Women in medicine who are going through menopause are potentially at the peak of their careers, however, according to a recent commentary, there has been little discussion of the impact and potential burden of menopause on physicians.
The authors write that taking steps to accommodate and accommodate physicians going through menopause should be an urgent priority.
“Menopause can cause debilitating symptoms in some people, and for female doctors, it can happen during the formative and potentially peak careers,” said Lindsey Shirreff, MD, assistant professor of obstetrics and gynecology at the University of Toronto. Medscape Medical News.
Shirreff wrote the editorial with Marie Christakis, MD, an obstetrician and gynecologist at St. Michael’s Hospital in Toronto, which focuses on menopause and the health of mature women.
“The proportion of women in menopause in medicine will increase,” they say. “Our goal with this article was to start a dialogue with healthcare institutions, encourage future research, and help spread knowledge.”
The comment was posted on August 15 at CMAJ.
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Natural menopause usually occurs between the ages of 45 and 55. At this stage in life, physicians can expect increased productivity, and they can seek promotions and positions of leadership, write Shirreff and Christakis.
However, the symptoms of menopause can be disabling, and 80% of women going through menopause may have common symptoms that persist for an average of 7 years. While treatment is available, about 28% of women aged 40 to 55 and 15% of women aged 55 to 59 may experience moderate to severe vasomotor symptoms, as well as abnormal uterine bleeding and mood changes. sleep, cognition and sexual function.
Studies of the impact of menopausal symptoms on work performance in fields other than medicine have shown that women face a higher likelihood of low to moderate work capacity, as well as reduced productivity. Those with symptoms were eight times more likely to report poor performance than their asymptomatic peers, and they were more likely to report extended absences from work.
In these studies, data were obtained from self-reports. They show that symptomatic women may experience an altered perception of their ability to work, even if work performance does not change. Women also report having difficulty coping with their symptoms when they perceive the stigma associated with discussing menopause at work.
Shirreff and Christakis write that the unique experience of symptomatic health care workers is not well understood yet, but understanding the experience of menopausal physicians is important and warrants discussion and future research.
Despite the lack of data, medical institutions must consider the impact of menopause on physicians, they write. An increasing portion of the medical workforce will soon enter menopause. In 2019, about 25% of female doctors were between the ages of 45 and 54. This represents 11% of all Canadian doctors. These providers offer knowledge and experience that can be useful to patients, hospital administrators, and public policy.
In addition, a corporate study identified significant costs to employers associated with menopausal symptoms and showed that organizations with greater gender equality in leadership positions receive financial benefits. The authors of the article write that the support and accommodation of doctors during menopause can help optimize patient care and financial efficiency.
According to the editors, public discourse emphasizes the importance of age and gender equality, which are relevant to menopause. Women doctors often delay starting a family and may start their careers later than men. They may take longer to get promoted and may earn less than their male counterparts. Ignoring their menopausal experience can further worsen their position in a field that has traditionally valued high performance.
“Menopause is an important and sometimes unpleasant life stage that can happen to people at the peak of their careers,” say Shirreff and Christakis. “Jobs need to consider and consider menopausal women to optimize their health and career goals, as this will potentially mitigate the wastage of valuable resources.”
Shirreff and Christakis supported the European Menopause and Andropause Society (EMAS) 2021 recommendations to make the work environment more supportive of menopausal women in the broader context of gender equality and reproductive and post-reproductive health.
These guidelines recommend that workplaces create an open, inclusive and supportive culture around menopause. This may include occupational health professionals and human resource managers working together to reduce discrimination, marginalization, and dismissal due to menopausal symptoms.
When educating health educators and other professionals about inclusion in the workplace, information about menopause should be part of the discussion, Shirreff and Christakis said. Menopausal women should be encouraged to seek treatment for troubling symptoms.
Health care leaders should be trained in how to have sensitive and practical conversations with doctors experiencing menopausal symptoms and also acknowledge that people experience different symptoms, they write. Instead of providing predetermined accommodations, healthcare managers should promote a de-stigmatized environment in which physicians can express their needs and be sure they will be accommodated. Discretionary leave or a modified work schedule can help those with severe symptoms.
“We hope that the EMAS recommendations can be reviewed by other institutions and incorporated into medical institutions,” say Shirreff and Christakis. “As medicine seeks to address issues of equity, diversity and inclusion, menopause should be part of the conversation.”
Gender equality in medicine is a key part of the conversation. Over the past 25 years, there have been more women than men in medical schools in Canada, but this has not resulted in gender parity in leadership positions or equal pay. Inequality becomes even sharper when race and ethnicity intersect with gender.
“Obviously, simply increasing gender parity in medical school is not enough. Targeted systematic intervention and behavior change should take place at various critical transitions in a woman’s career, such as when they are pursuing doctoral studies, receiving fellowships or residency.” — Nazia. Peer, MD, director of public health emergencies at Peel Public Health in Toronto, told Medscape.
Peer, who did not contribute to the editorial, wrote in 2021. CMAJ editorial on advancing gender equality in medicine.
“These transitions usually involve pregnancy or parenting, which can hinder or undermine their careers,” she said. “A supportive, caring environment that encourages and promotes fairness at various stages of a woman’s career is key to achieving fairness for women in medicine.”
Christakis and Shirreff are members of the Medical Advisory Board of the Canadian Menopause Foundation. Sherriff received a Quality Improvement Award from Pfizer Canada. Peer has not disclosed any related financial relationships.
CMAJ. Published August 15, 2022 Full text
Carolyn Christ is a medical and healthcare journalist who reports on the latest research for Medscape, MDedge, and WebMD.
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