Women’s Health in the workplace

Speaker 1

Hello and welcome to this webinar on women’s health in the workplace. My name is Sarah Keene, well-being consultant with Evo Health, and I’m delighted to be here today to address an incredibly important topic. The purpose of this session really is to support employers and managers alike to get a greater understanding of both why and also how they can better support women’s health in their workforce.

So just to give you an overview of what we’re going to cover, we’re going to begin with just some high-level statistics on women at work, some great progress that’s been made, as well as some worrisome trends to be aware of.

We’ll also then look at health considerations that are most relevant in relation to key life phases or stages and how then these in turn can inform interventions and initiatives that are run in the workplace that have the most positive impact and really serve to enhance the experience of female employees.

So firstly, it is important for us to recognise the growing awareness and acknowledgement around nuances in the spectrum when it comes to physiology of sex, sexual development in adulthood and also gender identity. And it’s useful for employers and managers also to have an awareness of approximately what percentage of their employees may fall outside more standard conforming definitions.

So when it comes to physiology of sex, for example, approximately 2% of individuals globally do not develop their sexual characteristics and anatomy and physiology in that standardised definition and may categorise themselves as intersex.

We also have individuals then who transition much higher among men transitioning to female, one in approximately every 30,000, and from female to men, one in every 100,000. Now, these figures may vary and these are just some high level stats, but it just gives you a sense of the prevalence of this.

And when it comes to gender identity, approximately 2 to 3% of individuals globally, again, don’t conform to maybe more standardised definitions. So again, really important to be aware of that so everyone can feel included, recognised and their needs and references honoured.

In this training today, we are focusing on health considerations related to normative female hormonal profile and anatomy just because we’re restricted time-wise. But again, nonetheless important for, as I mentioned, employers and managers to be aware of this. When it comes to equity and inclusion, the World Economic Forum have launched this gender gap index.

And over the last number of years, they’ve been measuring globally how men compared to women across four key parameters, political participation, economic participation and opportunity, educational attainment and health and survival.

And it may come as little surprise, but the two areas where there is still the greatest gap and lack of parity is in political participation, but also economic participation and opportunity. That said, really great progress has been made.

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And we see, according to a recent OECD report that 69% of working age women are participating in the global workforce, labour force. The UN report published in 2020 has a more conservative estimation of about 50%, but nonetheless, there is the majority of women working age women are participating in the world of work. What we see in the UK is there’s 2 million more women in comparison to 2010.

There’s almost 40% more women in high-skilled jobs, also since 2010. In top management positions, it’s grown by 25%. And in the UK currently, 18% of women are executives and 5% CEOs. Eight of top 100 companies in the UK are headed by women and 8% of the 4 to 500 CEOs are women. So while it’s nowhere close to what we would aspire towards, it’s certainly a great progress to see.

Lastly, you see in the bottom there women in associate, professional and technical jobs in STEM industry, so science, technology, engineering and math. and formerly dominated by men has grown by 40 percent. So again, we’re seeing really positive trends in that regard. However, in the workplace, we’re also seeing that women are at much higher risk of burnout.

And according to the Deloitte Women at Work 2022 report, 43 percent of women say their mental health is poor or very poor. And only 53 percent of women expressed that they were comfortable to discuss their mental health at work. And so this is really relevant as we’re really bringing mental health much more to the fore.

And in workplaces globally, there’s much more focus on mental health initiatives, but to really recognize that that stigma still remains for many individuals. So important for managers and employers to be aware of this, to be able to address it. We’ll see when it comes to generational differences as well.

Forty six percent of Gen Z’s say they’re stressed all or multiple at the time, and 38 percent of millennials. And we are seeing that across the board, while stats do vary, that young millennials and Gen Z tend to be more vulnerable to burning out and high levels of stress. So really important for us to be aware of that.

So some of the, let’s say, heightened vulnerabilities to stress that women encounter are due to a whole multitude of factors. And we could broadly break these down into life stage related stressors, as well as workplace specific issues that impact women more so than their male counterparts.

So when it comes to life stage, we are going to unpack this a lot more in the next segment, but just high level. We’re looking at things like recreational activities, relational challenges, family planning, parenting, perimenopause and menopause as being key factors to address.

When it comes to workplace specific stressors that women may be more vulnerable and inclined to experience, we see the prevalence of things like microaggressions, biased behaviour and pervasive stereotypes, non-inclusive behaviour. Even though these things can be subtle, they are still impacting women, a lack of mentoring, limited career opportunities, sexual harassment and values conflict.

Again, these are cited in the Deloitte Women at Work 2022 report.

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So while we’re focusing mostly today on life stage factors, it is important to also. So we’re going to start by understanding a little bit more about the impact of sex hormones on our thoughts. Now, both men and women have estrogen and testosterone. The big difference is in the ratio and the amount.

So if you imagine women have much, much higher levels of estrogen in comparison to men, but women also do have testosterone, but in much, much lower levels in comparison to men, typically. So you’ll see here, estrogen plays a huge part in maintaining our health and impacts many systems.

The biggest, of course, having its impact on our reproductive health, but also plays a part in immunity, managing our blood glucose levels, cardiovascular health, maintaining the health of our skin and hair and many other aspects of overall health. And you’ll see there that our levels dip considerably in later life.

So an adult female, you’ll see the band is quite wide because there is variance, but it’s much, much higher than an adult male. However, post menopause, it drops to that equivalent to an adult male. So this is a big, big factor. And we’ll be looking at the impact of that in terms of the health outcomes associated with it in a moment.

We also have progesterone, and this is produced by the ovaries and plays, again, a key part in reproductive health, but it impacts on sleep, mood and also plays a key part in breastfeeding for mothers postpartum. So just for you, again, to understand a little bit, we’re not going to get technical here at all. But the fluctuation of estrogen and progesterone over the course of the menstrual cycle.

The only reason I’m sharing this is because it can profoundly impact things like. mood, emotional self-regulation, as well as focus, cognitive function, and energy levels. Thankfully, in recent years, there’s much more awareness around this.

How this relates to female employees’ performance is that when we work with our cycles and with nature, there are times that we’ll have peak alertness, we’ll be really on the top of our game, and then other times that we’re more vulnerable and require to slow down and be gentler.

And when we have this awareness about working with our bodies and our own natural rhythms, it really supports that long-term balance and longevity. Whereas trying to override it or ignore it or pretend it doesn’t exist is one of those factors that can be contributing towards those high stress levels and individuals then at higher risk of browning out.

So here I’ve just, again, high level, included a few stats just around acknowledging and appreciating menstrual cycles very much so between individuals. They can last from 21 days for a full cycle to 35 days. They tend to be longer in younger women. And then as they age, they tend to shorten and become more irregular. And menstruation can vary as well from only two days to a full seven days.

And this, of course, has various effects on individual to individual basis.

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We see a recent survey of over 40,000 women in 2019 found that dysmenorrhea, which is that intense menstrual pain associated with menstruation, affects 85% of women. Psychological complaints, 77% of women. Tiredness impacts 71% of women. And one out of every three women have to stop their daily activities due to menstrual-related issues.

So it’s really, again, so important for us to recognize this rhythm, this cycle, and to work with it rather than override it. And we’re seeing that Spain and the EU is taking the first country to introduce paid menstrual leave because there are certain individuals then that have even more extreme symptoms and can be really incapacitated. So it’s important for employers to be aware of this.

It’ll be interesting to see how it unfolds and the uptake of that leave and come in once in years and see what other countries begin to follow suit. In relation to hormonal imbalances, research suggests that imbalance can be caused or certainly contributing factors have been recognized as high levels of stress.

Body weight, either excessive body weight or also extreme weight loss, can play a big part. Alcohol intake, dietary imbalances, medications such as birth control and contraceptive pills, as well as excess toxins. So things from house cleaning products or hygiene products, products from food and from fungi.

An excessive exercise also can be a part that impacts and equally the other extreme with high levels of sedentary behavior. All of these elements can contribute to hormonal imbalance and increase the likelihood of negative outcomes related to the menstrual cycle. And here we’ll see symptoms of imbalance.

And as you can imagine, some of these can vary to the extent with which they can develop taken individual, but certainly can impact again on general health and performance of fatigue, moodiness, breast tenderness, bloating, weight gain, difficulty, sleeping, painful. We already mentioned this, Mineria, and headaches as well. These are all indicators of imbalance.

So important for us again to keep this in mind as we start thinking about interventions and supports to put in place to enhance lifestyle factors that can alleviate those imbalances and help to restore homeostasis or balance to the body.

So this is just included to really highlight how significantly estrogen drops off in older adulthood and how relatively rapidly it does so in comparison again to that more gradual drop of testosterone that may be experienced in male counterparts. So again, we will unpack this a little bit more in a moment as we look at menopause.

But again, just it’s interesting to have that kind of high level perspective of this change in hormones over an entire life cycle. So when it comes to motherhood and parenting, there are certain considerations for employers and managers to be aware of, depending on where an individual is at in their phase.

So when it comes to pregnancy, it’s very relative to the term, whether it’s early, mid or late term considerations to take on board.

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And of course, there could be illness, such as morning sickness, fluctuations in energy levels, and people can experience a wide variety of difference in the intensity of the symptoms they experience. So again, good as an employer or manager to be aware of that and to be able to work in a supportive way with your employee.

And of course, there’s physical restrictions and adjustments that are required as the pregnancy progresses. And there can be significant lifestyle changes as well, particularly in sleep disruption and discomfort. So being aware of these and being able to put interventions and considerations in the workplace architecture into place. Post pregnancy, there’s postpartum health considerations.

Many people are aware of that higher risk of depression, especially in the weeks and months that follow delivery. And then there’s factors around whether an individual chooses to breastfeed and then, of course, caretaking in those early months. And that, of course, will all depend on the amount of maternity leave that is standard within an organization. But these are all elements to factor in.

And if you are on site in a workplace, is there spaces provided that are supportive for new mothers? And when it comes to parenting, it’s about 86 percent of women in the age of 40 to 44 are mothers, according to research by Pew Research. So it’s a high percentage. The average age of first born has increased from mid 20s and up to 31 or 32 years old, according to the central statistics office.

And of course, lifestyle changes come in tow with parenting, especially for first time mothers. So again, factors for employers and managers to be aware of and again, put support in place. And also important to be aware in the process or in miscarriage, that one in eight pregnancies and in miscarriage, according to NHS. So, again, you have variants in the statistics.

According to the National Institute of Health, it’s 26 percent of all pregnancies. And in miscarriage, however, it’s only 10 percent are clinically recognized. So that’s more similar to the NHS statistic there.

So again, as an employer or manager, just to be aware of that, the vulnerability and the roller coaster, it can be and particularly indeed as well for individuals who are undergoing fertility treatment and the disappointment that they may be confronted by. And the emotional roller coaster they may endure in that process.

So, again, really important to have that awareness and for line managers to be having these conversations to support their female employees when it comes to parenting. It’s widely recognized that unpaid domestic and care work disproportionately falls on women still, despite all the progress that’s being made.

And so it can be a real challenge for women to balance home and work life pressure and it can significantly negatively affect their mental and physical health.

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And some of the main challenges, exhaustion, depression, injury and then higher risk of chronic illnesses. So again, as an employer, being aware of our supports in place to manage that work life balance and to allow especially new mothers and in early parenthood, that extra flexibility to navigate these additional pressures and challenges that they may be confronted by.

So when we looked at that across the life cycle, the fluctuation of hormones, and we really saw how estrogen dives off so significantly in older adulthood. And it’s important then for us to unpack that a little bit more and understand a bit more about it. So while it did look dramatic in the drop off, that process still can vary in terms of how long it takes.

So they can decline in different rates and perimenopause or that lead up to menopause can vary from four to eight years. Menopause typically can happen between 40 and 58, but the average age is approximately 51.

Menopause symptoms can be relatively mild for some individuals to quite severe, and just as an employer or manager to have a sense of the prevalence of it, about 77% of women will find at least one symptom is very difficult to deal with, and 44% will experience three or more extreme symptoms.

So as a rule of thumb, about three or four of your female employees in that age category could potentially be dealing with extreme symptoms related to menopause. So really, again, important to be aware of putting structures and support in place.

Some of the adverse symptoms, I’m not going to go into an exhaustive list, but the main ones would be things like difficulty sleeping, affecting 84% of women, mood changes, anxiety, depression, greater risk of anxiety and depression, affecting 79%, and brain fog affecting 73%. So just again, to have that awareness of the impact that has on health well-being as well as performance.

So as an employer, what sort of support can you put in place? So symptom management protocols can vary widely. Lifestyle factors play a huge part. Physical activity, diet, stress management, all can really serve to buffer against the negative effects. Natural remedies such as acupuncture, aromatherapy, hypnotherapy, the evidence base is growing or the efficacy of these in terms of managing symptoms.

And of course, there’s biomedical intervention as well. Leaps and bounds have been made in the domain of HRT, and there’s many different ways of administering HRT.

Health care providers may also decide to prescribe other supports, such as antidepressants, if it’s fitting, but really adopting that kind of holistic, empowered, proactive approach, drawing from many layers to support the transition is optimal. There can be medical hormonal intervention in many phases, not just HRT and menopause or perimenopause, but also in contraception.

In early life birth control, we already briefly mentioned fertility treatment that can also really impact physical and mental health as an individual adjusts to the hormonal intervention, and as well as that with sex transition, as we mentioned at the very start for that small minority,

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it can also be a huge factor. So again, just as an employer manager, being aware of that and having that open communication with your employees around what supports they may be required as they go through various processes and stages. So as we draw this segment to a close, it is important to also acknowledge some of the strengths when it comes to women’s health and women in the workplace.

Women typically have a longer life expectancy of approximately by two years, comparison to male counterparts, and huge progress has been made. If you see here in 1925, the average life expectancy of a woman was 57.9, so just 58 years. And here we are in 2023, and it’s almost 83 years, so almost 30 years longer life expectancy in the last 100 years.

Women are much more frequently attending GPs and much more likely to engage with regular health screens in comparison to male counterparts. So this is another great strength and asset to recognize as a manager or employer.

And of course, we have this growing public awareness and open discourse around formerly what may have been considered taboo topics, which again is really, really positive and really not allowing anyone to suffer in silence anymore, and really appreciate that support is there for them when they require it.

So when it comes to interventions in the workplace, when we’re designing a wellbeing strategy, it’s important to appreciate there’s kind of three main tiers of intervention. So firstly would be that prevention phase, and that is the assessment of risk and hazards and how to buffer against or avoid harm. The second phase is intervention.

So where risk is reduced and challenges can be amended, huge part of the intervention phase would relate to education and promotion, health promotion in the workplace. And then lastly, we have treatment and that’s where there is repair and restoration and supporting people to come back to full health. When it comes to prevention, the manager plays a key part, the line manager in particular.

The role they play in employee wellbeing is increasingly recognised and they play a key part in terms of managing workload, role clarity, autonomy, giving opportunities for growth, team dynamics. These are all widely recognised as important parts of how a manager impacts their employees wellbeing.

When it comes to women’s health and particularly these issues and challenges we’ve just raised, it’s important that employees, their female employees feel supported and heard, that their workload is manageable and that that consideration is given to perhaps these phases of peak performance and then these phases of needing that to slow things down and having that kind of awareness of that cyclical nature when it comes to performance.

And part of that is also ensuring your employees always take adequate breaks and really listen to the body and honour their limits, that they’re aware of any additional needs or considerations their employees have.

Speaker 1

We spoke about some of perhaps the less prevalent challenges, but nonetheless they’re important on an individual basis to recognise. And being aware, as mentioned earlier, of those workplace-specific challenges like microaggressions, that may be more prevalent for female employees and allowing that flexibility when necessary. So this can play a huge part in that prevention phase.

In addition to that, in terms of general health, in that prevention phase as an employer, really providing and signposting and prompting for regular health screening. So the HSE has a brilliant hub, health hub, that you can check for resources and that you can also signpost employees to check out. We have cervical and, of course, breast screening, really, really important.

And the cadence of that screening will vary depending on the age of the female employee. DEXA scans to ensure bone health. Again, you may be aware that one in every two women over the age of 50 are likely to experience a fragility fracture related to the decline in their bone mass density in comparison to one in every five men.

So this is, again, one of those health issues linked to that big drop in Eastroden as they age. So, again, making sure employees are aware of how they can proactively maintain their bone health as they age. And then lastly, a metabolic panel and being aware of general health screening.

So when we look at a metabolic panel, for women to have a, again, it’ll depend on their age in terms of the cadence of this profiling and assessment, but especially among older women, especially as that Eastroden drops off, important to keep an eye on things like blood pressure, blood lipid profile, and the resting heart rate.

And for a more comprehensive panel, looking at things like liver function and fasting blood glucose, your glycated hemoglobin, which can give you a retrospective snapshot of your blood sugar management over the last three months or so.

When it comes to phase two, that intervention piece, where there’s many, many different approaches that you can take in relation to health promotion and education, things like trainings and workshops and courses can be a wonderful tiered approach.

So high level introducing a topic and then allowing people to experience it through the workshop and interactive piece, and then courses allowing them to go into a deeper dive.

And supportive interventions can also come in the form of day clinics, such as health coaching, for example, where an individual is not necessarily feeling in crisis, but could benefit from some added accountability and direction and support in making healthier lifestyle choices. We also have a crossover.

from an intervention to treatment in this last piece where we start to sign post professional support, whether it’s with a GP or a health coach or working with a counsellor, a psychotherapist or indeed with a holistic therapist who can support deeper relaxation, whether it’s through energy work, reflexology, acupuncture or indeed working with a nutritionist.

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Any of these supports can be offered in the intervention phase as well as the treatment phase. So just to summarise as an employer, the considerations you can give to each phase.

So as mentioned in the prevention phase, we spoke about the manager-employee relationship being a crucial part as well as health screening, but also important to recognise in this phase, conducting things like psychosocial risk assessments or really putting together a solid health and wellbeing, policy that gives consideration to your female employees’ needs and that that’s communicated to all staff and regularly reviewed and updated.

When it comes to intervention, making sure accessible resources and supports are available, providing trainings and education and also assessing the workplace choice architecture is conducive to making healthier choices and to supporting the needs of female employees. And then lastly, your own treatment.

We spoke a moment ago about that health professional support, supplementing that perhaps with your own organisational EAP, looking at health insurance benefits as well as considering special leave in certain circumstances. So I really, really hope that what we’ve covered today is insightful and that you leave with a greater understanding of why and how. You can support Women in Your Workplace.

It was a pleasure to be here. If you’d like more information, please check out our website or reach out and speak to one of our consultants. So I very much hope that this has been informative and supports you in gaining greater insight

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and why and how you can best help women.

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in your workplace. If you’d like further information you can check it out on our website so you will help.

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or equally reach out to our team at Hello at Zeebel Health and we will be more than happy to support and help you. Thank you for your time and attention.