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Four out of every five women say working through menopause is challenging. And one in five — 20% — have considered leaving the workforce because of it.
Often, these women are at the peak of their careers, with experience that’s tough to replace. Yet most employers have no formal menopause policy or benefits in place. That lack of support can affect productivity, career progression, and employers’ ability to retain top talent.
Key takeaways
- Chances are, a significant share of your workforce is affected. Perimenopause begins in a woman’s forties, and the transition to menopause can last a decade or more.
- Menopause symptoms are easy to misread. Fatigue, difficulty concentrating, and mood swings can look like performance issues.
- The cost of not covering menopause care is high. Menopause symptoms cost employers billions a year in lost work time.
- The law is changing. New federal, state, and international measures are starting to require menopause accommodations.
Why menopause in the workplace matters now
Over 50 million women aged 45 to 55 are already in the US workforce. And each year, roughly 2 million US women enter perimenopause, the transitional stage before menopause. For many, the hormonal fluctuations during perimenopause and menopause manifest in symptoms like sleep loss and mood changes that can affect their work.
In a 2023 Mayo Clinic study of more than 4,400 women aged 45 to 60, nearly 15% of participants experienced an adverse work outcome related to menopause symptoms. Women with the worst symptoms were 16 times more likely to miss work or scale back their hours.
By 2035, more women will be navigating menopause at work. The US Bureau of Labor Statistics predicts that 65% of women 55 to 64 will be working or actively looking for work, up from 61% today. For employers focused on productivity and retention, supporting women through perimenopause and menopause is an opportunity to keep experienced talent.
The real cost of unsupported menopause at work
A 2025 RAND analysis estimates that menopause symptoms cost the US economy $5.4 billion a year in productivity — and that excludes early retirement, missed promotions, and moving into lower-paying roles. For employers, specifically, menopause symptoms account for $1.8 billion in lost work time per year, jumping to $26.6 billion total with medical expenses added in.
Meanwhile, the support women want isn’t widely available. A Bank of America report found that 64% of women want menopause-specific benefits, yet only 14% believe their employer sees the need to provide them.
Recognizing the symptoms affecting your workforce
People rarely talk about menopause at work. In a national AARP survey, 38% of women over 35 and 31% of employers said menopause is not discussed in the workplace. Because it’s rarely discussed, managers may mistake symptoms for performance issues, preventing employees from getting the relief they need. Here are signs to watch for:
Early menopause and atypical onset
The average age of menopause is 51, but 5% of women go through early menopause in their forties, and perimenopause can begin even sooner, in a person’s late thirties.
Managers should know these physical changes can cause a range of symptoms that may show up as a string of “off days” or even missed deadlines. In a global study of more than 12,000 people over 35, the most commonly reported perimenopause symptoms were:
- Fatigue (83%)
- Exhaustion (83%)
- Irritability (80%)
- Low mood (77%)
- Sleep problems (76%)
Keeping this in mind can help managers respond with flexibility and understanding.
Fatigue and sustained energy loss
Hormonal shifts during menopause impact sleep regulation, metabolism, and energy production. 40 to 60% of women in the menopausal transition report sleep problems, and, among women 40 to 59, perimenopausal women are 56% more likely than premenopausal and postmenopausal women to sleep less than 7 hours.
Some women experience extreme exhaustion that no amount of napping or rest can shake. That drain on energy and focus can show up as slower output or trouble concentrating, which may call for an adjustment at work.
Mood changes and depression
Menopause is a high-risk window for mental health challenges, even for women with no prior history of depression. A study out of UCL found that perimenopausal women had a significantly higher chance (around 40%) of experiencing depressive symptoms and being diagnosed with depression compared to premenopausal women.
Vacillating estrogen and progesterone levels can shift brain chemicals like serotonin and dopamine, and this effect often gets compounded by the poor sleep perimenopausal and menopausal women get. At work, these swings can materialize as increased anxiety or drops in engagement.
Myths that get in the way of support
Misconceptions about menopause — hot flashes are the only symptom, they sprout up overnight, and you just have to “get through it” — can make it hard for women to talk about. Almost 60% of peri- and post-menopausal women say they don’t feel comfortable sharing symptoms at work. Just 3% have talked about menopause with HR.
At the same time, the number one reason employers say they don’t offer menopause-specific benefits is that employees haven’t asked for them. Open communication about menopause and available care can help employers keep experienced women in the workforce.
The legal landscape for menopause in the workplace
Both employers (74%) and women (64%) want policymakers to do more to ensure that all women can access high-quality, personalized menopause care and treatment, including access to hormone replacement therapy. New legislation and policy initiatives reflect this growing attention to menopause at work, but requirements vary by location.
At the federal level
In July 2026, U.S. Representatives introduced the Menopausal Workers’ Fairness Act. The bill proposes new federal workplace protections for employees experiencing menopause. It would cover employers with 15 or more employees and specified government employers. This bill has not yet become law, but if it passes, it would:
- Require covered employers to provide reasonable accommodations for known menopause-related limitations.
- Direct the Equal Employment Opportunity Commission to issue regulations and best practices, including examples of accommodations and when employers may reasonably request supporting documentation.
- Prohibit adverse employment action against employees for requesting or using an accommodation.
- Require employers to keep menopause-related information confidential.
At the state level
As of 2026, more than half of US states have introduced at least one menopause-related bill, and 21 bills have been enacted across 10 states. These bills fall into a few different categories, ranging from insurance coverage to public awareness to workplace protections.
For employers, workplace protection laws matter most, since they outline required accommodations and discrimination protections. Only a few states have them so far, and each has its own rules, which means multi-state employers have more than one standard to uphold:
For multinational teams
Under the UK’s Employment Rights Act 2025, employers with 250 or more staff must publish annual Menopause Action Plans as part of broader Equality Action Plans. These plans are voluntary now, but will become mandatory in 2027. These requirements apply in England, Scotland, and Wales, with specific rules for certain public authorities.
For U.S.-based employers with UK-based employees, now is a good time to review existing policies, identify reasonable workplace adjustments, and ensure employees know how to access support.
How employer adoption of menopause benefits is changing
Most employers (73%) say they want to do more to support workers going through menopause, and the percentage of employers offering menopause support or resources has grown over the past year. According to SHRM’s 2026 Employee Benefits Study, 27% of employers provide menopause benefits, up from 18% in 2025.
More specifically, these benefits cover:
- Hormone therapy
- Physical therapy for pelvic-floor issues
- Access to specialists in menopause care
- Menopause-specific paid leave
With adoption becoming more commonplace, menopause benefits are going from nice-to-have to employee expectation.
What to include in a menopause workplace policy
A good menopause policy spells out what support is available, how employees can request it, and what managers should do when someone needs help. The clearest guidance comes from the UK and Europe, where workplace menopause support is further along.
They recommend:
- Offering flexible schedules, such as breaks, reduced hours, or remote work.
- Improving physical comfort. This can mean anything from cooler workspaces to private washing facilities. You might also relax your uniform and dress code.
- Training managers. Coach managers to respond thoughtfully to requests and point employees to the appropriate resources.
- Addressing workplace culture. Make it clear that menopause-related bullying or dismissive treatment is unacceptable.
- Accounting for different experiences. Because menopause symptoms vary from person to person, your policy should allow for case-by-case adjustments.
- Pointing people to care. Give employees a way to get menopause support, whether through an EAP or women’s health platform.
- Putting it in writing. Reference menopause in sickness, attendance, and accommodation policies. Be clear about who employees can contact and how you handle requests.
- Reviewing policies regularly. Ask employees for feedback and update your policies as needed.
Choosing the right menopause benefit for your organization
Menopause benefits generally take one of three forms. The right fit will depend on your budget, existing coverage, applicable laws, and how much menopause-specific care you want to provide.
EAP add-on
Some employee assistance programs offer menopause resources such as educational materials, counseling, or referrals to more specialized care. Building on your EAP can be a lower-cost way to extend the benefits you already have.
Before you go this route, check whether the add-on includes menopause-specific expertise and access to clinical care. Otherwise, employees are left to find treatment on their own.
Point solution
A dedicated menopause provider focuses on care for people with perimenopause and menopause. Typically, this involves consultations with menopause-trained clinicians who can share symptom guidance and help employees explore treatment options.
Before choosing a vendor, ask about:
- The clinicians employees can access
- What types of care are included
- How the solution works with your existing health plan
- Whether employees can get ongoing care or only one-time consultations
Women’s health platform
A broader women’s health platform connects people to menopause care alongside fertility, pregnancy, and postpartum support. This can be a good fit for employers who want to cover several stages of reproductive health through one provider.
Carrot’s menopause support works this way. Members can access vetted specialists and, where their employer offers it, virtual consultations and prescriptions through partner clinics. The program also offers proactive education, metabolic health support, and hormone therapy, adapting to each person’s changing symptoms throughout the transition.
Frequently asked questions
What menopause benefits should employers offer employees?
It depends on your employee needs, existing health coverage, and applicable law. In most cases, employers should consider menopause-specific clinical support, care navigation, and paid leave beyond existing sick time.
Making employees aware of the benefits available to them is just as important. Fewer than 1 in 3 women know their company offers menopause benefits.
How much does menopause cost employers in lost productivity?
According to research from Mayo Clinic, menopause symptoms cost U.S. employers roughly $1.8 billion a year in lost work time, rising to $26.6 billion annually once medical expenses are added.
What percentage of companies offer menopause support as a benefit?
Of the 5,472 employers surveyed in SHRM’s 2026 Employee Benefits Study, 27% of surveyed employers reported offering menopause support or resources. Other surveys may vary based on whether they focus on specific planned benefits, broader education and counseling, or clinical care.
How do I build a menopause-friendly workplace policy?
First, consider practical changes such as flexible schedules, temperature control, and ways to connect people with relevant care. Then, put it in writing. Update sickness and attendance policies to address menopause, and clearly explain how employees can request accommodations and access benefits.
Make menopause support part of your workplace plan
The years women enter menopause tend to overlap with the years they move into senior leadership and take on more responsibility. Recognizing the symptoms, putting a clear policy in place, and giving people a straightforward, stigma-free path to care helps your most experienced employees do their best work.
A benefit like Carrot makes that support easier to deliver. Carrot gives employees personalized menopause education and access to clinical specialists. Contact us to learn what a modern program looks like.
