By Hallie Levine
For more than 20 years, Celia Chen navigated a demanding job as a marketing executive, traveling often and working long hours. But in her late 40s, she began to find it harder to keep up. After work trips, she felt tired and had trouble concentrating. She developed acne and experienced gastrointestinal problems. And even though she felt exhausted, she found it harder to fall and stay asleep.
At first, she attributed these symptoms to stress. But when she saw a new gynecologist at the age of 48, she learned they very likely were due to perimenopause.
“When you’re in your late 30s or 40s, you often assume that menopause is this faraway land,” Chen said. “But the reality is, the period of perimenopause can last for up to a decade. Symptoms can start gradually and not seem like a big deal, but if you hit a patch where your hormones are fluctuating and you’re under stress, it can get bad.”
‘Feeling Less Sharp at the Height of My Career’: How Menopause Symptoms Impact Work
Menopause marks the point in a woman’s life when she has gone 12 consecutive months without a menstrual period. However, the transition to menopause — often called perimenopause — typically begins in a woman’s 40s.
During this time, changes in reproductive hormones like estrogen and progesterone can cause a wide range of symptoms. In fact, around 90% of women over 35 experience hot flashes, mood swings, insomnia, depression, headaches, joint or muscle pain, memory lapses, fatigue, or other symptoms.
What’s more, menopausal symptoms can vary dramatically from person to person.
“You talk to 50 different women, and they’ll give you a collection of different abstract symptoms that change every month,” Chen said. “For me, it was the ‘brain fog’ that left me feeling less sharp at the height of my career, as well as the anxiety that seemed to come out of nowhere and keep me up at night. I realized that it was more important than ever for me to listen to my body so that I could navigate these big changes.”
Chen ultimately left her corporate job to work as a freelance consultant and health optimization coach, helping women who, like her, experience menopausal symptoms that impact their workday.
“All of these women worked incredibly hard to get where they are — they’re intelligent, talented, and accomplished,” she said. “Then they get hit with something that makes them feel as if they’re performing suboptimally. But they can still bring so much to the table, especially if their workplaces will make accommodations to help them through this stage in life.”
‘It Makes Really Good Business Sense’: Why Investing in Menopause Support Pays Off
At many workplaces, menopause is still the elephant in the room. But ignoring it comes at a high cost: Employers lose about $1.8 billion each year in workdays missed due to menopause symptoms, according to a 2023 study published in the journal Mayo Clinic Proceedings.
Another report by the Korn Ferry Institute found that about half of perimenopausal or menopausal women experience symptoms that disrupt their work, including hot flashes, trouble sleeping, brain fog, and depression.
Yet only about a quarter receive support from formal work policies or programs. And many choose to stay silent about their experiences. A 2023 survey by Bank of America found that almost 60% of women don’t discuss menopausal symptoms at work, partly because they worry they’ll be judged by their co-workers or be perceived as old.
“There is so much discomfort in talking about it, and there’s a lack of education on how to navigate it,” stressed Chen. “There’s a worry that if you tell a male coworker or boss what you’re going through, you’ll be looked down upon.”
But increasingly, employers are recognizing that they need to step up to the plate to keep accomplished and talented women. Alongside paid parental leave and child care programs, companies are beginning to embrace menopause-friendly work policies.
“It makes really good business sense,” Maura Cawley, a partner at global consulting firm Mercer, said during HAA’s National Employer Summit on the Aging Workforce last month. “About 20% of our workforce is midlife women aged 45 to 64. These are the prime menopause years.”
Supporting women during this life transition pays off in improved productivity and job performance. The majority of women (58%) with access to menopause benefits say this support positively impacts their work, according to the Bank of America report.
“Women are resourceful,” Chen said. “They want a solution that allows them to feel better, perform better at work, and have great lives. If we destigmatize it at the office, everyone will benefit.”
‘It’s Obviously a Work Topic’: How Companies Can Take Action on Menopause
Supporting employees through menopause requires solutions that address workplace culture, access to treatment, and helpful accommodations.
Here’s how companies can take meaningful steps to ensure women get the support they need.
1. Provide Coverage for Menopause Care
Menopause isn’t a disease that needs to be cured; it’s a natural stage of life. Although it can be debilitating for many women, it doesn’t need to be.
“When women get the right treatment for their menopausal symptoms, they often do great,” said Joanna Strober, founder and CEO of Midi Health, a telehealth platform specifically for women experiencing menopause.
A 2024 study published in the Journal of the American Medical Association, for example, found that for most women under 60, the benefits of hormone replacement therapy for menopausal symptoms outweighed the risks.
But obtaining treatment can be challenging given the ongoing shortage of doctors who receive menopause training; a 2019 survey of U.S. OB-GYN, internal medicine, and family medicine residents found that only 7% felt competent in treating a menopausal woman.
To make sure women get the care they need, employers should provide access to specialized clinical support, said Cawley. They can start by offering health provider directories with information on specialists who treat women going through menopause.
2. Offer Telehealth or Virtual Care Options
Women are more likely than men to delay or forgo necessary medical care. Employers can address this by making care affordable and easy to access. “In these situations, providers who offer telehealth become important so that women don’t have to take a morning off of work to get care,” Strober said.
Sonja Kellen, General Manager for Global Health and Wellbeing at Microsoft, said the company provides menopause support through virtual care provider Maven, including early identification of menopausal symptoms, treatment guidance, 24/7 coaching, and second opinions from specialists.
“We’re hoping that through providing menopause support, we’re leading the way in creating a supportive and inclusive workplace that sets a standard for other companies to follow as well,” Kellen said during HAA’s National Employer Summit on the Aging Workforce.
3. Allow for Flexible Schedules
Women going through menopause may occasionally need a mental health day or the option to work from home. “The idea is to support the whole person with mental health support, paid time off, and flexible schedules,” Kellen explained.
Microsoft, for example, offers a holistic health time off program similar to sick leave, allowing employees to focus on their mental and emotional well-being. “We really focus on the fact that it’s not just about physical sickness,” she said.
4. Provide Accommodations for Shift Workers and Physically Demanding Labor
According to the U.S. Bureau of Labor Statistics, about 15% of women cover non-daytime shifts, instead working night or early morning hours. This disruption to circadian rhythms can worsen menopausal symptoms, according to the Menopause Society. Research also suggests that women who work night shifts have an increased risk of early menopause.
To help counter this, the Menopause Society recommends access to bright light therapy at work, regular meal breaks, and light filters on electronic devices at night.
For women who have physically demanding work or roles that require them to stand or hold one position for a long period of time, more frequent rest, food, and water breaks are recommended.
5. Offer Cooling Options
While cooling isn’t the only accommodation women need, some ability to control the temperature at work is important, said Strober of Midi Health.
A 2024 report published in the Journal of the Menopause Society found that the most commonly reported triggers for hot flashes are working in hot or unventilated places and being in formal meetings. But almost all the women surveyed reported that taking simple steps like using a fan, opening a window, going outside for fresh air, or dressing in layers helped with hot flashes.
Cooling rooms are making headlines now, but even something as simple as providing portable fans for workstations can help, said Mercer’s Cawley, noting that small steps can make a big difference. “If there’s a dress code policy, ease up on it,” she added.
6. Prioritize Menopause Education
Employees and managers need information about menopause that’s easy to understand.
“You want to normalize the topic in your office and acknowledge that it’s a workforce issue,” advised Flory Wilson, CEO of Reproductive & Maternal Health Compass, a nonprofit that analyzes the reproductive and maternal health benefits offered by employers. “That way, if an employee is experiencing it and having challenges, she’s more comfortable expressing her perspective.”
Share information about menopause on your employee website, in break rooms and common areas, and in your internal communications about general wellness news. You can also offer seminars on aging in the workplace, managing menopausal symptoms, and improving sleep.
7. Create a Culture Where Women Can Discuss Menopause Openly
Women should feel empowered to talk about their menopause symptoms, even if their employer hasn’t yet embraced menopause-friendly policies and education, said Strober.
Research suggests that talking openly about menopause at work helps counteract the negative stereotypes about it.
One study asked workers to imagine attending a meeting where a female, middle-aged colleague was flushing, fanning herself, and wiping sweat from her face. In one version of the scenario, the woman explained she was “just warm,” while in the other, she stated it was “that menopausal time of life.” The workers rated the woman who openly discussed menopause as more confident, stable, and leader-like. “It suggests that people don’t view women going through menopause as less competent,” explained Strober.
8. Include Men in the Conversation
Men, especially those in leadership positions, have an opportunity to normalize conversations about menopause.
“It’s obviously a work topic,” said Dan Simons, Founder and Co-Owner of the Farmers Restaurant Group. “Most men in the workforce have a spouse or a mom or a sister who will go through menopause. It seems sensible to educate male employees on what is happening, or what will happen, to 100% of their female colleagues.”
Simons said he urges male colleagues not to shy away from the conversation: “I’m like, go ahead, guys. Say it. ‘Menopause.’ Say it out loud, just like you would talk about a broken ankle or a bruised elbow,” he said. “It doesn’t cost anything other than a bit of courage.”
Simons also talks about his wife, Suzi, and her experiences with menopause at work, with her blessing. He relays details about her up-and-down journey with hormone replacement therapy and menopause symptoms like anxiety and trouble sleeping, sharing how it’s impacted him as her husband. “Leaders can lead through storytelling,” he explained. When employers share their personal experiences, employees feel more comfortable talking about menopause.
9. Create a Peer Support Group, or Use the Ones You Have
Consider starting an employee resource group for people experiencing menopause symptoms. “You want to facilitate conversations to take some of the stigma out of it and provide peer-to-peer support,” said Cawley. The conversation could start with women in leadership sharing their stories, then an open invitation for all employees going through menopause to share input.
The peer group can help identify needs and opportunities specific to your workplace. The Menopause Society recommends asking the following questions and allowing employees to share answers anonymously if they’re more comfortable:
- How does menopause affect you at work?
- What are we doing already that helps?
- What else would help you manage your menopause symptoms at work?
You can also broach the topic of menopause within existing resource groups, including:
- Women’s groups: Menopause can be part of discussions about health or equity.
- LGBTQ+ groups: Trans, nonbinary, and men-identifying people may go through menopause.
- Groups for employees of color: Black and Hispanic/Latina women typically start menopause earlier and face more extreme symptoms than white women.
- Mental health groups: “If I want to effectively talk about mental health, I need to talk about menopause and hormones, because they can be so deeply intertwined,” Simons said.
‘The Best Career of My Life Right Now’: Thriving During Menopause
The good news for both menopausal women and their employers is that symptoms don’t last forever. They either improve with time, or they respond to the right medications and therapies.
When Strober began to go through menopause in her late 40s, she worried that her insomnia, anxiety, and overall brain fog would thrust her out of the workforce for the rest of her life. “I literally wouldn’t remember coworkers’ names,” she recalled. “I began to wonder if I was just too old and I couldn’t handle my job anymore.”
But when she found the right menopause provider — and was put on the right medications, including hormone replacement therapy — she noticed a difference almost immediately.
“I’m having the best career of my life right now,” she said, “and that’s because I have the right care.”
Women’s Health at Work
Women make up 47% of the U.S. workforce, but their health and well-being are undersupported. The Health Action Alliance’s upcoming Women’s Health at Work initiative will provide business leaders with innovative, science-backed solutions to the challenges women face at work today. Sign up for email updates on the initiative’s actions, insights, events, and recommendations.
SPONSORED RESOURCES FROM PFIZER
menopause: unmuted | A podcast series exploring first-hand experiences of this life stage and its impact on relationships, friends, family, and work.
Menopause Overview | A fact sheet about menopause and its stages, symptoms, and risks.
Postmenopausal Osteoporosis | Estrogen decline during menopause accelerates bone loss, which can lead to osteoporosis. Learn about the disease, its economic implications, and expert recommendations for testing