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Menopause

During the menopause physiological changes take place which lead to hormone changes. These hormone changes differ between individuals going through the menopause. As a result of hormone changes within the body, a wide range of symptoms can occur.

Guidance for employees experiencing the menopause at work

Here are some tips that may help deal with the symptoms of menopause:

  • Find out more about the menopause from available sources of information (see suggestions at the end of this guidance).
  • See your GP for advice on available treatment options.
  • Ask for a ‘Wellbeing Conversation’ and discuss your practical needs with your line manager, HR or another manager or colleague you feel comfortable talking to.
  • Ask for a referral to the Trust’s occupational health service to discuss support and possible work adjustments, for example:
  • Review control of workplace temperature and ventilation and see how they might be adapted to meet your needs. This might include having a desktop fan in an office or locating a workstation near an opening window or away from a heat source.
  • Consider flexible working hours or shift changes. If sleep is disturbed, later start times might be helpful.
  • Access to cold drinking water
  • Access to wash room facilities and toilets.
  • Agreed protected time to discuss work issues to help with loss of confidence.
  • Considering additional rest breaks.

Additional considerations and adjustments may be required for specific roles or locations. For example:

  • Where uniforms are worn, flexibility is helpful. This could include wearing uniform of lightweight fabric, providing additional sets of uniform as well as the provision of changing facilities during the shift if required.
  • Where work requires constant standing or prolonged sitting, having access to a rest room (e.g. to sit during work breaks) would be helpful, as would space to move about for those in sedentary roles.
  • In customer-focused or public-facing roles, it may help to have identified a quiet space for a short break so you can manage a severe hot flush.
  • Where adjustments are agreed, they should be reviewed on an ongoing basis to ensure they are having the required impact.
  • If those you work with are supportive, this can make a big difference. If you feel able to do talk about your symptoms and solutions with colleagues, particularly those who are also experiencing symptoms.

Helpful contacts & Additional information

Occupational Health Service rcht.occhealth@nhs.net
01872 252770
Health and Wellbeing – information of support Looking after your health and wellbeing | Intranet – Royal Cornwall Hospitals Trust
Wellbeing Conversations Guidance for Managers
Guidance for Wellbeing Conversation My Wellbeing Conversation Flowchart
Full guidance including tuition videos on how to have a wellbeing conversation can be found on NHS employers:
Wellbeing conversations – Our NHS People
Employee Assistance Programme self-referral for confidential counselling 0800 030 5182, or log onto the online portal
Health assured online Portal.
Username: Please see here (internal only)
Password: Please see here (internal only)
Health and Safety – 01872 25 2976
Risk assessment forms and advice HSE management standards indicator tool
NHS Choices – provides advice on symptoms and treatments for the menopause https://www.nhs.uk/conditions/menopause/
NHS menopause guidance http://www.nhs.uk/Livewell/menopause/Pages/Menopausehome.aspx
Menopause Matters https://menopausematters.co.uk/index.php
Menopause self-care http://www.menopauseselfcare.org.uk/
Penzance
CIPD https://www.cipd.co.uk/knowledge/culture/well-being/menopause
Video Guidance – Managers
Click on link to view Employees

Occupational Health and Wellbeing October 2022 V1.0 – Source: adapted from the Mid Yorkshire Hospitals NHS Trust

Sleep Management

One of the symptoms menopausal people report when they are going through the menopause is night sweats. To try to cool down, menopausal women may remove sheets, duvets or clothing as this can be a way to try to keep cool during the night. Further tips to help with night sweats are:

  • Wear lighter clothing
  • Keep the bedroom cool at night
  • Increase levels of exercise
  • Reduce stress levels
  • Avoiding potential triggers, such as spicy food, caffeine smoking and alcohol
  • A variety of products that claim to help ease the symptoms of night sweats are available on the market. These products have their own research to suggest that they draw the heat away from the body when it starts to heat up which can help to prevent or control sweating. These products include complete bedding sets that claim to optimise body temperature.
  • There is limited evidence available, other than information on bedding manufacturers’ websites to support the use of specialist bedding as an effective intervention for night time sweats during the menopause, but some women have reported benefits of using special bedding as part of the overall management of menopausal symptoms.

Occupational Health and Wellbeing October 2022 V1.0 – Source: adapted from the Mid Yorkshire Hospitals NHS Trust

Clothing During Menopause

  • Different people experience the symptoms of the menopause in different ways, hot flushes are very common at this time of hormonal changes. Hot flushes cause you to sweat heavily and can make you very uncomfortable. Some women find that, with the right clothing, they can limit this discomfort.
  • One way of doing this is to use comfortable, breathable clothes.
  • There are some ranges available with menopausal people in mind. These include nightwear, underwear, sportswear, and outerwear. The materials used in these breathable clothes are made from small fibres, which lie close to the woman’s skin and lift (wick) moisture from the material.
  • This moisture is then transported to the outer surface of the material, where it can evaporate, reducing the discomfort and embarrassment of hot flushes. This type of material is called wicking. It can be made from man-made fibres, silk, bamboo, or wool.
  • There is little research to show which fabrics are most useful for people during the menopause, so you might need to try different ranges to see which is best for you.

Occupational Health and Wellbeing October 2022 V1.0 – Source: adapted from the Mid Yorkshire Hospitals NHS Trust

Hair Thinning During Menopause

Suffering from hair loss can be a disheartening and upsetting experience for most people. Unfortunately, during the menopause it can often occur due to plummeting levels of oestrogen and an increase in testosterone.

Diet, lifestyle, and home remedies for hair loss

There are few people who would be willing to sit back and watch their hair fall out. Instead, several home remedies can be employed alongside herbal or conventional remedies to make sure that your hair is kept as healthy as possible:

  • Keep stress to a minimum. This will also help you sleep well at night, reducing another factor which might cause you to lose your hair. Exercise will help reduce stress, improve sleep and circulation of blood to the scalp to help you keep your hair on.
  • Be nice to your hair. Use gentle shampoo when you wash it and try to avoid tugging and tangling it. Dying it regularly can cause hair to become unhealthy and more likely to fall out. A scalp massage can stimulate extra blood flow to the scalp, which may prevent further hair loss.
  • There are certain foods which can improve the quality of your hair. Protein and iron rich foods (found in red meats) are good for strengthening your hair. Vitamin C, found in citrus and other fruit, is also beneficial, not least for helping you to absorb iron into your bloodstream.
  • Are there herbal remedies to help? If your hair loss is the result of hormonal changes caused by the menopause, using a soy-based supplement will be a good start. The best is made from fermented soya beans because absorption or take-up by the body is better. Vitamin C/E are also good supplements

If you are really worried and your hair loss is causing you concern, talk to your GP don’t try remedies off the internet, they may harm you as you don’t know what’s in them always talk to your GP

Occupational Health and Wellbeing October 2022 V1.0 – Source: adapted from the Mid Yorkshire Hospitals NHS Trust

Vaginal Dryness

Women can have vaginal dryness (also known as vaginal atrophy) can occur at any point in a woman’s life. It has several causes and is related to hormonal changes affecting moisture levels within the body including the vaginal area. Vaginal dryness has been found to affect over half of 51–60-year-olds, it often occurs around the time of the menopause due to changing levels of Oestrogen.

Vaginal lubricants can be purchased over the counter at your local pharmacy. These are water based and you can apply them into the vagina and around the vulva pre or during sex to ease any dryness.

Vaginal moisturisers – vaginal moisturisers work for several days. Applying them regularly should make the vagina and surrounding tissues more pliable/stronger. These can also be purchased at your local pharmacy.

What can I do to help myself?

  • Talk to your partner, don’t try and hide it, solve it!
  • Perform pelvic floor exercises – exercises for strengthening muscle tone in the vaginal area.
  • Washing the genital area- try to wash with lukewarm water or a soap free cleanser. Intimate washing with soap, bath oils and shower gels can aggravate dryness so using products with perfumes in should be avoided.
  • Eating a balanced diet- this is likely to contribute to a feeling of wellbeing. In addition, it may be advisable to avoid things that dry out bodily tissues such caffeine and alcohol.

If you are really struggling to cope, go and talk to your GP there are other medications available, but they need to be prescribed based on what’s best for you.

Occupational Health and Wellbeing October 2022 V1.0 – Source: adapted from the Mid Yorkshire Hospitals NHS Trust

Hormone Replacement Therapy

Hormone replacement therapy (HRT) HRT can help relieve many of the symptoms of the menopause such as the hot sweats and vaginal dryness. It also reduces the risk of osteoporosis. Hormone replacement therapy (HRT) is one of the main treatments for menopausal women. As the name suggests, HRT replaces some of the hormones that are reduced during and after the menopause. It usually includes a combination of oestrogen and progesterone.

If the menopause is causing you problems you should talk to your doctor about the relative benefits and risks of taking HRT, and other options such as non-HRT treatments. The decision to prescribe HRT should be based on a thorough evaluation of the potential benefits and possible risks of treatment undertaken by your healthcare professional.

There are several ways HRT can be taken, including:

  • Cream or gel, applied to the skin or directly into your vagina for vaginal dryness. symptoms
  • Tablets, taken by mouth or placed directly into your vagina to treat dryness.
  • A patch that you stick on your skin.
  • An implant, administered under local anaesthetic.
  • Small pellets of oestrogen are inserted under the skin of your stomach, buttock, or thigh.

HRT can help relieve many of the symptoms of the menopause such as hot sweats, vaginal dryness and helps to reduce the risk of osteoporosis. Osteoporosis is a disease in which the density and quality of bones is reduced, and they become more porous and fragile. This can lead to an increased risk of fractures.

HRT can also have side-effects which your GP will discuss with you and depends on the type of treatment you would be placed on.

Occupational Health and Wellbeing October 2022 V1.0 – Source: adapted from the Mid Yorkshire Hospitals NHS Trust

Hot Flushes

Getting to grips with hot flushes

Hot flushes are one of the most common complaints of menopause, as the periods of intense heat, warm skin, and sweating are uncomfortable. They can be triggered by wearing tight clothing, feeling stressed, or consuming alcohol, caffeine, and spicy foods.

If you are having hot flushes related to your menopause, it is best to talk with your doctor before starting any treatments.

What is a hot flush?

A hot flush is a feeling of intense heat, not caused by external sources. Hot flushes can appear suddenly, or you may feel them coming on. You may experience:

  • tingling in your fingers
  • your heart beating faster than usual
  • your skin feeling warm, suddenly
  • your face getting red or flushed
  • sweating, especially in the upper body

What causes hot flushes?

It’s not exactly clear what causes hot flushes. However, they’re most likely due to hormonal changes in the body. Some people barely notice hot flushes or consider them a minor annoyance. For others, the intensity may affect their quality of life in a rather negative way.

Start simple. Some people can manage their hot flushes with some simple tools or techniques. Here are some simple ways to find relief:

  • dressing in layers, even on the coldest days, so you can adjust your clothing
  • sipping ice water at the start of a hot flush
  • wearing cotton night clothes and using cotton bed linens
  • keeping an ice pack on your bedside table

Occupational Health and Wellbeing October 2022 V1.0 – Source: adapted from the Mid Yorkshire Hospitals NHS Trust

Mood Swings

These types of symptoms are often experienced by people transitioning to the menopause:

  • Feeling Low
  • Cross and Irritated
  • Irrational anger
  • Upbeat then low
  • Rage emotional

Mood changes can be frustrating not only for you but for all those around you. When investigating treatments, you might want to begin with methods that are likely to have the least side effects.

Alternative therapies such as yoga, meditation, massage, and acupuncture can give relief from stress and help lift your mood.

You may wish to talk to others about your mood changes, perhaps friends or join a support group or consult your doctor. Getting support to deal with the mood changes. Spending time with loved ones can also boost levels of oxytocin, a feel-good hormone, that counteracts mood imbalance.

Lifestyle changes combined with alternative therapies may be a good blend to assist manage mood changes. However, for some if the symptoms are more severe, different treatment may be necessary such Hormone Replacement Therapy (HRT). Speak to your doctor for guidance.

Not everyone will report feeling negative effects of the menopause but may instead see it as a transitional phase focussing on reflection, inspiration and a time of personal growth. Here are some tips that may help:

  • Staying connected: social support is important to help us share experiences and have others to go to in times of need.
  • Thinking positively about the experience: e.g., keeping a diary of things that happen each day that bring a sense of enjoyment.
  • Living in the moment: when we live in the moment this can reduce anxiety levels worrying about past or future events. Being mindful.
  • Taking time out for yourself: even if this is for fifteen minutes each day it may help you feel less stressed

Occupational Health and Wellbeing October 2022 V1.0 – Source: adapted from the Mid Yorkshire Hospitals NHS Trust

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