It started five years ago. Christine, then 47, was taking part in a regular Monday morning meeting at a large medical diagnostic imaging company in Melbourne. She felt her scalp prickle, her face turn scarlet and within a minute she was red hot, clammy and sticky.

“I was drenched,” she says. “It would happen eight times a day and I never knew when it was going to strike.” On another occasion, Christine was presenting her $13 million budget to the chief financial officer.

He was in a cheeky mood that day and provoked her throughout the session. Normally Christine would enjoy the office banter, but on this occasion she felt overwhelmingly teary. “I fled the meeting and parked myself in the chief pathologist's office,” she remembers. “He was very sympathetic, and sent an e-mail to everyone at the meeting saying, ‘Play stopped due to rain.'”

Symptoms

Welcome to menopause, that ‘passage' in a woman's life that can be as feared as childbirth but far less talked about. From anywhere between 40-something to 50 something (sometimes earlier, sometimes later) the symptoms of this major hormonal shift can induce sleeplessness, night sweats, depression, headaches, reduced sex drive, memory loss, fluctuations in body temperature, moods and energy levels. For the record, menopause is the period before menstruation stops, because two small organs called ovaries produce fewer hormones than before.

Statistics show that for 10 to 15 percent of women, the ‘Change' is totally disruptive to their lives both on and off the job, yet few workplaces have formally addressed the ways in which menopause can affect women and interfere with team morale.

Janice, a 52-year-old Indian woman who worked with Christine, was retrenched after co-workers complained of her ‘personality change.' “She just became bossy and controlling,” says Christine. “But it was not part of her cultural background to talk about something so personal.”

Judy, 54, the general manager of a large national sporting body (and the wife of a high-ranking policeman), says she feels particularly aggressive for two days each month. “I was in a meeting the other day with this woman who irritates me at the best of times,” says Judy. “But I felt so angry I could have happily stabbed her with a kitchen knife, walked out smiling and had a cup of tea and cake.”

Waking each night in a heavy sweat, Jude often hits the wall at 3pm, but – with only one other woman at work in the menopausal range – she has been unable to share her situation with co-workers. “What am I going to say to my boss? Excuse me Don, I really need to go home, I'm...menopausal. I don't think so!”

Song and dance

More than half the population goes through menopause and if 47 percent of the workforce is made up of women, then millions of women are grappling with it. Many who have returned to work in the corporate world will be hitting their straps professionally when natural forces throw them off balance.

So what can you do to help a co-worker through menopause? Well, nothing unless you are an expert on women's health, but a cup of understanding and a good dose of humour may work well. The fact that a musical about menopause is opening in Australia this summer (Menopause the Musical ) is evidence that this once taboo subject is coming out of the closet, together with an expanding list of books on the subject.

Jill, a director in a high tech company who was constantly wiping droplets of perspiration from her forehead , was put on ‘a Plan' after a professional development review found her to be “short-tempered, unable to remember detail and incapable of motivating others.”

She went to see an “executive coach” who prescribed the following intervention:

• Acupuncture treatments.
• A herbal formula to help reduce night sweats and improve sleep patterns.
• Change of diet, reducing wheat and diary products.
• Christine Northrups' The Wisdom of Menopause – an educational book on the topic to help Jill get perspective on this stage of life.
• Working from home on Fridays, with four three-day weekends per season to restore work/life balance.
• Jill also ‘came out' to her boss about being menopausal.

Lifestyle review

Melissa Nash, a nutritionist with Women's Health Hotline in Sydney, believes the main factor in predicting an easy or torrid menopause is lifestyle. “Diet and exercise accounts for 90 percent,” she says. And the key is to establish healthy habits when women are young. “I'm 33 and when I go for a walk I only see 50-year-olds and over in the park. Young girls with gorgeous figures who don't exercise will pay the price later on. The skinny ones explode when they hit menopause because their metabolism drops as they age. Some women have a super high metabolism when they are young. They look cute but they get such a shock when their hormones slow down and they don't have the habit of exercise.”

One of the main health risks to menopausal women is heart disease, which is the biggest killer of women in the United States. Another great threat is the onset of osteoporosis, or brittle bones, signalled by back pain, rounded spines and height loss.

Many general practitioners still support Hormone Replace Therapy (HRT) as an option to reduce symptoms, however both practitioners and clients are now cautious since the federally funded Women's Health Initiative in America (2002) found that HRT did not protect against heart disease as was once believed. On the contrary, the study found that combined drugs caused increases in breast cancer, heart attacks and blood clots.

Medical treatment is a matter for each individual to consider, however most women could benefit from the following measures in formulating a strategy to minimise the symptoms of menopause and embrace this phase as a gateway to a new, enriched life.

• Exercise: Develop an exercise regime as soon as possible. If you're over 40 and have never walked further than the milkbar, it's time to invest in a solid pair of trainers and hit the streets. Thirty minutes a day is all it takes, but walk at a fast pace – you shouldn't be able to talk. The best exercises for strengthening bones include walking, dancing, Tai Chi, weight lifting or sports such as tennis of golf. Swimming and cycling are excellent ways to keep fit.
• Eat calcium rich foods: These will also strengthen your bones. These foods include low fat dairy, canned fish such as salmon and sardines, broccoli, green leafy vegetables, tofu, fish sauce, tahini and almonds.
• Avoid fatty foods: Reduce the amount of saturated fats in your diet, such as meat and dairy products and fried foods. Stop buying processed foods such as packaged biscuits, cakes and pastries that are high in fat.
• Reduce salt intake: Avoid products that contain salt or sodium and don't add salt to your cooking. Salt increases the risk of developing high blood pressure, osteoporosis, heart disease and fluid retention.
• Get lots of sleep: Build your reserves in the years leading up to menopause (perimenopause). Cut out coffee and other foods that contain caffeine such as chocolate.
• Stress management: Yoga is an effective stress reduction practice as is meditation and Tai Chi. Deep, slow breathing can help cope with mood swings.
• Nutritional supplements: High quality nutritional and dietary supplements can support overall health and relieve unpleasant symptoms. Supplements should include vitamins, minerals, amino acids and essential fatty acids.
• Phyto Oestrogens: Many foods and herbs are sources of natural plant oestrogens. Ask your GP to supply you with a list. They include: alfalfa, parsley, soybeans, legumes, chickpeas, olives, sesame seeds, cherries and a wide selection of fresh vegetables. Ideally, 50 percent of your diet should consist of raw foods.
• Buy a juicer: Get into the habit of drinking fresh fruit and vegetable juices on a daily basis.
• Drink water: Aim to drink at least one and a half litres of pure water daily.
• Sun protection: To cut down on ageing of the skin, use a sunscreen of at least (SPF) 15 whenever you are outdoors. Make sure the sunscreen specifies full spectrum protection, which screens out both UVA and UVB rays.
• Support: Seek support from friends, family and certain key work colleagues.

Useful resources

Books

Menopause – Hormone Replacement Therapy and its Natural Alernatives by Dr Sandra Cabot (WHAS)

The Silent Passage by Gail Sheehy (1998 Simon & Schuster Adult Publishing Group)

150 Most Asked Questions About Menopause by Ruth S Jacobowitz (1996 Harper Collins)

Test your risk for heart disease:
www.thirdage.com/health/answers/heartquiz

Women's Health Hotline: 1800 151 052 or
www.whas.com.au

www.menopausematters.com

www.mhcs.health.nsw.gov.au