Cancer-Induced Menopause: A Hidden Workplace Challenge

Each year, menopause costs the UK economy an estimated £1.5 billion due to lost productivity and women leaving the workforce. For women affected by cancer, this challenge is even greater. Life-saving therapies like chemotherapy, radiotherapy, surgery, and hormone treatments can trigger sudden and permanent menopause, often without warning. Research indicates this impacts up to 40% of women under 40 and 90% of women over 40. Yet awareness and support remain critically low. Almost a third of patients are unaware treatment could cause menopause, while three in four say they received little to no information. This lack of awareness and support creates a hidden workplace challenge that needs to be addressed.

Understanding Cancer-Induced Menopause

Menopause is defined as the point in a woman’s life when she stops having periods, and it is confirmed once she has gone 12 months without a menstrual cycle. It is a natural part of aging, typically occurring in the mid-40s to 50s, with the average age being 51. However, cancer treatments can induce menopause prematurely. This is known as cancer-induced menopause, medically induced menopause, or treatment-induced menopause.

Several cancer treatments can lead to early menopause:

Surgery: Removal of both ovaries (oophorectomy) causes an immediate and permanent end to menstruation and estrogen production. A radical hysterectomy, often performed for gynecological cancers, involves removing both ovaries, the fallopian tubes, and the uterus, leading to immediate menopausal symptoms.
Chemotherapy: Certain chemotherapy drugs can damage the ovaries, leading to temporary or permanent menopause. The likelihood of permanent menopause depends on the woman’s age, the type and dosage of drugs used, and the duration of treatment.
Radiation Therapy: Radiation to the pelvic area can also harm the ovaries, potentially causing menopause. The effect can be temporary or permanent, depending on the radiation dose and location.
Hormone Therapy: Some hormone-suppressive therapies can temporarily halt the ovaries from releasing eggs, leading to temporary menopause. Treatments for hormone-sensitive cancers, like breast cancer, aim to reduce or eliminate hormones, effectively inducing menopause.

The Symptoms and Impact

The symptoms of cancer-induced menopause mirror those of natural menopause but can be more abrupt and severe. These symptoms can significantly affect a woman’s daily life and ability to work effectively. Common symptoms include:

Hot flashes and night sweats
Sleep disturbances, including insomnia
Fatigue and reduced energy levels
Irregular or absent menstrual periods
Vaginal dryness, itching, and painful intercourse
Decreased libido
Bladder control issues and frequent urinary tract infections
Mood swings, anxiety, and depression
Cognitive difficulties, such as poor concentration and memory problems
Joint pain
Weight gain

These symptoms can have a devastating impact on a woman’s ability to perform her job. Difficulties with memory and concentration can be particularly challenging in the workplace. A 2023 study of Irish hospital workers found that the most common menopausal symptoms affecting employees at work were fatigue (54%), difficulty sleeping (47%), poor concentration (44%), and poor memory (40%). Work performance was impacted for 65% of respondents, and 18% had taken sick leave.

One woman, a teacher who experienced menopause in her early forties following breast cancer treatment and a hysterectomy, shared her experience: “When I am in work, the fatigue has a massive impact on what I can achieve. My poor memory and concentration make it hard to absorb new information and focus during meetings/courses. It also makes it hard to do the work at home that the job requires – especially reports and bigger tasks.” Ultimately, she had to take voluntary redundancy because she could no longer manage her condition in the classroom.

The Legal Landscape and Workplace Rights

While menopause itself is not a protected characteristic under the Equality Act 2010, employees are protected from discrimination related to menopause symptoms if it relates to a protected characteristic such as age, disability, gender reassignment, or sex.

Disability Discrimination: In some cases, menopause symptoms can be severe enough to be considered a disability. Under the Equality Act 2010, employers are required to make reasonable adjustments to reduce or remove any disadvantages experienced by disabled employees.
Age Discrimination: Because menopause typically occurs around a certain age, less favorable treatment due to menopause symptoms could be considered age discrimination. This protection also extends to younger individuals experiencing early or medical menopause.
Sex Discrimination: Treating an employee less favorably because of menopause, a condition that only affects women, can be considered sex discrimination. Unwanted behavior or comments about someone’s menopause symptoms may also constitute harassment or sexual harassment.

Reasonable adjustments in the workplace can include:

Providing a fan or adjustable workstation to manage hot flashes
Allowing flexible work hours or remote work options
Providing breaks to manage symptoms
Modifying job duties or providing alternative roles
Offering access to workplace healthcare or counseling services
Reviewing workplace temperature control and ventilation
Ensuring easy access to restrooms
Providing a supportive and understanding work environment

What Can Employers Do?

Employers play a crucial role in addressing the hidden workplace challenge of cancer-induced menopause. By implementing supportive policies and practices, they can improve health outcomes, reduce long-term complications, and protect careers.

Raise Awareness and Provide Education: Many employees and managers lack awareness about menopause and its impact on women’s health and work performance. Employers should provide training and resources to educate their workforce about menopause, its symptoms, and available support.
Develop a Menopause Policy: Fewer than one in four employers currently have a menopause policy in place. Implementing a clear and comprehensive menopause policy demonstrates a commitment to supporting employees experiencing menopause. The policy should outline available resources, accommodations, and procedures for addressing menopause-related concerns.
Foster an Inclusive and Supportive Culture: Create a workplace culture where employees feel comfortable discussing their menopause symptoms and seeking support. Encourage open communication between employees and managers, and ensure that employees are not stigmatized or discriminated against due to their symptoms.
Offer Flexible Working Arrangements: Flexible work arrangements, such as flexible hours, remote work, and job sharing, can help employees manage their symptoms and maintain productivity.
Provide Access to Healthcare and Support Services: Offer access to healthcare professionals, such as menopause specialists or occupational health advisors, who can provide guidance and support. Consider offering employee assistance programs (EAPs) that provide counseling and other mental health services.
Make Workplace Adjustments: Implement practical workplace adjustments to accommodate employees experiencing menopause symptoms. This may include providing fans, adjusting workstation temperatures, ensuring access to restrooms, and offering quiet spaces for rest.

Seeking Legal Advice

If you believe you have been discriminated against at work due to cancer-induced menopause, it is essential to seek legal advice from an experienced employment lawyer. A lawyer can assess your situation, explain your legal rights, and help you pursue appropriate legal action.

Conclusion

Cancer-induced menopause presents a significant and often overlooked challenge for women in the workplace. By raising awareness, implementing supportive policies, and fostering an inclusive culture, employers can create a more equitable and supportive environment for women experiencing this transition. If you are facing discrimination or lack of support at work due to cancer-induced menopause, remember that you have rights and options available to you.