Menopause in the Workplace with Lauren Fisher, CEO of Embrace Women’s Health

[00:00:00] Debbie Goodman: Welcome to On Work and Revolution, where we talk about what’s shaking up in the world of work. I am your host, Debbie Goodman. I’m CEO of Jack Hammer Global, a global group of executive search, fractional talent, and leadership coaching companies. We’re We help companies find game changing leaders for their hard to fill roles.

So feel free to reach out if you’re wondering how on earth you can find the right fit for a key role in your leadership team. My main mission with all of my work is to help companies and leaders to create amazing workplaces where people and ideas flourish, which is why I am really thrilled to have Lauren Fisher

as a guest on the pod today, Lauren is founder and CEO of Embrace a platform that focuses on transforming menopause care and education. They do this through virtual consultations and AI driven care companion and workplace educational workshops. We’re going to dig into this, all of it in a bit. Um, previously Lauren founded Black Sheep Design, a full service design and build company, which is sold in 2022.

A through line for her is her passion for empowering women. She’s a partner at Dazzle Angels and 535 Ventures, where she mentors and invests in female founded tech startups. And now with Embrace, she is committed to changing the narrative around menopause and to revolutionize women’s healthcare. No small task, Lauren.

Welcome.

[00:01:35] Lauren Fisher: Thank you. Thanks, Debbie. Yeah, it’s awesome to chat to you.

[00:01:38] Debbie Goodman: Okay. So before we get started, let’s just put a disclaimer out there. Neither Lauren nor I are medical professionals or clinicians. The information that we’re going to share today is not medical advice, but Lauren is considered an expert on the topic of menopause having done not only tons of research, she’s founded a menopause care company.

She really knows the ins and outs of what’s going on in the world of menopause. And I consider myself a very experienced menopause case study as I’m currently transitioning through it. Thankfully with a lot more ease than many. So with that caveat, Lauren, thank you again for being here. Firstly, what brought you to this particular entrepreneurial venture from a world of design to this world of women, wellbeing, and care?

Tell us about the journey.

[00:02:27] Lauren Fisher: Yeah. I mean, it seems like a very big switch, um, but it just came from my own experiences. So I ran. a previous, uh, my previous company, which was a design and build company for 11 years. Um, and over the course of building the company, I actually developed Crohn’s disease. And what I realized through my experience in just dealing with Crohn’s was just how fragmented the medical industry was, how I struggled to find the right support and care.

And then following from that was, I try to fall pregnant with my first daughter and that was a journey in itself. And I think that just got me sort of digging into the bigger issue around women’s health and obviously, you know, as you kind of mentioned before, when I spoke about revolutionizing women’s health, it’s a huge topic.

 there’s such a range of topics. Of of areas that need to be explored. So so what subsequently happened is sort of about two years ago when I left my previous business I wanted to get into the women’s health and to see where I could make an impact. And as I said, my initial focus wasn’t necessarily on menopause, but when I started chatting to women and speaking to women in their forties, um, even late thirties, what kept coming up time and time again, was just how much women were You know, they couldn’t believe how menopause has taken them by surprise.

 The sort of symptoms that they were experiencing, the, you know, really like how much they were struggling to get the right amount of support. They didn’t know where to go to for treatments. They didn’t realize that some of the symptoms that were experienced could be linked to menopause. and that was kind of what got us realizing that, this was really an area that That needs support and I, I turned 40 recently and I mean, just being in this industry now for the last year, I realized, in my sort of perspective, I thought this was something that was like way far away and something I really didn’t have to think about and then already starting to see symptoms that I can identify in myself now. So yeah, so we started, that’s kind of what got us into, focusing on menopause as a start. Uh, we launched with a research project, so we spoke to 40 women, in depth interviews with each of them to really just try and understand what they were experiencing, what the issues were they were having, who, where they were getting help, how they were experiencing the workplace, um, and that was kind of how we built from there.

[00:04:57] Debbie Goodman: Okay. Well, let’s also just say that whilst you’re doing all of this in South Africa, I’ve been in the U S during my menopause journey, and I can tell you that it is absolutely identical. You would think that in the U S things would also be far further along than they are. And it’s equally fragmented, um, unavailable, lack of information, lack of access, et cetera.

So we’ll, we’ll talk about that, more in a bit, but let’s just actually start with this. Okay. The basics of what are some of the more common symptoms? Because as you said, some are overt and obvious, some less. So, um, I can’t tell you how many women, well, actually I can tell you because you know, how many women have no idea what’s happening to them when symptoms arrive. Because this is firstly not something that our mothers.

Taught us about it’s still a bit of a taboo topic women in their circles only start talking about it when they start to experience symptoms, perhaps. And although perimenopause can arise as early as forties, maybe I think you said even late thirties, it just catches women totally off guard wondering what the hell is going on.

So let’s talk through some of the symptoms, more common symptoms.

[00:06:14] Lauren Fisher: I think the, you know, the symptoms that women commonly associate with menopause are sort of your hot flushes, night sweats, um, weight gain, more on the physical side, insomnia, heart discomfort.

But I think where You know, we’re women are struggling to identify is when it comes to the psychological and mood related. so things like, increased anxiety, cognitive issues. So we see a lot of, we’re hearing from a lot of like, forgetfulness, kind of anger, lots of mood changes, memory loss, fatigue that they didn’t experience before.

And I think what’s been happening is, you know, you also, this is a group of women that are in, in a lot of instances are dealing with a lot, they’re dealing with children, they’re dealing with aging parents, they’re dealing with big careers and you know, a lot of the time these kind of psychological impacts gets written off to, it’s just what I’m going through or I’m just dealing with a lot, not actually realizing there’s actually a hormonal connection.

 and then you’ve got your, You know, what’s been termed urogenital issues, which is around your vaginal dryness, changes in your libido, bladder incontinence, which was a big one that people, that women don’t really talk about, and yeah, and then there’s what, you know, what’s coming up more and more is there’s a lot of other symptoms that are being identified that we would never have initially acknowledged, like, for example, itchy hands and feet, um, is one that comes up hair loss, a tingly feeling in your body, um, crying spells.

So the more I think what’s been happening is there’d been so little research initially done on menopause that we actually didn’t even know. Like the, the, you know, Breath of symptoms that are, um, that are associated with it. And, now there’s, they say there’s 34 documented symptoms, obviously in specific categories.

But we’re learning more and more as things progress.

[00:08:16] Debbie Goodman: All those symptoms, you say 34 documented symptoms, um, which as we can hear, some are more obvious.

If you’re having a hot flash, you’ll know about it. Um, if you’re having a night sweat, you’re going to feel it, but a lot of the others are a lot more subtle and may, and that’s why a lot of them report that they start feeling like. Um, am I going crazy? What’s going on with me? Am I depressed? Because the mood issues can absolutely lead into depression, but then they’re also in the midst of sometimes the furore of life, um, with all the care and all the work and juggling all the balls that it’s only natural that there would be completely exhausted, uh, somewhat, um, angry and, um, and a little erratic from a, um, a mood point of view.

And then when one eventually thinks that perhaps it’s something that one needs to attend to, uh, medically, or at least do a little bit of self care and go and check things out. There are so few experts, or even if you go to your GP, your doctor, even your gynae won’t necessarily give you the information that you’re looking for because they’re not educated on the topic.

So let’s just dig into what is the current state of menopause care. And you can speak from a South African point of view.

[00:09:34] Lauren Fisher: Yeah, I mean, I think you hit the nail on the head is that it’s, it’s just been so underserved and under acknowledged. we’re understanding the South African landscape, but also with an eye on what’s been happening globally.

Um, but in South Africa alone, I mean, it stems from, there’s just a big, a lack of basic training. So practitioners, um, that we speak to, it’s like a two paragraph module in, in their medical training and, there’s over and above that, there’s no locally accredited courses in South Africa.

Um, so it’s just, yeah, there’s a big dearth of practitioners that actually have enough menopause knowledge and experience to actually Really be able to put together a proper, care and treatment plan for women. So I mean, you know, in saying that South Africa, there are, there’s a couple of really amazing practitioners out there.

So, we’ve had conversations with, um, women in other parts of Africa where, I mean, there really is so little resources. So we’re lucky in that way that there are some practitioners who have some Some deep experience, uh, but definitely not sufficient to meet the need. And I think, as you said, a lot of what happens is women are going to their general practitioner or the gynecologist who they assume would be an expert in women’s health.

[00:10:58] Debbie Goodman: only to realize that often, gynae’s are very focused on reproductive surgery. not really, not always in all instances as well versed in kind of menopause. So yeah, the feedback that we got from women was kind of Often a feeling of being dismissed or not acknowledged or which is just so disheartening and, um, and once again, perpetuates the cycle that there’s something wrong with them.

Um, just to be clear that most gynae’s do not know about minimal menopause treatment and care, they are not able to identify symptoms and this is globally. and so for anybody who’s starting to think about, okay, let me just get attended to is, um, and we will add some resources to the show notes here and provide Lauren’s, uh, Embrace details as well for anybody who’s listening and is going, okay, I clearly went down the wrong route in order to try and find some support for these symptoms.

Okay. So overall, generally healthcare Care. We know that, um, there’s not a lot of access or knowledge or availability of support. Now let’s talk about what’s actually happening in the workplace. I mean, this is a podcast about workplace. So, um, what, what is actually happening in corporations, as they relate to women’s wellbeing in the phase of menopause, is there anything,

[00:12:25] Lauren Fisher: I mean, I think, you know, I’ll firstly talk to like what’s happening with, um, with women specifically and then kind of go into like how it’s being addressed.

I think what’s historically happened is, I think there’s been the sense of, well, if we don’t know about it and nobody talks about it, then the problem doesn’t exist. And now we’re learning that’s not the case. Um, so, you know, we’re starting to see studies coming out that show that, approximately 80 percent of women going through perimenopause and menopause will experience symptoms, um, to approximately two thirds of these will have symptoms that will impact them, will have impacted them at work, and one in 10 will consider leaving the workforce.

And I mean, you kind of extrapolate these figures out, you’re talking about a very, very large group of women that are being impacted by menopause. Um, so, and I, and I think what’s, what is also starting to be spoken about more is, is this understanding that you’re often talking to a group of women who are in the prime of their careers.

So these are women who are starting to get into leadership, executive positions, and they’re the ones experiencing it, but it’s just not being spoken about. Right. So I think we, you know, I know you speak about the U. S. Maybe. You know, there’s still, you still seeing a lot of issues in terms of, not enough care, not enough support, not enough practitioners around, uh, from a South African point of view, what’s been interesting is we, we are seeing movement in the U.

1. and the U. K. towards increased awareness within the community. Corporates. So there’s been, there’s a couple of companies like, Evernal, Midi, Stella that are starting to drive menopause, uh, sort of education, awareness, workshops, in the UK, they’ve actually passed it as legislation. so this happened last year where discrimination against a woman in menopause, was is considered legal discrimination, which is, yeah, quite groundbreaking.

Um, yeah. And then I think unfortunately in South Africa, we don’t seem to be, I think things are starting to shift, but definitely, Definitely at a much slower pace.

[00:14:43] Debbie Goodman: Well, I think here’s the thing is that as we know, things start slowly and then all at once. Um, and yes, there are more women than ever in leadership roles still in the minority, but nevertheless, there are many more, than there may have been a generation ago.

And many of those women are experiencing severe or marginal symptoms of menopause and as soon as a topic becomes destigmatized, as soon as women start talking without shame and without a sense of, Oh my goodness, I’m, I’m talking about something that would be so taboo that I would be shunned in some way, or discriminated in some way.

Um, With those women in powerful roles in leadership roles are once again role modelling what it’s like to be a full bodied woman doing all the amazing things, but also, and also, needing to cope with some of the disadvantageous symptoms, then the ball starts to really roll. I recall, uh, the, must’ve been, I was still in, in South Africa.

So this would mean about five years ago. Um, in my office, one of my younger staff members actually said, Oh, she’s got to go. She’s something wrong with her. She’s just, she’s so hot at night and she can’t sleep and, um, and just something must be wrong. And it was almost like she, she was first of all, very panicked.

 and because she was only in, I think her late thirties, early forties, she had absolutely no idea what was happening. And I, it was almost like I felt I needed to mother her in order to say, okay, this is likely what’s happening and it’s okay for you to talk about it here. And here is, here’s how we’re going to help.

Now, the more now, if I was not at my phase of life. I would not have had the knowledge myself. I would not have been able to guide. I would not have been able to de stigmatize. I would not have been able to normalize, um, the conversation. And I might have been equally in the dark. So the more women there are who know what’s going on, the more we can be passing this down to our female colleagues, or along the line with our female peers and our male peers, because they’re terrified too.

How do we talk about this? Um, what do we do about it? And of course, there’s nothing so enraging as telling a woman that she’s hormonal and, um, do not even go there. So I think that it’s slow, but it hopefully is going to become something that will snowball. And I think what certainly what I’m seeing is that where there’s money, usually research and products and support follows.

So we, I have a sense that as the commercial viability of menopause care, um, certainly in the private sector becomes more of a, a commercial opportunity, we will certainly start seeing, um, I would say in the next shorter while, um, a greater prevalence of, um, of availability of support.

[00:17:49] Lauren Fisher: I mean, firstly, kudos to you for being able to take that woman, and be able to talk her through it. Cause I think it’s, it’s definitely the exception, in terms of having these conversations in the workplace. And like a lot of what we’re hearing from, from women who are experiencing menopause is, There is, I think that there’s this perception of feeling like, Oh, I’m past my prime.

I’m going to be seen as irrelevant. Um, you know, it’s kind of this aging bias that we see in our society at the moment. And I think a lot of what needs to shift is also our own perceptions of women and, and kind of like owning this phase like this is what’s happening. This is what I’m going through.

[00:18:29] Debbie Goodman: I’ll, you know, there’s a massive wisdom that comes out of it and, and how do I kind of take that on now and make it mainstream. I think that’s the thing to, to be mainstreaming an issue that is going to be, um, that it happens to, all women who live long enough. So it’s an inevitability, and not only is there lack of information and access.

There’s also a lot of misinformation out there. So can you talk a bit about some of the myths? We spoke about this being a myth busting conversation as well. Um, what about that?

[00:19:06] Lauren Fisher: And I think you’ve, you spoke to the first one already, which is this perception that menopause only happens to, you know, people that are older, kind of late forties, fifties.

And I think the, The whole idea of perimenopause often gets overlooked and it can happen to women as young as, kind of mid thirties uncommon, but it, it really does happen and it can be very distressing when it does. Um, so I think that’s the first one. There’s a lot of myths around hormone replacement therapy, which then I’ll call.

menopausal replacement therapy. so there was a study done in 2002 that put a lot of fear in women about the risk of breast cancer. Um, subsequent to that, they’ve realized there were many discrepancies in that study and you know, the IMS have released guidelines that said that menopause, that taking the risk of, of breast cancer with taking MRT is actually very low.

Yes. Can we actually just pause there a second?

[00:20:08] Debbie Goodman: Because that was certainly something that I was very fearful of. I have cancer and risk of cancer in my family and it was almost like, well, okay, I’m going to go through menopause and HRT is going to be off the table for me. And I was lucky enough to find a menopause expert who had Not only examined that particular research study and was aware of the discrepancies but also subsequently the follow up research

But unfortunately, in the common ether, just that early study is what most GPs and gynae’s and anybody else that you speak to, that’s the thing that has stuck. If you’ve got risk of cancer in your family history then it’s complete, a complete no, no, and off the table Once again the caveat me the Lauren

I are medical practitioners, but just to be aware that this is Is something to, um, to actually inquire about, to not just take as the blanket truth. There have been subsequent studies to, um, to really probe and penetrate and disclaim what that initial study had initially said, because there were discrepancies in that research that have been significantly misrepresenting the actual truth.

So, um, So that’s just a really, really vital piece of information for some women who think that they would be automatically excluded from HRT.

[00:21:27] Lauren Fisher: Yeah, and I think, I think, as you said, uh, it, it really all comes down to finding the right practitioner who understands the nuances around HRT, I mean, and, it’s comes down to, as you said, looking at your family history, it’s the type of HRT that you’re going to be on, whether it’s oestrogen or whether it’s combined, it’s the form that it comes in, um, and the right practitioner will be able to guide you and take you through, um, The relevant tests.

But as you said, it’s created a lot of fear. If you look at, sort of MRT usage over the last 20 years, it had this major, major dive after that study. and things are only now starting. Starting to change the narrative. Okay.

[00:22:07] Debbie Goodman: Um, and then what about natural remedies? Um, because there will be some women who just go regardless of what the studies say, um, I prefer not to, I would, I prefer to try natural remedies and certainly our, our ancestors did not have access to medication, but they never, nevertheless needed to deal with the symptoms.

So what are some of those that work and which are bogus or which ones are bogus?

[00:22:31] Lauren Fisher: I think when you, when you talk about the word natural You know, natural medication, we kind of have to look at, there’s a few different avenues that those could involve. Um, so the one that keeps coming up is what’s often called bio identical hormones, or they now call it body identical hormones, which I’ll touch on.

Then there are supplements, then there are lifestyle based remedies, you could call it, or lifestyle based. Changes. Um, and if we, you know, if I just maybe speak to the first one, which is around the bioidentical. I think there has been a lot of misconception around what this actually is. Um, so as I said, I’m not a medical practitioner, but basically what it means is it mimics your body’s natural chemistry.

 I think where the myths start coming in is that they’re what’s called compounded bioidentical. Hormones, um, get seen to be more natural as pharmaceutical, and this isn’t necessarily the case. There’s some pharmaceutical, um, MRTs, which have a similar profile, and the problem, you know, we, we speak to practitioners around us all the time because it’s a question that keeps coming up.

The problem with some of the compounded bio identical hormones. It’s just that it’s not regulated. It’s not regulated. They can’t attest to the safety of the manufacturing process. Um, and you know, whether it works or not, obviously there’s still, um, evidence to be had out there, but that’s why a lot of practitioners who have done in depth menopause studies won’t necessarily.

prescribe that route. I mean, in saying that there are, you know, there’s lifestyle changes that have been shown to work. There’s psychological things like, I mean, for on a very basic level, Changing the way you eat, eating more protein, um, things like exercising differently, using more strength training, sleep hygiene, psychologically, cognitive behavioural therapy has been proven to work as well.

And yeah, there’s a couple of supplements as well that have been shown to have some sort of impact, but it’s a little bit of a minefield out there.

[00:24:58] Debbie Goodman: Yeah. Yeah. Yeah. And so I think that if, if you’re somebody who’s got a very poor lifestyle, as in your diet, your nutrition, you almost never exercise, you really don’t look after yourself.

If you shift some of your lifestyle issues. That’s going to have a big effect all around in any case, um, for somebody who’s already pretty clean living. Um, and, and this was me, I didn’t have too much to, to address, nutrition, exercise, sleep, et cetera, et cetera, except for my coffee. I would, I’ve refused to give up my coffee.

Um, but other than that, you know, no alcohol, all those kinds of things. I was like, listen, I’m living clean and I’m still got symptoms. So what do I do next? And, and then, you know, um, the amount of, um, products that I noticed my social media feeds were sending me because they realized I was of a certain age.

Um, has been pretty, um, pretty amazing to see that there are lots of offers out there and some of them will have absolutely no, um, no impact whatsoever. Um, it’s hard to know, for listeners who going, okay, but now what do I do with that? It is hard to know. And that’s the point it’s unregulated. really best is to try to, It’s to try and access an expert.

So let’s get into that. Let’s get into some resources. So Embrace what type of support do you guys offer to not just workplaces? Cause I know that you do workplace education and workshops. So if any listeners are in leadership roles, uh, HR related roles, CEOs of companies, and they think that this could be a really important thing to start having conversations about in your workplace.

 Lauren and Embrace are an access point for that. but what about individuals who don’t want this to be associated with their workplace who just like want to know, want to get some additional care?

[00:26:51] Lauren Fisher: I think the starting point is just knowledge. As you said, it can be a bit of a minefield and you’re getting like, feeds of products.

So finding the right sources of information. so the Embrace website, for example, we only take our information from international menopause guidelines. Um, going directly to the source, which is the IMS, um, is a brilliant resource for, for really just, What is the basic evidence based information? So I think that’s kind of basically, um, and then, yeah, as, as you mentioned, we do offer the workplace consultancy, but then over and above that, we have virtual consultations with a couple of amazing practitioners, and they’re really just there to, listen to you, to give you options, to help you find your way.

 and you know, there’s, we, we’ve had this conversation with a number of practitioners around, there are limitations to virtual. So particularly when it comes to prescribing MRTs, you need things like recent pap smears, uh, breast examinations to be in place. But I think there’s, there’s a lot that can be done around making you feel comfortable, comforted and knowing what your options are,

And so we have that we do have one practitioner available in person in Cape Town, Dr Natalie Clark and we really are here to help and support So we often have women just message us on one of our channels and just say, you know, I’m in Pretoria I’m in Johannesburg. I’m in wherever can you just help send me some names or Um, you know, some women are also not necessarily looking for a, a medical practitioner.

They might be looking for a coach, they might be looking for another type of resource, which we can, which we’re happy to assist as well. we’re, we’re looking at building this into, as we said, we, we’re building our AI, driven menopause care companion to really just try and have a place where you can actually have a conversation, ask questions.

You know, what we’ve realized about menopause is, as you said, like everybody’s got their own specific circumstances. So you might be someone who’s, you know, you’ve. You’re very healthy. You’ve done all of you’ve already done all of those right things. So now what? Um, or, you know, another woman will say I’ve, I’ve had a hysterectomy and I’m on the pill and everybody’s got very unique circumstances.

Yes. Trying to wade through information to figure out what is right for your circumstance can be very difficult. So this is what we’re going to build into The AI as well.

[00:29:17] Debbie Goodman: Okay. I mean, this is amazing. So for anybody who’s listening and feels like they just found the Holy Grail, um, there, yes, you may have, but there are some limitations.

Lauren, what’s the website address?

[00:29:30] Lauren Fisher: It’s www. get-Embrace. com.

[00:29:34] Debbie Goodman: Okay, so that’s your first place of your first port of call and at the very least you’ll be able to get access to information resources that are on the website. If you’d like to be able to have a virtual call with somebody who’s extremely knowledgeable will not be able to prescribe any medication, but we’ll be able to tell you what to do as a next step or give you advice on what to do as a next step or lay out what the options may be so that you can decide what next to do.

This is the place to go. Lauren, this is all that we have time for. This is such an incredible, incredibly large topic of conversation. just for everybody who’s listening, we are actually recording this on women’s day, the 9th of August, and you’ll be listening to it a little bit later, but this is really in honour of, of women’s day women all over, particularly in South Africa and

 from my perspective, all of the mothers, sisters, daughters, uh, friends out there who, who have been struggling and now perhaps can, can get access to some additional support to, which can be life changing. I’m a case study in, in that too. Thank you, Lauren, for being here. Thank you listeners for listening.

Have a great day. Bye now.

[00:30:44] Lauren Fisher: Thank you.