Navigating the Change
Nurses, like countless other individuals, experience myriad physical, mental and emotional symptoms during perimenopause and menopause, and the demands of the profession can often exacerbate these symptoms. Nursing is a difficult profession, characterized by long shifts, often without breaks, and continuous patient care, making it challenging to manage menopausal symptoms.
Besides these challenges, many nurses fear discussing symptoms with their colleagues and managers, acknowledging that stigma exists around menopause. Without support at work, some nurses are self-selecting out of senior positions, reducing existing work hours, taking pay cuts or leaving the profession entirely, resulting in the loss of much-needed senior-level health-care professionals.
“Menopause is not just a personal health issue,” says BCNU President Adriane Gear. “It’s a significant workplace concern that profoundly impacts the entire nursing profession. This stage of life affects a nurse’s well-being and performance, highlighting the necessity for support to maintain their health and ensure safe patient care.”
In Aug. 2023, recognizing the need for better understanding and support, The Menopause Foundation of Canada, in collaboration with BCNU and research firm Leger, conducted focus groups to study the impact of menopause on nurses. The research underscores the significance of menopause as an issue in the nursing profession.
The focus groups revealed how working conditions intensify the difficulties in managing the physical and emotional symptoms of menopause. The mental impact includes reduced self-confidence, anxiety about performance at work, apprehension when taking on more responsible roles, worries about licence loss and practice issues due to brain fog, insomnia and a reduced ability to focus.
BCNU Coastal Mountain region member Carol Swan is candid about her journey through perimenopause.
“Menopause is not just a personal health issue, it’s a significant workplace concern that profoundly impacts the entire nursing profession.”
- BCNU President Adriane Gear
“I endured perimenopause from about age 46 to 56,” Swan says. “That was physically challenging and mentally taxing – I had insomnia, but more startling was the irritability and rage. I became impatient in meetings, unable to concentrate on conversations, and I had to go on medication to be able to continue functioning at work.”
Swan, a public health nurse in Gibsons, is thankful for the candid relationship she has with her physician, who listened, empathized and offered a solution.
“Throughout my perimenopause, I used a Mirena IUD, which helped manage the hot flashes and other symptoms,” Swan shares. “With the physical symptoms better managed, I just had to deal with the mental and emotional swings, the mood changes and the brain fog. There is a personal balance, yes, weighing the possible risks versus relief of symptoms – but I need to work, and I have to be able to function.”
Swan says having a frank discussion about options is imperative and notes that pharmacological protocols may not be suitable for everyone. It’s important for nurses who are impacted by menopause to discuss associated risks with their health-care providers to make informed decisions about their bodies, symptoms and treatment options, she adds.
The data from the joint report further highlights the scope of this issue. According to the report, more than 90 percent of BCNU’s 48,000 members are women, and more than 50 percent are over the age of 40. This means a significant number of BCNU members are likely experiencing or approaching perimenopause/menopause, and the effects of their symptoms may disrupt their professional lives, making it harder for them to thrive in their careers while caring for their own health.
The report identifies four main characteristics of the nursing profession that affect how nurses manage menopause symptoms: workplace culture, physical and emotional demands, scheduling/ shift work and staffing.
Workplace culture can lack awareness or support, making nurses self-conscious about their symptoms.
The physical and emotional needs of their job can worsen their symptoms. Long hours and patient trauma can intensify joint pain and mood swings.
Scheduling and shift work, especially night shifts, disrupt sleep, aggravating pre-existing insomnia and fatigue.
Staffing issues like working short, increased stress and heavy workload make it difficult for nurses to take breaks and manage symptoms privately.
These findings align with the broader survey data, which indicate that although everyone’s experience with menopause is unique, nearly all nurses surveyed (95 percent) report having an average of seven symptoms each. Common symptoms include hot flashes (62 percent), sleep disturbances (57 percent) and mood swings (39 percent). Less common symptoms reported are anxiety (32 percent), urinary incontinence (23 percent) and heart palpitations (19 percent).
Pacific Rim region member Pamela Halonen began experiencing menopausal symptoms about 10 years ago. Halonen is a clinical nurse educator from Youbou, who provides education to clients with mental health and substance use disorders.
“Trying to concentrate on clients and being able to actively listen and stay involved with what we were talking about was tough,” Halonen recalls. “I could feel the hot flashes coming from my inner body. They started radiating through my face, which would get flushed and sweaty. Or I’d get sudden brain fog when trying to articulate a point. When you’re sitting in a meeting with clients, managers and directors, it is embarrassing.”
In response to these challenges, Halonen turned to medical treatments. In 2015, after trying a multitude of natural remedies, Halonen talked to her doctor, who suggested Hormone Replacement Therapy (HRT) products approved by Health Canada to treat menopausal symptoms.
“After starting HRT, things improved quite a bit. I understand that not everyone is comfortable taking hormone replacements, and there are risks to consider, but it’s worked well for me,” she says. “I’ve tried to come off HRT several times, but within a month, the symptoms returned, and I didn’t feel like myself again.”
The survey indicates a strong need for more workplace support. Three-quarters of nurses surveyed would like to see workplaces offer support, with most recommending simple measures. These include extended health benefits covering treatments and therapies, adjustments to the work environment for those going through menopause, educational toolkits for colleagues and managers, and menopause awareness sessions for employees.
By recognizing the unique challenges nurses face during perimenopause and menopause and implementing supportive measures, the health-care profession can foster a more inclusive and healthier work environment. These changes not only benefit nurses’ well-being but also enhance patient care and improve retention. •
Read the full report at menopausefoundationcanada.ca
UPDATE (Summer 2024)