Menopause and depression: what HR leaders need to know

The symptoms of menopause affect day-to-day life for many employees and go beyond hot flashes and mood changes. Depression is common and can drastically impact an individual's well-being. This article offers insight into how employers can approach menopause and depression in the workplace to best support their employees.

As organizations strive to foster inclusive and supportive workplaces, it becomes increasingly vital for HR leaders to delve into nuanced aspects of employee well-being. One such critical facet that often goes overlooked is the impact of menopause on mental health.

According to a study conducted by the Mayo Clinic, nearly 11% of employees reported missing work in the last 12 months due to menopausal symptoms like hot flashes and sleep disturbances. Bloomberg estimates the global productivity loss due to menopause tops over $150 billion a year, showing the impact that untreated menopause symptoms have on the workforce.

While some of the most commonly-known menopause symptoms are physical, employees’ mental health and emotional well-being can also be adversely affected. Research published in the International Journal of Environmental Research and Public Health found that 67% of women experience psychological symptoms. Another survey found that 53% of women experiencing menopause suffered from low mood and depression, 50% reported anxiety, 42% reported anger and mood swings, and 33% reported feelings of worthlessness.

Understanding the complex interplay between menopause and depression is paramount for people leaders. The workplace is a microcosm of diverse experiences, and acknowledging the challenges that employees experiencing menopause may face is the first step in reducing menopause stigma and fostering a more inclusive work environment. By addressing the unique needs of this demographic, organizations can not only enhance employee well-being and workplace satisfaction but also bolster productivity and retention rates.

In this article, we’ll discuss the intersection of menopause and depression, delving into common symptoms and exploring the pivotal role HR leaders play in supporting employees through the menopausal transition.

Understanding menopause and its impact on mental health 

Before employers can truly begin to acknowledge the link between menopause and depression and take steps to support employees going through menopause, it's imperative to understand what menopause is and its symptoms.

What is menopause?

The menopause transition marks the end of a biological woman's reproductive years and is a phase characterized by hormonal fluctuations that can significantly influence emotional and mental health. Menopause causes menstrual cycles to cease, and monthly periods to stop. The average age of menopause for most women is around 51, but it can occur anywhere between the ages of 45 and 55.

Menopause is a result of the gradual decline in the production of reproductive hormones, particularly estrogen and progesterone, by the ovaries. The transition to menopause is often divided into three stages:

1. Perimenopause: This is the transitional phase leading up to menopause when hormonal fluctuations begin and menstrual cycles may become irregular. It can start several years before menopause, typically in a woman's 40s, but the exact duration varies.
2. Menopause: Menopause is defined as the time when a  woman has not had a menstrual period for 12 consecutive months. At this point, the ovaries have significantly reduced their production of estrogen and progesterone.
3. Postmenopause: The years following menopause are referred to as postmenopause. During this stage, the symptoms experienced during perimenopause often diminish, but other health considerations, such as the risk of osteoporosis and heart disease, become more prominent. Hormone levels stabilize at a lower level than during the reproductive years.

Physical menopausal symptoms

Menopause is associated with a range of physical symptoms, and while not all employees will experience the same symptoms or to the same degree, some common physical menopausal symptoms include:

Hot flashes and night sweats

Hot flashes are sudden, intense feelings of heat, often accompanied by sweating and flushing of the face and upper body. Night sweats are episodes of intense sweating that occur during sleep, leading to damp sleepwear and disrupted sleep. Approximately 75% of women experience vasomotor symptoms including hot flashes and night sweats.

Vaginal dryness and discomfort

Declining estrogen levels can lead to changes in the vaginal tissues, resulting in dryness, itching, and discomfort during sexual intercourse. Approximately half of post-menopausal women experience vaginal dryness.

Sleep disturbance

Changes in hormonal levels can contribute to difficulties in falling asleep or staying asleep, leading to disrupted sleep patterns. It's often cited as one of the most exasperating symptoms of menopause, reported by up to 60% of people experiencing menopause.

Body composition and weight changes

Some women may experience changes in body fat distribution, leading to weight gain, particularly around the abdomen. During the menopausal transition, women gain, on average, one pound per year. However, weight gain does vary widely between individuals.

Changes in skin and hair

Following menopause, a reduction in collagen occurs, with nearly a third lost within the first five years. This decline in production may contribute to changes in skin elasticity and moisture. Hair may also become drier and more prone to breakage.

Joint and muscle pain and bone density loss

A common symptom experienced by 40% of women as a result of menopause, joint and muscle pain can occur as a result of hormonal changes including a reduction of estrogen. Reduced estrogen levels can also contribute to a gradual loss of bone density, increasing the risk of osteoporosis and fractures.

Psychological & mood symptoms of menopause

Menopause is not only characterized by physical symptoms, but also by various psychological and mood symptoms that can impact a woman's mental well-being. Around half of women experience mood symptoms related to menopause with some of the most common being:

Mood swings

Hormonal fluctuations, especially changes in estrogen levels, can contribute to mood swings. About 40% of women have mood symptoms during perimenopause that are similar to PMS, or premenstrual syndrome. Women may experience heightened emotional sensitivity, low energy, irritability, and mood fluctuations.

Anxiety

A 2020 study found that 58% of perimenopausal women aged 45–55 had anxiety symptoms. Changes in hormonal balance can influence neurotransmitters in the brain, potentially contributing to a mood disorder. However, other changes related to menopause can also contribute to anxiety. For example, sleep problems can cause anxiety, but anxiety can also result in poor sleep, creating a negative cycle.

Irritability and tension

Hormonal shifts, particularly lowering of estrogen levels, can lead to increased irritability, tension, and a reduced tolerance for stress. One study found that 70% of women cite irritability as the most common symptom of menopause.

Poor concentration

Some women report difficulty concentrating and memory loss during menopause, referred to as 'brain fog' or 'menopausal cognitive decline'. Results from one study found that almost 50% of participants listed forgetfulness as a symptom of their menopause transition, and another study revealed that 75% experience problems with memory or concentration.

Decreased libido

Psychological factors, along with hormonal changes, can contribute to a decreased interest in sexual activity. Research indicates that sexual function worsens with advancing menopause status, with 40% of women reporting low sexual desire, 25% experiencing poor vaginal lubrication as a symptom of menopause, and 12% reporting difficult or painful intercourse.

Loss of confidence and self-esteem

Research suggests that the symptoms of menopause adversely affect body image. Changes in body composition, skin, and hair, coupled with the societal perception of aging, may contribute to a decrease in confidence and self-esteem.

Feelings of loss or grief

Menopause marks the end of the reproductive years, and some women may experience persistent feelings of loss or grief associated with this life transition. This can affect a person's sense of identity or self-worth which can further compound confidence issues related to menopause.

Menopause and depression

One aspect of mental health and menopause that has not been mentioned yet is depression. It is a complex topic, as research suggests that the hormonal fluctuations associated with menopause can make a person more susceptible to depression. Symptoms of menopause can also lead to depression, and depressive symptoms and menopausal symptoms can closely resemble one another.

Depression is one of the most commonly reported symptoms of menopause. One study found 42% of perimenopausal and postmenopausal women experienced depressive symptoms. The Harvard Study of Moods and Cycles established that premenopausal women with no history of depression who entered perimenopause were twice as likely to develop significant depressive symptoms when compared with women who remained premenopausal during the period of observation.

A previous diagnosis or existing mental health issues can also play a part in the risk of depression during or after menopause. The Study of Women’s Health Across the Nation (SWAN) revealed that women with a history of depression before menopause are at increased risk of depression during the menopausal transition. Researchers followed a cohort of 443 perimenopausal women as they transitioned into the menopause. During the follow-up, 39% of the women experienced an episode of major depression. Women without a lifetime history of major depressive disorder (MDD)had a lower risk of developing major depressive disorder during the menopausal transition than those with a prior MDD history.

Symptoms of depression

Depression, which is also sometimes referred to as major depression, major depressive disorder, or clinical depression, is a common mental health disorder. However, despite its prevalence in society, it can cause severe symptoms that impact many facets of an individual's life including their recurrent thoughts and normal activities. Symptoms of depression can include:

• Persistent feelings of sadness, anxiety or emptiness
• A poor sleep routine including too much or too little sleep
• Emotional changes including feeling hopeless or pessimistic
• Losing interest in activities and socializing
• Feelings of irritability and restlessness
• Brain fog, difficulty concentrating or finding it hard to make decisions
• Low energy or fatigue
• Thoughts of death or suicide

The role of HR in supporting employees through menopause 

In the pursuit of fostering a workplace that prioritizes the holistic well-being of its employees, HR leaders play a pivotal role in understanding and addressing the unique challenges posed by menopause. 

Recognizing the impact of this natural life transition on individuals' physical and psychological well-being is crucial for cultivating a supportive organizational culture and building a workplace where employees feel empowered to support both their mental health and their careers.

Why menopause matters in the workplace

Menopausal women are the fastest-growing demographic in the workforce, with nearly 80% employed. Understanding the impact of menopause in the workplace is essential for HR professionals so that they can understand the business challenges and learn how to support these employees at an individual and organization-wide level.

Hormonal fluctuations and associated symptoms, such as sleep disturbances, hot flashes and mood swings, can affect an employee's concentration, focus, and cognitive abilities. 45% of women state that their menopause symptoms have negatively affected their work, and 47% have taken a day off work due to their symptoms but have not told their employer the truth about their absence. It’s therefore important to not only acknowledge what employees going through menopause face but to create a workplace culture where menopause is understood and accepted by everyone in your organization. 

Fostering a supportive environment would allow employees to thrive by being more comfortable in talking about their circumstances and making choices that enable them to balance their work and well-being. Recognizing and accommodating these challenges is essential to overcoming these struggles and maintaining optimal job performance.

While menopause itself is not protected under most discrimination laws, and most employees and HR benefit managers agree menopause is a life stage rather than a medical issue, employers must be aware that some symptoms may qualify as disabilities under disability discrimination laws.

Best practices for HR

Creating an inclusive workplace culture that supports employees going through menopause requires a combination of empathy, education, and well-crafted policies. HR can play a crucial role in promoting awareness, destigmatizing conversations, and implementing robust accommodations.

Education and awareness

In a study conducted by the Bank of America, 81% of respondents felt there is a need for better education on menopause, before, during and after it starts. Implementing training programs to educate employees and managers about menopause, its potential impact on the workplace, and the importance of fostering a supportive environment can help employees feel more well-informed. Raising awareness and educating employees about menopause can take many different formats, including workshops and seminars, online training, distributing printed materials, and signposting employees to other resources.

Open communication channels

80% of women feel that menopause is too personal a subject, meaning they do not feel comfortable discussing menopause at work. Encouraging open communication can help create a culture where employees feel comfortable discussing their menopausal experiences. This open environment can help reduce the stigma and perceptions about menopause, and make it more likely that employees will seek support when they need it. Consider creating an employee network or support group focused on menopause, and give employees the time and physical space to be able to connect to others during work hours.

Flexible work arrangements

According to Deloitte, 97% of women fear that requesting flexible working would negatively impact their careers.Offering flexible work arrangements, such as adjusted schedules or remote work options, will enable you to accommodate the varying needs of employees experiencing anxious symptoms, depressed mood, and other symptoms of menopause.

Menopause benefits

When asked why they don't offer menopause benefits, the number one reason given by employers was that their employees haven't asked for them—yet 64% of women say that they would like menopause benefits in the workplace. Of those who do have menopause benefits, 58% say that they positively impact their work and 83% would recommend their employer as a great place to work. Women also say that more employer support for women going through menopause would help them feel more supported by the company.

However, it is not just employees who perceive the advantages of offering menopause benefits. Employers believe they would see an improvement in loyalty, productivity, engagement and retention.

Employers can establish themselves as leaders in the menopause space by integrating comprehensive menopause benefits that address the physical and mental aspects of menopause into their employee benefits package. 

Maven's Menopause program offers dedicated on-demand care for employees throughout their menopause journey. With 24/7/365 virtual access to menopause specialists, your employees can get advice, prescriptions, and support when they need it most. With Maven, employees will also have dedicated mental health support from specialists who can help them navigate the anxiety and depression-related issues associated with menopause.

Policy development

31% of women say they want their workplace to have a dedicated menopause policy. HR personnel can work in collaboration with employees to develop and communicate policies that explicitly address menopause-related accommodations, ensuring that employees are aware of available support and resources.

Strategies for managing depression during menopause

Depression during menopause is a multifaceted challenge, and effective management often involves a combination of clinical, therapeutic, lifestyle, and workplace strategies. There are various menopause treatments and other approaches for employees that can help them navigate and alleviate symptoms of depression during this transitional phase of their lives.

Medical and therapeutic interventions like hormone replacement therapy

When discussing medical and therapeutic interventions for depression during menopause, there is no one-size-fits-all approach. However, there are a variety of treatments available; some of which focus more on managing menopause symptoms overall, such as hormone replacement therapy (HRT) while others specifically address the symptoms of depressive disorders, such as antidepressant medications and Cognitive Behavioral Therapy (CBT).

Hormone replacement therapy is a medical intervention that involves supplementing the body with hormones, typically estrogen and sometimes progesterone, to alleviate menopausal symptoms. While hormone replacement therapy is primarily prescribed to address physical symptoms like hot flashes and night sweats, some studies indicate that it may also have positive effects on mood swings and cognition.

Cognitive Behavioral Therapy and other talk therapies can be beneficial in dealing with the mental health impact of menopause. They can give employees the tools to deal with the symptoms of depression, challenge their thought patterns, and give them the support they need to make positive changes.

Antidepressant medications can be another crucial component in the comprehensive management of depression during menopause once officially diagnosed. While hormonal changes play a significant role in menopausal depression, neurotransmitter imbalances in the brain, particularly involving serotonin, are also implicated in depressive symptoms. Antidepressants work by modulating the levels of neurotransmitters in the brain, helping to alleviate symptoms of depression.

Lifestyle and holistic approaches

When navigating a depressed mood during menopause, embracing lifestyle changes and holistic approaches can be valuable in fostering mental and emotional well-being. Beyond medical interventions, lifestyle choices play a significant role in shaping the overall health of individuals experiencing menopausal depression.

A well-balanced diet rich in nutrients can positively influence mood and overall well-being. Emphasizing whole foods, including fruits, vegetables, lean proteins, and whole grains, supports optimal physical and mental health during menopause. Additionally, Omega-3 fatty acids found in fish, flaxseeds, and walnuts have been associated with mood improvement.

Engaging in regular physical activity also has proven benefits for mental health. Exercise can help alleviate symptoms of depression, reduce stress, and minimize sleep problems. Incorporating activities like walking, jogging, yoga, or strength training into a daily routine can contribute to overall well-being during menopause.

Practicing stress management techniques, such as mindfulness meditation, deep breathing exercises, or progressive muscle relaxation, can be effective in reducing symptoms of depression. Creating a wellness routine that includes activities promoting relaxation and self-care is crucial for mental and emotional balance.

Workplace accommodations

As well as culturing an inclusive environment, embracing open communication in the workplace, and offering flexible work arrangements for employees, other workplace accommodations can be offered, including:

• Amending deadlines
• Changing your employee's responsibilities, even if only temporarily
• Access to quiet spaces for relaxation or focused work
• Paid time off to attend medical appointments and/or counseling sessions

Supporting employees' mental health through menopause and beyond

Menopause is a significant transition for many employees and is characterized by a range of physical and psychological symptoms. Certain symptoms, such as sleep disturbance, brain fog, and emotional changes can contribute to depression. However, normal hormonal shifts that affect estrogen and serotonin levels also play a part in increasing irritability, anxiety and sadness. 

While there are treatment options including lifestyle changes, CBT, and antidepressant treatment, employers have the power to support employees further by giving this matter and the employees it impacts the deserved respect and compassion.

Supporting employees with menopause and depression within the workplace is an evolving journey that demands a deep understanding and proactive strategies from HR professionals. Key insights and takeaways that can guide HR professionals in effectively supporting employees during this transformative period are as follows:

• Promote awareness and open communication that encourages conversation and reduces stigma.
• Recognize the experience of menopause varies widely among individuals so support and flexibility need to be tailored to each employee.
• Staff training and education are paramount for managers to address menopause-related challenges effectively.
• Stay informed about legal considerations related to menopause and depression in the workplace to ensure a fair and inclusive workplace.
• Develop and communicate workplace policies that explicitly address menopause-related accommodations. Inclusive policies create a framework for supporting employees and outline the organization's commitment to the well-being of its workforce.
• Create menopause-friendly spaces and consider workplace modifications that enhance the comfort and well-being of employees experiencing menopausal symptoms, including depression.
• Menopause is a dynamic and individualized experience. Continuously evaluate the effectiveness of support measures and be open to adapting strategies based on feedback and evolving needs.
• Provide resources such as informational materials, workshops, and access to counseling services through menopause-specific benefits. Offering a range of supportive resources helps employees access the assistance they need during challenging times.

By internalizing these lessons, HR professionals can play a transformative role in shaping workplace environments that not only acknowledge the challenges of menopause and depression but actively work to uplift and empower employees during this stage of their lives.

Maven can help you prioritize women's health and make a significant difference to your employees' lives.. Find out more about how Maven can support employees through their entire reproductive health journey by booking a demo today.