Foreword

Publishing information

This British Standard is published by BSI Standards Limited, under licence from The British Standards Institution, and came into effect on 31 May 2023. It was prepared by Subcommittee CH/314/1, Menstruation and menopause in the workplace, under the authority of Technical Committee CH/314, Ageing Societies. A list of organizations represented on these committees can be obtained on request to the committee manager.

Acknowledgement is given to the following organizations that were involved in the development of this British Standard:

Acas
Black Women in Menopause
Bloody Good Period
BMR Health and Wellbeing
Brabners LLP
BT
Buro Happold
Daisy Network
Dementia Prevention UK
Encompass Equality
Endometriosis UK
Equality Counts
Federation of Small Businesses
Global Equality Collective (GEC)
Henpicked: Menopause in the Workplace
Individual capacity – Surgical menopause perspective
Individual expert – Menopause Anxiety
Individual expert – PMDD
Individual expert – Workplace policy and neurodiversity
Institute of Workplace and Facilities Management (IWFM)
Institution of Occupational Safety and Health (IOSH)
Lemur Health
LGBT Foundation
M for Menopause
Mediabrands
MenoClarity
Menstrual Matters
SKC Occupational Health
Smarter Change
Society of Occupational Medicine
Technical Committee CH/338, Menstrual Products
The Glasgow School of Art
The Menopause Consortium
The University of Sheffield
TOTM
UNISON
University of Glasgow
University of St Andrews
Versus Arthritis
Wm Morrison
Women of a Certain Stage
Your Healthcare Academy

Information about this document

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Use of this document

As a guide, this British Standard takes the form of guidance and advisory recommendations. It is not to be quoted as if it were a specification or a code of practice.

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0 Introduction

0.1 General

Understandings of menstruation, menstrual health and peri/menopause in Western society, including the UK, are complex and influenced by many factors that are as yet not fully understood or openly discussed. This can make it difficult for women, trans and non-binary people to understand and manage their physical and mental health symptoms, and for health care professionals and workplaces to adequately support them.

The way we work is changing; however, in many cases, core working practices are still not far from those that were designed at a time where women were not equally represented or prioritized as employees. As pressure grew for women to enter the workforce, it became a case of them fitting into existing frameworks where their specific needs were not served, and in many cases are still not served today.

Within this document we use the term “symptoms”; this is used to recognize that, even though menstruation and peri/menopause are not medical conditions, some find that these changes have an impact on their quality of life.

NOTE 1 It is important to recognize that some symptoms associated with menstruation and peri/menopause can be caused by an underlying medical condition (seeAnnex A).

NOTE 2 Throughout this document there are references to both menstruation and menstrual health. For the purpose of this document, menstruation refers to the monthly period in which bleeding occurs, while menstrual health has a broader meaning including physical or mental health and wellbeing (e.g. including underlying medical conditions) related to the menstrual cycle.

NOTE 3 The everyday use of the term “menopause” often refers to the entire duration of the menopause transition, unlike the medical definition, which differentiates perimenopause, menopause and post-menopause. In this document we use the term “peri/menopause” to reflect the entire menopause transition.

In many cases, menstrual health and peri/menopause are managed independently and privately without the need for workplace support. However, organizations can provide adjustments or support to create a more comfortable working experience.

It is important to understand the impact of culture on how menstruation and peri/menopause are often represented. Portrayals of menstruation and menopause in the workplace are uncommon, and when these narratives are explored, they tend to focus heavily on severe physical, emotional and psychological symptoms. This can influence general attitudes and beliefs that reinforce the stigma that menstruation is always a problem and that menopause is a negative, isolating phase. Portrayals of menopause as an age-related condition are also not helpful to younger employees experiencing menopause prematurely. Furthermore, diverse needs and experiences linked to ethnicity, religion, sexual orientation, gender identity and neurodivergence are often neglected.

It is also important to recognize that peri/menopausal symptoms can coincide with significant mid-life challenges and responsibilities, and research has shown that stress and symptoms of peri/ menopause are inextricably linked. For example, maintaining job performance might be difficult when employees are also dealing with stressors such as a combination of existing health conditions; fertility issues; managing childcare and care for older parents; worrying about children leaving home; financial constraints; relationship breakdown or other stressful life events. When there is a lack of knowledge within the organization of how to support employees through these stressors, as well as with the symptoms of menstruation, menstrual health conditions and peri/menopause, this can lead to issues such as presenteeism, absenteeism, disengagement and additional/increased turnover costs.

NOTE 4 SeeBS ISO 25551for guidance on generating a carer-inclusive workplace andBS ISO 25550for guidance on generating an age-inclusive work environment.

This document can assist organizations to identify misconceptions around menstrual and peri/menopausal health, and the impact the stigma surrounding them can have on workplace support. The practical workplace adjustments and activities recommended here support existing activities around workplace wellbeing and occupational health and safety initiatives. These workplace adjustments support and complement existing medical provisions in a more rounded and holistic way.

Within this standard there are examples of adjustments that can be made; however, the experiences and impact of menstrual health and peri/menopause vary for each employee, as does their support and environment requirements or preferences.

0.2 Why start addressing this topic now?

Within the current landscape of skills shortages, recruitment challenges and attrition of talented employees, alongside a significant number of workers experiencing peri/menopause in the workplace; and in a time where employees and stakeholders are more socially aware and have expectations about their wellbeing at work, it is important that organizations re-evaluate their job and workplace designs to make them suitable for all employees. Under the Equality Act 2010 [1], employees have a right to be protected from disadvantage or less favourable treatment if they have one or more “protected characteristics”. There is no expressly protected characteristic of menstruation or menopause. Instead, legal protection is likely to arise as a result of protection from discrimination in relation to sex, age or disability (or a combination thereof ).

The Health and Safety at Work etc. Act 1974 [2] states that it is the duty of every employer to ensure, so far as is reasonably practicable, the health, safety and welfare at work of all employees. This means positively protecting employees, where reasonably practicable, from foreseeable risks that arise out of or in connection with their work. Therefore, at times (on a case-by-case basis), this might extend an employer’s legal duty to ensure that work or working conditions do not exacerbate an employee’s symptoms to such an extent that would expose them to material risk to their health, safety or welfare, or cause harm.

The Management of Health and Safety at Work Regulations 1999 [3] has the requirement to risk assess factors that arise out of or in connection with work that affect health, safety and welfare. Therefore, when an employer is notified of any known condition, issue and/or symptoms, which might mean that an employee is more likely to be exposed to occupational risk or could be harmed while at work due to their specific situation, the employer might need to undertake some form of person-based risk assessment and put in place arrangements to manage health and safety risks. Where relevant, this is done on a case-by-case basis.

This British Standard can assist organizations to understand which actions relating to menstrual and peri/menopausal health can be taken to protect the welfare of employees in the workplace, and to make the work environment more suitable for everyone.

There is also a financial case for taking into account menstrual and peri/menopausal health in the workplace. A proportion of employees experience symptoms which leave them feeling they have no other option but to leave the workplace if they cannot find support at work. There are direct financial costs associated with the recruitment and training of new staff to replace those who have left. There are also indirect costs due to the loss of talent, knowledge and experience within the organization.

The lifestyle and emotional costs that employees face when they leave employment are equality and human rights issues, with tangible financial costs for both employees and employers.

Generating awareness of good practice when supporting employees and creating positive work cultures benefits organizations by:

increasing employee engagement and productivity;
improving the health and wellbeing of employees and boosting their healthy working life expectancy which, in turn, benefits their immediate families;
increasing employee retention, and reducing the costs of attrition, recruitment and training;
improving leadership culture by generating more awareness among managers without personal or lived experience; and
improving diversity and inclusion objectives by preventing the loss to the workplace, due to inadequate or inflexible working conditions.

Throughout this standard, recommendations are made for organizations to take into account. These recommendations are not exhaustive; however, they provide a good framework from which to start.

0.3 Myths around menstruation and menopause

Myth 1: Everybody is talking about menopause and menstruation - the workplace does not need to/should not provide support

Response: While it might seem like lots of people are talking about menstruation and menopause, the reality is that employees do still struggle to find support. It cannot be assumed that everybody has support outside of work nor that they are receiving the support they need from medical professionals. Those with menstrual health conditions can struggle to get a diagnosis and access the treatments or support they need to help manage their symptoms. Many employees do not know what to expect of peri/menopause and can be caught off guard when signs and symptoms first appear. Knowledge of menstrual health and peri/menopause is known to affect an employee’s experience of menopause both for themselves and those around them (partners and significant others, colleagues, managers, etc.). Aspects such as ageism and gendered ageism are real issues, especially in the workplace. In some cases, there has been a derogatory view that women are less capable or that older women are of less value to organizations. Fearing that gendered ageism and unconscious bias might prevail in their organizations, employees do not often communicate that they are experiencing peri/menopause. Other elements which are sometimes forgotten are cultural differences, stigmas, neurodivergence and intersectionality. The additional burden of discrimination on employees from marginalized backgrounds might deter them from disclosing their situation and seeking support.

Myth 2: Menstrual pain is not that bad and people who say it is have low pain thresholds

Response: Menstrual pain can vary from mild discomfort to severe cramps with a stabbing pain. In the case of debilitating pain, there might be an underlying cause and if an employee approaches their organization, it is important that their experience of pain is not underestimated based on others’ lived experiences.

Myth 3: Everybody’s experiences of menstruation and menopause are the same

Response: Experiences of menstruation and menopause vary significantly, which is why it is important for any workplace to take into account individual experiences and not just design for the average experience. Compounding factors that can influence an employee’s experience include ethnicity, age, gender, disability, thinking style/neurodivergence, sexual orientation, job role and pay. It is important to avoid stereotyping or generalizing, and enable each employee to seek support for their individual needs.

Some examples of how characteristics can influence an employee’s experience of menstrual health or peri/menopause are listed in Table 1.

Myth 4: Menopause happens overnight

Response: This is not the case, as menopause is typically arrived at after a gradual process called perimenopause. This usually happens in midlife but can happen earlier, with the length of time, and the number and severity of symptoms depending on the employee.

Myth 5: Menopause only has an impact on women above the age of 45

Response: It is a common misconception that menopause is limited to women of an older age, although this is the case for the vast majority. It has been reported that 1 in 100 experiences menopause before the age of 40, either naturally or due to a medical intervention [4]. Anyone going through medical menopause, whether temporary or permanent, can experience similar symptoms, often more acutely, as those experiencing menopause naturally at a later age, and might require similar support in the workplace. Trans men and non-binary people can also experience menopause.

Myth 6: Post menopause you do not experience any menopausal symptoms

Response: Although menopausal symptoms generally end several years after someone’s last period, symptoms can persist for varying lengths of time.

Myth 7: Menopause is much worse than menstruation - there is no support required for menstruation

Response: Conversations around menopause have been instrumental in contributing to removing the stigma and shame associated with it, and some organizations have responded by applying initiatives which are more inclusive of employees who experience peri/menopause. However, there is still a lack of discussion on topics relating to menstrual health and menstrual bleeding, due to stigma and shame, and employees who experience painful or significant menstrual symptoms can feel the need to suffer in silence and not obtain the support they require. Organizations can provide better support by taking into account the experiences of their employees throughout their lifetimes (from menstruation through to menopause and beyond).

0.4 Questions which this standard can help to address

Table 2 identifies specific clauses which address important questions in this topic.

1 Scope

This British Standard gives guidance on developing policies and practices that are supportive of the menstrual and peri/menopausal health and experience of employees in the workplace.

The standard does not cover medical guidance or clinical options outside of the workplace. However, it does include reference to qualified sources where such information is available.

The standard is of use to managers, as well as human resources (HR), health and safety (H&S), occupational health (OH), architects and interior designers undertaking office fit-outs, and specialists in wellbeing and diversity and inclusion (D&I). It is for those employees who are responsible for managing individuals’ performances, workloads, wellbeing or work environments.

NOTE 1 The recommendations are applicable to all sectors, employee demographics, and small and large organizations, and can be adapted to individual business needs.

NOTE 2 This document does not consider andropause.

2 Normative references

3 Terms and definitions

4 Introduction to menstrual health and peri/menopause

5 Practical actions

5.1 General

5.2 Physical aspects of work

5.3 Policy guidance and practice

5.4 Supportive workplace cultures

5.5 Work design

5.6 Inclusivity in menstrual health and peri/menopause at work

5.7 Examples of role adjustments

5.8 Considerations for small and medium-sized enterprises (SMEs)

5.9 Evaluation and metrics

Bibliography

BS 30416:2023

Menstruation, menstrual health and menopause in the workplace. Guide

Current

Published:

31 May 2023