Menopause-related symptoms can be debilitating. Many workers say they lack employer programmes – and have no choice but to leave their roles.

In March 2016, Madhu Kapoor decided to resign from her position in the British government department where she'd worked for 23 years.

"I loved what I did, and I was loyal and committed," says the 58-year-old, from North London. "But I wasn't coping, and I thought the best thing to do was to leave."

The mother-of-two was in her mid-40s when she first began experiencing symptoms of perimenopause. She suffered with night sweats, heart palpitations and migraines that left her feeling weak and lethargic. She struggled to focus at work and dreaded attending the regular meetings that were part of her job as a recruitment specialist. "I lost all my confidence. I thought I wasn't good at anything," she says.

But when she shared how she was feeling with her leadership team, she said she didn't get the reassurance or emotional support she was looking for. About six months after that conversation, she decided to hand in her notice. Though her family was shocked, she felt she had no choice. "I didn't know who to turn to."

The topic of the menopause is becoming less taboo in some countries, as grassroots campaigns like Menopause Mandate and Let's Talk Menopause help break down stigma and build awareness. Yet its professional impact on women (and anyone who experiences the menopause) remains largely unaddressed, say experts. 

In a late 2023 survey, UK workplace-healthcare provider SimplyHealth surveyed more than 2,000 working women aged 40 to 60. Twenty-three per cent considered resigning due to the impact of the menopause, and 14% are said thy are planning to hand in their notice. Although the survey's sample size is small relative to the seven-million women in the UK workforce in that age bracket, it does support anecdotal evidence from women speaking out publicly about their experiences as a menopausal worker. And if the issue remains unaddressed, it could impact millions of workers who take the same decision to leave. 

Plus, even for workers who don't leave, the financial toll of sick days, unpaid leave and missed opportunities due to menopause adds up to an astronomical cost. Researchers from the Mayo Clinic estimate women's losses at $1.8bn (£1.43) per year in the US alone.

Some employers have seen the dire need to support these mid-career workers – many of whom are in leadership positions – and have introduced menopause-specific support programmes. Yet experts say that change needs to happen faster – or millions more workers like Kapoor may feel they have no alternative but to quit.

'I just couldn't continue at that pace'

Nearly eight out of 10 women go through the menopause while they're still at work, according to London's Faculty of Occupational Medicine. Most will experience its onset between the ages of 40 and 58, with the transition phase in which hormones begin to fluctuate – called "perimenopause" – lasting up to eight years.

Three quarters of people will experience at least some effects during this time, with night sweats, fatigue, headaches, joint pain and anxiety among the 34 medically recognised symptoms. And for, 25% of people, these symptoms will be debilitating, with a significant impact on their day-to-day lives. 

Despite how widespread the problem is, workers going through menopause report rarely feeling supported. Recent data from consultancy Korn Ferry showed only 26% of 8,000 women surveyed received help via formal workplace programs or policies; and in a 2023 survey of 11,000 female union members by UK trade union Unite, four of five women reported their employer provides no support at work for those with menopause symptoms.

Many workers not only lack help from formal programmes, but also feel they don't have an open avenue to even broach the subject of the menopause.

Samantha was 40 years old and working as the PR director of a manufacturing company when she first began experiencing fatigue, hot flushes and brain fog at work. At first, it didn't occur to her the symptoms could be a sign of the menopause. The topic only surfaced when she visited the doctor about the frequent, heavy periods that had sapped her energy. Throughout the next two years, the mother of two found it increasingly difficult to manage the demands of her role alongside severe symptoms. Weekly trips from London to New York, regular 05:00 starts and juggling multiple responsibilities took their toll. "I just couldn't continue at that pace," she says.

Samantha briefly considered the idea of bringing up the topic with the person designated to handle HR matters at the company, but his age and gender made it feel awkward, she says. When she finally floated the idea of a job share or bringing on an extra person to manage her workload, her CEO declined the ask. Feeling left with no other option, she handed in her notice six months later, and opted to start working as a freelance PR and marketing consultant instead.

'No-one wanted to talk about it'

Tamsen Fadal, a US-based journalist, author and menopause-support advocate, believes the number of women who feel compelled to quit because of the menopause is under-documented and underestimated. "We have to ask ourselves when women leave the workplace at this age or during this transition, how many are not talking about why," she says. "This is a real issue."

For many people, the topic of menopause remains taboo. Fadal believes people find it particularly difficult to share their struggles and articulate the help they need from employers. "No-one wanted to talk about it from our mothers to our doctors, so how could employers?" The threat of ageism makes it even harder for many women to speak out, she adds. "Going in and articulating our needs is scary. The fear of ageing out of a workplace has not left our minds."

Getty ImagesMany women say they feel alienated around male leaders while going through the menopause (Credit: Getty Images)

The fact that many leadership teams remain male dominated adds to the decision to keep quiet in the workplace, says Lauren Chrien, a UK-based corporate menopause trainer and professional coach. "With men still occupying a majority of senior leadership positions in most sectors, there can be a lack of understanding or empathy towards menopause as a critical health issue."

Closing the gap 

Some companies are working to change, rethinking their benefits suites to help provide better accommodations and programmes for menopausal women. Adobe, Bank of America and Bristol Myers Squibb are among a handful of major global employers now offering menopause-specific benefits, such as access to specialist private medical advice, paid leave and hormone replacement therapy (HRT) covered by health-insurance plans. Smaller companies, too, are beginning to understand the importance of these programmes, and take similar approaches.

There's still much more work that needs to be done, however. "Some workplaces are being proactive in providing support, but others may not believe it's necessary, or don't know where to begin," says Fadal. 

That's why several campaigners, charities and organisations are working to close this gap. The Menopause Workplace Pledge – in which UK employers commit to actively provide menopause support to their staff – has been signed by more than 2,600 employers, including Tesco, the Royal Mail and NHS England since 2011. Last year, US advertising agency TBWA\Chiat\Day partnered with the Menopause Information Pack for Organizations (Mipo) to launch the #HotResignation tag. It called on HR leaders to consider how resignations were connected to the menopause, and provided free toolkits and resources to help them improve retention.

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The change from employers can't come fast enough, adds Fadal. "We have to stop asking women to handle the double threat of [menopause] stigma and ageism, and help them get what they need to help them feel whole, partly through education, and partly through support at work and in the doctor's office."

Like Fadal, many of the leaders pushing for change have experienced the lack of workplace menopause support first-hand. A former senior executive in financial services, Chiren walked away from her high-pressure role when severe menopause symptoms left her feeling like she "might have dementia". She'd walk into meetings and feel suddenly unable to get out the right words, her throat tight with anxiety. "One time, I was holding onto the arms of a chair watching the clock tick down with no clue what that meeting was about," she remembers. "I'd never experienced anything like it before."

Chiren believes greater awareness of potential symptoms in the workplace could've made all the difference. "I wouldn't be having a conversation with you now if I'd worked with an employer who had had this on the agenda, who had managers who knew what menopause was and were able to open that conversation and signpost me toward help and support," she says. In response, Chiren founded Women of a Certain Stage within weeks of handing in her notice, offering coaching, courses and events designed to provide support to women and educate employers.

Kapoor, too, now uses her two decades spent in HR and recruitment to provide corporate workshops and training via her platform M for Menopause, plus advice to women navigating the challenges she also faced.

"I'm from a traditional Asian family background," she says. We didn't talk about sex, periods or menopause. The reason I do what I do now is for more women to be able to understand what the symptoms could be and increase their knowledge and awareness," she says. 

Had that been the norm eight years ago, says Kapoor, she might still be doing the job she loved.