Only one in five employers take into account menopausal symptoms in performance reviews of female staff, according to a new survey. The menopause begins at an average age of 51. Employment law specialists at Irwin Mitchell, which commissioned the YouGov research, warn businesses could lose skilled workers if they continue to disregard how symptoms such as joint pain, hot flushes, fatigue and anxiety can dramatically impact performance in the workplace. Yet only 13% of companies employing a high proportion of women had menopause policies, the survey found.