In March 2019, the House of Commons published a briefing paper entitled Women And The Economy. It revealed that 15.3 million women in the UK aged 16 years and over were in employment in October to December 2018. According to the Mental Health Foundation, women in full-time employment are nearly twice as likely to have a common mental health problem as full-time employed men.

A poor work-life balance is one of the biggest contributors to increased stress in women and various social factors, such as being guardians of family health and/or carers, put them at greater risk. However, women’s readiness to talk about their feelings and their strong social networks may help to provide some protection.

Rising stress levels can adversely affect women’s physical wellbeing as well as their mental health, raising the risk of heart disease and musculoskeletal problems, for example. Many women work in health and social work, retail and education – jobs that often require repetitive physical work, prolonged computer work, which can cause eye strain or posture problems, and longer periods of standing and/or contact with the public, which leads to emotional stress. 

Research conducted by Nexium Control found that 28 per cent of women have suffered from heartburn at work, 10 per cent have experienced heartburn during a meeting and 7 per cent have had to call in sick because of their symptoms.

Community pharmacists can help to spot physical signs of rising stress and tension in female customers before these become a chronic condition. Mel Crate, founding director of Luminate, which provides workshops and coaching on improving mental health in the workplace, says that women may visit their GP with what seems like a minor physical symptom when there’s actually an underlying mental health problem. “Physical symptoms include frequent headaches and migraines, minor illnesses, such as susceptibility to colds, lethargy, skin conditions, weight gain or weight loss, digestive problems, muscle tension and feeling run down,” she says.

Everyone responds to stress in different ways... Mindfulness, yoga and any type of exercise may help

If women are experiencing a stressful time in the workplace, they need to find ways to counteract any harmful effects. “Everyone responds to stress in different ways and it’s important that women receive the right support,” says Ms Crate. “Mindfulness, yoga and any type of exercise may help. Women may benefit from psychotherapy or cognitive behavioural therapy and could also try breathing exercises.”

In December 2018, the British Medical Association launched its report on Addressing Unmet Needs In Women’s Health. Women make up 47 per cent of the working population and provide most informal, unpaid care for children, sick or frail older relatives, and increasingly both. Although women are more likely to come into contact with health services than men, they are more likely to miss appointments due to their caring responsibilities.

A Public Health England survey in June 2018 revealed that 31 per cent of women experience severe reproductive health problems, but fewer than half of them seek help. The survey found that 35 per cent of women have experienced heavy menstrual bleeding, which can be associated with higher unemployment and absence from work. Many women conceal their gynaecological symptoms from work colleagues. The women in the survey said they would like reproductive health to be normalised so that any issues could be discussed openly and self-managed where possible.

Dr Philippa Kaye, a GP with a specific interest in women’s health, agrees that society needs to be better at talking about gynaecological issues. “For women working, for example in jobs where they can’t go to the toilet as needed, issues such as heavy periods can be extremely difficult,” she says. “I would recommend women speak to a line manager or HR department about any issues to see if any changes can be made. However, if they have a health issue that is affecting their ability to function, and therefore work, they should see their doctor.”

Stigma and myths

The normalisation of periods is essential to remove the stigma and myths surrounding the female body. Several period or hormone-related books for women are being published this year, including Hormonal by Eleanor Morgan, Period Power by Maisie Hill and Period. by Emma Barnett, which has thrust these topics into the media spotlight. 

Tracie Miles, Ask Eve cancer information nurse at The Eve Appeal, says that by talking about intimate health, women will find it easier to recognise when something isn’t normal. “Pharmacies could stock leaflets about gynaecological health to encourage conversations and raise awareness,” she says. “Some women may be too embarrassed to come to the pharmacy counter to ask for advice. If a woman is picking up thrush treatments or vaginal moisturisers and then putting the product down, or is loitering around the intimate health section, pharmacy staff could wander across and quietly ask if she needs any help.”

Some women may be too embarrassed to come to the pharmacy counter to ask for advice

Some women’s health topics are gradually becoming less taboo. In May 2019, lubricant brand Sylk launched Masturbation Month in a bid to normalise female sexuality. Although Sylk can be used for vaginal dryness (associated with the menopause, pregnancy, depression and cancer), it can also be used as a sex aid, during cervical examinations and with pelvic floor devices. According to Canesten, one of the main ways to gain a better understanding of intimate health is to ensure a correct diagnosis – thrush and bacterial vaginosis, in particular, are often confused with one another.

Dr Ellie Cannon, GP and media commentator, says it’s important that pharmacists feel comfortable discussing any issues related to vaginal bleeding, vaginal discharge and pelvic pain. “The key issue is that there may be significant symptoms where a delayed diagnosis can be very debilitating,” she says. “Not just involving cancer, but other conditions, such as endometriosis, which can affect work, relationships and mental health. Women trust pharmacists, so may go there for advice initially rather than to their GP.”

Sanitary product usage

Leading sanitary protection brands, such as Always, Bodyform and Lil-Lets, are taking steps to educate young girls about periods, to reduce stigma and help build up customer loyalty. Although brands continue to dominate sanitary protection, as trust is an important issue, private label is growing as women seek cost-effective solutions.

Mintel’s UK Feminine Hygiene And Sanitary Protection Products report in January 2019 revealed that disposable sanitary pads remain more popular than tampons and the gap has widened over the past year. To some extent, this may be linked to the cost of sanitary protection products – 45 per cent of menstruating women saying that price dictates what format they buy.

According to a Euromonitor International report, Sanitary Protection In The United Kingdom, in March 2019, women having lighter periods (due to the rising use of the contraceptive pill and long-term contraceptives) has had a positive impact on panty liners and slim, thin and ultra-thin towels. However, at the other end of the market, there are women trying to deal with heavier periods and leakage. In September 2018, Always launched its Platinum range with a highly absorbent leak barrier at the sides and an enhanced, more absorbent core.

Varied needs

As with any other category, women vary in their needs and preferences. “Some women will be sensitive to certain sanitary products, while others find that the hormonal changes related to the menstrual cycle trigger monthly episodes of thrush,” says Dr Kaye. “All-cotton products, although unlikely to cause irritation, may not be as absorbent and there may be skin problems related to constant moisture. Some women prefer to use a product such as a menstrual cup for these reasons.”

Increased awareness and concern over single-use plastics means reusable products are gradually showing growth and steering customers away from traditional sanitary protection. According to the Euromonitor International report, there is increasing demand for organic products and more sustainable and cost-effective reusable products, such as menstrual cups, which can last up to 10 years, are also gaining momentum.

Hey Girls manufactures environmentally friendly plastic-free sanitary products – pads, tampons, cloth pads and menstrual cups – and tackles period poverty in the UK with a buy one, give one policy. The Scottish social enterprise also delivers menstrual health education sessions. “We have recently launched a sustainable applicator tampon made from sugar cane,” says Molly Brown, education programme manager at Hey Girls. “For every product sold, one is donated to a girl or woman in need. Our products are already available from some supermarkets, but we would be interested in expanding into community pharmacies.”