Menopause: more meaningful and effective support at work

Your questions answered

Emma Wee answers some of the audience questions that we didn't get to cover during this webinar.

Disclaimer

I am not a medical practitioner, and any comments and research mentioned here are from those who are medically trained or are engaged in medical research.

Everybody is different and have different requirements; the information presented here is purely to inform and each person needs to find their own path, practitioners and hopefully, the best outcome for themselves.

Emma's personal journey

I noticed changes from around the age of 42, such as insomnia, allergies and extreme tinnitus. I only started HRT five years later. I didn't think I was 'bad enough' to warrant HRT and I just kept referring to the usual NHS symptoms – irregular periods, low mood, hot flushes and insomnia – and I only met one criteria. I went to the GP after 18 months of feeling progressively exhausted, with severe working memory challenges, joint pain (it was painful to walk first thing in the morning) and hip bursitis. In essence, I felt I had run out of options to feel normal and my quality of life and wellbeing was severely impacted.

Peri/menopause within the workplace

Where is the data that says menopause is an acquired neurodiversity?

Peri/menopause can be considered a disability under the Equality Act 2010 if its symptoms have a "substantial and long-term" impact on an individual's ability to carry but normal day-to-day activities for 12 months or more. If menopause is deemed a disability, employers are legally obligated to make reasonable adjustments to support the employee and must not discriminate against them.

As it is seen as a transient condition that has significant impact on cognitive processing (as opposed to something like a stroke which is a permanent physical change to the brain), peri/menopause falls under the Acquired Neurodiversity banner and is therefore eligible for reasonable adjustments in the workplace.

Read more:

Neurodiversity at work: a biopsychosocial model and the impact on working adults (Nancy Doyle)

Menopause and the workplace (UK Parliament)

Do reasonable adjustments result in a change to contract?

Reasonable adjustments should be put in place to allow someone to manage the role they are in. They are not legally binding but there is a duty of care from an employer to ensure employees are supported.

Being asked to take a drop in pay due to reasonable adjustments or because you have a disability is discrimination. Moving to a different job role within an organisation to allow you to function better is a reasonable adjustment.

Here is a recent judgement supporting this within South Yorkshire Police.

HRT and treatment of symptoms

HRT is only one of the tools at our disposable for supporting our systems through the menopause – diet, exercise and other supplements are also options. Whether you choose to use hormones or alternatives, make sure that it's right for you.

On protective factors of HRT, can you explain how this affects eyesight and diabetes?

As oestrogen levels drop, we become more insulin resistant, and cortisol levels rise; this is one of the reasons why women will be at a higher risk of diabetes without HRT.

Oestrogen also has an anti-inflammatory impact on the body, has been found to have a protective quality to the retinal nerve cells as well as increasing ocular blood flow.

The drop in circulation is one of the factors behind macular degeneration. Again, the earlier the intervention of HRT, the better the outcome.

This podcast is excellent on all things HRT: You Are Not Broken, episode 328: Should I take hormones? (Kelly Casperson, published 27 July 2025 - YouTube version also available).

GPs should be treating the symptoms presented; there isn't a specific timeline, but individuals should be listened to and not dismissed.

I had extreme abdominal pain for months which turned out to be huge fibroids – at A&E I was told "it's probably just your hormones out of whack", was refused a scan and given a prescription for pain relief that I wouldn't be able to access for at least another 18 hours. We need to demand more from our medical practitioners.

Is there now testosterone available on the NHS? My GP has told me that you must go privately to receive testosterone during perimenopause.

This is simply not correct; GPs are able to prescribe testosterone, and many will. There may be a supply issue in your health authority, but the NHS does prescribe it widely. I would ask to be referred to the menopause service in your area.

Can the acquired conditions also be triggered by pregnancy (just thinking about the hormonal changes)?

The changes in the brain during pregnancy are very different. Oestrogen levels are approximately 10 times higher during pregnancy than at any other time in a woman's life, and the brain actively shifts the wiring in the brain to encourage more nurturing and to create a different focus for when the child is born. The impact of 'baby brain' is said to last for up to two years post-partum. I feel that the peri/menopause is more relevant as an acquired neurodiversity because the impact over time is more significant.

I asked my GP about bone densities if I don't have HRT – he dismissed me.

This podcast tells you everything you should know about the menopause and bones. I'd print out the transcript and hand it to him: The Dr Louise Newson Podcast, series 2 episode 24: Bone health, hormones and the real risk of osteoporosis (Dr Louise Newson, published 9 September 2025).

If you are concerned, you can also get a DEXA scan which measures bone density. This is fairly limited on the NHS, but you can have them done privately.

Don't forget that exercise (weight resistance based) that forces the bones to create more density, as well as adequate levels of vitamin D, are also part of the solution. Dr Louise Newson's book 'The Definitive Guide to the Perimenopause and Menopause' is excellent.

Is progesterone recommended if someone has had a hysterectomy?

The current advice is that women are not kept on progesterone after a hysterectomy. However, there are significant benefits for supporting sleep, cardiovascular health and especially bone density health as there are progesterone receptors in the osteoclasts which are the bone building cells – see the Dr Louise Newson podcast mentioned earlier.

If we have lower levels of progesterone, we run the risk of not replacing the bone that we lose as part of the menopause. I have insisted that I have it as part of my protocol post hysterectomy.

I have a friend who is on the pill version of HRT. She isn't comfortable with this and wants to move on to gel or patches, but her surgery are flatly refusing. Surely as the patient, she has a right to choose what she has?

I would be asking for a specific medical reason for why they are refusing; if it's for supply reasons, then frankly that isn't good enough.

If I was in this position, I would be ringing pharmacists nearby to ask what the supply level is like and then asking to be referred to the menopause specialist. If you can, go privately for a tailored protocol as GPs will (usually) honour a prescription if they have a letter from a consultant requesting it (that's what I ended up doing).

There is no substantive reason why a person should be refused HRT if they feel that there are enough symptoms to treat. Our periods and hormone blood tests are not an adequate marker of where we are in the perimenopause journey, as they are not consistent.

Are we able to replace our collagen with supplements/gels? I have been told by a doctor that you cannot replace it.

It's true that you cannot replace lost collagen, but taking collagen and other joint-supporting supplements such as glucosamine and MSM can support what we do have left and stimulate the production of new collagen.

Bovine collagen supports skin, bones and internal organs. Marine collagen supports skin, hair and nail health. There are also vegan alternatives.

Many of my clients see many benefits including the lifting of brain fog and easing of joint pain.

How long would a woman take HRT for to alleviate these symptoms?

The onboarding of HRT should take around 1-3 months. If things don't feel right, then ask for it to be changed. It can take some trial and error but once you have a protocol that works, you should see a definite improvement of symptoms.

Is the green tea supplement now available as a treatment option on the NHS? If not, do we have a date?

The advice is generally to reduce things that would increase inflammation, but I don't know if this would be seen as a viable treatment on the NHS.

Why does use of an electric blanket increase one's risk of getting cancer?

In the section of my presentation that referenced the use of electric blankets, I was drawing on a study by Dr Avrum Bluming, medical oncologist and former senior investigator at the National Cancer Institute, which was created to demonstrate other things that cause inflammation in the body in order to debunk the flawed data presented by the Women's Health Initiative – not that electric blankets cause cancer in themselves!

Dr Bluming wrote a book with Dr Carol Tavris called 'Oestrogen Matters'. In an episode of the unPAUSED podcast titled 'The Truth About Estrogen: What the Women's Health Initiative Got Wrong with Dr Avrum Bluming and Dr Carol Tavris' (Dr Mary Claire Haver, published 21 October 2025) they dismantled the 2002 Women's Health Initiative study that terrified an entire generation of women away from hormone therapy, and reveal why the fear was based on misinterpreted data, flawed conclusions, and a refusal to correct the record.

Dr Mary Claire Haver's book 'The New Menopause' is also excellent and she often posts about the most recent research papers on her Instagram.

Further reading

Oestrogen and cognitive functioning in women: lessons we have learned

Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52,705 women with breast cancer and 108,411 women without breast cancer. Collaborative Group on Hormonal Factors in Breast Cancer (Lancet)

Effects of oestrogen plus progestin on health-related quality of life (New England Journal of Medicine)

Menopausal Hormone Therapy and Breast Cancer: what is the evidence from randomised trials? (Climacteric)

Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association (Circulation/American Heart Association)

Oestrogens for Prevention of Coronary Heart Disease: Putting the Brakes on the Bandwagon (Circulation)

Guidelines in Action: New Considerations for Primary Prevention of Stroke Related to Premature and Early Menopause (Stroke/American Heart Association)