The impact of menopause on self-employed and freelance workers (long-read)
The first time I realised something wasn’t right was when I started forgetting things. Everyone who knows me will tell you I’m a stickler for organisation, lists, planning. On the ball. I used to hold a lot of information in my head – but suddenly started to find that I couldn’t remember basic things, like what I’d spoken to a client about an hour before. Or what I’d agreed to do for a piece of work. Juggling five or six client projects at once was never an issue, but it was clearly becoming one. Next came the brain fog. I found myself losing my train of thought part-way through running a focus group, doing a presentation, or delivering a training session. Not ideal. Gradually, I started wondering whether I was starting with early onset dementia. Something I say with knowledge, rather than flippantly: we lost my stepdad to mixed dementia in 2021.
Add into that mix a lack of sleep due to insomnia or night sweats; new three-day headaches bordering on migraines; changes to my period which meant zero energy due to two heavy bleeds in one month; and a new, crippling addition of anxiety – something I’ve never experienced before. My ever-present challenge of freelance imposter syndrome quadrupled, and I found myself constantly worrying and querying my approach. Simple tasks that I would normally breeze through became almost impossible, and I struggled to find any joy in my work, holidays, or home life. Everything felt a little bit beige.
I didn’t mention any of this to my clients, for fear of them thinking I wasn’t up to the job. I’d worked tirelessly to build my freelance consultancy for 14 years. I had (and hopefully still have) a good reputation to uphold; I didn’t want anything to damage that. I did (fortunately) start talking about what was going on with Simon my business coach. And, as a result, recognised it was perimenopause and began taking some practical steps to help me work around it (more on those below).
Symptoms and how they specifically impact freelancing
None of the symptoms I mention above will come as any surprise to people going through the same thing. But whilst there’s been an increase in discussion (and action) around menopause in the workplace, we don’t often hear about how menopause can specifically impact those who are self-employed; those who are working freelance and don’t have a ‘workplace’ or HR team. I wanted to write this article to raise awareness of the impact of peri and menopausal symptoms on everyday freelancing, and to open a dialogue about what the potential solutions and support mechanisms could be. More specifically, I’ve written this piece for existing freelancers, client organisations and people thinking about freelancing.
Rather than rely on my own experience, I decided to get some feedback from other freelancers. 47 of you kindly took the time to share your experience with me via a short snapshot survey*. I was reassured to find many similar experiences to my own, but equally shocked at the detrimental impact that perimenopause and menopause was having on business. Here’s the top ten symptoms reported by respondents, with some specific impact examples:
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- Tiredness/low energy/sleep issues/need for rest and recovery (n=29 or 62%)
“Not able to work as many hours in the day due to fatigue, brain fog and other symptoms. It therefore takes me longer to complete projects and therefore to be paid, impacting income.”
“The primary issues have been tiredness from menopause induced insomnia and hot flushes. It’s so hard to motivate and be on form when feeling so tired from a lack of sleep and having a foggy unclear head. I am so fed up at times of telling myself I feel tired.”
“INSOMNIA (I don’t say that lightly) means that I can lie awake for hours worrying or be up at 4am working. My daytime activity can’t change according to how much sleep I’ve had (I have meetings etc like normal employed in rooms) so I have to plough on through.”
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- Brain fog/memory issues (n=24 or 51%)
“Does make me realise there’s no safety net. My sharp mind is what I’ve always sold, and it doesn’t seem to be there at the moment.”
“It’s been chaos to be honest. Thought I was going mad and the business I have built up over 15 years has nearly crumbled in the last 12 months- not because I don’t have clients – I have loads but because my confidence has eroded, my brain doesn’t think straight, my organisation is non-existent and some days I just want to hide. For the first time ever I have missed deadlines- it’s like my brain and my body are at war- disconnected and disappointed with one another.”
“My job involves a lot of brain work. I can’t effectively do that when beset by 3-day long headaches, recurrent UTIs with temperatures of 40 degree, and flooding through my clothes on an unpredictable basis. My work is also stymied by brain fog and low motivation.”
“Menopause brain, with symptoms of brain fog and memory loss, have also affected my ability to retain information and think as sharply.”
“I can’t concentrate for long periods of time and need to take frequent breaks. I can get really tired after long sessions at my computer. I have difficulty expressing my ideas verbally or in the written form – I’m just not as clear as I used to be I often doubt my ideas and approaches, redoing pieces of work time and time again and still not thinking they are clear enough.”
“Brain gaps – not even fog – just glaring black holes where information used to be.”
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- Lack of confidence/self-doubt (n=16 or 34%)
“I have bouts of panic and crushing self doubt, often after winning new work/clients when I come to believe that I can’t do the work. This can keep me awake at night, exasperating the tiredness.”
“Also impacting confidence hugely – don’t want to take on significant work as worried I might not be able to do it anymore.”
“I am a bit less confident, I have to triple check everything I write, I forget things. I try to leave myself good notes – it all takes extra time.”
“Loss of confidence: won’t take on new clients for fear of the work being beyond my skills, avoid taking on new tasks with existing clients for the same reason.”
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- Anxiety (n=11 or 23%)
“It’s meant having to really be careful about the type of work I take on. One of the most debilitating things has been loss of confidence, anxiety, and fatigue. I have to plan my work around these.”
“Anxiety levels vary enormously meaning that workload, deadlines etc can be easier/harder to deal with depending on hormones.”
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- Problems concentrating (n=9 or 19%)
“Not being as good at concentrating and struggling to be able to move from one client work to the next. Being tired and not ‘on it’ as I need to be.”
“I can’t concentrate for long periods of time and need to take frequent breaks. I can get really tired after long sessions at my computer. I have difficulty expressing my ideas verbally or in the written form – I’m just not as clear as I used to be I often doubt my ideas and approaches, redoing pieces of work time and time again and still not thinking they are clear enough.”
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- Irritability/mood swings (n=7 or 15%)
“The mood swings hit me like a train. I felt suicidal.”
“I still experience mood swings that can seriously effect my self-confidence and thus ability to apply for work let alone succeed.”
“Tiredness and irritability was hard to bear with the uncertainty of freelancing until I was diagnosed.”
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- Body temperature/hot flushes (n=7 or 15%)
“I went into surgically induced menopause 10 years ago aged 42. As a result I have always really struggled with keeping my body temperature under control. Therefore I always have a fan with me which I will and do bring out in meetings. I have squashed comments (usually by men) about it.”
“Hot flushes hit at the most unhelpful times; when presenting, running meetings etc. brain fog means forgetting words when talking to clients; flushes and night sweats affect sleep meaning tiredness and fatigue = difficult to motivate self in working day and keeping up with demands of work. Tire more easily when travelling / delivering workshops.”
“I experience extremely powerful hot flushes a few times a day, and have developed strategies to mitigate these such as wearing cardigans which I can easily take off and put back on, using fans, using a handkerchief to dab my visibly perspiring face. However, I’m not the typical age for menopause as I’m in surgical menopause, so I know a lot of my symptoms are not attributed to the menopause by those who don’t know me as they would think I’m ‘too young’, so I feel as though people find it very strange when these things happen, and this makes me self-conscious. Particularly as my job involves lots of client meetings and presentations, so the focus is often on me, so it’s hard to hide when these things are happening! Also when night sweats interrupt my sleep it can affect my concentration and energy levels with work.”
“Disrupted sleep (night sweats, difficulty going back to sleep if woken up) means I’m very tired in the mornings. The fact that I mostly work from home means I can allow myself to sleep in and so start work later which means I actually have a brain in gear when I’m working. Early morning meetings (especially if in person and I’ve had to travel to get there) are hard for me. Hot flushes – the move to Zoom meetings have been a godsend! Taking off a layers on screen can be more discrete than in real life where its also more obvious that I’ve gone pink and sweaty and am taking off my cardi. I feel so embarrassed doing this during a work meeting. Hot flushes are worse if I’ve been rushing so I give myself much longer than I previously would to get somewhere but often have to make up the work time lost in the evening or at the weekend.”
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- Low motivation (n=5 or 11%)
“Some of the symptoms – brain fog, low mood – were making it impossible to get in the zone where I do my best work (I’m a writer). I was also feeling unenthusiastic about what I usually love doing.”
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- Other physical symptoms (n=4 or 9%)
“…crazy jitters and ultra-pins and needles which affect being able to sit at a desk / pc and type. Weak, sore joints meaning sitting in one place for anything over half an hour becomes really painful.”
“Joint pain which means I can’t exercise as much and don’t feel on top of my game generally.”
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- Heavy periods/change in periods (n=4 or 9%)
“Heavy periods (like not just heavy but alarming blood loss!) making it difficult to leave home.”
“The unpredictability of my flow and cycle takes up more brain space than it needs – constantly trying to second guess what sanitary products I may or may not need. Period pants are a godsend but they won’t last all day on their own on a heavy day. Not really anything to do with being self-employed, just an ongoing battle for people with wombs!”
In addition to the above there were several less common but equally impactful issues reported:
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- Headaches (n=3 or 6%)
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- Feeling of overwhelm (n=1 or 2%)
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- Handling emotions/feeling emotional (n=1 or 2%)
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- Weight gain (n=1 or 2%)
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- Vaginal atrophy and uncomfort (n=1 or 2%)
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- No joy/lack of caring (n=1 or 2%)
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- Problems coping generally (n=1 or 2%)
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- UTIs (n=1 or 2%)
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- Gynaecological issues (n=1 or 2%)
Only one respondent said they experienced no major impacts on their freelance work. Three respondents felt they had no other option but to leave their full time job and/or had gone freelance to seek greater flexibility and a way to manage their symptoms. And three respondents had entered surgical menopause.
“Medical side effects from chemically induced menopause due to hormone therapy have resulted in me having to take time off work due to cracked ribs due to osteopenia; a reaction to the treatment to prevent osteopenia that resulted in me not being able to walk for a week; weight gain and lack of body strength that has affected my mental health, leading to impacts on self- confidence in front of clients and my ability to do my work. I have had to take quite a bit of time off this year due to side effects and medical treatments connected with menopause that has meant a reduction in income and worry that I am not offering my clients the quality of service I pride myself in.”
Unique challenges of freelancing and menopause
Many of the above symptoms are listed on menopause checklist, and are common with people experiencing menopause in the workplace. But they highlight the unique challenges for those of us who are self-employed. For example:
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- There’s no sick pay when you’re freelance. If you don’t (or can’t) end up doing the work, you don’t get paid. Usually there’s no one else to help you juggle multiple projects or pick up the workload unless you’re in a collective or have an arrangement in place with fellow associates. Symptoms can be unpredictable, but it’s essentially a choice of plodding on regardless or taking the income hit. It’s easy to end up in a cycle of not looking after yourself, despite perhaps thinking you’re superhuman.
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- You’re often reliant on recommendations and you’ll go to whatever lengths you can to protect your reputation especially around reliability i.e. rightly or wrongly, we’ll carry on until we absolutely can’t anymore.
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- It might feel difficult to approach an in-house HR team if you experience issues with client colleagues or management who aren’t so tolerable of your symptoms. Guidelines may exist for the in-house workforce, but they may not automatically be extended to you.
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- On a rolling basis, you’ve got to find the energy to continually find work, network, apply for contracts, sort your accounts, manage your marketing, attend interviews – these are things that you don’t have to keep doing in a PAYE role.
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- There’s no one in the office telling you you’re doing a good job. You have to deal with heightened feelings of anxiety and imposter syndrome yourself (unless you raise it with other freelancers).
These are just examples, and I’m sure many of you can add to this list.
“I’m scared to tell people – what if I don’t get work because of it?”
“Impacts networking ability as I’m really struggling with names / info about people I used to take for granted. Also impacting confidence hugely – don’t want to take on significant work as worried I might not be able to do it any more.”
“As a freelance consultant I carefully manage my workload, projects, contracts etc. Not knowing how I’m going to feel mentally and physically means all the careful planning can go totally out of the window and time management means nothing.”
How organisations can support freelancers experiencing menopausal symptoms
It would be helpful to see freelancers included in workplace strategies and represented on the Government Taskforce around menopause in the workplace. But how else can organisations help? I asked our survey respondents to make some suggestions on what they’d find most useful. These included:
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- The need for client organisations to normalise menopause; including more openness and understanding that it’s something that simply happens and that those experiencing it should not be disregarded.
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- Greater awareness, empathy, and compassion including basic education for all managers on menopause.
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- Encouraging sector organisations (like the Museums Association) to provide guidance which includes freelancers. For example, raising awareness of the unique aspects of self-employment and menopause, providing networking opportunities for menopausal freelancers and advice to both organisations and freelancers who need it.
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- Greater client openness of requests from freelancers to manage their workload in a way that suits them and still delivers what’s needed (including in contracts).
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- Trained NHS healthcare professionals and access to them outside of working hours (plus information via GPs not just online).
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- Greater evidence-based information and access to HRT which has been an issue.
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- Financial solutions being put in place e.g freelance sick pay/a Universal Basic Income.
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- Better working conditions for freelancers in general e.g. rates of pay.
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- Consideration of including menopause as an option on access monitoring forms completed by freelancers at point of contract with client.
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- A grant system towards helping freelancers look after their mental and physical health.
“Generally across employers there needs to be a greater understanding about menopause. We need much better collective support and recognition from the leading bodies in our sector such as ACE, Museums Association etc. about how it can impact freelancers. I joined a menopause fitness support group set up by an Obs & Gynae Consultant recently that has hugely helped mentally, physically, and emotionally. It’s not free but is at a reasonable price. Something like that around supporting peers, sharing information about techniques to combat tiredness or brain fog, more opportunities to collaborate to share the load or simply not feel so lonely in the process. An online monthly/weekly meet up?”
“More widespread knowledge and lack of shame around women’s health generally.”
“My main bit of work was with a leading funding body and they were understanding. It didn’t mean the work eased up but I could at least tell them what was going on. That helped in itself.”
“It’s hard when your workload is unpredictable to manage the impact of cyclical challenges eg premenstrual fatigue. Better working conditions for freelancers in general re: rates of pay, not making people self employed when they are ‘really’ employees to save money, building in self care days to longer term freelance contracts perhaps?
“I’m a member of a (very expensive) professional body & it has no peri/meno support available to either employed or self-employed… I would like that to change.”
“By continually trying to find something that is right for me, talking about it, pushing for support I now feel stronger, happier and am more active than I have been all year so far. The isolation that so many people feel needs to be broken. Menopause is not a condition simply a phase of life. I really do believe that we are having menopause much worse than it used to be due to our polluted, chemical laden world and that is something that is not being spoken about too.”
“Giving us a bit of flex to enable us to be our best would be so helpful (eg- perhaps meet later in the day – that helped me as first thing was usually dreadful when I hadn’t slept etc).”
What freelancers can do to support themselves
Realistically I think a lot of this comes down to us helping ourselves and supporting each other. When I started realising that my symptoms were probably related to the perimenopause, I read as much evidence-based information as I could on the subject. I felt armed and ready to go to my GP and specifically asked to speak to a menopause-wise doctor. I was fortunate and received excellent advice and care – not always the experience of others.
There are some practical things you can do as a freelancer to cope with the symptoms and the impact it may have on you and your business. Everyone is different, but the best thing I did (apart from getting medical advice) was to completely reposition who I work with, so that my clients align with my core values; I ringfence a full day each week with no client meetings so that I can flexible if I need to catch up on client work; and I built in more time for daylight, fresh air and exercise (usually just 20 minutes a day). Those of you completing the survey also suggested the following ideas:
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- Knowing other people’s stories and experiences; go to peer-to-peer support and networking opportunities where information is shared on coping techniques.
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- Consider mentoring/coaching to especially help with imposter syndrome/confidence building.
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- Choosing clients who align with your values and enable you to get the support you need.
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- Be kind to yourself.
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- Slow down.
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- Put systems in place to give you space to have a day off, manage fees and workload to accommodate it.
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- Reframe menopause as a positive thing.
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- Seek medical advice/support and talk through HRT and non-HRT options with your healthcare provider (also consider your nutrition).
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- Build client relationships that are authentic and honest.
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- Set boundaries.
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- Know your worth.
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- Don’t neglect caring for yourself.
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- Take a bottle of water with you everywhere.
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- Wear layers.
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- Make time for exercise.
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- Put a small, silent, electric fan on your desk which is off camera.
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- Build in recovery time (for example after a day of long meetings).
“Manage your time well, build in recovery time and slow down to enable you to deal with how you might be feeling. Be kind to yourself when thinking feels hard, get out in nature, and recalibrate so you can do what you do well. Don’t expect to have the energy you might have had previously – biologically and neurologically things are changing and with it some of the drivers you might have used as engine’s previously. This is natural and part of getting older and wiser. Enjoy the freedoms that not menstruating bring you. Eat, exercise, and support your bodies needs with intention. You are not I’ll – this is a natural process – you are not going mad, just changing. Notice when your endocrine system is overstretched – don’t get labelled as Hypo or Hyper anything. If you are freelance, you can build client relationships that are authentic and honest – so if you are feeling under par you can be real. Don’t try and overcompensate or overreach yourself – you are asking to burn out. Notice who you work with well and encourage those relationship- they are the best client work you can have. Know it will pass in time – though some of the symptoms remain you learn to cope. Becoming a post-menopausal woman is and opportunity to grow into Eldership – grasp it, it is regenerative! It’s not all about fertility or be a ‘sexual object or desirable’. If you focus on the quality of who you are as a person these projections falling away can be a huge weight off. Good luck!”
“Remember menopause and ageing are your super power even though it might not feel like it.”
“I’ve had to learn to relax. If I can’t work one day, I now listen to what my body needs and do that. Sometimes it’s going for a run or walk, sometimes I need to sleep and sometimes I need to pick up my knitting instead. Once I’ve given in to it, it usually passes and I’m able to get on with working again. The trick is to be kind to myself and not beat myself up about it. It is what it is, and it’s important to look after me.”
“I have been on some menopause yoga workshops and it’s been good for reframing menopause as a more positive thing, as happens in some other cultures and traditions.”
“I personally think that it’s up to freelancers to ensure they get the support that they need. This may be by picking clients who have decent policies in place and asking to tap into those. Or negotiating flexibility with clients so that you can manage symptoms better.”
“Just chatting to others going through similar things is the best tonic, not feeing alone and being able to laugh about it!”
There’s also a range of support suggestions on the NHS website.
What next?
Menopause can be a positive experience for many people; some position it as a time to restore, renew, reinvent; a chance to think and act differently. I’m all for that – but whether you identify as cis gender, non-binary or trans (quick plug at this point for the queer menopause collective), I think we all need better support (whether freelance or otherwise) and that currently – certainly for me – comes from my fellow freelance colleagues and perimenopause/menopause networks like the Manchester Menopause Hive rather than anywhere else.
Taking one of the survey suggestions, I’m curious whether other freelancers would be interested in a monthly menopause get-together if I decide to host something – perhaps an online networking lunch; where freelancers can come together, share coping strategies and experiences in a safe space? Maybe even have a speaker every so often? If this sounds like something you’d be interested in attending or supporting with, please email me and I’ll add you to my freelance menopause list (you can view my privacy policy here).
Thank you
I hope this has been an useful and interesting read, whether you’re a freelancer or an organisation. A huge thank you to those freelancers who kindly took time to complete the survey, and to share their personal experiences, thoughts and ideas with me. Whilst far from a robust study (that was never the point), I felt it was important to have a range of voices and experiences for this piece.
Marge Ainsley, Freelance Cultural Consultant and Trainer