In her new book, Hot and Bothered: What No One Tells You About Menopause, author Jancee Dunn takes readers on a deeply researched (and sometimes hilariously personal) journey through menopause in modern America. From examining the history of hormone therapies, to conducting deep-dive interviews with menopause experts, to discussing her own experiences with symptoms (like, say, getting a brutal hot flash moments before interviewing a major movie star), Dunn gives us a clear-eyed, sometimes enraging, but ultimately deeply hopeful look at how our society treats menopause and the people who experience it — and what we can do to make it better for the next generation.
In this excerpt below, Dunn explores how the U.K. had led the way in supporting menopausal women in the workplace — and the lessons U.S. companies can learn from it.
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My mother is 81, and only recently has she told me about her hellacious experience with menopause while she was at work. (Until recently, we’ve never discussed menopause at all. When I got my first period, my mom gave me The Talk. No one gives you a talk for your last one.)
Mom used to supply furniture for offices. During the five years that she had hot flashes, she would often attend meetings as sweat dribbled down her red face. “I learned to stand away from the conference table if I was talking to a group,” Mom told me, “because otherwise the sweat would drip onto the table and distract everyone even more.”
She pretended it wasn’t happening, and so did everyone else. Mom’s five-year literal meltdown — the average duration of hot flashes, research shows, is seven years — occurred during the Reagan administration. Since then, not much has changed. Menopause is seldom discussed in the workplace, let alone supported.
The corporate world still isn’t clued in that roughly half the earth’s population goes through menopause. In fact, even as workplaces are becoming more welcoming to new mothers (as of 2022, all employers covered by the Fair Labor Standards Act are required to comply with the PUMP at work provision, and provide break time and a place for nursing mothers to express milk) “menopause in the workplace is where pregnancy and lactation were 30 years ago,” North American Menopause Society president Stephanie Faubion told Fortune magazine recently. Why is menopause still one of the last taboos of occupational health?
Perimenopause, on average, commences in a woman’s 40s; the average age of menopause is 51. Women age 45-54, many at the peak of their careers, make up over a fifth of the U.S. labor force.
We can learn from the U.K., which is globally leading the way in meno-friendly policies and initiatives. Last year, the UK created a four-nation Menopause Taskforce to strategize ways that menopause support and services can be improved in education, physician training, and the workplace. Pink-haired firebrand and taskforce co-chair Carolyn Harris, a Welsh Member of Parliament and Labour Party member, was successful in changing the law in Wales, Scotland, and Northern Ireland and removing the prescription fee for menopausal hormone therapy. Children are even learning about menopause in England’s schools: the subject has been included on the Relationships and Sex Education (RSE) curriculum since 2020.
Earlier this year, the UK government appointed its first Menopause Employment Champion, Helen Tomlinson, to encourage employers to develop policies that “ensure women experiencing menopause stay and progress in work.”
Then there’s the UK’s Menopause Workplace Pledge, begun in 2021 by the organization Wellbeing of Women when organizers become concerned by the amount of women leaving the workplace because of menopausal symptoms (in one survey, 17 percent quit a job for that reason.) It calls on employers to support colleagues going through menopause at work and to talk “openly, positively and respectfully” about it. More than 2000 organizations have signed the pledge — and not small companies, either: they include the Royal Mail and the supermarket giant Tesco.
Last year, London’s mayor Sadiq Khan announced a groundbreaking menopause workplace policy for City Hall staff, which included paid menopause leave, flexible hours for women with symptoms, temperature controlled areas, training for managers, time off for medical appointments, and a campaign for greater awareness of symptoms. “What we’ve got to do as blokes, as managers, is talk about this, and to get rid of the stigma,” Khan told the network ITV.
Last year, Bank of Ireland instituted a policy offering employees ten days of paid menopause leave. Other countries are stepping up as well. In Australia, more than $40 million was awarded in 2022 by the national government to establish specialist and service hubs for menopause, as well as an extensive education campaign for doctors and employers.
There is nothing even remotely similar to any of these policies here in the United States — although New York City mayor Eric Adams did announce in January that he was planning to create more menopause-friendly environments for City workers.
Menopausal health is a public health issue. It’s time to advocate for menopause-friendly policies here in the U.S.
The U.S.-based organization Let’s Talk Menopause suggests forming an employee resource group, or ERG. An estimated 90 percent of major employees in the U.S. have ERGs. Uniting with like-minded others — even if it’s just a handful of you — can increase your influence as well as your negotiating power.
The changes you could promote, courtesy of Let’s Talk Menopause and UK-based human resources experts CIPD, include allowing for flexible work hours, like a later start time if night sweats have made an employee’s sleep hellish.
Employers could allow breaks more often, so women can run to the bathroom, or provide heat-reducing accommodations such as fans, cold drinking water, and cool rooms (so that women do not have to furtively thrust their heads inside the company fridge as they pretend to look for something.)
Companies can also reduce stigma — and retain valuable employees who are thinking of bolting — by educating all their workers on the symptoms of menopause, and create clear menopause policies so that women experiencing symptoms know exactly what they’re entitled to.
It’s frustrating and exhausting that the onus is on women to effect change. But if it’s possible, I encourage women in the workplace to normalize the conversation around this natural life change. We’ll see real and lasting change only when we start talking about menopause more openly. The more we talk about it — to friends, family, coworkers, policymakers, your mail carrier — the more steadily we chip away at the stigma.
One declaration I have heard repeatedly as I’ve interviewed healthcare professionals, executives, and marketers is that millennials who are now heading into perimenopause are not sucking it up as previous generations did. Rather, they are exceedingly vocal in advocating for workplace support. “Oh my god, millennials are a pain in the ass,” one CEO told me with equal parts irritation and admiration.
Maybe they will be the ones to drag this subject out of the shadows in the workplace. (They, and younger generations, have already worked to destigmatize menstruation, as anyone who follows #PeriodTok can attest.)
But I’m doing my part, too. Now when I’m on the job and engulfed in menopausal flames, I make a point of saying, Give me a minute, I’m having a hot flash. I don’t like saying it. I do it anyway, because I think of my mom, melting like a candle during her meetings.
If Mom had just announced that she was having a hot flash — instead of pretending that nothing was happening, even though she looked like she had just emerged from the sea — her disclosure may have made some of her coworkers uncomfortable. But maybe she would have felt better.
Adapted from Hot and Bothered: What No One Tells You About Menopause and How to Feel Like Yourself Again by Jancee Dunn with permission from G.P. Putnam, an imprint of Penguin Publishing Group, a division of Penguin Random House, LLC.Copyright © 2023 by Jancee Dunn
Author photo credit: Jancee Dunn
