The following guide forms part of the standard for workforce policies. These policies apply to all eligible staff within NHS Scotland, regardless of the board you are employed by.

What is the purpose of the Menopause and Menstrual Health Policy?

This policy aims to:

• Support employees and minimise the impact that menstrual health and menopause symptoms can have at work.
• Create an open culture where employees feel confident enough to talk about menstrual health or menopause symptoms and can ask for the support and adjustments they need.
• Increase awareness through education, inclusive discussions, and compassionate leadership.

Who is covered by this policy?

This policy applies to everyone working within NHS Scotland. That includes all employees, plus bank, agency, and sessional workers, volunteers, contractors, and anyone on placement, such as students or trainees.

In NHS Scotland, 77% of the workforce is female. A significant number of employees will be experiencing menstruation, have menstrual health conditions, and will experience or have experienced menopausal symptoms. NHS Scotland is committed to supporting good menstrual health and transition through menopause.

Manager responsibilities

As a manager, you are responsible for creating a supportive environment. You should:

• Be supportive—Listen with empathy to employees who choose to share that they are experiencing menstrual health-related symptoms, a menstrual health condition, perimenopausal symptoms or menopausal symptoms.
• Access information—Increase your knowledge and awareness of menstrual health, perimenopause, and menopause-related symptoms.
• Make adjustments—Proactively consider workplace adjustments that could help an individual.
• Review support regularly—Menstrual health, perimenopause, and menopause symptoms and needs can change over time.
• Signpost to help—Make employees aware of the support available, including occupational health services.
• Support employees who are absent from work—For any absences related to menstrual health symptoms, a menstrual health condition, perimenopause, or menopause, follow the Attendance Policy.
• Adopt a person-centred approach—If employees are experiencing challenges in their role due to menstrual health or menopause, consider having supportive conversations. You could also make the necessary adjustments outlined in the Capability Policy.

Procedure

Effectively supporting your employees with these symptoms is good management. It helps to:

• improve team morale
• retain valuable skills and talent
• address inequalities
• reduce sickness absence.

Supported conversation

When an employee tells you that symptoms are affecting them at work, approach the situation with sensitivity and have a conversation as soon as possible.

Symptoms associated with menopause and menstrual health are often considered a private and personal issue. Employees may find it challenging to discuss openly how these symptoms are impacting them at work.

Individuals may experience the following: 

• feel that their symptoms are embarrassing 
• think their manager might not understand 
• worry that they may not be taken seriously 
• fear that it might impact people’s perception of their ability to do their job

If they feel uncomfortable speaking to you, they may choose to speak with another manager. The other manager should provide a safe, confidential space for the employee to discuss their concerns. They should liaise with you as the direct manager and HR to facilitate any reasonable adjustments or support.   

Trade union representatives can also play a role in supporting your employees to have supportive conversations. 

The goal of this conversation is to agree on a support plan that works for the employee. You'll discuss any workplace adjustments or changes that could help make the employee’s work more comfortable and manageable.

After the meeting, you will give your employee a copy of the notes. This is their simple action plan and will include:

• The adjustments that you've both agreed on.
• A review date to check in and see how things are going.

Menstrual health symptoms and related conditions

Menstrual health symptoms can include heavy bleeding, pain and cramps, irregular periods, and mood changes.

Related conditions can include:

• premenstrual syndrome (PMS)  
• polycystic ovary syndrome (PCOS)
• premenstrual dysphoric disorder (PMDD)
• endometriosis
• fibroids
• adenomyosis  

Common symptoms of perimenopause and menopause include:

• hot flushes and night sweats
• sleep disruption and fatigue
• difficulty concentrating, memory problems, loss of confidence
• mood changes, including anxiety and depression
• headaches, bone and joint problems and pains
• irregular periods and heavy bleeding

Workplace support and adjustments

There are many practical adjustments which can support all employees

at work. These will be different for everyone, and not all adjustments are possible in every workplace.

Examples of adjustments that can be considered include:

• easy access to drinking water, toilets, and changing facilities
• flexible or more frequent breaks
• flexible working hours or location
• access to period products
• a fan or better ventilation
• lightweight or additional uniforms

A referral to occupational health for advice on adjustments is an option. However, it shouldn't be the default first step for getting the support your employee needs.

Absence reporting and recording

If an employee is absent from work due to menstrual health, perimenopause, or menopause-related issues, they should report the absence as normal, following the Attendance Policy. As a manager, you should follow the absence recording procedures outlined in the same policy.

Resolution of disagreements

If a disagreement arises, the employee has the right to raise the issue under the Grievance Policy. It may be appropriate for either party to seek advice on resolving the matter from HR colleagues or a trade union representative. They should seek early resolution wherever possible. 

Useful links

• Menopause in the workplace
• NHS Inform - Menopause
• Guide to reasonable adjustments