Yet Another Way To Discriminate Against Women - Menopause

Here we go again. Yet another obstacle women face in the workplace is revealed. What's the issue now? You're going to love this – menopause based discrimination. Yup, now not only are women not allowed to look any older than 30, their bodies are not allowed to behave any older either.

There appear to be a number of factors at play when it comes to why this is happening. One, according to Dr. Wendy Walsh, a Doctor of Psychology and media commentator who says she is “obsessed with the science of love," is that “At the underbelly of all patriarchy is the desire to control women's reproduction. There is discrimination against post-menopausal women because they have no reproductive use."

It's not that men are consciously thinking, “Nope. Don't need her in the office because I can't have a child with her." Instead, it's a matter of socialized mass thinking that has men behaving badly when it comes to women who are past reproductive age. They see them as an unnecessary burden that is of no use to them. In other words – No longer a sex object. So why bother?

This goes hand in hand in hand with the fact that all of those pesky menopause symptoms keep women from being the smiling, compliant, subservient worker bees that far too many male bosses expect. It's as if the very fact of being a woman has given bosses (read men) a reason to say, “See. I told you they couldn't do the same work men do." Walsh says the fix is that we have to “Stop pathologizing womanhood." Indeed.

Being a woman is not and should not be treated as some sort of disease and, as such, neither should menopause. Men suffer from depression; loss of testosterone; effects of age – yes, shocking I know, men age; dementia; and so on and so on. They get a pass. But women get treated like the plague when their bodies behave naturally. Which leads to the other reason for the discrimination and other workplace difficulties, that women may have taken themselves out of the race to bear and raise children – something else that we have to stop pathologizing. Puberty, pregnancy, motherhood, menopause. These are not diseases. They are life.

The question now is how to parse and address this latest mess that is coming more and more to light as there are more women than ever in the workforce and they are, as one does, ages. Luckily, there are women out there fighting the good fight on that front. One of them is Karen E. Adams, MD, NCMP (North American Menopause Society Certified Menopause Practitioner). She is a Professor of Obstetrics and Gynecology and the Director of OHSU Center for Women's Health Menopause and Sexual Medicine Program at Oregon Health and Science University.

Dr. Adams has an office-based obstetrics and gynecology practice, one of the focuses of which is women over 45, which is why she created the CWH Over-40 Clinic in 2010 “to provide focused, specialized care to perimenopausal and menopausal women." In other words, she's the menopause guru.

80 percent of American women experience hot flashes and/or night sweats during their menopausal transition. Other common symptoms include insomnia and mood issues (anxiety, irritability, depression, especially if they've had these symptoms in the past). Some women notice “brain fog." Some notice a spare tire around their waist even though they are eating and exercising just as they always have. There can be hair thinning, skin thinning and wrinkling, and sometimes a decrease in libido. As women get further out from menopause they often notice vaginal dryness with intercourse.

The definition of menopause is no periods for a year, and the average age of menopause in the US is 51.

Most symptoms are most profound in the years surrounding the menopause transition. This is called the perimenopause and typically lasts about four years. Vaginal dryness is unique in that it tends to start later (like the late 50s) and worsen with time. Hot flashes will decline with time but often women continue to have a low level of hot flashes even into their 60s. But all this is very individual. I have some patients who started hot flashing in their 40s, and others who never really had much at all.

I have a patient who is an attorney, and when she came to see me, she couldn't get through a meeting with a client without sweating through her blouse. It was driving her crazy, and she said, “I need this fixed yesterday." I have another who is a neurologist, and she was unhappy that she was having a tough time remembering long lists of her patients' medications when she'd never had that problem before. One of my patients is a very high-level administrator at a hospital, and she felt like she wasn't as “quick" as she used to be in meetings and working with her team. She was pretty sure no one else noticed, but she really was noticing and she was incredibly self-conscious about it.

I've had women be mortified over heavy bleeding in their 50s just as they were at age 12 when their periods started. I had a recent perimenopausal patient tell me about having hemorrhage-type bleeding while she was on a business trip. She had to go to the bathroom every hour or two all day. She ended up coming home early. I'm so glad she came to see me. Thankfully bleeding problems are easily treated.

Most of my patients who experience these things struggle with how they are feeling at work, but have not experienced overt discrimination due to these issues. Mainly they are incredibly hard on themselves. I've never had a patient report being blatantly judged or eliminated from a position for being menopausal (but remember, I'm in Portland, OR. Maybe in Los Angeles or New York City. But I even have a patient who was a producer in LA for her entire career. She retired in her late 60s and moved to Portland. She worked as long as she wanted to. But remember, she was not in front of the camera. The story may have been different if she was competing with young women for roles.

In fields that involve fashion or lifestyle or other youth-oriented focuses, being 50+ might make a woman less relevant, or she may feel less relevant even if she is not. This may also relate to how high in the corporate structure she is, since age and wisdom may be a positive if you're a CEO, but probably not so much if you're an administrative assistant.

Some industries, like the airline industry, have very strict rules about retirement for pilots at age 60 (for both male and female pilots), but they took age out of the equation for flight attendants many years ago.

However, any industry that involves entertainment—TV, movies, even news—have very different, albeit unwritten, standards for men and women regarding aging. Older men are considered distinguished, reliable, and attractive in a leading-man kind of way, whereas older women are just considered old. They certainly aren't considered for leading romantic roles.

The flip side of this is seen in industries in which experience and knowledge are paramount. Examples would be science, academics, medicine, research, etc. in which older employees, both men and women, are looked up to. In those fields, a woman in her 30s would be just getting started, and women in their 50s and beyond are most productive, often because their children are grown and they have fewer conflicting responsibilities. In my field of medicine, women are more productive in their careers the older they get.

Certainly, if a woman has medical concerns like hot flashes, depression, or anxiety affecting her performance at work she should run, not walk, to her doctor! Those things can be very effectively treated. If she's not sleeping well due to insomnia or night sweats, same thing—get medical help pronto. Sometimes women have irregular or heavy bleeding during perimenopause, and that is also 100 percent treatable.

I think of sex as “life juice," and women who have regular sexual activity tend to be happier overall. So, although a lack of sex drive or celibacy in menopause may not translate directly to the work environment, her overall sense of vibrancy and well-being can be impacted if she has pain with sex or otherwise has an unhappy sex life. Those things are also 100 percent treatable. It's so important that women not accept this as “normal" after fifty.

Sadly, memory issues and brain fog don't always respond to hormone treatment. It's worth a try. But if there's no improvement in a couple of months and with better sleep, it's probably not going to improve with longer-term treatment. There is some interesting research going on right now looking at treating menopausal “brain" fog with ADHD medications, but we are not using those right now outside of research trials.

I think what most of us want is to have our health and how we are feeling be an internal perception, not something that is visible or obvious to our work colleagues. So we want to be healthy and feel healthy and not have our bodies get in the way of doing what we love to do, whether that's work or hobbies or at home.

I'm very excited about the next generation of women who have my generation to look to as role models. There were few women in my workplace for me to look up to when I started in the mid-90s, but now there are many more of us in leadership positions. Hopefully, we can mentor our more junior women colleagues so they won't have to be such trailblazers. Of course, that's more true in some fields than in others. Engineering and very high-technology fields still have few women in leadership roles.

Women have always been judged on their looks more than men have. So, as we age, it's a challenge to feel positive about ourselves as we see ourselves looking older. Some women embrace it, going gloriously grey and loving their smile lines, but others spend a lot of time and money on upkeep. Botox, fillers, laser resurfacing, teeth whitening, hair coloring, even tummy tucks and liposuction are ways some women choose to fight Father Time. Neither approach is right or wrong. It's really about what a woman wants for herself and her own reasons for doing what she's doing. It's a Feminist issue if a woman is pleasing others rather than herself, and if she feels there's no place for her at work simply because of her age.

Most of my patients are very happy being fifty and up. Many say, “I wouldn't be thirty again for anything!" At this age, they are likely to know who they truly are, more likely to stand up for themselves, and less likely to allow themselves to be coerced or browbeaten into something they don't want to do. They are less interested in pleasing others and more interested in pleasing themselves. As a proud member of the 50+ generation, I will say unequivocally it's great. However, I do love my Botox.