Menopause, the Workplace, and How to Access Support

These shifts can require time and possibly external support to manage, especially if you’re navigating a chronic condition. Another major consideration around the discussion of menopausal support is how women can navigate the workplace most effectively, ideally with support from their leadership and colleagues.

“Women do not need to wait until symptoms become debilitating. Earlier treatment often means better outcomes and less disruption to work and daily life,” says Christina Ni, MD, a board-certified psychiatrist based in Calabasas, California.

“Symptoms like insomnia, brain fog, fatigue, hot flashes, and mood changes directly affect work performance,” Dr. Ni says.

• Hot flashes
• Brain fog
• Trouble concentrating
• Anxiety
• Depression
• Sleep
• Mood

More than hot flashes or other physical problems, the mood symptoms of menopause are behind most absenteeism, says the study’s lead author, Stephanie Faubion, MD, director of Mayo Clinic Women’s Health and medical director of The Menopause Society.

When these women are not supported by their employers, problems can arise.

Stats on Menopause in the Workplace

“For some people, menopause can be the tipping point — but it does not have to be permanent or career-ending,” Dr. Ni says.

A Real Life Example of Menopause’s Workplace Effects

Miranda Bryant, of St. Paul, Minnesota, had always been organized and efficient at work. But seven years ago, when she transitioned to a new role at a global health research institute, where she had worked for several years, she suddenly found herself struggling to keep up with her assignments.

Before weekly meetings with a much-younger female supervisor, Bryant, who was in her fifties, organized her laptop to highlight recent accomplishments and upcoming action items. But during the meetings, she would scramble to find the information. Then, when her institute went virtual during the COVID-19 pandemic, Bryant began to experience anxiety, so she took a monthlong medical leave. When she returned, her boss fired her.

In retrospect, Bryant realizes that her mental health symptoms largely resulted from perimenopause. “At the time, I wasn’t connecting the dots to my shifting hormones,” she says. She saw the link clearly only after other perimenopause symptoms appeared, including insomnia, joint pain, and headaches, and once her periods stopped altogether.

Bryant isn’t unique in having menopausal symptoms clash with the work environment.

Companies that ignore this widespread problem may not realize its substantial impact on productivity and the bottom line, Dr. Faubion says. “We estimate the economic impact from this is a loss of $1.8 billion annually,” she says.

Women lose out financially too. According to the 2024 AARP survey, many women utilize their company’s leave options amid this transition, with a third of them reporting that menopausal symptoms have led to them missing work.

Many symptomatic women turn down plum assignments or promotions, or even retire earlier than planned, due to menopause, hurting their salaries and future career, Faubion explains.

“Because estrogen impacts so much more than reproductive health, it has the potential to amplify existing health issues,” Ni says. She advises that the following symptoms often worsen as hormone levels decline:

• Bone density
• Cardiovascular risk
• Chronic pain
• Metabolic health

“For patients already managing chronic conditions, menopause can act as a ‘stress test,’ exposing vulnerabilities that were previously manageable,” Ni advises.

Ni also highlights the connection between menopause and higher rates of depression and anxiety. “The key is recognizing that these changes are biologically driven and treatable. They’re not simply ‘aging’ or something women should push through,” she affirms.

Many companies are unfamiliar with the ways that menopause impacts women. If your workplace lacks support for women going through menopause, your first step might be to start a discussion with your human resources (HR) department.

Managers and HR departments should receive structured training to identify symptoms and to handle discussions about menopause sensitively. They could also implement menopause-specific absence policies to prevent unfair penalties or disciplinary action for regular short-term sick leave.

Companies that already offer generous benefits might not have to change much, but others should take a hard look at their policies if they hope to retain women employees in midlife, Faubion says.

How to Feel More Comfortable in the Workplace During Menopause

This underscores the importance of advocating for workplace solutions, both as employees and leaders. Because Bryant felt alone and adrift after her own experience of perimenopause, she became a menopause coach to assist other women. She also moderates the Facebook group Women Helping Women Through Menopause.

When it comes to advocating for or setting yourself up for success, some options can include:

• Asking for Time Off Don’t shy away from requesting sick leave. This can help accommodate both mental and physical needs.
• Inquiring About Flexible Work Arrangements Symptoms like brain fog, sleep issues, and fatigue can make keeping a rigid schedule challenging during the menopausal transition. Ask your employer about ways that they can add some flexibility to your schedule, to help you work around these symptoms.
• Advocating for Comfortable Office Temperatures Since hot flashes are a common symptom, you could advocate for the air-conditioning to be set to a comfortable temperature or ask for a fan to be placed near your desk.
• Keeping Clothing in the Office Because both night sweats and daytime sweating are possible, having an extra set of clothes or uniform nearby could come in handy.

Instead of living with discomfort in silence, Ni urges those with symptoms to feel empowered to bring their symptoms to their healthcare professional and to share as much detail as possible.

“Managing menopause alongside chronic illness often requires a whole-person approach that addresses sleep, mood, hormones, medical conditions, and symptom burden together. The goal is not just symptom relief, but preserving quality of life and function,” Ni says.

“Too often, people assume they are burned out or ‘not coping,’ when there may be an underlying biological transition contributing,” Ni says. This is especially true for those navigating both a chronic condition and menopause. However, Ni says that many women’s symptoms improve significantly after identifying and treating them.

Anyone whose symptoms are bothersome should discuss them with a healthcare practitioner. Not every gynecologist understands menopause, but you can find someone trained in the condition on the Menopause Society website, or via telehealth on sites such as Midi and Alloy.

Prescription Options

“We now have more hormonal and nonhormonal options, and a healthcare professional should tailor treatment to someone’s symptoms, medical history, and risk factors, rather than using a one-size-fits-all approach,” says Ni.

Some options for medications include:

• Hormone Replacement Therapy This involves supplementing estrogen, progesterone, or both with tablets, skin patches, gels, or sprays. These are safe for most people experiencing menopausal symptoms, but the type and dosage will vary depending on your needs.

  [8]

• Gabapentin According to Ni, this medication was originally developed for seizures and nerve pain, but it can also help alleviate hot flashes — particularly nighttime symptoms — and improve sleep problems, chronic pain, and migraines.
• SSRIs/SNRIs These are antidepressants, but Ni says that they’re often prescribed during menopause to reduce hot flashes, night sweats, mood symptoms, and sleep disruptions.
• Newer Nonhormonal Medications Elinzanetant (Lynkuet) and fezolinetant (Veozah) are nonhormonal options for hot flashes and night sweats that target temperature-regulation pathways in the brain.