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Menopause

Menopause is not an illness or medical condition: it is a natural and normal point in life. Medically it marks the end of menstruation, when periods stop and have been absent for 12 consecutive months, but the term is often used much more widely to describe the time of transition leading to this point.

A range of cognitive and physical symptoms are associated with the hormonal changes involved and for those who experience these, sometimes severely, it can be a difficult time. Symptoms for barristers can be exacerbated when coupled with the long hours, stress and high demands on time and concentration. However, support and treatment for menopausal symptoms is available and relatively simple adjustments can assist with navigating an individual’s experience positively.

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About

In the UK the average age to reach menopause is 51. However, periods do not usually stop suddenly. Hormone levels in the body change gradually in the lead up to menopause (a stage called perimenopause), causing physical and psychological symptoms for some people. The most significant symptoms for those affected during perimenopause may be experienced for some years before actual menopause, often while menstruation is still present (perimenopause on average starts in the 40s and can last for months or years depending on the individual).

The challenging, sometimes distressing, changes and symptoms which, for many, accompany perimenopause are often under-recognised, stigmatised or not taken seriously. The symptoms can have a prolonged adverse impact on physical and mental health.

Around 80-90% of women and others going through menopause-related changes will experience some symptoms. The severity and duration of symptoms varies a great deal by individual, but many who are affected find that symptoms can affect their home and working lives. Physical symptoms, such as hot flushes, disturbed sleep, joint pain and migraine can impact on the ability to function at work and at home. Psychological and emotional symptoms including low mood, anxiety, memory loss and poor concentration can also seriously affect engagement, productivity and confidence. For some, this can seriously affect their wellbeing.

Stigma and misconceptions about menopause often lead to an inability or reluctance to discuss it with others, with the consequence that people experiencing symptoms frequently suffer in silence and may feel isolated. Many feel as though they must simply ‘grit their teeth and get on with it’, or ‘soldier on’, without support, in order to avoid being seen as less competent.

Who is affected?


Menopause is an inclusive subject and it is important that people of all genders understand its effects and are involved in conversation in order to accommodate and support those experiencing it first-hand. Despite menopause usually being thought about as something that only affects women, it also affects people of different genders, including transgender people who were assigned the female gender at birth, inter-sex people and non-binary people. There are also related issues, for example those related to fertility treatments, surgeries, radiotherapy, chemotherapy and hormone treatments for certain cancers, which are related to or may affect the experience or treatment of menopause symptoms.

Menopause and the Bar

Symptoms for barristers can be exacerbated when coupled with the long hours, stress and high demands on time and concentration. Generally occurring in mid-life, perimenopause often coincides with increasing life-pressures. These can include crucial career development stages, when taking on more significant cases or being more active at work can be an important element of advancement which may seem incompatible with coping with or discussing difficult menopausal symptoms. For many it can also coincide with teenage children and caring for elderly parents.

 

What are the symptoms of menopause & perimenopause?

Menopause is when an individual has not had a period for 12 months. It is a specific point in life. Perimenopause is the time leading up to menopause in which menopausal symptoms may be experienced. Perimenopause can last for months or years, depending on the individual. Post-menopause is the time after menopause. An individual who is post-menopausal (more than a year since periods) may still experience menopausal symptoms for many years.

Some of the most commonly experienced physical and psychological perimenopausal symptoms include:

  • Hot flushes – short, sudden feeling of heat, usually in face, neck and chest, which can make you sweat and your skin flush red. They frequently lead to a feeling of anxiety, particularly in public settings and may occur once or twice, or many times a day and at night
  • Brain fog (including difficulty concentrating/faulty memory)
  • Night sweats – hot flushes that occur at night which can have a serious impact on quality of rest
  • Disturbed sleep
  • Anxiety
  • Depression/suicidal thoughts
  • Low mood or mood swings
  • Heart palpitations – heartbeats that become suddenly more noticeable, faster or more intense
  • Fatigue
  • Issues with self-esteem
  • Weight gain
  • Vaginal dryness
  • Aching joints/muscles
  • Migraine/headaches
  • Increased risk of osteoporosis – weak bones
  • Irregular periods

Support for individuals experiencing menopausal symptoms

Most individuals get only some, not all, of the typical symptoms. They can be short lasting, but not always – for some they can go on for a significant period of years and their severity can cause real distress.

There are specific ways you can look after your physical and mental health as you go through the changes leading to menopause:

  • take practical steps to deal with hot flushes by keeping cool and avoiding possible triggers, such as spicy foods, caffeine, alcohol, smoking or stress. Dress in layers, so you can take off some of your clothes and cool down when you are affected
  • eat a balanced diet
  • stop smoking
  • limit alcohol intake
  • manage workload and work towards ensuring regular, confident and open meetings with clerks or practice managers
  • exercise regularly as this may help to reduce hot flushes, sleep better and lift mood
  • seek professional advice

If you can manage your symptoms yourself, you may not need to see a doctor. But you may wish to speak to your GP if you’re finding your symptoms hard to deal with or if you get symptoms before age 45. Effective treatments are available, including hormone replacement therapy (HRT) and cognitive behavioural therapy (CBT). Alternative therapies may also assist some symptoms.

 

How can you support a colleague experiencing menopause?

Individuals suffering menopausal symptoms can find it hard to talk to clerks, practice managers or other colleagues – particularly if they are male, or younger – as they feel they will not understand or take symptoms seriously. However it is not necessary to become a menopause expert to support these conversations. All that is needed is an understanding of how menopause might impact and a willingness to have an open conversation, particularly in regard to the practical needs of the person affected.

Support can be provided by:

• Creating and promoting an open culture
• Practice managers and colleagues in chambers undertaking menopause training to become aware of the potential effects of menopause at work and the need to understand the changes that occur for many individuals. Education is the key to better understanding of the issue.
• Having in place good occupational health policies and clear workplace guidelines within chambers to support an inclusive culture
• Regular practice management or other workplace support meetings to develop awareness of current needs, challenging issues and workload
• Adapting work environments (e.g. by simple means such as making fans available or considering room swaps to ensure that air conditioning is available)
• Supporting flexible approaches to working, including working from home to assist with managing anxiety or coming into chambers later where poor sleep is an issue
• Sharing resources and guidance

Wellbeing at the Bar would like to thank Lyndsey De Mestre QC for leading on the development of this resource.

The information and resource packs on this website are designed to help you and your colleagues to work as a community for better wellbeing and professional resilience. If you want to provide feedback on these resources, or to get involved in promoting wellbeing please get in touch.


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It can be difficult to make a living from law and it can be pressurised and demanding. Competition and an adversarial approach to everything can make collegiate relationships difficult. This website aims to provide you with the knowledge to manage these stressors, make emotionally informed, wise professional decisions and thrive in your chosen profession.

A simple expression that sums up wellbeing is ‘travelling well’

1 in 6 barristers feel in low spirits most of the time