Should severe menopause symptoms be a disability? One country thinks so.

LONDON - As a growing number of countries start giving women menstrual leave to deal with period pains, Britain is considering going one step further, saying that severe menopause symptoms could be a disability.

On Thursday, the Equality and Human Rights Commission (EHRC), an independent watchdog that enforces legislation in the United Kingdom, published guidance saying that if menopause symptoms “have a long term and substantial impact on a woman’s ability to carry out normal day-to-day activities, these symptoms could be considered a disability.”

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“If menopause symptoms amount to a disability, an employer will be under a legal obligation to make reasonable adjustments,” it added.

Equality legislation in England, Scotland and Wales prohibits employers from discriminating based on age, sex and other factors; parts of the law also apply to Northern Ireland.

Symptoms of menopause can include hot flashes, cardiac effects, brain fog and other mental heath effects. The average age of menopause is 51, though it can begin earlier or later. The phase before women transition from childbearing years to menopause is called perimenopause; it is during this time that estrogen and progesterone levels decrease, and it’s this “big drop in estrogen levels that causes most of the symptoms of menopause,” according to Johns Hopkins Medicine.

Many women in their late 30s and 40s experience irritability, trouble sleeping and anxiety - but find their symptoms are often dismissed by doctors. Where possible, employers should consider providing rest areas or quiet rooms for women experiencing menopause symptoms, as well as fans or cooling systems, the EHRC said. Workplaces could also support women by allowing them to wear cooler clothing, or allow staff to work from home where possible, it added.

Symptoms can be so severe that some women even decide to leave the workforce, the EHRC said.

Katie Taylor, 54, was one of them.

Until her early 40s, the British mother of four ran marketing for a children’s charity. But from the age of 43, she began experiencing a host of symptoms she first thought were unrelated - from brain fog, low mood and heart palpitations, to anxiety, insomnia and weight gain. She lost confidence and “felt terrible,” she told The Washington Post in a phone interview.

Her doctor blamed depression and her busy lifestyle. She was prescribed antidepressants, which didn’t work, she said: “They just made me feel numb.”

It was only four years later when her father, a retired professor of surgery and breast cancer specialist, suggested that she see a gynecologist, that Taylor discovered the true cause of her symptoms and began taking menopausal hormone therapy - or hormone replacement therapy (HRT).

She described the diagnosis as “a lightbulb moment” and said she felt “absolute relief that I wasn’t going mad.”

“But I felt incredibly angry that I’d been misdiagnosed, that I’d been made to feel like a hypochondriac and that I’d left my job,” Taylor said.

Unable to find others in the same situation online, she turned to Facebook and created the Latte Lounge - a community for women over 40 to share help and resources. Now a website, the Latte Lounge provides resources and information about perimenopause and menopause, treatment options and a directory of specialists.

Taylor said Britain is “leading the way” in raising awareness about the effect of menopause on women’s lives.

Experiences like Taylor’s aren’t unusual, said Louise Newson, a British general practitioner and menopause expert.

But Newson had a mixed reaction to the new guidance. On the one hand, “it’s always good when menopause is spoken about - and if you look at what the definition of a disability is then menopause can be a disability for many, many women,” she said in a phone interview.

“What I find really frustrating, though, is that it needn’t be a disability for many women if they have access to evidence-based treatment in the form of replacing their missing hormones,” she said, noting that not many people globally are offered HRT.

Both she and Taylor point to research from 2002 that suggested that hormone replacement therapy caused cancer as a reason that many women stopped taking it.

Education and clear, evidence-based information is key to understanding and treating menopause symptoms, Newson said, for both medical professionals and people who may not understand their lifestyle or treatment options.

But, she added, there’s a growing awareness of the variety of symptoms a woman may experience.

Vicky Coy, a deputy project manager in Britain, said in a phone interview that she wasn’t aware of the wide range of symptoms when she entered perimenopause in her early 40s.

HRT has helped regulate her emotions, she said. But while she doesn’t think her colleagues will have noticed any difference, she said the effects of her symptoms on her memory and thinking have been noticeable - even on HRT.

“I feel like I’m working at maybe 60-percent capacity of what I was previously able to do with my brain,” she said. “And that’s quite hard because I used to rely on my brain all the time. I didn’t have to think about it being sharp and focused, whereas now I don’t trust it at all.”

She’s unsure how much employers can do, given how differently symptoms can affect each person - and also how much employees will want to disclose, as they won’t want to affect their chances of promotion, for example.

“People tend to be in more senior positions when they reach perimenopause and menopause,” Coy said - and “therefore it has a bigger effect on your ability to do your job.”

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