Women's health manager guides

Hi everyone, and welcome to this Academy bite size module.

I'm Richard Norris Bupa's, head of SME and Specialists.

And at Bupa, we're passionate about women's health and today we're talking about period health and I have with me doctor Petra Simic, who's been an NHS doctor for more than 20 years.

So Petra, should we get going?

Yes, Richard.

Symptoms

Around 80% of women experience period pain at some stage, with five to 10% of women finding the pain severe enough to disrupt their life.

Petra, can you talk us through some of the symptoms people may experience?

Richard, so it's important to talk about periods.

Women experience these every month and even a normal menstrual period will have a degree of discomfort related to it for many women, whether that be abdominal cramping or back pain or just even the onset of the period and heavy bleeding for the first couple of days.

However, there are women who have underlying conditions that cause their periods to be really quite difficult, such as endometriosis.

Around one in ten women have endometriosis, many of which don't know they have it.

That can give quite painful periods, particularly in the days leading up to the period starting.

You can have problems with fibroids, which can give you very heavy periods, or polyps, which can do the same.

There are conditions such as PMDD, which is a premenstrual dysphoric disorder, which is where you can have really quite dramatic changes in both your mood and emotions in the time leading up to your period.

Menstrual migraine, the list is quite long of problems women can have around their periods.

So you can see that the time of the month is not quite as simple as it might seem for some women and for some it's really quite life affecting.

So that is quite a long list of challenges in there.

I'm really keen, particularly as a male leader, to find out what I can do to help.

But also, almost a quarter of women take Importance time off work their period, and unfortunately, more than a third lie about the reason for their absence for fear of embarrassment or judgement.

So how important is it that organisations and managers normalise discussions around period health in the workplace?

Well, as you said, Richard, is a long list and we know it affects many women and more women are working than ever before.

I think in the UK we have established that we think heavy and painful periods make up for around 6 million sick days a year, which is a huge number.

And although we can think about the impact to a business, I think if we just take a step back and think about the impact of an individual to be unwell enough to take that much time off work on a regular, potentially monthly basis, you can imagine how disruptive that is to someone's life.

It's really interesting that I see many women with period problems who don't attend my surgery because they have period problems.

So they come for other reasons. Really good examples.

I feel tired all the time, Doctor.

I'm exhausted.

I'll ask them their symptoms, everything's fine.

And then we'll get the blood test back and discover they're anaemic.

And when we explore it, they're anaemic because their periods are so heavy.

Yet they had accepted their heavy periods. as just a variation of normal for them, and it might be that their family has spoken to them and while she has heavy periods and their sisters, so they've sort of normalised what actually is quite disruptive menstrual health.

So organisations are really quite at risk of losing talent during this time if they're not recognising that, is there anything else they can do?

And I think it's about supporting the conversation around period health to start breaking down the taboo because I'm privileged enough to have spoken to thousands of women about their periods because of the job that I do.

So I do that in my consultations.

But when I think about it, I haven't had lots of conversations with my friends or my relatives about their periods.

And I think until women start being more open about their experience of menstruation, it's going to be hard for us to find the women that are suffering probably in silence.

So our job as thought leaders, as businesses, as organisations is to kind of join together to kind of break the taboo and start getting rid of the shame or embarrassment.

This is a completely normal function, and we need to get better at being comfortable talking about it.

So as a manager being open, being empathetic, creating the right sort of environment and showing some flexibility.

Yeah, I think showing some interest in it.

I do think generally male managers are almost more interested in it because they know less about it.

And sometimes being a female manager might not make it more beneficial.

They may not be more sympathetic or empathetic, because if your female manager has been dealing with really difficult periods for ten years of their career, are they going to be really empathetic to the next person, or are they going to say, "well, I cope with it, you should just carry on".

So I don't think, again, this isn't a women's issue, this is just a human issue.

And I think that empathy, that listening and that kind of open mindedness will go really far in this space.

Okay, great. Thank you.

All right, let's move on to the next one.

So we know that women face challenges when accessing help and support for period health.

Petra, can you talk us through some of the common barriers women face?

I think, Richard, the number one main thing is really a lack of awareness of women that they may be struggling unduly.

They may have symptoms that might be manageable or treatable.

So I think lack of awareness is really important.

How can we help women to recognise when they could have a better quality of life if their period health was managed better, there's embarrassment and shame that goes with it.

I also think there's normalisation amongst families where people just accept quite difficult periods because everyone's had them and a real lack of awareness of the kind of treatment options there are available.

So for lots of women, they kind of seem to think, well, this is just it, isn't it?

Every month this is how life.

I have to take two days off of work and I have flooding and I can't go to the supermarket.

And when you sit down with them and explain that there are treatment options available, they kind of seem surprised.

So I think there is a big awareness piece.

I think, in terms of in the workplace, if you are noticing regular absenteeism, then I think it's important that you always ask what's going on.

If you notice a pattern and if it's period related, you are going to see a pattern in most cases.

So you would do what you normally would and have quite open conversations.

I think the other thing to think about is that where we'd all been based in offices, I suspect that was quite a barrier for women that were having period problems.

The move towards hybrid and flexible working will be really great for women that are having period problems that might actually make them not seek help because they find that much they can kind of go along for longer without getting help.

So in some ways, flexible working, although helpful, might actually mean it's harder to spot when people are struggling with their period and it's impacting on their life.

Yeah, sure. Okay, great.

Thank you.

So our final question, 87% of people who menstruate have Support experienced stress or anxiety in the workplace because of their period and feel male colleagues may be judgmental.

What can organisations practically do to address how they support period health in the workplace?

I mean, that's quite a shocking statistic, isn't it, that's the majority of people who menstruate experiencing those kind of negative kind of connotations to it.

I guess the first thing you'd want to do is really address what's going on in the workplace and that there is no particularly negative or toxic things going on.

Periods are a very personal thing and they're very private and I'm not sure it's something that you should necessarily be talking to someone on an individual basis about, because it's still quite a big taboo and people feel very protective over their health information.

Quite rightly.

As an organisation, you could have conversations around period health that are actually a little bit more general to kind of open up the debate.

There's been lots in newspapers over recent years around period poverty.

So there's 500 million women and girls globally who don't have access to sanitary protection and that has significant impacts on their life.

There's even been period poverty in the UK.

I think the food banks are finding that sanitary products are some of the most in demand.

So period poverty there's a sustainability issue so the use of single use period products like tampons and towels actually what about the sustainable and environmentally friendly alternative?

So the reusable products are loads that are available now from cups and reusable pads and period knickers.

So there's some really interesting conversations.

The tampon tax that was eradicated only last year 5% that women were paying tax on sanitary products that was finally eradicated.

So I think you could have some interesting debates and conversations that show your people that you're not scared of the word period that you're not worried about having women in the workplace and then there are practical things.

What's the toilet set up like is it kept nice and clean?

What's the sanitary disposal units like?

Have you thought about providing sanitary products for your staff?

Periods can start unexpectedly.

Just putting them in the toilets might be enough of a message to say hey look it's okay, we're kind of on your side so I think there are some practical things I think there's some kind of positioning things and those kind of conversational things to allow women to know that it's okay to have their period.

It's kind of alright.

Completely fine. Exactly.

So I think you've outlined a number of great steps how you can normalise it a little bit more in the workplace and then as a line manager just being really open to the discussion as you would be with anything else and being flexible and creating the right environment.

Thanks Petra.

You've given us loads to think about that.

So lots of practical steps that we can bring into the workplace.

I hope you've enjoyed today's bite size Academy and if you need more help and support then please cheque out the women's health hub on bupa.co.uk Thanks very much.

Hi, everyone, and welcome to today's Bitesize Academy.

My name is Richard Norris.

I'm Bupa's SME and Specialist Director.

And at Bupa, we're very serious about women's health and today I have Dr. Petra Simic with me, who's been a doctor in the NHS for 20 years.

Today we're going to be talking about the menopause, and as a male leader, it's something I'm absolutely passionate about is women's health, but not always the most comfortable area to discuss.

So, hopefully today we'll have a really great discussion and be really informing.

So, welcome, Petra.

Thanks for having me.

That's all right. Should we crack on with the questions?

Yeah, let's. Excellent.

Okay, so the first question that we have

Menopause discussion in the workplace is given that around one in every three women have either experienced or are currently going through the menopause, how important is it that organisations and managers normalise the menopause discussion in the workplace?

It's really important, Richard.

Women are the fastest growing demographic in the workplace.

We have around 4 million 45 to 55 year old women working.

And at the moment, the shocking figures are that around one in four are leaving their workplace due to symptoms that they're experiencing that can be attributable to the menopause.

From a purely practical point of view, organisations are really at risk of losing great talent, wisdom and experience if they don't take a step back and have a think about what they can do to help women during this period of time.

And supporting women during the menopause not only helps an organisation with their staffing and their turnover, but it also shows to their people that they really care about them more broadly.

And the menopause doesn't just affect women, but also the people that live with women and we all live with women in our lives.

So I think there's a really broader piece around awareness that workplaces can really have a significant impact in.

Yeah, sure. And one in four, that's a shocking number.

And so sad that people feel like they should leave the business rather than actually get some support and stay there.

And particularly in this time of recruitment and retention issues that everybody has just from a business perspective.

It's so disappointing, isn't it?

Because by the time you've got to that point in your career, you've often got lots of experience and skill and to feel like you have no choice but to leave, I think that is really sad, as you say.

No, I agree. Okay.

Thank you very much.

Should we keep going?

Go on.

Symptoms of the menopause

So research shows six in ten women feel their menopausal symptoms have had a negative impact on their work.

Petra, for those who don't know, can you tell us what are some of the key symptoms of the menopause and how they might affect employees in their workplace?

Sure Richard, I think people have heard of the menopause and think particularly about symptoms that they may have heard more about.

So, hot flushes, night sweats.

So they're probably the commonest symptoms that people talk about when they refer to the symptoms of the menopause.

And menopause just means the stopping of periods.

Now, when your ovaries stop working,

they don't just do it overnight, they reduce in function over years.

And so you develop symptoms that you can attribute to the menopause for some years leading up to the point at which your periods stop and that period of time we call the perimenopause.

Now, the perimenopause can be just as disruptive as the moment at which your periods stop.

It's all part of the continuum.

And I think for a lot of women, they don't realise they're experiencing menopausal symptoms because they're still bleeding.

In fact, their bleeding might be more frequent than prior to this perimenopause time.

And the types of symptoms women can have that they may not realise are menopausal are things like joint takes and pains, dry skin, poor concentration.

In fact, many women come and see me because they think they're losing their mind or they're getting Alzheimer's because they've got word finding difficulties.

They're struggling with more complex tasks, things they could normally do.

Women are notorious for being multitaskers.

Suddenly they're really struggling to do the things they'd normally do.

They'll talk about putting their phone in the fridge and that kind of thing.

So hormones can affect how sharp we are with our brain function.

There's other things such as changing libido, skin changes, dry eyes, headaches.

So the types of symptoms you can have are really quite extensive.

And often it's not until they're all put together that women perhaps realise that this might be happening.

Interestingly, the average age is around 51 for when women's periods will stop.

But like I said, they'll be getting symptoms for some years beforehand and they may have symptoms for some years afterwards.

So the average duration of these symptoms is seven years.

But about one in three women will go on much longer than that. Although I've said 51 is the average age.

About one in ten women will go through the menopause before the age of 45 and about one in a 100 under the age of 40.

So you can imagine this is actually affecting huge numbers of women, perhaps more than we'd realised.

Thank you for that answer, Petra, that really does affect an awful lot of people.

So let's move on to the next question.

How should managers approach menopause

Research also shows one in four menopausal

women, so they don't get the support they need from their manager.

How should managers approach the way they support employees experiencing the menopause?

It's a really good question and an important question.

I would say that probably menopausal women don't feel they're getting the support in general because those symptoms that I've talked about actually go on to make people feel quite anxious and quite low as well.

But we should approach menopause just like we do any of our other health issues.

So I don't think the menopause should be treated any differently from any other health issues, but we do need to recognise that it exists.

So just because you might have a team that contains women that would be in that demographic, I don't think you need to be unduly concerned because most women will go through the menopause and actually do entirely well and have no problems at all.

So it's important that we don't get concerned about employing people of this age or having people of this age in our teams.

But if someone does appear to be struggling, just like you would with any other issue, you would sit them down and ask if there is anything that you can do to help you, encourage them to get support.

And I don't think managers should become experts in menopause or should be trying to diagnose menopause and their team members.

I don't think they'll be thanked very much for that, but they should make sure that they have supports for their teams and make sure their teams know what support is available to them.

So as an organisation, you might want to see if you've got a specific menopause policy in place or that your health policies also incorporate menopause as part of that.

Think about flexible working, think about sickness policies and just really having open conversations around understanding, well, knowing for your team to know you understand the impact of menopause so they might feel comfortable coming to you and mentioning that that may be part of their problem.

So it really is about being open, not trying to be an expert, but certainly not shutting down the conversation if it's brought up.

I definitely won't be trying to do any diagnosis anytime soon.

So just in summary, supportive as you would anything else you're dealing with with your people and being really aware of what the issues might be and just helping. And empathy I think, Richard, understanding that this is not something that's going to go away overnight, that it's going to need long term support, but that some of the mechanisms and things that you might need to be in place may actually be relatively easy for you and just allowing people the ability to talk.

I've heard recently some stats around women when they're asked what they need, are often very good at saying exactly what it is that they need.

So listening to that and trying to put that in place if it's reasonable.

Okay, thank you very much.

Right, let's keep moving.

How to start a conversation

So there will be women experiencing the menopause who function as normal at work, but in some cases there will be people who are struggling and don't know why. In those situations what advice would you give to a manager on how best to start a conversation?

I don't think there's anything special about the menopause in terms of how you talk about it.

You might want to use tools that you've used before in a mental health space because this is a very personal thing.

So if someone is struggling at work, you would normally have a fairly open conversation with them to ask them, Is anything going on?

Is there anything I can help with?

Do you need support?

You'd be very open.

I think you shouldn't be scared of having those conversations with women of this age who may be going through it and being also open minded to the fact they may be much younger than you would imagine that might be going through it.

So I think that openness is really important.

Sometimes it can be helpful just in team meetings to talk about the menopause and make sure that your team are familiar with what's available to them.

We've done quite a lot of work in this space, as you know, Richard, because part of the problem is an awareness piece.

You don't know you've got a problem until someone put the blocks together.

So you see it very clearly.

So we have some great resources that people could use, such as the Bupa Women's Health Hub, the Bupa Menopause Helpline.

You can signpost people back to their GP and for people to have access to it we have the GP Menopause Plan. So we have lots of ways in which we can support people, but also people's GP, their nurse and their local Practise.

Everyone's upskilling themselves all the time.

This is a really hot topic.

So directing people, if they ask you for support or ideas and just being open to conversations.

Great having open conversation, being empathetic sign posting where help might be?

Yes, absolutely. Okay, great.

Working environment

Thank you. What about the working environment?

Is there anything line managers should be reviewing to make sure people are practically supported?

So, yeah, there are some really practical tools out there, so carrying out a workplace assessment can be really helpful.

So the HSE website has some templates that you can use to do both physical and mental wellbeing risk assessments.

You may need to put specific measures depending on the type of industry that you work in.

So thinking about things like uniforms, are they layers?

Are they man made fibres?

Are they natural fibres?

That kind of thing can really help with people that are having hot flushes or sweats.

Can you put in flexible hour policies to allow people. It can really affect your sleep if you're going through the menopause.

So perhaps having a different work pattern might really help you if you're struggling with your sleep, having access to lots of water, managing the temperature in an office, it sounds silly, but I've certainly been involved in air conditioning wars in offices where someone's turning it up and someone's turning it down, but making other people aware that there may be an optimum temperature and trying to keep it out for someone else, trying to protect them from perhaps the embarrassment is constantly having to fight their own corner.

And I think it's just allowing all of your staff to know they're entitled to work in a comfortable environment.

That works for them, because then they perform better and they enjoy their job more.

So there are practical things, but I think the biggest thing and I've heard this from lots of women is knowing that their manager has their back and is supporting them.

And although they can't necessarily appreciate what they're going through, they can appreciate how it might feel.

And I think that's the biggest thing anyone can take away is being empathetic and being supportive, because we all have women in our lives.

And I find lots of male managers actually find this topic really interesting because they often then go home and talk to their other half about it or their mums or their sisters.

And it's really quite eye opening.

So this isn't a women's issue.

It's an everyone issue because we all have women in our lives.

So it's great.

I think there's more conversation about menopause than ever before.

And I think people in the workplace can do things that really make a material difference in this space.

Actually, one of my colleagues has made a huge difference to his relationship with his partner as well.

Just by having this conversation and getting more into it at home, it's made a massive difference.

I mean, huge difference. So if you're not sleeping, if you're anxious, if your sex drive is low, or having some of the vaginal symptoms of menopause, that's going to dramatically affect an intimate relationship, and to be able to have someone come home from work and say, actually, I heard about the menopause today darling.

Do you want to talk to me about it, or is that I think that's a really amazing difference.

So this isn't just an issue for the women in your workplace.

It may well be affecting the men in your workplace indirectly.

So it's a really valid point. Yeah, absolutely.

And then the other big take out from that is awareness.

I think that your point about the air conditioning wars resonates.

I'm always cold, so I'm going to bring an extra jumper now myself.

There you go. You're an ally, Richard.

Okay. Right.

Top tips

So to finish this off, finally, what top tips would you give to a manager to support someone dealing with the menopause?

So the first thing I'd say is let's normalise the menopause.

It will happen to all women once they're old enough for their ovaries to stop working.

It is a normal process.

We don't need to be embarrassed about it.

It's not shameful.

We live in a society that really values youth.

And I think we need to move that dial to start valuing experience and skill.

And so we need to just be talking about the menopause.

That is the only way we can improve the life of women going through it.

And by being open, we can do that by having conversations in places by men talking about it.

I think I've been involved in conversations that have been mainly women.

And actually the most interesting conversations are when we've had men at the table because they bring a great insight and a great viewpoint from it.

So being open and raising awareness.

There are really practical things to be practical about what you can do whether it's having flexible working, considering the uniforms you're asking people to wear, the air conditioning, the temperatures that you're asking people to work in really think about what you can do in your environment that will make it more comfortable and really importantly is be flexible.

People going through the menopause are not all the same they're all having the same experiences.

You will have people that go through the menopause you will never know.

There will be no disruption to their life either they've had a very easy time of it or they've managed their symptoms incredibly well.

They may not need any additional supports in place.

You may have someone who's going through the perimenopause life is chaotic.

It's difficult.

They may need lots of support and it may need to be there for quite a long time but at the end they'll be really appreciative of the support that's enabled them to deliver their best self in the work environment.

I think you'll get really good outcomes from that so it's not a one size fits all the, menopause is inevitable.

It affects us all whether we're women or we live with women or we know women and so there's plenty that we can do.

Great. Thank you very much.

So in summary normalise it treat it as with anything else in the workplace support be flexible and signpost people to the right things to help.

Yeah, that's exactly it. Thanks very much.

Petra well, we hope you've enjoyed today's session and we really hope that it's helped you with the conversations you might want to have back in the workplace.

If you want any further help from us at Bupa then please check out the Women's Health Hub and you'll get all the help you need there.

Hi everyone, and welcome to this Bitesize Academy session.

My name's Emma Shatliff, manager of the Bupa Academy.

In today's session, we'll be discussing the role managers can play when supporting employees with endometriosis in the workplace.

I'm delighted today to be joined by Dr. Samantha Wild, Women's Health clinical lead at BUPA.

Thanks for joining us today, Sam.

Thank you for having me, Emma.

Let's get started with the first question.

So Sam, endometriosis is the second most common gynaecological condition in the UK, yet over half of the population don't know what it is.

So can you try and maybe explain what endometriosis is but also some of the symptoms that people may experience?

Yes, of course.

So about one in every ten women of childbearing age has endometriosis, which makes it as common as diabetes.

So it's unbelievable really that half of the population hasn't heard of it and it can affect any race or ethnicity.

Transgender and non-binary people too.

And it's a chronic and often very debilitating condition.

Doctors don't really know why it happens, but endometriosis is a condition where the cells that normally are found lining the womb also grow in other parts of the body.

So each month this tissue thickens, it builds up and then it breaks down.

But unlike the tissue that’s building inside the womb that can leave the body as a period.

These cells can't leave the body.

And so they cause local scarring, inflammation, and that can cause pain as well.

So this can happen often inside the pelvis, around the ovaries and fallopian tubes.

It can occur in the ligaments, which can make sex painful, but it can also go in other parts of the body, too.

So it can grow in the bowel, it can grow in the bladder, it can also grow in the lungs.

And so, yes, it can cause a lot of problems.

And so one of the most common symptoms is the pelvic pain that normally will start just before the period and then continue throughout the period as well.

Pain during sex is, as I said, the endometriosis can grow on the ligaments between the womb and the passage.

Very heavy, painful periods, heavy because there's extra cells there that need to leave the body.

Extreme fatigue.

And some women may find it very difficult to get pregnant again because of where the endometriosis is growing.

And some people may feel very sick or constipated or suffer with diarrhoea at the time of the month too, again, because of where the endometriosis is.

And understandably this can make women feel very down and depressed because of the long term pain that they have and all those symptoms that they're experiencing.

So those less common symptoms will happen in about 10% and they're the symptoms that occur because the endometriosis is growing in the bowel or the bladder or the lungs.

So at that time of the month, those women may either cough up blood and experience pain.

They may find that they have blood in their stools when they're opening their bowels, or there may be blood in their urine when they pass urine.

Saying that though about 20% of women won't get any symptoms at all.

And the endometriosis is not causing enough of a problem.

It's not causing enough inflammation and scarring to cause some symptoms, but it may still affect their fertility and so they only find out they have endometriosis when they're undergoing fertility testing.

I'd heard of endometriosis, but I don't think I was aware of quite some of those symptoms that people could experience with having that condition.

So 58% of those people within endometriosis will visit their GP over ten times before being diagnosed and on average it takes 8 to 9 years to get a diagnosis in the UK, which I found alarming really, to think that that's how long it would take.

So what are some of the barriers people living with endometriosis face when seeking treatment?

I think the difficulty is it's still such a taboo to talk about periods.

So many women don't realise that they are experiencing a problem, they don't know what is normal and they may never have heard of endometriosis in the first place.

So there's often a tendency just to get on with it and then just to put it down to it's women's things, I've just got to put up with it.

They can also feel very embarrassed about approaching their GP as well, and there's always a tendency to put other people first and they may not want to waste the GP’s time.

The nature of the symptoms also mean that a lot of women will get misdiagnosed.

It can be very similar to a lot of other conditions and so they may not get that diagnosis straight away.

And the only way to definitively diagnose endometriosis is to actually have an operation to have a laparoscopy.

So it's a surgical procedure and there is a waiting time obviously, for that.

Over-the-counter medications can work for some, but some people may need to take stronger painkillers or hormonal medications and all of these come with side effects as well.

So endometriosis can really impact on someone's life and it can really affect their mental health.

Living with uncertainty as to what they're suffering with in the first place, whether they'll be able to conceive in the future.

The pain that they may be in, the lack of sleep that they may be experiencing too.

And it can affect your relationships.

If it's very painful to have sex, you may not want to have sex with your partner.

You may find it difficult to open up to them and they may feel that they're being rejected as well.

So we do encourage women to try and talk about it as much as they can.

Don't be afraid to tell your partner how you are feeling so that you can get that support.

Thanks.

It's interesting.

I think we talk about some of those barriers that people experience when going through endometriosis.

So we know, I suppose, how to may be open up and start conversations.

Some of those barriers may contribute to why one in six women with endometriosis give up work.

So just how important is it that organisations and line managers support employees with endometriosis in the workplace?

So organisations risk losing female talent because the impact symptoms are having on them and they will feel often that they're misunderstood or unsupported in the workplace.

So we know that 55% of individuals with endometriosis have had to have time off work frequently.

And you know, you can understand why from what we've been talking about today.

And so women who are living with endometriosis need to have that more support at work.

They may be missing out on opportunities to do better within the workplace, you know, opportunities for promotion.

There may be financial implications as well.

And 27% of women actually say that they do feel that they've missed out on promotion because of endometriosis.

87% say that they there have been financial implications to it.

So we've got to provide better support within the workplace to make a big difference really to those women, to their lives, to create a more inclusive atmosphere for them so that they continue to thrive and fulfil their potential.

And you find that with people now working from home, in the past, if they have to go into the workplace more frequently, than symtoms they just couldn't ignore, whereas working from home they could mask them a little or do you think well at home it's not bothering everyone else, so I'll just put up with them.

Is that having an impact? Exactly, Yeah.

So I think it's it's good to be able to work more flexibly and to work from home.

And that's something that we'd recommend that workplaces look at offering for women suffering with endometriosis.

But as you said, that does mean that they can mask them.

And if you're not seeing a colleague on a day to day basis, as you might have done before in the office, you might not notice that they're struggling.

So it's very important just to be aware that that may be occurring.

But for women suffering with pain or heavy periods, obviously it's far better for them to be in their own environment.

40% of women with endometriosis worry about losing their job and 87% believe the condition has impacted their long term financial situation.

So what are some of the effects of endometriosis on the workplace and how can line managers in particular offer support?

So I think understandably, sickness and absence, women may need to have time off because of their symptoms or because they're undergoing investigations or indeed treatment for their endometriosis.

And as we've heard it can impact on their mental health as well.

So we need to make sure that we're aware of that and providing support for that.

They may also be experiencing difficulties with their symptoms whilst they’re at work.

So they're not able to work properly and they may be trying to keep their symptoms hidden as well.

So really important that, you know, line managers are aware of all the ways that endometriosis may impact a woman at work and make sure that everybody else is aware of it as well.

So they recognise that it's happening.

They're taking it seriously.

They're offering flexible working environments when they can and also, you know, just be understanding to the woman and listen to what she needs support her in any way that they can and signpost to any services that are available.

I think as you highlighted earlier, half the population still don't know what endometriosis is.

So actually it's really important.

I suppose organisations do regular communications or messaging around the condition to the whole of workforce because if you have someone on your team that's suffering and having to take long periods of absence other team members may feel that. unfair or they're having to pick up the slack if you like.

So actually they have an understanding and could be more sympathetic about some of these debilitating symptoms.

You know, it will hopefully provide a more positive environment in the workplace.

That's very true. Yes.

So we've just got to really champion endometriosis exactly what it takes to make sure that everybody understands.

And I think some people do find coping with endometriosis to be very challenging.

So in those situations, what advice would you give to a line manager on how best to start a conversation?

So I think it's really important firstly, to establish good relationships with all of your team so you get to know them by having open conversations so that they feel comfortable and able to talk to you.

And then hopefully then if they are struggling, you will notice quickly and you can approach them then.

And I would just start by asking them how they're feeling.

Is there anything that you can do to help?

And if they're ready to talk to you, then great, hopefully they will open up.

But don't be offended if they aren't ready at that stage to talk to you.

You know, give it a bit more time, but also offer somebody else that they may feel that they are more comfortable to open up to or offer to speak via someone else if they'd rather someone spoke on their behalf.

So listen to them then, you know, hopefully when they're ready to talk to you.

Listen, you know, try not to medicalised it.

You're not a doctor.

So just listen to their needs. And

I think just remember that every woman's experience is different.

So you know, that that's all I can say really is ask them what would help them.

Let them be aware of what is available.

So, you know, EAPs are fantastic.

I would always recommend signposting to Endometriosis UK, which are a wonderful charity that can provide lots of support and talk about flexible working too.

But you know really let the woman tell you what she thinks will help and, you know, do what you can to try and support that.

Thanks.

Well I’ve certainly learnt a lot from this session today, so thanks so much for joining me.

Not at all, thank you.