Breaking the Silence: ICAS research on Menstruation, Menopause and Miscarriage in accounting

As part of our Shaping the Profession (StP) programme, we’re proud to launch a groundbreaking piece of research: Exploring the lived experiences of women in accounting around Menstruation, Menopause and Miscarriage—what we call the 3M.

In this article, Sarah Chisnall, Director of Public Affairs at ICAS, explains why ICAS decided to investigate these lived experiences affecting working women’s lives.    

When I began my career in the early 1990s, the workplace looked very different. Women faced enormous challenges, from rigid dress codes to overtly male-dominated environments. I vividly recall being asked when I worked for a local council to go home and change out of a trouser suit because it was considered “unsuitable” for work. In most offices, you would simply never dream of mentioning your period or how menopause was making you feel and those who suffered the tragedy of losing a pregnancy were expected to ‘soldier on’ as if nothing had happened. These experiences inspired my MSc dissertation on the treatment of women working in the public sector, where I interviewed many women about pay inequality and barriers to progression. I’m now at the other end of my career journey and can find some working environments challenging, especially when a hot flush hits! 

Thankfully, we’ve come a long way since then. But even now, conversations about women’s health at work often stop at pregnancy and motherhood. The 3M —menstruation, menopause and miscarriage —remain largely invisible in public debate and workplace policy. This silence matters: When these realities are ignored, women’s wellbeing suffers, and careers can be impacted. 

Why this research matters 

ICAS research shows that while trust in the profession remains high, there are persistent barriers to career progression—particularly for women and those from minority backgrounds. Alarmingly, nearly three in four professionals report experiencing discriminatory or exclusionary behaviours in the workplace. This underscores the urgent need for action beyond rhetoric. 

Our independent study, commissioned from academics at the Universities of Edinburgh and Heriot Watt draws on: 

• In-depth interviews with women across accounting roles— in industry, practice and professional bodies. 
• Analysis of existing research on the 3M. 
• Review of policies and practices from ten selected organisations from businesses to professional bodies.  

The findings are stark: A continuing culture of silence and stigma, and a lack of structural support for women navigating these experiences. These findings are drawn from a combination of the interviews and analysis of what's already out there in research and company policies. They don’t necessarily reflect what happens at ICAS or ICAS policy.   

Key findings 

• Culture of stigma and silence: Women can feel isolated and fearful of being open about the 3M, often making career decisions based on these experiences. 
• Leadership, role models and management: Male dominated leadership teams reinforce silence and slows progress. More people-focused and supportive leadership is essential. 
• Workplace physical design and environment: A lack of privacy, inadequate personal care breaks and unsuitable office layouts add to women’s stress. 
• Flexible work patterns: Rigid requirements can make managing the 3M harder, increasing discomfort and anxiety. 
• Existing policy gaps: Most organisations lack specific policies on the 3M. Where policies exist, they are often seen as tokenistic rather than meaningful commitment.  
• Role of professional bodies: Rarely seen as sources of support yet uniquely positioned to drive sector-wide change—especially for the self-employed and those in SMEs. 

What needs to change 

The report calls for: 

• Supportive leadership that normalises open conversations, and workplaces that support mentorship schemes, increase general awareness and encourage male allies. 
• Normalising flexible working arrangements to accommodate health needs and improve physical workspaces rather than making them the exception. 
• Inclusive policies that go beyond token gestures and reflect real commitment.
• Proactive roles for professional bodies to champion wellbeing and set standards for the profession by including 3M provision in mentoring schemes, syllabus, and continuous professional development and raise awareness about incorporating the 3M in material and equality initiatives.      

At ICAS, we have already begun to offer targeted support and create spaces, like the CA Women's Network, for open discussion around the 3M themes through its wellbeing and inclusion work. This includes webinars and network events focused on women’s health and career experiences, alongside wellbeing initiatives such as access to 24/7 counselling. We also continue to promote the CAW Gender Equality Toolkit, developed to help employers play a significant role in shaping inclusive workplace cultures where all people, regardless of background, can thrive. These ongoing programmes will continue to evolve in response to member feedback and insights from the 3M report. 

This research is not just about identifying problems—it’s about shaping solutions. By breaking the silence around the 3M, we can create workplaces where women feel supported, valued and able to thrive. 

The research team

• Qi Li, Assistant Professor, Heriot Watt University, Edinburgh, co-author of the report. 
• Louise Crawford CA, Emerita Professor of Accounting, Newcastle University Business School, co-author 
• Rania Kamla, Professor at Heriot Watt University, Edinburgh, co-author 
• Eleni Chatzivgeri, Lecturer, The University of Edinburgh, co-author 

Join us in driving meaningful change: 

Read our short interactive report

 

Read the full report

With thanks to:

• James Baird CA, Chair of ICAS Research Panel and the Shaping the Profession Steering Group
• Sarah Chisnall, ICAS Director of Public Affairs
• Marie Gardner CA, former ICAS Head of Research
• Laura Butcher, ICAS Director of Member Engagement
• Sarah Speirs, ICAS Executive Director of Engagement and Advocacy
• Nifemi Tukur, ICAS EDI Manager and member of the ICAS Research Project Steering Group
• Helen Cardno, ICAS Director of HR and member of the ICAS Research Project Steering Group
• Tracey Rob Perera CA, Chair of the ICAS EDI Committee and member of the ICAS Research Project Steering Group
• Alpa Dhanani, Professor at Cardiff University, member of the ICAS Research Panel and the ICAS Research Project Steering Group