Today (18 October) is World Menopause Day, and the theme for this year is the link between heart health and hormones. Janet O’Neill highlights some ways employers can support cardiovascular health among employees in this cohort.
Even though twice as many women die of heart disease than breast cancer in the UK, according to the British Heart Foundation, women are twice as likely as men to get the wrong diagnosis after a heart attack. Almost one in two women (47%) experience heart failure, stroke or death five years after a first heart attack, compared to just 36% of men.
As World Menopause Day seeks to highlight, a reason for this is that oestrogen, a heart-protective hormone, starts to decrease as women enter the perimenopause – the time leading up to menopause, which starts to affect women in their late 30s and early 40s.
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Another reason is that heart problems continue to be perceived as a men’s health issue. This means the way in which women can experience a heart attack, with much milder symptoms than the widely advertised chest pressure and pain radiating up the arm, is less understood.
We often come across women referred into our occupational health services, who are tempted to dismiss symptoms such as shortness of breath, light-headedness and feelings of nausea or sweating, when they were actually having a heart attack.
What should employers do to raise awareness of heart health risks?
Explain the symptoms of a heart attack
By making sure both men and women know all the possible symptoms of a heart attack, employers have a valuable role to play in giving people the confidence to go straight to A&E.
Unlike a cardiac arrest (when the heart stops beating and the person loses consciousness), the symptoms of a heart attack (when blockages reduce oxygen to parts of the heart) can be much more subtle, especially for women, and include:
- Feeling lightheaded or dizzy
- Shortness of breath
- Sweating
- Feeling sick (nausea) or being sick
- Overwhelming feeling of anxiety (like a panic attack)
- Chest pain – a feeling of pressure, heaviness, tightness or squeezing across your chest
- Pain in other parts of the body – it can feel as if the pain is spreading from your chest to your arms (usually the left arm, but it can affect both arms), jaw, neck, back or stomach
- Coughing or wheezing.
Encourage women to check their heart health
Most women are now aware of the importance of actively checking themselves for breast lumps and having regular eye and dental checks. Very few are aware of the importance of checking their heart health.
Encourage those over the age of 40 to take up their free NHS health check, which includes a heart health assessment or offer free health checks at work. These can be done on a voluntary basis, as part of a wellbeing day, or offered as part of an employee benefits package.
The reduction in oestrogen associated with menopause not only increases the risk of heart disease, but also causes a range of symptoms that can put women under incredible strain.”
Those who have a history of heart issues within their family, have gone through early menopause, or are considered at risk due to high cholesterol, should also be encouraged to get a home blood pressure testing kit, so they can regularly keep an eye on their blood pressure.
Don’t underestimate the impact of menopause
The reduction in oestrogen associated with menopause not only increases the risk of heart disease, but also causes a range of symptoms that can put women under incredible strain. As well as experiencing the more well-known side effects, such as hot flushes, menopause can also lead to fatigue and significant cognitive difficulties.
Many women suddenly find they can’t do basic things, such as remembering words or giving presentations. The anxiety and stress associated with this are not only bad for heart health, but have also contributed to one in ten women deciding to quit work due to menopause symptoms.
Although treatment, such as hormone replacement therapy can help, it takes time to take effect, so you might also want to consider reasonable adjustments. These should be tailored to individuals but could include a stress risk assessment to review particular difficulties at work, or access to occupational health to look at bespoke adjustments depending on symptoms. For example, memory aids could be used to reduce errors.
Promote positive lifestyle changes
Simple lifestyle changes, such as quitting smoking, taking more exercise and eating more healthily can help to reduce the risk of heart disease. Reducing stress levels can also help, with research by the World Health Organisation showing that working 55 hours or more a week increases the risk of developing heart disease by 17%.
Initiatives as simple as encouraging everyone to disconnect from work in the evening and take fresh air breaks during the day can make a big difference.
Working 55 hours or more a week increases the risk of developing heart disease by 17%.”
Healthy eating is also essential to sustaining good heart health, but many women entering menopause are also juggling looking after teenagers and older relatives, so may struggle to cook healthy food from scratch every night. Encouraging them to get other family members to help out and use frozen vegetables, tinned beans and bulk cooking can go a long way towards motivating them to eat well, for less, instead of reaching for cholesterol-rich fast food.
Train managers
Although menopause takes place when women are aged 51 on average, perimenopause can start 15 years before, meaning women in their late 30s and early 40s often have no idea why they’re struggling with fatigue, memory loss and anxiety. It also means they have no idea they need to start taking extra care of their hearts.
Managers are often one of the first to notice when an employee isn’t coping, so should be encouraged to take employees aside and explain how they’ve seen them struggling and let them know about any appropriate support in place.
Having these conversations can be daunting for some managers, so it can also be helpful to create a menopause policy and offer training on how to open up a conversation about menopause. Published case studies about how other women have been supported, as well as employee support groups and workshops, can also help to create a culture where people feel safe asking for support.
Supporting employees experiencing menopause or perimenopause should be a year-round activity, but this World Menopause Day should give employers and occupational health professionals pause for thought.
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