient appointments in Bristol’s NHS hospitals currently at a minimum of 21 weeks, it’s vital that open conversations are happening within the workplace. But the women we spoke to say that in order to have those conversations they must first feel confident they’ll be supported by their employers.
MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.
There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.
The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.
Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.
Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.
Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.
“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.
Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.
But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.
That includes his own teenage daughter.
“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.
It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.
“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”
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AP data journalist Kasturi Pananjady contributed to this report.
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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
How a sperm and egg fuse together has long been a mystery.
New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.
“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.
The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.
Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.
It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.
Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.
Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.
The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.
The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.
The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.
The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.
The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.
“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.
When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.
“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.
“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.
The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.
Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.
The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.
“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.
They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.
“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”
This report by The Canadian Press was first published Oct. 17, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
