Authors: Professor Christobel Saunders, AO, Associate Professor Rhea Liang, Professor Amanda Dawson, and Dr Deborah Wright

 

 

Over the last 20 years the number of women surgeons has increased, bringing diversity of viewpoint and experience, and contributing to a workforce that better represents the populations we serve. There are now 894 women RACS Fellows over 40, and 402 women SET Trainees—meaning this number will increase significantly over time.

 

All females will go through menopause—a natural transition that takes on average seven years. For most, this will occur between their mid-40s and mid-50s, often a time of increasing seniority and productivity. But menopause can also affect much younger women, for example in association with cancer treatment, with even more significant consequences for long term health.

For some this transition will be relatively uneventful, but for a quarter it will be associated with debilitating symptoms such as hot flushes, poor sleep and anxiety. Despite legal protections in Australia including the Sex Discrimination Act (1984), Disability Discrimination Act (1992), Age Discrimination Act (2004) and Fair Work Act (2009), and in Aotearoa New Zealand the Human Rights Act (1993), Employment Relations Act (2000) and Health and Safety at Work Act (2015), those going through menopause can still experience being ‘othered’ within the workplace¹.

A 2020 study by the British Medical Association²  reported that 93 per cent of respondents had experienced menopausal symptoms; 90 per cent of those said that these symptoms had an impact on their working lives and 38 per cent reported that the impact was significant. More than a third had made changes to their working lives because of menopause but only 16 per cent had discussed their symptoms with their line manager (47 per cent wanted to but did not feel comfortable doing so).

A 2022 report by the Australian Institute of Superannuation Trustees indicated that menopausal symptoms resulted in reduced working hours or early retirement costs to women of more $15.2 billion per annum through lost income and superannuation alone³.

The current impact of menopausal symptoms on our working lives is significant but can perhaps be mitigated to improve the experience of women surgeons, to ensure optimal workforce participation, and to best serve our communities.

The 2024 Australian senate inquiry into Issues related to Menopause and Perimenopause⁴, suggested amendments to Section 65 of the Fair Work Act, to ensure women can access flexible working arrangements during menopause. In their submission to that inquiry, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists suggested focusing on the strengths and achievements of older women and avoiding gender-based ageism as well as avoidance of pathologising menopause.

We encourage all those who manage or work alongside surgeons going through menopause—which is all of us—to be mindful of the impact it may be having. Ensuring a respectful and supportive culture in your department means those who require mitigations for a time—a cooler operating room, a change to participation in the on-call roster—can ask for them and can continue to contribute the knowledge and skills it has taken so many years to gain.

RACS is currently developing a policy on menopause. If you would like to contribute comments, experiences or suggestions, please email us at [email protected]. 

Footnote: In this article ‘women’ is used to refer to self-identified gender while ‘female’ is used to refer to biological processes of menopause or data categories applied by RACS. RACS aims to be inclusive of all gender identities.

References

1.    Atkinson C, Beck V, Brewis J, Davies A, Duberley J. Menopause and the workplace: New directions in HRM research and HR practice. Human Resource Management Journal 2020; 31:49-64.
2.    British Medical Association. Challenging the Culture on Menopause for Working Doctors. London: BMA; 2020.
3.    Australian Institute of Superannuation Trustees. Measuring what matters: Understanding our economy and society while informing policy. https://treasury.gov.au/sites/default/files/2023-03/c2023-379612-australian_institute_of_superannuation_trustees.pdf
4.    https://ranzcog.edu.au/wp-content/uploads/Senate-Inquiry-to-menopause-and-perimenopause.pdf