With my 44 years I was feeling a little too young to be signed up for an afternoon course on the perimenopause. On the other hand, if the way ahead involves menopause, perhaps preparing for it is simply what any smart cookie would do. Certainly if, like me, she isn't on friendly terms with her hormones.

When I think how furious and at the same time intensely sad my hormones currently make me feel for a couple of days each month – to say nothing of the physical symptoms – I'm apprehensive about the years ahead. When my hormonal system undergoes a period of radical change, what will I have to face?

We – a dozen female TU/e employees – find out from Bram Schoolmeesters, occupational physician in training at HumaCapitalCare and working for TU/e. It seems pretty funny to be getting a lesson on the perimenopause from a man in his early thirties, but he does it well, bringing knowledge and empathy to the task.

The only thing he says that doesn't go down well is that it's wise to wear cotton pajamas when having hot flashes during the night. No amount of absorbent cotton will help alleviate a full-blown hot flash say those with firsthand experience, whose own measures extend to setting up an XL fan beside the bed.

Menopause

Let's start with the basics. What is perimenopause? And what is the difference with  menopause? Perimenopause is, to put it simply, the period in which a woman's body runs out of eggs, and the production of the sex hormone estrogen fluctuates wildly before plummeting.

Broadly speaking, between the ages of forty-one and fifty a woman's menstrual cycle becomes irregular and hormone levels swing up and down, hitting peaks and troughs. This phase is known as the perimenopause or the period of menopausal transition. Aha, so some symptoms may soon be coming my way. This is the phase in which symptoms like hot flashes are most likely (among 76% of women), as are mood swings (57%), including the infamous ‘short fuse’.

Once a woman has had her last menstruation, menopause begins. Generally speaking, this happens around the age of fifty-one. Although the estrogen level stops swinging all over the place, this doesn't mean the symptoms drop away. Take depression for example. If it has reared its head before, vulnerability to it may now be heightened.

After about the age of sixty, a woman enters postmenopause. From here on in, a woman should be alert to the possibility of things like osteoporosis (diminished bone density), and the risk of cardiovascular diseases increases.

It should be said that the list of symptoms mentioned above is far from exhaustive (sorry). Others to be aware of include sleeplessness, night sweats, headaches, joint pain, urinary incontinence, vaginal symptoms, a flagging libido, brain fog, weight gain (averaging 5 kilos), changes in fat distribution (goodbye hourglass waist) etc., etc.

Some figures on perimenopause

• 96% of women experience perimenopausal symptoms
• For 62% of this group these symptoms are severe
• 93% of the latter group are open to treatment with, say, hormones or sleep medication.

Menopause practitioner

No, perimenopause is not an illness, it's a natural process. Nonetheless, the symptoms can greatly diminish a person's joie de vivre, possibly for a number of years. This is why Schoolmeesters impresses upon us that it's wise to pay our family physician a visit early on.

He also knows, however, that some family physicians are not well informed about treatment options, which is why ‘that's only to be expected’ is all some have to offer. In that case, it may be time to see a menopause practitioner. Of course, a specialist healthcare professional may simply the preferred option.

“You don't need a referral to see a menopause practitioner, so you can go ahead and make an appointment. But you may want to check your health insurance first, as the reimbursement for this service is included in the supplementary packages,” says Schoolmeesters, offering another good tip.

Some figures on perimenopause and work

• 40% of women find their work suffers due to perimenopause
• Among women aged between forty-four and sixty, in 34% of cases absence due to illness is related to perimenopause
• 76% of women don't talk to their manager or HR about perimenopausal symptoms
• 2.1 billion euros is the annual cost to society of lost productivity (‘presenteeism’) and absence due to perimenopause

Taboo

Why the HR world has picked up perimenopause as an important theme is evident from the above statistics. (The workshop has been organized by HRM.) Perimenopause is the cause of a great deal of absence from work and presenteeism. The latter term means being present at work but not at all productive, due to concentration problems, for example. Understandable if you're routinely experiencing, say, sleepless nights.

Many of the women present say they don't talk at work about perimenopause, and the figures tell the same story. Either because it feels taboo, or because they simply prefer to keep things businesslike. Besides, no one wants to be known as the employee with aches and pains and other symptoms. That could jeopardize a woman's present position or a promotion that may be on the cards.

But this taboo must be broken because by making some small changes, a woman can make her life much easier, and her work will benefit too. Schoolmeesters: “Find out where there's some flexibility: can you work from home, work more flexible hours, or take a lunchtime walk to get some much-needed fresh air?”

Get over your embarrassment and have that chat with your manager, is his finally piece of advice. “Will this workshop be made available to – preferably obligatory for – all TU/e managers?” This is the question the course participants ask him in return, prompted by the absence today of any members of this target group, as revealed by a quick check. Which is a shame, because knowledge and understanding are the first step towards finding a solution.

Do you have a question or suggestion about work and transition? Please contact A&O advisor Sanne Thijssen

In the ‘Cursor goes course-hopping’ feature, our editors will take part in the various training sessions, courses and workshops that TU/e offers throughout the year with the aim of allowing students and staff members to increase their knowledge and skills in a variety of fields. If you happen to offer a course, training session or workshop yourself that might be of interest to this feature, or if you know of any such event, don’t hesitate to contact Cursor’s editorial board.