Miranda Bryant has always been organized and efficient at work. But four years ago when she transitioned to a new role at the global health research institute where she had worked for several years, she suddenly found herself struggling to stay on top of her assignments.
Before weekly meetings with a much-younger female supervisor, the 57-year-old from St. Paul, Minnesota, organized her laptop to highlight recent accomplishments and upcoming action items. But during the meetings, Bryant would scramble to find the information. Then, when her institute went virtual during the pandemic, she began to experience anxiety, so she took a monthlong medical leave. When she returned, her boss fired her.
In retrospect, Bryant realizes 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.
Menopause Symptoms Affect Productivity, Absenteeism, and Women’s Careers
Bryant isn’t unique at having menopausal symptoms clash with the work environment. “The physiologic changes associated with menopause occurs at one of the most important times in the careers and work lives of women,” says Makeba Williams, MD, associate professor of obstetrics and gynecology at Washington University in St. Louis.
According to the Center for American Progress, more than 1 in 10 workers today is a woman in her mid-fifties or older — a figure that has grown significantly in the past 20 years. And women in their forties, well before their final period, experience symptoms of perimenopause ranging from hot flashes, brain fog, anxiety, and more.
When these women are not supported by their employers, problems ensue. A survey in 2022 by the Fawcett Society, a British nonprofit advocating for women’s equity, found that 1 in 10 women have left a job directly due to menopause symptoms.
Some 13 percent of midlife women have had one or more unfavorable work outcomes due to menopause, including missing days of work, according to a large survey of 4400 women published in Mayo Clinic Proceedings in April 2023. Women with the most extreme symptoms were 15 times more likely than others to have work-related issues.
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 The Menopause Society.
Costing Company Talent and Money
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. 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.
One of Dr. Williams’ patients was attending abusiness dinner when she rose from her seat and noticed that she bled through her clothes and soaked the seat cushion. She hurried back to her hotel room without accomplishing her business goal. A university professor she knows has such problematic brain fog she no longer teaches advanced level courses. And women whose job involves physical labor can be stopped short by frequent hot flashes, disrupting their work.
Black women — whose menopause symptoms are generally more frequent and last for more years — also face workplace discrimination, pay inequity, and stigma, says Williams, who studies menopause in Black women. These women are more likely than white women to report unfavorable work outcomes in midlife, along with poorer health and well-being, she notes.
Advocate for Solutions in the Office
Many companies are unfamiliar with the ways menopause impacts women, so your first step might include starting a discussion with your human resources department. The Fawcett Society that surveyed British women has called for all businesses to develop a “menopause action plan.”
This should include time off for mental health or symptom relief as well as flexible work arrangements when needed, experts say. Companies already offering 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.
If you feel comfortable discussing your personal situation with your supervisor, there are benefits to doing so. “The more conversations that are had, the more we can normalize the menopause transition,” Williams says.
With hot flashes a common symptom, advocate for air conditioning to be set at a comfortable temperature or ask for a fan to be placed near your desk. Williams recommends that women store extra clothing in the office for times you might feel especially sweaty or have heavy period bleeding. If you are required to wear a uniform, be sure the company understands that they should be made of fabrics that are cooling.
An Australian review of the research published in Maturitas in 2016 found working women were less bothered by their menopause symptoms when they felt supported emotionally and with reduced temperatures in their workplace.
Because Bryant felt alone and adrift from 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.
Anyone whose symptoms are bothersome needs to discuss them with a healthcare practitioner. Not every gynecologist understands menopause, but you can find someone trained in the condition on the The Menopause Society website, or by telehealth on sites including Midi and Alloy.
Drug therapies for menopause symptoms include hormone therapy, which are safe for most women, and nonhormonal options such as Veozah (fezolinetant).
“Effective treatment is something I advocate for,” Williams says. This can both improve a woman’s quality of life as well as her ability to function better at work.
