Thistle Health Collective · GP-led menopause education for workplaces
Accomplished women step back from work every year — not because ambition ran out, but because nobody taught them, or the people around them, what menopause actually is. Dr Romey Giles, a practising GP, teaches both halves of that conversation.
The average age at menopause. Perimenopause — when symptoms usually begin — often starts years earlier, in the early-to-mid forties.
Around three in four women experience symptoms, and roughly one in four describes them as severe.
Symptoms commonly last four to eight years — a long stretch to navigate in silence, and a temporary one.
In a large UK survey, one in ten women who worked during menopause had left a job because of their symptoms.
Figures drawn from NHS guidance and the Fawcett Society’s Menopause and the Workplace survey (UK, 2022). Individual experience varies widely.
Women in their late forties and fifties are usually the most experienced people in the room — and, statistically, the fastest-growing group leaving the workforce early. The exits are rarely dramatic: a quiet move to part-time, a promotion declined, an early retirement that surprises everyone. Behind many sits the same untold story — unmanaged symptoms, a workplace that never mentions them, and the fear of being seen as less capable. None of it is inevitable: symptoms are treatable, the adjustments that help are cheap, and what’s missing is education.
“The most experienced women in your organisation are not a retention risk. Silence is.” Dr Romey Giles — GP & Medical Educator
Menopause isn’t a single event you wake up to at 51. It’s a transition that unfolds over years — and knowing which stage you (or your colleague) are in changes everything about what to expect and what helps.
Typically early-to-mid 40s · lasts years
Hormone levels begin to fluctuate — not fall smoothly, fluctuate — while periods continue. This is when most symptoms actually start: disrupted sleep, hot flushes, mood swings, brain fog. Because periods haven’t stopped, many women (and their doctors) don’t connect the dots for years.
One point in time · average age 51
Technically a single milestone: the point twelve months after the last period. Everything before it is peri; everything after is post. Surgery, some cancer treatments, or early ovarian insufficiency can bring it on much earlier and more abruptly — sometimes in a woman’s thirties.
The decades after — often the best ones
For many women, symptoms gradually ease and a striking steadiness arrives. Long-term health deserves attention now — bone density and heart health in particular — but this stage is also where many women describe their clearest thinking and boldest career moves.
Every body runs its own schedule. These stages describe the common pattern, not a rule — which is exactly why guessing is a bad strategy and education is a good one.
Symptoms don’t stay home when you go to work. Here is what the most common ones look like in a professional setting, for anyone who’s wondered — or wondered about a colleague.
A sudden wave of intense heat, often with a racing heart — in the middle of a presentation, a client call, a packed meeting room. Brief, visible, and mortifying only because nobody talks about it.
Night sweats and 3 a.m. wakefulness add up to running a demanding job on five hours of sleep — for months. Much of what reads as “fading energy” is simply exhaustion with a hormonal cause.
Losing a word mid-sentence, re-reading an email three times, blanking on a name you know perfectly well. It feels like lost competence. It isn’t — it’s a temporary, well-documented cognitive effect of fluctuating oestrogen.
New-onset anxiety, irritability, or low mood — often in women who’ve never experienced them before. Frequently misdiagnosed, and one of the strongest reasons women quietly lose confidence at work.
Perimenopause can make cycles erratic and heavy, turning travel days and long meetings into logistics problems no one else knows they’re solving.
The symptom that does the career damage. Symptoms get misread — by the woman herself — as decline. She starts avoiding visibility, declines the stretch role, and eventually concludes it’s time to go. This one is preventable with knowledge alone.
The key fact: symptoms are treatable and temporary — competence is intact. Lifestyle changes, workplace adjustments, and medical options including hormone therapy (a conversation for a woman and her clinician) resolve or ease most of what’s listed above.
Dr Romey teaches mixed rooms on purpose. Menopause stops being a private burden the moment everyone in the room shares the same basic knowledge.
For women navigating perimenopause and menopause
For men, colleagues, and managers — this page is for you too
Say: “Is there anything that would make work easier right now? Whatever it is, it stays between us.”
Don’t say: anything that makes it the punchline. The jokes are exactly why nobody asks for help.
When a woman with twenty-five years of experience retires early, the loss isn’t a headcount. It’s the client trust built over a decade, the unwritten knowledge of how things actually get done, and the mentoring pipeline for everyone behind her. Replacing a senior employee routinely costs months of salary — replacing her judgement can take years.
Menopause arrives at exactly the age women step into senior and executive roles. When symptoms go unsupported, the candidates for your next leadership round quietly take themselves out of the running — and a decade of gender-equity progress unwinds one resignation at a time. Every woman kept through the transition is a leader retained, a mentor for the women behind her, and proof that the path doesn’t end at fifty.
A few hours of education for staff and managers. A policy that names menopause alongside other health topics. Temperature control, flexibility, and a culture where asking is safe. Organisations that do this keep women through the transition — and keep them into the postmenopausal decades, which many describe as their most productive and decisive years.
To be explicit about what this is not: it is never a reason to hesitate over hiring or promoting women in midlife. That conclusion is discrimination — and poor strategy, since it selects against the most experienced cohort in your market. The point is the opposite: the talent is exceptional, and the support that keeps it costs almost nothing.
Alongside her sessions, Dr Romey prepares a tailored organisation impact report: from your workforce’s aggregate demographics, it maps what menopause means for your organisation today, the five-year trajectory, and the effect on your leadership pipeline — ready to take to your board.
Built from aggregate headcounts only — no individual employee data is ever collected or stored.
Every session is evidence-based, plain-spoken, and designed for mixed audiences — because menopause isn’t just a women’s issue, it’s a workplace one.
The whole-team session: what menopause is, what it isn’t, what it looks like at work, and how to talk about it without awkwardness. The single highest-leverage session for changing a workplace’s culture around it.
Enquire about this session →How to open the conversation, handle disclosure well, make adjustments without drama, and build a policy that people actually use. Includes scenario practice for the conversations managers fear most.
Enquire about this session →A candid, warm, occasionally funny talk on menopause and working life — for conferences, leadership offsites, and awareness events. Tailored to your audience and industry.
Enquire about this session →Small-group and one-to-one sessions for women navigating the transition: making sense of symptoms, preparing for clinical appointments, and making career decisions with a clear head instead of a foggy one.
Enquire about this session →
Dr Romey Giles is a practising GP and medical educator with the Royal Australian College of General Practitioners (RACGP). She believes the menopause conversation has been left to whispered corridor exchanges for about fifty years too long — so she founded Thistle Health Collective to change that.
She teaches menopause the way it should have been taught all along: to everyone, in plain language, grounded in current evidence, and connected to the place where its cost is most visible and least discussed — working life. Her sessions put women’s lived experience and the business reality side by side, because they are the same story told from two directions.
Dr Romey works with organisations of every size, from leadership teams to all-hands rooms, and with the women themselves. Her measure of success is simple: fewer brilliant women concluding, wrongly and alone, that it’s time to go.
Tell Dr Romey what you have in mind — a team session, manager training, a keynote, or you’re not sure yet. She’ll reply with availability and a suggestion for the right place to start.
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