Hello everybody, and thank you for joining us for the webinar that's very first Women's Health webinar. We've run tens of thousands of webinars over the last 12 years, but today is our very first webinar specifically focusing on women's health and the menopause, to celebrate World Menopause Day. I'm Catherine from the webinar Vett, and tonight I am very excited to be joined by 5 panellists, with very diverse backgrounds, but everybody is here to help to raise awareness about the menopause, to normalise conversations around the menopause, and to hopefully drive change around the menopause.

So thank you to all of our panellists for being here this evening. Before we get started, just a quick reminder that you can ask any questions that you have for our panel by typing them into the Q&A box. And I will try very hard to keep the session to time so that we have time to take questions at the end.

Before we get started, Dawn is just gonna launch a couple of quick poll questions for us to help us to understand who is joining us this evening. So if you could just cast your votes now please, that would be brilliant. Wonderful.

That's great. Thank you. So we've got 88% of females joining us and 12% males joining us.

OK, thank you, Dawn. Second poll question is just up now. So are you or any of your team experiencing the perimenopause or the menopause right now?

Just changing. There we go. So we've got 74% off, 15% on, and 11%.

I'm not sure. OK, that's great. Thank you everybody.

Poll number 3, has the topic of menopause come up in your veterinary practise? Yes or no? OK, so 64% say yes, which is brilliant, and 36% say no.

OK, and very final question. Right now, would you find it a challenge to talk about the perimenopause or the menopause with your manager or with your team? We've got 31% are saying yes and 69% are saying no.

OK. Wonderful. I think that's all for whole questions.

That's great, thank you, Dawn. Brilliant, so I'm now gonna hand over to our panel for the introductions, and we'll start with you, please, Liz. Yeah.

Hi, everybody. Thanks for having me and thanks for hosting this webinar on a very important topic, and particularly in our profession. So I'm Liz Barton.

I'm currently the head of communications at VetCT. I'm a vet graduated in 2004. And around about sort of the mid 20 teens, I co-founded Well Vet and Vet Moms, I sort of grew increasingly interested in women's health issues, and as editor of Veterinary Women.

I actually wrote the survey and the report on the impact into the effect of menopause on the veterinary profession. So that's why I'm here today. Lovely, brilliant, thanks, Liz, and we'll go over to you next.

Claire, please. Hi, yeah, nice to be here as well. I'm so, excited to be invited to be part of this panel.

So I am Doctor Claire Gilbray. I am a medical doctor, Edinburgh graduate, 1999, so I've been a doctor for 20 odd years and I, specialising in general practise, and also psychiatry, and I work a lot in the space between sort of physical and mental health. Providing sort of well-being services.

I'm the chief medical officer of a company called Echo Wellbeing who particularly focus on women's well-being in the workplace. And yeah, I'm really excited to be here and I'm just pleased that we're having this conversation because if you come back a couple of years ago, I don't think this conversation would actually have happened, so I'm really pleased to be here today. Brilliant.

Thanks, Claire. Rob, over to you, please. Hi, my name is Rob Williams.

I'm also a vet and I work in HR and I work in the people team at Vet Partners, and, this feels very much like being at work cause every job I've had, I've been surrounded by women. My bosses have almost always been email so this feels like being at work. Thanks, Rob.

Belinda, over to you, please. Thanks very much. We should probably start by saying Happy World Menopause Day today, which is, great, and, for the reason we're all here.

So I'm not a vet. I am a researcher, at University of Edinburgh Business School. My key interests are around research are in, psychology of women's health at work.

And I'm currently working on a 3-year project called Supporting Healthy ageing at Work, where we're specifically looking about the hidden health or taboo health, at work of, workers in mid to later life. Brilliant, thanks Belinda. And finally over to you, please, Alison.

Hi, good evening. I am Alison, and I'm a practise manager in Devon, and I am one of the directors of the veterinary Management Group. I, offered to join the panel this evening because I have suffered with breast cancer, which has tipped me into the menopause.

So there's not only, you know, there are other ways that women end up in the menopause, not just, through a natural progression. So it's really nice to be here this evening. Brilliant.

That's great, Alison. Thank you very much and thank you all for being here, for giving up your Tuesday evening to help to celebrate World Menopause Day with us. We really appreciate it.

So now I'm gonna pass over to Claire. So Claire's gonna kick off the session, by talking to us a little bit about the menopause. Brilliant, I'll probably just keep this short because I guess I want to make sure we've got enough space to have the, the actual panel and the conversation, but I, I guess to, to set the scene about what we're talking about, if we talk about menopause in itself, we're obviously talking about.

And the point at which a woman goes a year without having had a period. And actually the conversation goes well beyond that one day, doesn't it? It goes into the what we really should be terming the perimenopause.

So all the kind of symptoms, be they physical, be they mental, that are in the lead up to that point and beyond, and we know that for some women they can go through this phase with absolutely no symptoms and for other women, about a third of us. Unfortunately, we'll have moderate to severe symptoms as we go through the perimenopause. And for some women, again, this can last maybe just a year, but for other women it can go on and actually I've seen data going right up to 20 years.

This is not something that's necessarily going to be just about the hot flushes and night sweats, which maybe people associate with the menopause, but there's a whole transition that happens. For 100% of women that can be very unique to that individual. I mean, Alison's brought up a point even then in her introduction that it doesn't necessarily come at the age that we expect for various different reasons and therefore there needs to be this dialogue and conversation so that women feel supported and feel understood through this phase of life.

And what we think about of, of perimenopause, what they, again, the research shows is the average age for a woman to go through the menopause. So that point of the year after, having had their last period is sitting at about 51 years of age. But we know that women will frequently start experiencing symptoms earlier on in their 40s.

If we're experiencing symptoms under the age of 45, we're talking about an early menopause, and if we're talking about symptoms that are starting under the age of 40, and we're talking about premature ovarian insufficiency and, and, and, and again, as Alison's pointed out, there are other reasons why why women will go through this phase at a different, a different rate or a different time. And I think the other thing that's come, which has been amazing through this opening of doors and conversations around perimenopause, is just this understanding that it's not confined to the physical symptoms that actually if you look at the symptoms that women are, are experiencing around this time, they can go from something like . Skin rashes right through to depression and anxiety and, and other kind of mental health, symptoms and you could probably write a whole textbook on all the different symptoms that women will experience around this time and therefore it's really important that we, we can have these conversations so that women can can know what's happening to them and therefore know what options they have with regards to improving their symptoms.

So a big part of this is helping women to feel less alone and less isolated and feeling like they don't need to deal with this themselves behind a closed door like a taboo, like it's something that's a female's problem. And I think that's the other thing that's great about this panel is that you have Rob sitting here, so because this affects everyone, you know, whenever I put out kind of any messages to do with the menopause, I'm often contacted by men who would like to understand the menopause more so that they're able to support, be it their partner, be it someone at work, be it a family member. So I think it's really important when we have these conversations that they're not just held by women behind closed doors, but they're, they're open to everyone because it affects everyone.

OK, brilliant, that's great, Claire. Belinda, do you have any thoughts on that, to hear your thoughts about why awareness, you know, is so key for women and for men? Mm, no, absolutely.

So, something that Claire just said actually, resonates throughout our research, and that is that menopause affects everyone. Obviously my research focuses on a work context. And so we're very much speaking about, line managers understanding, more about menopause, as well as the, the, the, the people who experience menopause themselves.

And one thing we have found from our research, our most recent research, is that awareness is, is important for everyone to have an understanding of, but women themselves, awareness of menopause is so empowering, you know, this is something that we've discovered, just in, in how I'm a qualitative researcher, generally, so. I'm very interested in, in the language that women use to describe menopause and how women talk about menopause. And this recent, sort of celebrity endorsement, if you like, of menopause, we've seen this big wave of media interest in menopause, and it has created an awareness of menopause for women who seem to have engaged with it really positively.

And that I've had women say to me, now I'm understanding my body, I understand what's happening, and there's a lot of power that comes with that, so I think this, this general wave of awareness is, is hugely positive, . And it's also quite amazing when we talk about this awareness of menopause. I'm constantly surprised as a researcher of menopause, but also somebody who's sort of starting to experience it myself.

Why don't we know about menopause until we're kind of in it, in the process of it. You know, when I, when I was pregnant, I had so much information about what it was to be pregnant. You know, and all these phases of our life, and then menopause just seems to be this sort of black box of a mystery.

And so I think what's happening right now is hugely positive. But we do have to be mindful that not all women want to talk openly at work about menopause. I've had quite a number of people say to me, we just have to be really careful as to, while we're reducing the stigma, not to make it go the other way.

So we have to be sort of mindful of that as well, and that's why we need, peer-reviewed research, just to sort of catch up with that momentum of awareness at the moment, if you'd like. Mm, OK, brilliant. Thanks, Belinda, that's great.

So if we have a look specifically at the veterinary industry, and the impact of the menopause, I'm gonna hand over to you, Liz, please. I know you've got lots of information to share with us from your recent survey. Yeah, thank you.

So, I'm just gonna share my screen. So I've just got, I mean, these are, this is the, the actual copy of the, the menopause report. Can you see that?

OK. Yeah. OK.

Perfect. And, basically, just kind of looking at the percentage of, female practising vets. So the, the percentage of males is the inverse of this, this curve, if you like.

And if you look at the maroon line, that's the 2006 data from our CVS facts. And if you look at the purple line, that's the, the data from our CVS Facts 2018, sorry, compared to 2006. And there's really not a huge improvement in the retention of women over time.

And particularly the kind of drop off from 40 onwards, you know, so that by the latter stages of career, there's, you know, many fewer women in the, in still practising. I'm just gonna flick through the next couple of slides, but this is one reason why we have to take this very seriously when we're talking about, you know, a profession with a retention and recruitment crisis. This is a whole cohort of women that if we can support them, better through the menopause, then, you know, hopefully we'll help to, to help them stay supported and working longer.

So we had over 250, recipients to this, survey, and the data mirrored almost exactly, a survey put out by the British Medical Association a year previously, which had over 2000 respondents, so. Yeah, the data seems to be pretty solid. But 83% said the menopause had impacted their health, and again, talking about those kind of more mental health side of things, fatigue, irritability, insomnia, very commonly reported symptoms.

And even though the survey was filled in by a majority. People who had been impacted by the menopause, over 90% said they would still like to know more from both a personal and a business and HR perspective. So even though this is a cohort of women who are going, you know, predominantly women who are predominantly of menopausal age or have been impacted by the menopause, you know, there's still obviously quite a knowledge gap there.

Again, nearly 50% said the the impact on their mental health had been moderate to severe. 75% were concerned about the impact on their lives, and, and a third, said it had had a moderate to severe impact on their working life and career. And from the kind of qualitative point of view.

We actually had, quite a few women saying they'd reduced the number of hours or they'd stepped down from management positions, or they'd stopped working altogether because of the impact menopause had had on their lives. Some had even gone on to say that the mental health impacts had had resulted in them feeling suicidal. So this really is important stuff to make sure we support people.

Yeah, absolutely. Wow, OK, thank you, Liz, thanks for sharing that. Alison.

Did you have anything to add, please? I'd love to hear a little bit about your story. Yeah, I, I can resonate with those slides, to be honest with you, the.

With my journey of having breast cancer, the menopause happened quite quickly, for me, because I was on HRT and I just got told to stop. So I went straight into the menopause very quickly. I find the I've never suffered with anxiety, but I struggle with anxiety now.

And that's, that's quite a new, a new thing for me, and it's quite difficult to manage. I get brain fog, and as a practise manager, you've got lots of people sort of coming at you in all directions and, you know, how do you keep all of those balls, up in, up in the air? And I can understand why.

Women leave the profession. I'm very lucky. I've got very understanding colleagues.

I've got an understanding boss. And I'm, I'm still working through strategies that stop me from dropping those balls and, coping, you know, with, with the anxiety that I struggle with. To be honest.

I think it's quite important that we don't. As women, I think we can laugh off the menopause as well. And I, I think often that's an uncomfortable, it, it's because we're uncomfortable talking about it, that we joke about the hot flushes and things.

And actually, when you feel soaked, it's not particularly funny. But, but I think that, that's a, an easy thing for us to do. And then the people around us can't understand because we're just laughing it off.

Mhm. And to say it's such a natural and normal experience that women go through. Why do you think that is that it is such a taboo subject still that we just make jokes and things like that about.

I don't know whether it, it is psychologically because you're starting to feel older. And, you know, throughout all of our lives, none of us like to feel older. We, we've, we've gone through these crises of being 40 and, and that sort of thing.

And, and whether it is just, you know, none of us want to get older. I, I don't know whether you feel. Perhaps less sort of feminine because your periods have stopped, your fertility is dropping.

You know, the other side effects of the menopause with things like your hair thinning and your nail splitting, and, you know, you look tired because you're not sleeping because you're waking up with, with hot sweats. All of those sorts of things, I think just. Generate a, a feeling of, you know, probably a bit of embarrassment really.

OK, thanks, Alison. So how can we change the narrative around the menopause, and encourage people to normalise these conversations? I'd love to hear your thoughts, Belinda, please on that.

Hi, thanks very much. So yeah, so actually, one of my key points in response to this question is actually just touching on something that Alison just said. Through our research, we're finding that a key part of women's narrative around menopause is very much associated with gendered ageing and the appearance of bodily ageing and actually came to, the subject of, menopause through research project that I was working on, around the, appearance of bodily ageing.

And, so it was, it was very much, and the light in my studies just in my office has just gone out, so I'm just waving. So, so it's really this sort of idea of an association of menopause with gendered ageing. And I think that's one reason, What one narrative that women have, but also one way we can change the narrative, I think is by by sort of combating that.

Normalising and stigmatising has to be absolutely up there. One of the, the things that we're looking at doing at the moment is actually engaging in positive stories around the menopause as well. And, I actually, I was sort of saying, I'm not going to produce another, another article unless it ends with a positive story, because I think that's really important because there are a lot of positive stories coming through our data as well.

I mean, menopause is a serious issue and it's something to be discussed, but, you know, that there are positive aspects to it as well, which I think are sort of largely ignored. But the big thing for me in my research at work, the way we can change the narrative and the way organisations can change the narrative is to create a sense of safety. And we, we refer to this concept of psychological safety, which just really means that organisations have a culture, a climate where women can actually say, do you know what, I'm not, I'm not feeling this today.

I didn't sleep last night. I, you know, I just can't function. Or, you know, I'm flooding and therefore, I just, you know, come and help me because I, you know, I'm, I'm really struggling.

And, so there's this sense of creating that sort of climate of psychological safety within organisations, within teams, and that's a crucial way that we can actually change the narrative. It's a great point, thanks Belinda. Claire, I'd love to know your perspective on that as well, please.

Yeah, I think, I think this is, thankfully where we're going with this conversation into the one where we can change it from being something that we are a little bit fearful of and we don't really understand into something that Belinda's talking about, about the kind of positive aspects of being in this transition and almost encouraging women at this point to kind of take stock of life a little bit and think about where we're going and Not view it as the end of something, but view it as the beginning of something so that we can kind of take on board that what Belinda's and, and, and, feel our strength at this point in our transition. And I think the thing that's happened, I've certainly seen as a, as a medical profession is that. The fear around treatments, for example, has shifted, and if we go back, maybe even just 1 to 2 years ago, there was a lot of conversations to do with medical staff, our own GP, often not even knowing how to treat people who are in the perimenopause and an awful lot of kind of conversations that were really negative about.

Being able to access treatment, being understood by doctors, people having to go to lots of different doctors or go into the private system in order to get help. And I think what has happened even just in the last 1 to 2 years is that there has been a big shift in that. There has been a sort of a waking up, I think, of, of the medical profession and particularly primary care.

And, and GPs taking on board the need to be upskilled and to learn and to take away some of that fear for women because I think that has been there and I, I do feel that that that's shifted, and I, I'm hoping that that changing will also have changed the narrative generally. Into, OK, so I understand more about what I'm going through. I also feel I'm getting support from the right people around me.

I know that I'm gonna get support from my primary care doctor, or my nurse or whoever. I, I have someone that I can go to and I can somebody that can give me the right advice because it felt like Felt like even the doctors didn't know what the right advice was for a while. And then we can then move into, OK, so how can I use my lifestyle?

How can I use my workplace in a positive way? Because because often women are at the point within the veterinary profession and other professions where they're stepping into real leadership roles at this point in their life, and taking on more senior positions. And we don't want to lose that, you know, we don't want to lose the woman, woman, at that stage in their life because we, we've got so much wisdom and so much for for a career that we have progressed to that point to then put it back down again because we're suddenly into something that's seen as being negative.

So there's. There's, there's a kind of a trying to kind of dispel the fear that surround menopause as much as possible and then also move then into, so how can we view this as a positive transition really back back to sort of Belinda's conversation at the beginning to do with changing that. The way that we think about it and the way that we talk about it, and, and make it not into something that needs to be joked about, as Alison brought up as something that is serious, but that there is actually effective help out there for it and things that we can do to make it into a positive experience.

Mm. Brilliant, that's great, Claire, thank you, thanks very much. .

OK, so does in terms of actual conversations in veterinary practise, so day to day conversations that people might have in practise, does anybody have any tips or advice on how best to support these conversations around the menopause? Rob, I provide it to you, please. Yeah.

I have an anecdote. Everything, everything is always good in anecdote form, and it's in my mind cause it happens, . Not that long ago, but about 6 or 7 weeks ago, so I worked in quite a large team and, and one of the guys came and said, Can I have 5 minutes with you, which could be anything, and you're sort of walking down to the room going, I hope you're not handing your notice in.

You're not handing your notice in. He wasn't, so we got to the room and I could see she was really, really nervous, and she started talking and then she stopped and she said, I think I'm going to cry, and I said, Oh please don't, because if you start crying, I'll start crying too, and neither of us want that. So she started to tell me her story and basically it was very similar to, to what Alison was describing, anxiety and brain fog, and just being really anxious, even for tiny little things.

And she'd gone to her GP and her GP had said one of the possible reasons for you feeling like this could be the start of menopause. And his colleague was pretty a bit younger maybe than typically people start the menopause, so the, the GP had organised for some investigations to be done. So she spoke for about 20 minutes and then she stopped and there's a pause, and I said thank you so much for sharing with me.

I want you to promise me something. She said, what? So you're not gonna worry about taking medical appointments when they offer you medical appointments.

If you're in the room with the doctor and they want to do another test next week, just say yes. It doesn't matter what we're doing at work or what's going on. I want you to take your appointments.

And the reason I said that is because I knew this colleague was really kind of a stickler for rules, and there'd be a rule about how you book medical appointments and all that kind of things like we don't need to follow the rules. And then the only other thing I said, is there anything I can do to help you now? So in a 25 minute conversation, I said 88 words.

I counted them afterwards. That's about 30 seconds worth of speech. So I think, and I know nothing about the menopause.

I, I, I now have gone and learned quite a bit following that conversation, and then, when I was asked if I would, sit in on this call. So I now know an awful lot more, but I knew nothing when she pitched it to me and you, so you don't need to know anything to start off with. What you, I think there's two things you need, .

Which anybody leading a clinical team, well, any team, but a clinical team predicted. There's only two things you need to lead a team, and that's empathy and the ability to demonstrate to the people in your team that you care. So the empathy thing, I don't mean in an emotional way, really.

What I really mean is that you You give you yourself as the leader, the opportunity to understand the perspective of the person who's talking to you. And one of the things that vets are really bad at doing is, is listening to truly understand the other person's perspective. Most vets.

Because of how we're trained and the very short quantums of time we have clinically when we're, when we're dealing with clients. Is we listen to respond and we listen to fix somebody's problem for them. If the last thing you want is me fixing your menopause problem cause that's not gonna work.

But if I listen, if I listen to you in a way that I can truly understand your perspective and what you're experiencing and what you're concerned about. Then I give myself the opportunity to help you, and then I do, I, I can do the second part of leadership which is caring for you. Those are the only two things like there's a A trillion words written about leadership and what it is, but it comes down to those two things, empathy and care.

And if you can, if you're in a leadership role in a, in a practise and you are confronted with A conversation like I think I'm going through menopause or I've just had a cancer diagnosis or my marriage is falling apart or whatever. If you can do those two things, listen. And then offer support, genuinely meaning, to offer the support, then you'll be fine and your colleague will be fine.

It's when you start second guessing or trying to fix the problem or ignoring the problem. Oh, that's not, that's not my problem. That's your problem.

Then you're, you're not gonna, it's, it's. It's the wrong thing and you've got the wrong idea of what it means to be the leader or the manager. I mean, they, they're kind of the same thing really.

So that would be my advice. Listen, listen, listen, listen, listen, and then allow a pause. Cause maybe they're not quite finished and they have more we should say, and then when they finished.

Then, then you can say and say very little, because you don't need to say very much. That would be my advice. Thank you, Rob.

That's great advice, thank you for sharing. Anybody else have anything to add around? Yeah, I just wanted to, I just wanted to kind of pick up on the, the point of kind of listening to people as individuals, because, I mean, we know that there's at least 34, probably more symptoms of menopause.

Some people have sort of real mental health issues, others will have physical health issues and. You know, I think kind of not just thinking, oh, they're talking to me about menopause, so they're having hot flushes, they just want, you know, just, let's give them a room that's air conditioned or something. I think just making sure it's a real individual conversation.

Cause some people may benefit from sort of anxiety counselling or being directed to their GP or just practical things like, you know, people who are suffering from sort of weak bladder, just put them in the consulting room that's nearest the toilet, you know? And, you know, there's a, a lot of around. Kind of joint pain and joint stiffness and things, and maybe they just need support with kind of heavy lifting or not being booked the, you know, the, the Great Dane for a bitch and things.

So I think there's lots of individual kind of little practical things that can be done. . And again, kind of coming back to, Belinda's point earlier about not everybody wants to have this conversation to kind of not make it a, a thing that everybody has to have a conversation, you know, around menopause.

Because for some people, it's a, a very liberating thing, and can actually, you know, be a, quite a positive experience. So, yeah, it's about not generalising, . And I think it's wonderful with these kind of workplace toolboxes.

I think with all kind of well-being things, and whether it's mental or physical health, they're all individuals, and it's about presenting people with a toolbox of different options that might suit them as individuals. And I think as kind of managers and veterinary teams, you know, we can kind of explore what what toolboxes, you know, are available to our team members, and then, you know, have that conversation with them and then say, well, these are the different things that we could do, which do you think might work for you? Brilliant, thanks Liz, that's great advice, thank you.

We also sent a menopause template to a menopause policy to all staff. Just so that everybody knew that this was something that we were, you know, more than happy to, to talk about if they wanted to do that. I think the veterinary Management Group wrote one about 2 years ago, which they sent out to members.

So that's a, a nice way to, to start some dialogue as well, often. Brilliant, that's great, Alison, thank you. Anything to add Claire?

Well, I was just, I think, I think this has drawn in all the points I probably would have made, and I think I was gonna go round again to what Belinda said that Liz brought up that what what people need and want will be very individual and what people will want in the way of conversations even will be very individual and You know, again, some of the kind of workplaces that I think do this really well have, have had someone who is within that practise as the named support person, so that again, it's you, you have a, a person that you can go to. Maybe does know more than maybe somebody else and is able to kind of signpost you to the services that you would find helpful for your unique needs, if that makes sense. Again, it depends a bit on the size of the practise, whether you have the ability to do that, but.

Knowing who to speak to can be really helpful, you know, not everyone maybe will have a Rob who is so, easy to talk to and, you know, who is open to listening and has his empathy and hat on and is really good at that. And but so having just one person, I think that you know that you can go to speak to can make a massive difference, in this, in this situation. Mhm.

Absolutely brilliant, thanks Claire. So let's move on and let's talk a little bit about workplace policies and in particular, does anybody have any tips around what actions we can take to highlight best practise workplace policies? I think the only thing I would say about stuff like policies and guidelines and things.

This is another feeling of vets. I feel I can say it because I'm a vet. People sometimes, read things as black and white.

Which is echoing part of what the other guys were saying, you can't do that with this kind of personalised, individualised support. So the, if you have a policy, it should just guide your thinking, but you've got, you can't be defined by rules. Yes, we have a, a rule at work about how you inform your line manager if you have a medical appointment.

But actually, if, if your colleague is anxious. And stressed and all of the other emotions. The last thing they want is, I've got to remember to phone that guy and tell him I'm not going to be in like I, we don't need that.

So I think using the the policy should be there to guide roughly how you support your colleague and then the, the fine detail is a collaboration between you as manager and your colleague. That's how you come to the solution for your colleague. So the policy should only ever be as as guidance.

It shouldn't be read as well now on page 6 it says we have to do this because if you do that, then you'll undo all that listening stuff you've done because you're not. You're not giving them the individual care that they need and deserve, so I think that would be my, my take on that. The policies, policies are brilliant, particularly if they include sources of further information and help, because again, managers can't know everything, but if, if the policy can articulate.

68, 1012 sources of further information. That, that's probably a really good thing to include as well. Mhm.

Yeah. Brilliant. Thank you, Rob.

I'd love to know your perspective on that, Belinda. Thanks, so we found that, generally speaking, a, a policy, a blanket policy in in and of itself is, is nowhere near enough, but we, we do, we have also recognised that having a policy is absolutely crucial. To starting, that level of support, because it's an indicator that the, the organisation is willing to enter into what comes next.

So, mustn't stop at policy, but I think really need to start with policy, and that's something that, that's come through quite loudly. It's quite interesting, just going back, to something that Claire touched on at the beginning, that the the research that we're doing and actually the, the broader research area, really making it quite a big distinction between physical and psychological symptoms and how they're, experienced and how they're managed by the individual experiencing them, but also within the, the workplace. They seem to be.

Quite distinct in, in actually, how they, how they're experienced and how they're managed. For example, we found recently in a paper published earlier this year that social and line manager support seems to protect work performance with psychological symptoms, whereas less with physical symptoms, where it was actually, being able, providing. An environment where women themselves could tap into their, their, their habits, their agentic behaviours, their coping strategies, seemed to protect performance when looking at physical symptoms.

And so this sort of touches on previous work, but we found it quite strongly in a study that we, we've just conducted. And so I think any, any sort of further work that we do will certainly make a distinction between the physical and psychological symptoms because they seem to be experienced in a really different way. And as Liz pointed out, there are 3 for at least symptoms.

And it's, it's interesting, you know, what's a symptom? Anxiety is the key one, right? So, is, is anxiety a symptom of menopause?

Do other aspects of work exacerbate that? And so we're always mindful of what is a symptom, but actually, you know, does work make it worse? Does that make problems at work?

So it's, it's, you must we also don't look at symptoms in isolation. So again, it's really about enabling women themselves to really harness those, coping strategies, because what we also have found is that menopause can, disrupt, resilience, confidence, you know, these parts of, ourselves that, you know, enable us to tap into those coping mechanisms or those coping strategies. So it's almost as though the workplace has a Has a role to play in kind of replacing that element of, you know, being able to replace that sort of resilience, confidence, if you like.

Line management training is key, and I always love, loved hearing Rob's story. And if more line managers were approached, the, the way that Rob does, it'd be great. We found that women, women really feel comfortable and almost expect .

To be, to, to have someone at work who, who has lived experience of menopause in some way. So we know that women are more likely to ask for help from somebody they feel has experienced menopause either themselves, or maybe it's a man who's spoken about his wife experiencing menopause. And it's not always to say that older women, maybe they breeze through menopause, and maybe they might not be the best person to ask for support.

So, it seems to be that sort of lived experience and that empathy, Rob, that you were talking about is really crucial to, to sort of helping, helping women with menopause. And the final point I would make on this section, it's something I'm sort of playing around with, it's this idea of performance and this idea of, You know, meeting the requirements of the job that really does women talk about that, about their menopause symptoms around anxiety, around this, you know, performance-driven. Metrics.

And from what I understand about the vet community, there's a lack of flexible work, options, it's quite high stress. Someone referred to it as you're either, standing up or driving a car, lifting heavy things, and then there's sort of, it's a very sort of physical job, very stressful job, in terms of work conditions. And the performance around that, and there's this idea around, always sort of striving for that optimal performance, and I think a lot of women I speak to in other jobs, similar kind of jobs, police, for example, teachers, bus drivers.

They're trying to mask the impact of menopause at work and trying to always strive for that, that sort of level of performance, and so I do wonder, tapping into that psychological safety bit if there's a way that, You know, there's a, the reimagining of what performance is and actually means to women. Thanks, Belinda. Is there anything anybody wants to add?

I, so you just mute there. Yeah, I just, you know, going back to the, the report that the British Medical Association published, they put in a few, sort of recommendations and just kind of talking about workplaces and sort of best practise. One of their points was, developing an inclusive culture.

So, including actions to address sexist and ageist behaviours in the workplace that prevent women speaking about menopause and asking for support. And then I added an addendum, improving understanding of the impacts while fostering a no blame culture. So I think there is a lot around, as Belinda's just said, kind of psychological safety and making sure that the culture is somewhere that people don't.

Feel that if they go to their line manager and say they're experiencing symptoms of menopause, and, you know, is there any help and support that they can have, that that's not gonna either make their performance be kind of watched more closely or judged by their colleagues or potentially that they'll even be overlooked for, you know, promotions and and that kind of thing as well. So, you know, it's just really important to kind of have that supportive culture extending into, you know, ageist behaviours and, and sexist kind of comments and things as well. Yeah.

I think, just to follow on from that, I think it's important to remember there are lots of legal protections for people as well that they often aren't aware of that relate to the stuff that Liz has just spoken about and there's There's quite a bit of case law and there's quite a number of cases at the employment tribunal that have ruled against employers who didn't. Support their colleagues that were experiencing menopause in an appropriate manner, or that made lots of really negative interrogatory comments, or that almost forced their colleague out of work because it became untenable for the person to stay. The other thing that's really interesting is there is, there's, case law in the Employment Appeal Tribunal, Rooney versus Leicester City Council, which established that, If the symptoms were debilitating enough that menopause can be treated as a disability, which brings in a whole raft of additional protections for the employee under the Equalities Act 2010.

The last thing any employer wants is to have a A discrimination case brought against them on the basis of sex, age or disability in particular. So if the moral and ethical, reasons to try and do this well, don't, don't, like get you thinking you should, then hopefully the legal, but those projections are there to protect both sides, but they're particularly there to protect the employee and, anybody who's got a rubbish attitude to this kind of stuff would do well to understand what the law says, and tasks them with being responsible. So I think most people don't, aren't aware that this stuff exists to help them.

Great point. Thank you, Rob. I wasn't aware, so thank you for sharing.

I was just gonna say, can I say something really briefly as well I just . I just like worry about some of this conversation that can happen where this production of a policy becomes a bit of a tick box kind of exercise for companies and I think, you know, it's as I think Rob said in his kind of point about it not really being about the policy, but about how it's put into practise and . You know, you really what you want to think is beyond the actual policy itself and, and thinking about the individual that you're creating this policy for rather than it just being about putting a policy in place.

I have this slight worry that there are some companies out there, particularly taking in, you know, Rob's point about the legal aspects that are attached to it that are just doing it to tick the box to say, oh, we've got a menopause policy, therefore, we're covered. Without really thinking about how that impacts on, on women and I think, you know, the numbers are there which are just massive to do with, you know, loss of earnings, loss of, you know, women leaving work and retention is, is. So hard and recruitment is so hard in in veterinary medicine and you know, I work with them within the medical, you know, NHS practitioner health service.

It's the same kind of thing there as well. It's people leaving their jobs at this stage in their life and, you know, there are, there are so many reasons to really kind of think about this properly in your workplace and to do it well, rather than it just being about producing a document that ticks that box. Thanks Claire.

So true. Thank you very much for sharing. OK, brilliant, we've run out of time already, for the panel discussion, so we're gonna just open up the chat box and we've had lots of questions coming in, so I'll just start reading through these now and feel free anybody to to jump in with your responses.

So where can we. Liz's report on the impact of the menopause on the veterinary profession. Where can we find that list?

I've just dropped a link in, so I, I actually answered that one, with a comment. So yeah, I've, I've dropped it in. I don't know if everybody can see that, or if I should just drop it into the chat as well.

Oh, it's been dropped to chat as well. Perfect. Brill, thank you.

And what we can do is we can put it on the webinar vet site afterwards as well so people can go and find that if they'd like to. OK. Brilliant, then we've got another, it's a comment which is quite interesting to get some thoughts on, and younger staff seem to think HRT means menopause isn't an issue.

Any comments around that, please? It's interesting, isn't it? So there is this kind of thought that HRT now is this thing that we were scared of, but now we are pro HRT and adding a bit of testosterone as well, and then everything's absolutely fine.

We've got rid of all our symptoms, but for anyone who's kind of been through this or had anyone who they live with or have, have, have experienced it, it's, it's HRT doesn't, isn't the be all and end all, and . Yeah, again, you know, that has to be to do with a sort of practise wide conversation and education, and I, I have sympathy because I think it did come up earlier in this webinar as to where, where do we get this education from, you know, where does it come from? It, it doesn't happen when we're at school, you know, I got it because I went through medical school, but who is, who is handing over that information, so.

I often have this, you know, we, we, we need to share this information within, within men and women, but there's also something about sharing with our children. You know, that there is almost that same conversation that we would have about starting periods and, and general puberty and and sexual health that we need to extend into menopause and education around it because otherwise it just isn't happening. So it's not, you know, I, I've got sympathy for younger people not going through it and what's out there on social media and picking that up and then therefore taking that as the, the answer, but there there is some need for us to educate our, our children in order for that mindset, I think, to be changed.

Yeah. I come in on that as well, actually, just around HRT. I'm not a medical doctor.

I have a PhD in management, so I, I, I'm not going to talk about the medical sort of side of it too much, but, I would say that, you know, Claire, you're saying, where are we getting our information from, we're getting a lot of our information from celebrities right now, who probably have, less medical training than I do. So, you know, it's, I think we, we need to just be aware of that. I think in in terms of HRT and this sort of seeming medicalization of, of menopause that's happening at the moment.

And that's, that's sort of balanced out with a lot of participants say to me, that in the workplace, they just wish that menopause was legitimised, and this word legitimised comes up quite a lot. And it's, I think it's dismissed a lot because it's not medicalized. And so there's this wish for it to be legitimised in a way that it's talked about as a, as a serious issue and a thing, but not so much so that it's referred to and in the same breath as as having an illness, for example.

So it's a really as a, as a social scientist, it's a really tricky thing in terms of the language that women use around menopause. Yeah. Brilliant.

Thanks, Belinda. We've got a couple of questions all relating to a lack of, confidence, and we have one comment, I feel like I'm defective and not as good as the other younger team members, so I've tried not to talk about the problems I've had. Any comments on that?

Yeah, this is, I wrote a paper that was published last year and it was all about how, women use, so through throughout, women's life there was strong, confident, and then menopause hits and it was really interesting how women started to use quite self-deprecating narrative, in how they spoke about themselves, and, yeah, and it was quite striking. So, so that, that's not a surprise to me, but, That, that, you know, you pop that in, in the chat, and it's, it's, and I think that's where the sort of positive aspect of, of menopause or hearing those positive stories can really help and whether confidence is a symptom of menopause or not, sometimes it's on the list of 34, sometimes it's not. But it's a, it's a really significant part of the menopause experience, this drop in, in, confidence that women feel.

And quite often it's, very much in relation to younger, generally younger female colleagues and, and seeing themselves through, through their eyes. It's very relational. Yeah.

I think it fits a lot with what Alison was saying earlier as well about this kind of thought that it's associated with ageing and what we again in that whole social media kind of framework that we're meant to be out there running marathons and jumping over mountains and we're meant to be also managing our four children and And cooking a, a beautiful vegan meal for our family and that this just funny expectation that's put on women and then, and then they don't see themselves hitting that. And I think particularly it, it's does seem to be significant within these kind of careers where people have been seen to be successful the whole way through. They generally speak.

Will have had more than one string to their bow. So in order to get into veterinary medicine, you've not just achieved your exam success, you've also been a musician or creative or, you know, you've sat on various different boards and, you know, to get even into that university plaything. So these women within veterinary medicine have been high achieving their entire lives.

They're perfectionists, they are people who have that drive. And then they find that they're not maybe hitting those kind of standards that they've put up on themselves and then they're bombarded by images of what they could be doing by other people who are putting stuff on social media. And it's just whenever I sit with a woman and give them some time to talk about what's happening, nearly 100% of women will break down and cry because of the fact that someone's actually listening to them and maybe offering them some help because they've most women.

Particularly this particular type of personality, will have been putting up with symptoms for quite a period of time and thinking that they should be able to just deal with it on on their own because of this perspective and also because of personality kind of traits that are there. So, . It's, it's, it's, it is a massive knock on confidence and I think particularly within it, you know, certain career strain, you know, personality types, I think take that harder than others, and expectations are higher on our, on ourselves.

Thanks Claire, really good point, thank you. . We've got another question around, I think it's what you were speaking around earlier, Rob.

How do we get more understanding and support when there's not enough staff and not enough breaks to start with? I think I, I can have a really weird, not weird, I don't really buy this as an idea, and the reason I don't is because if we can't support people when they need it most, then like what's the point? Like what's the point of seeing all these patients and animals?

If, if our colleagues need our help, they need our help and if that means we see 10 less people today, but we keep our, our friend, our colleague. Healthy and in work, then that's what we need to do. We shouldn't be.

I don't know, it just, it really annoys me when people say they don't have enough time or it's too difficult. It's not too difficult. You're saying it's too difficult to help your colleagues, to me that's not acceptable.

So I suppose the, the thing is the whole paradigm has, has to change that, actually if we, you know, what if we put the people first, then we'll get so much more for doing that than if we If we create an environment where that person can't come to work anymore, because that's, that's what will happen, they won't come to work anymore. And then we've like Claire and all the other guys were saying we've lost all this amazing human capital, this experience that people have built up. We've just lost because we didn't have it within ourselves to, to help them when they needed it most.

That to me that's completely unacceptable. So something has to change really is what I would say that the support needs to be given, but we may have to change other things that are happening. Yeah Brilliant.

Thanks, Rob. I also think there's quite a lot of very small things that actually don't take an awful lot of time that are going to help that woman feel very supported and understood. You know, things like, like Liz said earlier about putting them nearest the consulting room with the, the loo that's closest.

Looking at uniform, you know, just taking out maybe one cons consulting slot so that they, they get that time to, to regroup. These are all little things. They don't account to hours and hours in a day.

And if you lose the person, you've lost a whole person. But if you lose, you know, 3 consults over the course of 4 or 5 hours at work, like is that really gonna Make a material difference to anything, no, but it's gonna make your colleague's life so much better, when they're at work. That seems to me.

Of course we would do that. It's a shame that people work in environments where that's not possible and we what we really need to do is change that. Yeah.

And in the middle of, well, I've finished first draught of a chapter that I'm writing on menopause and teachers, and the findings were around, you know, changing the, the climate to make, you know, the overworking, but the reality is the work is the work, and, you know, teachers it it it is what it is. But the findings were the, what I've kind of, the three T's is what women want toilets, access to toilets, and time to use them. They want time to do their workload.

They just or to start a bit later. They want flexibility of time to manage their bodies and temperature. They want to be able to control their temperature.

And it's interesting, just those three things come up again and again and again. So, if there's a place to start, I think it's that, and I think those, those 3 things have come up on this, this call quite a bit today. Brilliant, that's great.

Thank you. And thanks everybody. We've got lots more questions around tool kits and where we can find them and things like that, but what I think it might be best for us to do is we're just running out of time now is we'll collate all of those and we will publish them all with the recording on the webinar website tomorrow so that you've got everything all in one place.

Brilliant. Oh well, thank you all very much for joining us tonight. It's been wonderful to see we've had over 100 people on with us for the majority of the session, and we've got lots of comments coming in thanking the panel, saying how wonderful it is that we are doing this webinar.

So, thank you very, very much to all of our panellists. You've been brilliant. I feel like I've learned so much myself about the menopause and What we can do to, to really, you know, drive change and specifically to support our veterinary colleagues as well.

So this session will be recorded. It will be available tomorrow on the webinar vet platform. So please do go back and rewatch anything, share it far and wide, awareness is key.

The more that we can share this, the more that we can get people talking about this, and the more that we can drive change. So thank you very, very much. To everybody for joining us, and we will see you all soon.

Oh, Liz, go on. Can I just make one final comment? Yeah, we're hoping to, start trialling some workplace interventions following on from Belinda's work within veterinary practises.

And if anyone would be keen for their practise to be involved in trialling some evidence-based workplace interventions, then, you know, you can reach out to me, or I'm sure, Belinda as well. . And yeah, it'd just be great to to start actually, yeah, getting some evidence base behind this in, in vet practises specifically.

Thanks Liz. Absolutely. If there's anything, Liz, that you want us to share as well with the recording, then just let us know and we can pop that on as well.

Fantastic, thanks. Amazing. Oh well, thank you again everybody for giving up your Tuesday evenings to be here with us and happy well menopause Day.

Thanks everybody.