As more women remain in the workforce through their menopausal years, many employers may need to do a better job of adopting policies that help ensure working conditions don't make women's symptoms worse, recent European guidelines urge.

Employers need to be sensitive to shifts in physical and mental health that women may experience during menopause, according to recommendations from the European Menopause and Andropause Society (EMAS) recently published in Maturitas.

Symptoms like hot flashes, for example, may require cooler workplace temperatures, while symptoms like insomnia may require flexible schedules or efforts to reduce job-related stress.

"Very few employers are talking about menopause in relation to their occupational health and safety policies and procedures, and how they might best support women, and those who manage them, with transitioning through menopause," said Gavin Jack of Monash University in Australia, lead author of a separate research review of workplace polices published in Maturitas.

Women go through menopause when they stop menstruating, typically between ages 45 and 55. As the ovaries curb production of the hormones estrogen and progesterone in the years leading up to menopause and beyond, women can experience symptoms ranging from irregular periods and vaginal dryness to mood swings and insomnia.

For working women, menopause can also negatively impact job performance because it can impair concentration and memory. Many women are unable or unwilling to request accommodations that might make work easier, Jack and colleagues note in their review.

At the same time, women who are overworked or stressed on the job may experience worse menopause symptoms, the researchers note.

High temperatures, poor ventilation, confined spaces, excessive crowding, and insufficient spaces for rest or bathroom breaks can all contribute to an environment that causes problems for menopausal women, the researchers also note.

While more studies are still needed to determine what specific interventions or policies in the workplace might make remaining on the job easiest for women during menopause, employers in the meantime should move forward with creating a culture that makes women feel comfortable disclosing symptoms or requesting accommodations, the researchers conclude.

In a Maturitas article outlining the EMAS recommendations, Amanda Griffiths of the University of Nottingham Innovation Park in the U.K. and colleagues note that managers might need training in how to support menopausal women and deal with any symptoms in a sympathetic manner.

Among other things, employers can provide desk fans, air conditioning and cold drinking water when women have hot flashes, for example, or offer flexible work schedules for women with insomnia and take steps to reduce stress that can exacerbate symptoms, the recommendations also suggest.

Women may also need access to clean bathrooms and more frequent toilet breaks if they experience particularly heavy menstrual bleeding during the menopause transition or have urinary incontinence.

Even though the specific symptoms may vary from one woman to the next, and the accommodations needed might differ based on the type of work, all employers should make women feel comfortable on the job during menopause, said Sagar Borker, a researcher at KVG Medical College in India who wasn't involved in the research review or the EMAS recommendations.

"Menopause symptoms can change work performance tremendously," Borker said by email. "If the lady gets symptoms treated then her efficiency improves, but if symptoms are ignored, self-medicated or left untreated then work performance will keep deteriorating."

SOURCES: http://bit.ly/1ZYWKTz and http://bit.ly/1UMXW9d Maturitas, online December 16 and 29, 2015.