Jackie Marshall, NEC, talks about the menopause

Please note that, while I may refer to women or female pronouns in this article, I understand that there may be other people that also experience menopausal symptoms, including transgender, non-binary and inter-sex colleagues. This article is intended for all members.

There are three stages to the menopause, perimenopause (the period before), menopause (during) and postmenopause (after).


Before menopause, declining oestrogen levels can cause people who menstruate to experience premenopausal symptoms. Menstrual changes, hot flashes, vaginal dryness, sleep problems and other symptoms are the result of hormonal shifts that are taking place during this time, which is called perimenopause.

The perimenopause normally begins around the age of 40 when the ovaries produce less and less oestrogen. It can last for around 10 years. On average, people experience perimenopause for four years before menopause begins.


The menopause is a natural process of ageing for women. It is the stage of life when the ovaries completely stop producing reproductive hormones and there are no monthly periods for a consecutive twelve months. A natural decrease in the production of oestrogen and progesterone, which are the reproductive hormones and regulate menstrual cycle, may cause numerous physical symptoms, which vary from person to person.

It naturally happens for many people when they are between the ages of 40 and 58. Also certain operations like hysterectomy can bring on instant menopause..

Menopause is not a gender or age issue, but it will predominantly impact on women. Most women experience symptoms of some kind. For some, symptoms can be quite severe and they can affect an individual both physically and psychologically. It is also important to be aware of the indirect effects of the menopause on other people such as work colleagues, partners, friends and close family members of individuals going through the menopause. The transition can put additional pressures and challenges on relationships.


Postmenopause is the time when a woman has not had a period for 12 consecutive months. It is said that women are in the postmenopause stage of their life from the start of the menopause until the end of their life.

Often, women think that all the uncomfortable symptoms associated with menopause disappear once postmenopause begins. This, however, is not always the case. The symptoms some women experience during their postmenopausal years can be very similar to those they have already had during perimenopause.

In some cases, complications may occur which may include:

  • Osteoporosis – the normal decline in bone density could be accelerated during menopause due to hormonal changes and the age
  • Increase in the risk of cardiovascular disease
  • Urinary incontinence


  • Hot flushes
  • Breast tenderness
  • Burning mouth syndrome
  • Brain fog
  • Chills
  • Dry mouth and dental problems
  • Dry skin
  • Fatigue
  • Hair loss or thinning hair
  • Inability to concentrate
  • Itching
  • Mood changes
  • Metallic taste in the mouth
  • Irregular menstrual cycles
  • Heavy bleeding might occur for a day or two
  • Excessive sweating during night and insomnia
  • Vaginal dryness, itching and pain during sexual intercourse and low libido
  • Frequent urinary tract infections
  • Mood swings including suicidal thoughts and anxiety
  • Fatigue
  • Weight gain due to uneven fat distribution
  • Hair, skin and nail changes
  • Heart palpitation

The list is endless. In addition to symptoms, there are some long-term health issues which include:

  • Blood pressure
  • Diabetes
  • Cholesterol
  • Glucose intolerance


Menopause pilots are currently taking place at HMP Warren Hill and HMP Littlehey, and a Menopause Working Group has been set up. It is recognised that the menopause is difficult for many women but there are additional obstacles for operational staff. It’s not so easy for operational staff to open a window or sit near a fan, as many of our wings and landings don’t have windows. It’s not so easy for operational staff to run to the loo and change items of clothing if they need to do so, as they have prisoners to supervise. It’s not so easy for operational staff to wear lighter or comfier clothing as they must wear a uniform. It’s not so easy for operational staff to work a shorter day as they’ve had no sleep because they have a shift pattern. Again, the list is endless, but the Menopause Working Group are dedicated to developing an organisational culture that supports employees experiencing the menopause.

Training packages are being put together for POA reps, menopause champions, first-line managers and senior managers.

The fitness test is always a subject of debate for the POA and it can be another stumbling block for women during the menopause. If you are suffering, then your fitness test can be deferred for 3-6 months, exceptional cases can be.

Representing over 30,000 Prison, Correctional and Secure Psychiatric Workers, the POA is the largest UK Union in this sector, able to trace its roots back more than 100 years.