In a webinar BRIA recently hosted about the menopause transition, someone asked what to do when she is sitting in an executive meeting with a group of men and she has a hot flash. She was worried about embarrassing herself, and the biased views that come with being an aging woman in a male-dominated field.
While this may seem discomfiting, my first thought was to say “grab the nearest folder or magazine to fan yourself.” I was going to explain that I keep a fan with me at all times and use it whenever I have a hot flash, confessing— “I am having a hot flash”—to everyone around me. Simple as that: no judgment. Plus, it’s a great way to encourage others to talk about perimenopause and its common symptoms.
As a physician, I feel comfortable sharing my personal perimenopause symptoms and capitalizing on the opportunity to educate others about the natural changes that occur to women during the menopause transition. As a psychiatrist specializing in women’s mental health, I am also aware of the importance of honest communication, and often use my experiences with menopause to encourage discussion about mood and behavioural changes spanning the reproductive stages.
How naïve of me to think that other professions and occupations support such transparent conversations about common changes across the life cycle! I was recently watching the Danish series, Borgen, where the foreign minister, a 50+ year old woman going through menopause, had to leave an important high-level meeting because she was having hot flashes and sweats while her younger colleagues alarmingly looked on. She escaped to the bathroom to dry her sweat-stained clothing, rather than addressing her hot flashes as a normal part of this life change and soldiering on.
Since launching our new clinic, BRIA, I am continuing to learn about the unique challenges that women face when they are enduring difficult life stages. Shame, denial of symptoms, and a fear of being seen as weak force women to downplay their symptoms and carry on — especially when working in a male-dominated field.
Over the past two decades working as a perinatal psychiatrist, I am thankful to observe that the stigma of postpartum depression (PPD) has lessened. The silence has been broken with celebrities talking about PPD more openly, TV shows publicizing the experience by portraying strong, successful women with PPD, and social media groups advocating for support and education for new moms in need. Unfortunately, the same cannot be said for the perimenopause stage. Menopause is today where PPD was 20 years ago — a vulnerable life stage to be endured silently and alone.
I give many presentations to female medical teams about the importance of recognizing women’s mental health concerns across the reproductive life cycle. Inevitably, the conversation turns to our own experiences and how we can better help the women we treat. I am proud to be a co-founder of BRIA, a virtual mental health clinic that supports women’s comprehensive psychological, biological, and social needs. When I speak to medical colleagues about our multidisciplinary services, they all have the same reaction: “this is such a necessary clinic that so many women can benefit from.”
When I speak to female business leaders from large corporations, banks, and law firms about BRIA, I often hear personal accounts of fertility challenges, pregnancy losses, and postpartum depression and anxiety. “I wish BRIA was around when I had a baby” is a common comment I hear. But few in the midlife stage talk about their struggles with perimenopause symptoms.
Rarely, male executives will acknowledge that their spouse or family member had PPD. And when I present the need for mental health services during the menopause transition, I am often met with, “That only affects a small fraction of our employees.” I want to retort, “So you don’t employ women between the ages of 40 to 55? No one suffers from such horrific periods that they are terrified of going to work and bleeding through their pants? No one goes on sick leave for mood symptoms that worsen around perimenopause? No one suffers from anxiety, depression, irritability, and rage during these hormonal shifts? No one has brain fog, fatigue, lack of concentration and motivation, and a constant fear of being fired because they cannot be as productive as usual? No one has hot flashes that keep them up at night and force them to flee the workspace during the day to hide their sudden and embarrassing sweats?”
Either you are not employing enough women, I hold back from saying, or you are grossly ignoring those who are struggling during these hormonal roller-coaster stages.
What I’ve come to terms with is that we cannot blame men for not understanding what we go through as women. It is up to us to start and amplify the conversation and to be honest about our vulnerable mental and physical changes in order to effect change and gain more support, especially in the work environment.
The continued efforts to increase awareness and advocacy for women’s mental health throughout the reproductive stages will help empower women who are too often judged as weak or fragile. For now, when I talk about BRIA and the importance of women’s mental health to male-dominated businesses, I keep a fan by my side and as I cool myself during a hot flash, I smile at the women in the group who nod knowingly in solidarity and in silence.