Female Health

• Menopause is defined as the single point in time when menstruation has ceased for 12 consecutive months.
• The average age at which women reach the menopause is 51, but it normally ranges between 45 and 55.
• The period of hormonal change lasts about 6 years.
• It may be accompanied by the following symptoms: hot flushes, night sweats, sleep disturbances, fatigue, poor concentration and memory, weight gain, irritability, mood disturbances and skin dryness.
• There is an increased risk of osteoporosis and cardiovascular disease.
• There may be a lowering of self-esteem which leads to poor psychological health.
• 10-15% of women have severe symptoms.
• Menopause occurs at a challenging time for many women – elder care, increasing job responsibility, chronic illness, teenage children, ‘empty nest’ syndrome.
• The menopause often attracts stereotypical and largely negative responses and is not well understood.
• Women are reluctant to disclose to colleagues.
• The menopause is not an illness but changes in oestrogens levels can result in intermittent symptoms around this time which can be exacerbated by work.
• Sufferers are often criticised, ridiculed and suffer harassment when the subject is broached.
• The University of Nottingham were commissioned by the BAWP to research the experience of ageing at work for women police officers aged 40+. The full report can be found on the BAWP website.

Best Practice

• Raise awareness amongst managers about the health implications of ageing in general and the menopause in particular; this should form part of managers training.
• Increase formal and informal sources of support and information – women’s networks; local contact numbers for advice; formal support and information from Occupational Health Units.
• Improve aspects of the physical working environment – more comfortable uniforms; women only showers, toilets and restrooms; more supportive car seats; reduction in weight of equipment carried when on foot and regular breaks; suitable desks, chairs and computer screens; improved ventilation/provision of fans.
• Allow greater flexibility in job roles and working arrangements by making use of the flexible working provisions.
• Workplace health promotion – regular health checks; fitness programmes and facilities (all ages); easier access to Occupational Health Units.
• Standalone policy on menopause or integrate this into the attendance management policy.Any such policy should include the following:-
• Recognition that the menopause can be a problem but is not an illness or disability.
• A Health and Safety Risk Assessment which includes prevention and control measures in relation to the menopause.Paid time off for medical appointments.
• Menopause related sickness absence excluded from attendance management formulas i.e. Bradford formula.
• Training in understanding and dealing with the menopause for managers, safety representatives, Federation and Union representatives.

Useful Websites
www.simplyhormones.com
www.londonwomensclinic.com

There are many risks to the Health & Safety of ‘new and expectant mothers’. A new and expectant mother is a term used for women who are pregnant, have given birth in the last 6 months or are breast feeding. These risks include exposure to chemicals and other harmful agents and physical hazards such as manual handling.

Pregnancy should not be treated as an illness, however, normal working conditions may not be suitable during pregnancy and whilst breast feeding. The HSE published guidance in 2003 to help employers provide a safe and healthy working environment. The HSE guidance emphasises the risk of muscular skeletal disorders during pregnancy.

Hormonal changes can affect ligaments increasing susceptibility to injury. Following a caesarean section there is likely to be a temporary limitation on lifting and handling capability.

Fertility Treatment

Men and women sometimes need time off work for fertility treatment. Families going through fertility treatment will need support as this is a sensitive time and for the treatment to be successful care needs to be taken.

Best Practice:

• Provide training in how work may be altered to accommodate changes in posture and physical capability, including taking breaks during pregnancy.
• Consider job rotation, relocation or suspension on full pay.
• Liaise with the woman’s own GP to ensure capability
• Risk assess the situation after a return to work from maternity leave.
• Ensure your force has a fertility treatment policy which includes an agreement for paid leave for such treatment.

Useful Website
hse.gov.uk/pubns

Cervical cancer is thought to be caused by infection with the human papilloma virus or HPV. HPV is nearly always sexually transmitted and is the major cause of the two types of cervical cancer. The most common symptom of cervical cancer is bleeding from the vagina at other times than during a period.

You may have bleeding:

• Between periods
• After or during sex
• At any time if you are past menopause

Some women also have:

• A vaginal discharge that smells unpleasant
• Discomfort or pain during sex

Cervical cancer can be easily diagnosed and treated if caught early, women aged 20 to 64 should be screened every 3 to 5 years. Cervical cancer is the 2ndmost common cancer in the under 35 age group. 2,700 women in the UK are diagnosed yearly.

There are 24,000 severely abnormal cervical screens each year. Recently the NHS has commenced a vaccination programme for teenage girls who wish to be protected against cervical cancer.

Best Practice:

• A policy on cancer screening which includes paid time off for screening and follow up appointments and necessary treatment.
• Providing staff with information on screening. (This facility should be available to all women workers regardless of age and hours worked.)
• Regular exercise and a low fat diet can help to prevent all forms of cancer and heart disease.

Useful Website
www.womenshealthlondon.org.uk

Pre-menstrual syndrome (PMS) can be very debilitating. Some women can experience extreme emotions such as depression, aggression, tiredness, irritability and bloatedness.

Changes in the levels of progesterone and oestrogen can cause headaches. According to The National Association for Pre-Menstrual Syndrome (NAPMS) one woman in three will regularly experience PMS symptoms and 1 in 20 has symptoms of severe PMS.

There is a lack of research on the menstrual cycle relating to the exposure to hazards at work. However, the research suggests a number of factors can be associated with menstrual disorders. These include strenuous physical work, demanding work, stressful work, exposure to environmental noise, hot and cold working conditions.

Symptoms

Tiredness, irritability, weepiness, lack of concentration, sore and tender breasts, feeling bloated and back ache are the main symptoms of PMS. Some women may also experience severe cramping pains, sometimes accompanied by nausea and diarrhoea.

To alleviate the symptoms eat calcium rich diet, reduce salt intake, and increase Potassium (found naturally in bananas, oranges, figs and tomatoes). Eat less meat and more fruit and vegetables. Increase oxygen flow with exercise and deep breathing. Heat often helps, try a hot bath or hot water bottle. Also take vitamin supplements such as vitamin B6 and evening primrose oil.

Toxic Shock Syndrome (TSS)

TSS is a rare but potentially fatal illness that affects women. It is caused where normally harmless bacteria, commonly found in the nose, armpit, groin or vagina suddenly produce toxins, and it is associated with women using tampons.The symptoms include sudden high temperature, vomiting, a rapid pulse, fluid loss, sore throat, aching muscles, skin rash, dizziness, headaches and confusion.

Best Practice:

• Raise awareness of the risks in the workplace.
• Improvements in workplace facilities particularly for the disposal of sanitary items.
• The development of workplace guidelines for PMS sufferers.
• Nomination of a designated person (preferably a woman) to provide advice and support.
• Conduct a review of sickness and absent management procedures and suggest modifying the trigger levels for sickness absence procedures to take account of PMS.
• Contact local Federation and Union reps.

Useful Website
http://www.usdaw.org.uk

Breast cancer is the most common cancer in the UK. About 48,000 women get breast cancer in Britain each year. Most (eight out of 10) are over 50, but younger women, and in rare cases, men, can also get breast cancer.

A woman’s breasts are made up of fat, connective tissue and thousands of tiny glands, known as lobules, which produce milk. If a woman has a baby, the milk is delivered to the nipple through tiny tubes called ducts, which allow her to breastfeed.

Our bodies are made up of billions of tiny cells. Normally, cells grow and multiply in an orderly way. New cells are only made when and where they are needed. In cancer, this orderly process goes wrong and cells begin to grow and multiply uncontrollably.

Learn more about the causes of breast cancer.

Breast cancer can have a number of symptoms but usually shows as a lump or thickening in the breast tissue (although most breast lumps are not cancerous). If cancer is detected at an early stage, it can be treated before it spreads to nearby parts of the body.

Learn more about symptoms of breast cancer.

If you notice any of these symptoms, see your GP as soon as possible. After an examination, they may feel it necessary to refer you to a specialist breast cancer clinic for further tests.

Read more information about how breast cancer is diagnosed.

Types of breast cancer

There are several different types of breast cancer, which can develop in different parts of the breast. Breast cancer is often divided into non-invasive and invasive types.

Non-invasive breast cancer

Non-invasive breast cancer is also known as cancer or carcinoma in situ. This cancer is found in the ducts of the breast and has not developed the ability to spread outside the breast. This form of cancer rarely shows as a lump in the breast and is usually found on a mammogram. The most common type of non-invasive cancer is ductal carcinoma in situ (DCIS).

Invasive breast cancer

Invasive cancer has the ability to spread outside the breast, although this does not mean it necessarily has spread. The most common form of breast cancer is invasive ductal breast cancer, which develops in the cells that line the breast ducts. Invasive ductal breast cancer accounts for about 80% of all cases of breast cancer and is sometimes called ‘no special type’.

Other types of breast cancer

Other less common types of breast cancer include invasive lobular breast cancer, which develops in the cells that line the milk-producing lobules, inflammatory breast cancer and Paget’s disease of the breast. It is possible for breast cancer to spread to other parts of the body, usually through the lymph nodes (small glands that filter bacteria from the body) or the bloodstream. If this happens, it is known as secondary or metastatic breast cancer.

Breast screening

The exact causes of breast cancer are not fully understood, but many factors increase the likelihood of developing it, including age and family history of breast cancer.

Women who have a higher-than-average risk of developing breast cancer may be offered screening and genetic testing for the condition. As the risk of breast cancer increases with age, all women aged 50–70 are invited for breast cancer screening every three years. Women over 70 are also entitled to screening and can arrange an appointment through their GP or local screening unit.

Read more information about breast cancer screening.

Treating breast cancer

Breast cancer is treated using a combination of surgery, chemotherapy and radiotherapy. Some cases of breast cancer may also be treated using biological or hormone treatments.

Being diagnosed with breast cancer can affect daily life in many ways. However, there is support available for many aspects of living with breast cancer including emotional, financial and long-term health issues.

One in nine women are affected by breast cancer during their lifetime. There is a good chance of recovery if it is detected in its early stages. For this reason, it is vital that women check their breasts regularly for any changes and always get any changes examined by their GP.

Learn more about how breast cancer is treated.

Find your local cancer support services (including breast screening).

Online Personal Education and Risk Assessment (OPERA)

If you are concerned about your risk of developing inherited breast cancer, you can use Macmillan’s online interactive assessment tool, which is called OPERA.

The tool is based on the National Institute for Health and Clinical Excellence (NICE) guidelines for the classification and care of women at risk of familial breast cancer. It is designed to be used by patients and health professionals to assess a person’s risk of developing the condition based on their family history of both breast cancer and ovarian cancer. This is because the genes that are mainly responsible for breast cancer are also linked to ovarian cancer.

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