The cursor hovered over the “send” button at the top of the email, and it was a good 30 minutes before Judith Murphy finally summoned the courage to press it, she recalls. The modern languages teacher is 51 years old and, two years ago, the perimenopausal symptoms she was experiencing became impossible to ignore. She was, she says, floored by crippling fatigue, chronic breast pain and anxiety.

The email was a survey going out to all colleagues - some 300 teachers and support staff - to ask if other women at George Heriot’s School in Edinburgh were struggling and whether they, too, needed support.

After sending it, Murphy was all set to hide away in her classroom for the remainder of that day, so plagued was she with doubt about whether she had done the right thing. While she had the support of the school’s senior management team, the received wisdom in society seemed to be that you should keep schtum, soldier on and never admit that the menopause could be tough. What if her colleagues preferred it that way? What if no one responded? What if they then looked at her differently?

“I really felt as if I had unleashed some terrible secret,” she says.

It is no puzzle as to why Murphy felt such trepidation. Half of the population is destined to go through the menopause - provided, of course, that they live long enough. But it is a time in a woman’s life that has long been shrouded in secrecy, with jokes about hot flushes often the closest people come to an open discussion.

‘Overwhelming’

Recently, things have started to change amid a widening acknowledgement that the menopause can be a hugely challenging stage in a woman’s life. Last month, BBC Breakfast held a menopause-themed week and explored the issues women face. Presenter Louise Minchin spoke candidly about her struggles with heart palpitations, hot flushes, anxiety and a short fuse. She described the menopause as like “going over some sort of cliff edge”.

The following week, the Scottish government also stepped up to become the first administration in the UK to hold a debate on the issue. The minister for older people, Christina McKelvie, declared that the menopause was finally getting the attention it deserved, adding: “We would all agree that the menopause has always been, at best, stigmatised, ignored or treated as a joke and, at worst, used as a way to degrade women.”

So Murphy unwittingly became part of the vanguard - and the response was far from the deafening silence she had feared. Soon after she sent out her email, the responses started to land from colleagues, many of whom congratulated her for her bravery in broaching one of the last remaining taboos.

Murphy’s survey established that there was an appetite for support, with 40 staff responding that they would like to raise awareness of the menopause and 40 saying that they would welcome a visit from a specialist to provide information, advice and tips. So, one Wednesday after school, in the midst of the exam period, George Heriot’s held its first menopause event for staff in its almost 400-year history.

That evening, principal Lesley Franklin went from never having talked about the menopause with colleagues - despite recently having gone through it herself - to being part of what turned out to be a wide-ranging, no-holds-barred discussion.

Vaginal dryness. Drop in libido. Heavy periods. Perhaps not terms you would expect to hear bandied around the staffroom of one of the most prestigious private schools in Edinburgh. However, after the event, led by consultant gynaecologist Ailsa Gebbie, who has run a menopause clinic in the capital for 30 years, one teacher in her late forties described the session as being “as effective as hormone-replacement therapy”.

“We spend our lives at work,” she said. “We need to feel comfortable. Events like this are what helps.”

Murphy describes the experience of the menopause as being “overwhelming” and says it had a more significant effect on her than puberty or becoming a mother. It led to her having to make lifestyle adjustments to cope, including taking a six-month break from her nine-year relationship and asking for changes at work.

She used to coach the basketball team after school, but the fatigue, combined with the fear of a heavy bleed as she ran across the court, or the excruciating pain if she was accidentally bumped in the chest, forced her to give it up. Instead, she now runs a more sedate Americana music club at lunchtime.

Murphy says: “The demands of the job of teaching weren’t bothering me, but the evening fatigue was overwhelming so I just decided to make a shift towards coming in early, working at lunchtime and going away sharp. Since I made that change to my day, it has just been so helpful.”

Some women sail through the menopause but for others it hits like a “ton of bricks”, says Gebbie, the gynaecologist whose specialist advice provided the focus for the George Heriot’s event.

The most common symptoms are fatigue, hot flushes and sweats, and these are likely to continue for “years, not months”, she says. Although she stresses that it’s a phase that will pass (see box, page 16), it can last for more than a decade - although not usually at the same level of intensity; the symptoms will still be there, but “more in the background”, she explains. And work does tend to become tougher, adds Gebbie, for those in demanding professions and public-facing roles where there’s no space to let off steam or have a break.

Teaching is, of course, a predominantly female profession with women making up 90 per cent of primary teachers and 64 per cent of secondary teachers in Scotland. Gebbie says the menopause usually hits between the ages of 45 and 55. The latest teacher census, published last year, shows that 21 per cent of primary teachers in Scotland are women aged 45-54, as are 15 per cent of secondary teachers.

Despite the high number of staff in the demographic most likely to be experiencing symptoms, teachers say the menopause remains poorly understood in schools. The upshot, according to the EIS teaching union’s education and equality officer, Jenny Kemp, is that as female teachers get older, they may not feel welcome or like they belong in school.

The EIS has issued new guidance about what schools can do to help women going through the menopause. The key messages female teachers were keen to get across in the guidance were about the need to get the basics right, says Kemp. This included things such as having a sufficient number of staff toilets, as well as teachers having the ability to control the temperature in their classrooms.

Speaking up

“Schools are not built around women’s biology, so if a teacher needed to splash their face with cold water or change their underwear, there might not be a suitable space,” says Kemp. “Similarly, if they were drenched in sweat by the time they got to school, there might not be any showers or changing facilities.

“There was also a lot of concern about temperature control and moderation. The new schools are almost as bad as the old ones - there are not necessarily windows you can open or blinds you can easily close. The upshot is people get really hot.”

Teachers who got in touch with Tes Scotland said that the “highly visible nature of teaching” and the fact that teachers always had to have their “game face on” made it a particularly tough career to be in while experiencing menopausal symptoms.

One of the biggest things Kemp believes a school could do to support women is to facilitate “open discussion” - which is, of course, what George Heriot’s did. As Franklin, the school’s principal, puts it: “The very fact that we have done this means that people will be more willing to speak - and the more willing they are to speak, the more we can put things in place to help them.”

Emma Seith is a reporter for Tes Scotland. She tweets @Emma_Seith

This article originally appeared in the 14 June 2019 issue under the headline “It’s as effective as hormone-replacement therapy”