Women at Work - Working Through Menopause (at Work)

0:01Amy B, do you remember that moment in season four toward the end of our episode aging up, not out when I brought up menopause? Yeah. Yes, I do. And I have to admit, I got a little squirmy when you did, but I realized that we were going to go there. And we did. It was a squirmy moment for me, too, a bit, though it made total sense to talk about menopause if we're talking about aging at work. Yeah, totally.

0:31So do you remember the email we got after that app came out from the woman in her early 50s who works in banking? I do. I think I actually responded to that email. So she was an Amy too. And I went into our inbox in search for her email. She gave us the OK to read this part and it makes me smile once again. So let me share it with you. She wrote.

0:57I think this is the first time I've ever heard the words menopause and work in the same breath. Yes, I had to take off my sweater, plug in my little laptop fan, then get chilled and have to put my sweater back on all during this podcast. But the feeling that I'm not alone really made my day. I love that. I remember reading it and thinking, yeah, that's exactly why we talk about topics that sometimes people don't want to talk about.

1:26Right, so we don't feel alone. Yeah, I agree. You're listening to Women at Work from Harvard Business Review. I'm Amy Bernstein. I'm Amy Gallo. We're taking a break from focusing on the emotional roller coaster that is the coronavirus crisis to focus on some of the more routine but still unpredictable changes a lot of women are living with. The transition to menopause. I'm in the thick of it myself and maybe you are too.

1:55So because menopause is a health issue and we're not doctors, we invited a doctor, one who specializes in addressing the symptoms of menopause, to give us an overview. So menopause is kind of when it's been a whole year of no period. So it's like the retrospective diagnosis. You have to make it going backwards. Period menopause is that whole time leading up to menopause. And then once you are menopausal, it's been a whole year. You're always post-menopausal.

2:22That's Heather Hirsch. She runs a menopause and midlife clinic at Brigham and Women's Hospital in Boston. We spoke to Heather in early March in our studio before we were under order to stay home. Heather, welcome. It's great to have you here today. Thank you. Thank you for having me. So what are the most common menopause symptoms and especially ones that might affect how women show up or perform at work? Yeah. So there's the classic symptoms that we all kind of know and think about.

2:51hot flashes, night sweats, trouble sleeping or difficulty with sleep. Many of my patients will say, every night at 2 a.m., I'm just wide away. I feel you. And there's the restless sleeping and then the inability to get back to sleep. And then there's, you know, brain fog, which I'll say to my patients, do you have brain fog? And if they do, they'll say, uh-huh, even though it's not really medical term, but. Oh my God, but.

3:19Once you've gone through it, you know exactly what that is. Exactly. Mood symptoms or change of baseline from your baseline mood. So all types of mood symptoms. Women can feel either more emotional than they used to. They'll tell me, you know, I cried at a Clorox commercial and I never used to be very tearful or anger or hostility. Symptoms can last five to seven years. Yay.

3:47So the idea that menopause is just this one point in time or this one year is a myth that can really harm women because when you're post menopausal or even after menopause, you can have symptoms that last a really long time, affecting your social life, affecting your life at work, and just every arena of your life. So so many of our listeners are younger.

4:10And I do want to ask about chemically induced menopause, maybe by hysterectomy. How does that differ from what might be more normal course of life menopause? Right. So it's really important to know that not all one menopause is the same. Women can experience this very differently, particularly if they've had a couple of these different types of menopause that occur early. So the first is a surgical menopause where your ovaries are removed.

4:39is very common. Younger women who have endometriosis, who have polycystic ovaries, sometimes do have surgical removal of their ovaries, putting them into menopause in their 30s. There's also premature ovarian insufficiency, which is menopause before age 40, which occurs in about one in 250 women who are between 35 and 39. So it's not all that rare.

5:07And this is often found when women are going to fertility centers because they're finding they're having trouble conceiving. And then they have the new diagnosis of premature ovarian insufficiency. Also women who have radiation for cancer or any type of pelvic radiation are also going to have chemically induced menopause who are under age 40. And this population is very different.

5:37and unique because they're losing their sex hormones so early. So imagine having, you know, severe brain fog, feeling like you've aged very rapidly, not being able to sleep, and then having to go to work. It's really, really life-altering. I'm curious, what are some of the other myths that you find women in your clinic, particularly women who are working, that they come in with that they're surprised to learn are not true?

6:05So the biggest myth that I spend time as a physician debunking is that there is no treatment that you just have to suffer through that there is nothing that you can do that you know Oh, it'll just be a year and then you'll be over. So that's that's one of the biggest myths Yeah, so there is treatment and I say this because if it is affecting your quality of life Especially at work, you know the benefits of taking treatment are gonna vastly outweigh any minute risks. So we talk about menopause as if it's an illness. First of all, what do you think of that? And then are there any benefits of going through menopause? You know, I think it is the most important transition in a woman's life. Of course there's puberty and of course there's pregnancy and all the other reproductive changes that we go through.

6:58But this last one, again, for all of the reasons we've talked about socially, economically, menopause is, to me, a really big public health issue that we're currently doing nothing about. And so starting to talk about it is going to help that transition better. And menopause can be a great time for women, a really great time. And, you know, we have to sort of change that narrative that Once you go through menopause, you're just gonna have hot flashes, never be sexually active, pee your pants and retire. We have to change that narrative because post-menopausal women, women who are in there, you know, some women go through menopause early, so whether it's your 40s, your 50s, your 60s, bring so much to their jobs, to their families that keeping them thriving and happy and functioning and feeling well and living their best life is so important.

7:57What I really want to see, and maybe you're working on this, is an education of other physicians about menopause, because what I'm seeing with my counterparts who are my age, you know, mid to late 40s, is that they're going to neurologists, they're going to their GPs, they're going to different specialists, and they're saying, no, no, that can't be perimenopause or that can't be menopause. Are you seeing a lot of lack of information among other doctors? So much.

8:25So, so, so much. So it's a big mission of mine to help educate other physicians. We know that women who have untreated symptoms increase the cost of health care, miss work more often because they are going to so many different doctors. They may be going to see a psychologist for their mood. They may be going to see a sleep medicine physician because they can't sleep. They may be going to see an endocrinologist because they're gaining weight or they're having hot flashes.

8:54when all of these things really are likely menopause and could be treated just in one place. So I spend so much time educating physicians because there is almost no specialty of medicine who won't see a menopause related complaint. And if we can educate and get women treated, they can stop missing work, they can feel better and be more productive because when they don't, they retire earlier.

9:22Well, Heather, thank you so much for joining us today. This has been really informative. Thank you so much for having me. Thanks, Heather. That last point that Heather made about how a lack of general awareness about menopause can lead women to retire earlier was an eye-opener for me. I hadn't really thought about menopause or the taboo around talking about it could be contributing to a woman's decision to stop working.

9:52Yeah, and she said the less we talk about it is some sort of a personal issue and the more we talk about menopause as a public health issue. One that's natural to discuss at work the better women's experiences of it will be. Yeah, that makes a lot of sense to me. So this is an idea that Geneva Patterson covered in an article she wrote for hbr.org called it's time to start talking about menopause at work.

10:21Geneva is a senior faculty member at the Center for Creative Leadership in Brussels. She spoke to me from her home in Belgium. Geneva, thanks so much for joining us. Oh, you're welcome. It's a pleasure to be with you. Well, it's great to have you. Thank you. So talk to us about your own experience with menopause symptoms at work. Well, the biggest Most pernicious ones were when I was in meetings and I couldn't remember what I was talking about even one minute from the next or I would work on a project for example alone or in groups it didn't matter and I had what we now know or what we've called for many years brain fog I was just kind of in a fog and not really

11:11not really understanding my own thinking process, which would be lack of clarity of thinking and forgetfulness. Those were the most obvious, right? The lack of something being clear was the most obvious at work. So then you decided to talk about it with your colleagues. How did that go down?

11:34Well, it depended on who the colleague was. I felt really lucky and continued to feel that way that I have a boss who is three years older than I am and had had her own experiences, not as dramatic as mine, but she had gone through menopause and it was comforting that she was so receptive. Did you have trepidation about talking to her? Oh, yeah, for sure. For sure. But, you know, Amy, after having been through some of the experiences that I did, I almost felt like I felt obligated, not only because I'd been so embarrassed and frankly ashamed at some of my work or ways that I'd behaved, but I also felt an obligation to other people at my company, other women, other men at my company to say,

12:26Okay, so I may be one of the examples of more dramatic symptoms of menopause, but I felt like by sharing, which is one of the keys to making workplaces more open and accepting of menopausal symptoms, that I was actually furthering a culture of openness and change and transformation around women's issues, and then this being a big one for many of the people in my company, potentially.

12:56So we're in the middle of the coronavirus crisis and I'm wondering if that has had any effect on your thinking. Has it changed it in any way? It's such a good question. I think it's changed in the way you deliver the news because we rely on people to share their realities in the moment. So if I'm on a conference call with my boss and I'm having a hot flash and feel incapacitated for even a couple minutes I might miss important information or I might be at pains to share important information in the moment. So the fact that my team knows that I might be having a hot flash and we have a communication signal about it something funny like hey guys I'm in that moment just give me a break even that.

13:51can make a huge difference in terms of how you get actual work done. So the symptoms, you know, brain fog, you know, hot flashes, whatever the symptoms are, and there's a wide range of them, they hit you when you're, you know, for a lot of women, you're in a position of leadership and responsibility that comes at that age, at that point in your career. Yes. How can we handle the anxiety around that?

14:21I mean, talking about it could raise our anxiety. You know, if you haven't been through this yet, you're suddenly worried that when you do, you're going to be in the middle of a presentation and all of a sudden your brain's going to shut down. What do you say to women who are worried in prospect or just worrying about it generally? Yeah, well, I would say what helped me was understanding what I was going through.

14:51knowing what's going on in your body and why is is one thing but breathing something as simple as breathing and understanding what you will say about it that whatever is going on with you standing up at a podium speaking to an audience of a hundred people or two hundred people like my my colleague and yet the woman that I wrote about briefly in the article understanding that that could happen to you.

15:19and preparing yourself to say one, two things, right? You have a sentence in your head that's going to come out and that you practice so that you're ready when that happens. And I have found now, especially through my own experience, that I created a mental obstacle. And in fact, when I did share it with my boss and then ultimately with other people at work, everyone was so forgiving.

15:48isn't even the right word because everyone just appreciated it so much so often with taboos you assume that there are taboos but as soon as you puncture that that balloon if you will you know you realize that there's so many people going through the same thing and that empathy abounds so it may not be as risky as you're making it out to be and that was true in my case and I wish I hadn't held on to it that long mm-hmm So wondering what your thoughts are on talking to a boss who is a guy or young and just isn't Situated to know a whole lot about menopause symptoms. What are your thoughts? What do you do? How do you educate that person? Yeah, so I think you educate that person like you would educate anyone about a topic right about pregnancy for example

16:48Where you bring various pieces of information right so you can bring statistics you can bring personal experiences and make it Not all about me make it about us and what we need to achieve together and Like a style of working. This is helpful for you to know about me I'd like to know more about you person right this guy in your you know 25 30 35 what have you what can you tell me about?

17:15yourself. And how can we share information such that we have a shared experience and can do our best work together? So I wonder what you say to women who just don't feel comfortable having this conversation with their boss. They don't have that relationship. They don't have the confidence to be so candid about their symptoms. What do you say to these women?

17:43Well, so if I were coaching someone, I would try to strategize as to how she could make her life easier and get the work that she needed to get done done as well as the team. So whatever her level of transparency is, I would try to figure out ways with her to make simple changes, to help her institute really simple ones, to find out what it would be like for her to work from home if she could do that.

18:12different hours, for example, telecommuting, these things can be done. So I think that there are ways for women to be creative even more now with the COVID experience that we're living and show that they can get the work done and then they can do it for themselves and that they don't need to sacrifice those boundaries that are important to them, that they don't want to break. I want to go back to talking to men about these symptoms.

18:38thoughts on even just like a script to begin with, if you want to bring your male boss into your current predicament in a way that doesn't embarrass him, but helps him see where you are so that you can at least take some of the anxiety out of that particular relationship. What do you say? Sure, sure. Well, I can give you an example from my own experience.

19:07continue to and at the time was working with a client and EVP of a large financial services organization and he and I had been working together at that time maybe three months and we had had let's say you know a bunch of email exchanges maybe five phone conversations and then this was our second face to face. And it was in my menopause heyday where, you know, I never knew what to expect. And so I knew that. And I knew that anything could happen. It might not, but I prepared myself with my water, with my tissues, with my power suit and, you know, the layers that I was able to peel off if I needed to. And I sat down

19:53And I'll call him John. I said, John, I'm so happy to be here. And this is our second face-to-face meeting. You haven't spent a lot of time with me face-to-face, but I just want to let you know that in the event I pull out my tissues during a hot flash, I will be right here. I'm focused on our conversation. If it's distracting, just let me know. And if I do, in the event I do need to take a break and use the restroom or take a walk, I'll let you know. And I'll come back as focused as before.

20:23That's something that I said to him and in the next minute he said Geneva I am so thankful that you just shared that with me now I know what I'm going to tell Diane his wife now I know what I'm going to tell Diane tonight at dinner because she has been trying to figure out how to have a conversation with her colleague in a meeting next week because she too is going through this. But I think by being forthcoming and by being neutral about it, you neutralize and normalize the experience and then you move on. Yeah. So we focused a lot on sort of the downside of menopause and perimenopause, but I just wanted to share

21:16My own take on this. Yeah, please I'm on the other side of menopause and what I found was that once it was behind me I kind of felt more confident and you know, I'd come through what was at times a bit of an ordeal and it had been fine in the end and I kind of learned how to deal with the brain fog and You know, I know how to throw a window open when I feeling you know superheated and I'm wondering if I am the only person you've talked to sort of felt like it helped me grow and come into myself a little more. Yeah, that's interesting. Oh, you're not the first and it's so when you experience challenges you are forced to get out of your comfort zone quite literally, right? And then you go through

22:11a challenging experience and, you know, resilience is the word of the day, but there's a reason for that. Yeah, I agree with you, Amy. I have the same experience and it's true for a lot of the women that I've spoken with. There's some solidarity around that and it's emblematic of one of the most magnificent features of being a female. It's really powerful in a lot of different ways at a lot of different levels.

22:38Yeah, and it absolutely amplifies that feeling of I've got this because you do. Yeah, you've got this. That's right. Geneva, I want to thank you for joining me today. This was terrific. I really appreciate your candor. Oh, you're very welcome. And I was so happy to be invited and to speak with you one-on-one was really great. Thank you so much.

23:02Now we've got Tina Opie with us. She's a management professor at Babson College and has been a regular guest on the show since its beginning. Hi Tina. Hi Amy G. Hi Amy B. And Tina we are so glad to have you here because your expertise is authenticity and shared sisterhood in the workplace, which as it happens tie into navigating menopause. But honestly what sparked us to think of you as a good guest is that memory of you coming into the studio to record a conversation with us for a previous season of the show. And you were having a hot flash. I opened the door to the studio and someone else got you a glass of water. And it was like no big deal at all for us. Do you remember that moment and what was going through your mind?

23:54I do remember that moment. And I think that was back towards the beginning when I didn't really know you all that well. And so I had a fleeting thought of, do I just sit here and sweat and be miserable? Or do I tell them what's going on? And in typical fashion, I decided to tell you exactly what was up. I was having a hot flash. I needed some water. And then I think you all were kind enough and gracious enough to accommodate that. And then we went on with the interview.

24:24Well, and I think whether it's menopause or something else going on for someone when they try to hide it, the struggle for them to hide it seems so much more awkward.

24:34than just actually talking about what's happening. And so I really appreciate moments like that. It relieves the pressure from what could be an uncomfortable situation, but doesn't necessarily need to be. And for me, one of the reasons I'm so drawn to authenticity research is not just because I think it's a cool topic, but because I really do think that that's how you get the best out of human beings when you allow them to share that. Yeah.

24:58So, I have a couple of questions about this, but the first one is, do you think that if there had been guys in the room you would have revealed that you were having a hot flash? Yes. When I think about discussing menopause in the workplace, I divulge it. So with my colleagues and clients, I'm very matter of fact, I'll make myself vulnerable and say, listen, you may notice it's similar to I think what Geneva may have shared when she says with the client when she says, if I pull out my tissue, just know that I'm going through menopause. It's nothing weird. That's what's happening. That's sort of what I do with my colleagues and my clients with my students. I joke about it.

25:38And then they would laugh and then we move on. So I think I'd reveal it to men as well. Right. That's the part I have a real hard time with, I have to say, is that I feel comfortable talking about it with women, particularly women around my age. You know, I'm 46, definitely in the depths of perimenopause with the hot flashes and other symptoms.

26:01And I think about talking about it at work and I'm fine thinking about sharing it with my women at work colleagues. But then when I think about mentioning it to men, I have to say, I sort of get uneasy about it. What makes you uneasy about it? I mean, what do you think is going to happen? Well, there's a couple of things. I think one is I have been very, I don't know, trained or just learned over time to really try not to draw attention to my body around men.

26:31And it's something that draws attention to my body and to my reproductive ability that I don't want that dynamic entering the conversation. Wow. So this may be one of the advantages of being from a historically underrepresented group because I don't think these white men are interested in me. So I'm just discussing, very matter of fact, this is what's going on with me, bro. We're going to have to figure this out in order to get the project done. I'm going to need.

26:59bottled water at all times. You see what I'm saying? So this is one of those potential unintended benefits of being invisibleized in the workplace. I'm already considered different and in many spaces people question why I'm there. So I just, one more thing, I'm going through menopause. I mean, so now I'm just a black woman.

27:21going through menopause. It's interesting you mentioned you're already different because I think one of the things as a white woman that I often try to do is downplay my difference and try to align with people in power because that's how we gain power often in organizations, right? So in some ways, maybe that's what I'm trying to do is not only not draw attention to my body but just not draw attention to the fact that I'm a woman. Well, for me, I try to view my difference. It is definitely sometimes a disadvantage. But for the most part, I look at it as a superpower because it affects how I think, it affects how I've lived, it influences the experiences and the wisdom that I have. And so menopause is just one other difference. Right. So Tina, let me ask you something. We have gotten a lot of email from listeners who are

28:16In varying degrees stressed out about the effect of menopause symptoms on their professional performance, their performance in the office. One of them wrote to us about how she found herself crying for the first time in her professional life in the office. Others, you know, are worried about flying into a rage. You know, you are kind of the plaything of your hormones.

28:45in these moments, but these are women who are also moving forward in their careers and now have the burden of the stress to deal with. What do you say to them? Well, the first thing is take a deep breath because those are real and valid emotions and concerns. Today I was in a meeting and I texted one of my girlfriends who's also a colleague who I trust and I said, please text me if I'm talking too quickly.

29:14or if I'm getting, you know, sort of off tangent. And she said, okay. So that's the first thing I might say is, who at your workplace can you trust to give you feedback? I think the critical thing is, is I don't think that women can get through this alone in the workplace, or you can, but I think it's more of a struggle. I also think we should consider a collective approach, which is what would it look like at your workplace if you and women who were younger the same age older talked about these kinds of challenges that uniquely confront women and came up with some priorities and presented together to your supervisor because it does become a retention issue. I think that if you work for an organization where you have a supervisor who's empathetic, who you can trust with these kinds of things, who develops policies to have your back,

30:08That says a lot about that individual and hopefully the climate of the organization. And I think you may find that you have better retention rates and hopefully more engaged employees. Right. I mean, I've been lucky because my symptoms so far don't interfere with my ability to do my job. I mean, I've had days where I've been really tired because I was up all night with hot flashes. You know, in that case, when I'm working directly with someone that day, I might say, and I can think of two people in particular where I've said, I'm sorry, I was up all night with hot flashes. And we had an interesting conversation about that with their experience. It was actually a really nice moment. But I haven't had to have the like, okay, I feel like my job is being impaired, which we're hearing from a lot of our listeners.

30:53that, you know, whether it's brain fog, loss of sleep, that the symptoms do affect their ability to perform. Yeah. I mean, with brain fog, I am a note taker. So again, going back to this meeting that I led, I developed the PowerPoints for that weeks ago. I circulated that to other people. I reflected on it. I prayed on it. I meditated about it to make sure that it was sharp. And then I had handwritten notes.

31:23sort of a script that I had written beforehand to facilitate the conversation. And because I'd practiced it so many times, I didn't need to really reference them, so it felt authentic. But I have to do more and more of that. I mean, that's how I prepared in general, but I do not go into a meeting now without some notes and some pre-written ideas because I have literally lost my train of thought. But, you have a team around you who can hopefully help you get back on track and who isn't judging you because they know that this is a real issue. It's not that you're unprepared. It's that you literally have, I mean, it's a medical condition. Right. Right. It's a medical condition that for too long, we've treated as some kind of like, you know, a woman's problem, a personal issue. Yes. That was the point that Heather made when we talked to her that hit me hard. And I think she's absolutely right.

32:22when we strip away the embarrassment that we feel. Yes. That makes it a little easier for everyone to talk about it. Yes. Right. Yeah. But I wanted to share some survival tips from one of our listeners named Karen. There were some really cool ones in here. Well, one literally cool one. She's a big fan of the fan, strong desk fan.

32:47But some of the others that I hadn't thought about was like lighter makeup. She says she switched to the lightest makeup she could find. So she doesn't have to worry about her makeup running when she's having a hot flash. She talked about coffee as a real lifesaver. And this one really resonated with me. She said, taking better care of myself and my psyche. With her kids in middle and high school, She always dealt with her own needs last. But when menopause arrived, she rediscovered her hot tub and purchased a massage subscription. Those little indulgences helped her get through the toughest days. And then, of course, she also talked about moral support. But I just loved how practical she was. And also, she really paid attention to what she needed. And she took care of business. Yes.

33:43Amy, I know you've shared that you're on the other side of this, but I'm curious what strategies worked for you when you had symptoms at work. You know, I was pretty lucky. My symptoms were pretty mild though. I did have the brain fog and I didn't realize what it was. So I embraced forgetfulness. The losing sleep was really, really hard and the way that I dealt with it was I sort of just doubled down on exercise. I try to wear myself out physically every single day and that helped a lot. So for me, the exercise has been critical. I think I'm going to have to significantly eliminate my sugar as a result of going through perimenopause because it literally inflames my body. And I don't know if that's because of menopause or age or just what it is. But I think those kinds of decisions

34:40really help. I feel so much better when I drink enough water, when I exercise, when I eat healthier. And I think those kinds of things and positively framing them as me nurturing my body is helping me. And that's, that's another piece of advice that I think we women could consider it. And then the men and other people who love them can consider is that They're telling you the truth they're experiencing something something is changing they're not crazy or frantic or what was the word hysterical how women used to be described. And so when they tell you that something has changed believe them. You might not be able to diagnose it but something is going on and it's your responsibility as a medical professional and as a partner to help them.

35:31figure that out. Yeah. I had to convince my midwife to actually give me a blood test to test my hormones. She said, oh, they fluctuate so much, they won't be telling. And I said, fine, I don't care, fine, please do the test just so I can at least have a baseline. And she called me to apologize. And she said, you know, because you're on the young side, I didn't think we were going to see anything. But it is clear from your hormone level that you are in paramanapause.

35:56And she's a midwife, you know, she sees this all the time. And I think there's just a disbelief that our symptoms are related to this. They want there to be another answer. And there's a long history of dismissing women's medical issues. And I think that's partly why we know so little.

36:14about menopause and why it's so taboo to talk about at work in elsewhere. But you know this is why you need the moral support and you need to at least open up to friends about this because you learn more from each other than you're going to learn in a lot of those conversations with your doctor. All my tactics that have worked have been things that other people have told me to do. I'm not making real big changes yet to accommodate for my symptoms or to lessen my symptoms, but there are things like the brain fog. I have started keeping a file on my computer for colleagues who I interact with regularly. And after talking to them, I just make a few notes in there about what we talked about because I found I was losing track of conversations. And, you know, that's been one tactic that's been really helpful for me to sort of keep the brain fog in check so that doesn't impact my interactions or my work. Like I said earlier, that is a definite survival tactic is to take notes. Yeah. Yeah. Tina, thank you so much for talking with us today. This has been really helpful.

37:20Thank you for having me. That's our show. I'm Amy Gallo. And I'm Amy Bernstein. Our editorial and production team is Amanda Cursey, Maureen Hoek, Adam Buckholz, Mary Dew, Tina Toby Mack, Erica Truxler, and Rob Eckhart. Thanks for listening and take good care.