Too many suffer in silence

Attitudes are changing around women's health issues in the workplace. Photo / Getty Images

Historically regarded as the weaker sex, women were once thought too irresponsible to vote and certainly not capable of working if they had children. Of course, we now know that women are more likely than men to survive famine and epidemics, have a longer life expectancy and can run a country while pregnant.

But the fact remains that the ability to bear children comes with a range of gynaecological and reproductive conditions that can cause troublesome symptoms such as fatigue, pain, nausea and mood disturbances.

At work, most women still keep symptoms of premenstrual syndrome (PMS), pregnancy and menopause under wraps, especially from their male managers, with reasons ranging from embarrassment to fear of appearing less able. A male boss is unlikely to hear, "I have a severe premenstrual headache" or "my period cramps are so bad that I need to go home". He's more likely to hear that a woman has a "migraine" or "food poisoning".|
About 90 per cent of women experience PMS at some point in their lifetime and it is generally most severe for women in their 40s, often a time when women are taking on more responsibility at work in more senior roles. Symptoms of PMS that may affect a woman at work are irritability, depression, oversensitivity, mood swings, fatigue, bloating and a severe headache. More acute forms of PMS manifest in extreme anger and anxiety and can significantly affect a woman's ability to function.

Menopause generally occurs from the late 40s to the early 50s, and common symptoms include hot flushes, sleep disturbances, weight gain, low mood and fatigue. Other gynaecological conditions experienced by some women are endometriosis and vulvodynia, both of which can cause significant pain.

Dr Prudence Fisher is a clinical psychologist working in private practice at Auckland Psychology and specialising in women's health. Fisher says the majority of the women she works with who experience exaggerated PMS, menopause symptoms and gynaecological pain do not disclose their symptoms to the workplace.

"Instead, if they need time off work they don't specify the reasons. Pregnancy pain tends to be easier for women to speak to their line managers about in order to adapt their workplace to better manage pain."

Fisher says women are usually more comfortable in talking to women managers but stresses this is a generalisation. She says most clients will not disclose complex pain conditions such as vulvodynia as they consider it too personal, but she notes that some women who suffer endometriosis and have complex pelvic pain do need to disclose this because of the severity of the pain, and to date she has not heard of any adverse responses in relation to pelvic pain.

Although attitudes may have changed in the way men view women in the workplace, some women who speak up or oppose a male viewpoint may still be subjected to comments such as, "it must be PMS".

Fisher says it is very hard for women to have an opinion dismissed within a dysfunctional framework such as having PMS or being menopausal.|
"PMS is a time for innovative thought and creativity and to demean this surge of energy is not great for any woman. Menopause is a time for reflection and the desire to pass on knowledge, so again to have this valuable knowledge minimised and stigmatised is harmful to a woman's development and productivity."

She is hearing fewer instances of PMS being framed in a harmful way, "but whether people still think it, I'm not sure".

She believes many women don't approach their managers about symptoms through embarrassment or fear of seeming weak. "I think women are trained to feel 'less than others' if they have a gynaecological condition such as pain or exaggerated PMS." She believes too that a culture of "staunchness" exists in New Zealand, with older generations in particular believing women should just get on with it and not be running to the boss with "female problems".

"In organisations that encourage self-care and a work/life balance, it is generally the more mature women that need to be encouraged to keep this balance," she says.

"Younger women appear to have a greater sense of entitlement to having their need for a life out of work met. However, the majority of women I work with are pushed to over-extend themselves more than men in the workplace. There are strong gender practices across industries that overload women with the more labour-intensive, 'female', less visibly-rewarding tasks."

Struggling to hide pain at work can negatively impact a woman's mental health. Fisher says if women need to hide complex gynaecological pain conditions they can experience an increase in central nervous system functioning and develop anxiety if this work context persists.

"At the least, they become irritable and are less able to complete pain management strategies such as physiotherapy because of this, and less able to manage workload, household and family tasks effectively. Their lives can become limited to going to work and managing the pain. A life with no pleasure or effective rest leads to resentment, anger, anxiety and low moods."

Fisher believes HR departments can assist by empowering women to work well and productively when suffering symptoms.

"Viewing the reproductive cycle as positive and creating an environment where women can work in comfort are helpful actions that organisations can implement. Ask women what they need to work comfortably and productively, such as a stand-up desk in cases of unprovoked vulvodynia, quiet work spaces and a manageable workload so as not to increase central nervous system wind-up and greater gynaecological pain. Circulate educational material on how many women function very productively and creatively in the week prior to their periods but need minimal distraction, and how work overload exacerbates pain and menopausal and PMS symptoms. Have processes in HR that provide a quiet place for women to be able to negotiate their needs with managers."

She adds however that HR needs to guarantee privacy for this work and not automatically report to line managers.

Prudence Fisher can be contacted at prufisher@actrix.co.nz