This article explores how menopause and perimenopause affect women in the workplace, through my own experience of leaving a career I loved when I didn’t know hormones were to blame.
Menopause and perimenopause are often treated as private matters, whispered about, or ignored entirely. Yet, for millions of women, these hormonal changes collide directly with their careers.
The workplace, designed without this stage of life in mind, becomes a daily test of endurance. Brain fog can make critical thinking harder. Exhaustion turns once-manageable workloads into mountains. Anxiety creeps in where confidence once lived.
Even though every woman who reaches midlife will experience this transition, most workplaces remain silent on the issue. There are no policies, no training for managers, and little understanding of how deeply it can affect performance, opportunities, and long-term career prospects.
The result is predictable: talented women missing promotions, stepping back, or leaving entirely, often without knowing why they are struggling in the first place. I was one of them.
Jump to:
My Breaking Point at 47
At 47, I walked away from a corporate job I had spent almost a decade building. I told myself I was burned out, stressed, maybe just not tough enough anymore. The truth was less obvious and far more profound: I was in perimenopause for a few years and had no idea.
The symptoms were there, constant fatigue, a brain that refused to cooperate, and a nervous system on edge, but I didn’t recognize them for what they were. Deadlines that used to excite me now triggered panic. I would wake up in the morning unrefreshed, sitting on the edge of the bed crying and plotting about what reason to find so I don't have to show up at work that day.
I would drag myself through the day and collapse at night, wondering what had happened to me. I asked for medical help and was dismissed. I asked for understanding at work, but could not explain what I was facing. I was really valued and appreciated, but deep inside, I knew that I needed a change.
Eventually, I quit. I pivoted to pastry school, then built a food blog, carving out a career that gave me control over my schedule and allowed me to function on my own terms. It was a lifeline, but it was also a loss. I left not because I lacked ability or drive, but because no one, including me, understood what was happening.
The Hidden Career Cost
I am far from being alone. Untreated, unrecognized menopause symptoms cost women more than comfort; they cost careers. Promotions are missed because confidence erodes. Stretch opportunities are declined because brain fog and fatigue make them feel impossible.
Some women scale back their ambitions quietly. Others, like me, leave entirely. The financial consequences accumulate over time: lost income, stalled pensions, and reduced retirement security.
The loss is not just personal. Companies lose experienced employees who carry institutional knowledge and leadership potential. Replacing them is costly, both in recruitment and in the expertise that walks out the door.
Why Symptoms Are So Damaging
Perimenopause and menopause are driven by fluctuating and declining hormones, mainly estrogen and progesterone. These changes can affect:
- Energy levels: Chronic fatigue despite sleep or insomnia. Sleep disturbances lead to daytime fatigue that no amount of caffeine can fix.
- Cognitive function: Brain fog, memory lapses, and reduced concentration are very common.
- Mood stability: Anxiety, irritability, or low mood undermines confidence and collaboration.
- Physical discomfort: Hot flashes, night sweats, joint pain, and migraines add another layer of difficulty, disrupting focus.
These are not “mild inconveniences.” They can directly impair job performance and professional confidence. When workplaces fail to acknowledge this, women internalize the struggle as personal failure. They overcompensate, burn out further, and often exit quietly.
Systemic Failure: Medicine and Work Combined
The struggles of menopause in the workplace are not only about office culture; they are the product of a broader failure that starts in the medical system and spills into professional life. Many of the challenges women face at work could be reduced with proper medical care, but most never receive it.
The medical gap is staggering. Most medical residents in family medicine, internal medicine, and obstetrics and gynecology never receive proper training for menopause in medical school. For many women, this means years of symptoms dismissed as stress, aging, or personal weakness.
I experienced this gap firsthand. When exhaustion, chronic muscle pain, anxiety, and brain fog began undermining my ability to work, I went to my doctors for answers.
They told me to relax, sleep more, and manage stress; some wanted me to be on antidepressants, my gynecologist wanted to remove my uterus, and my family doctor told me to lose weight, eat less, and move more, as if I hadn’t already tried. No one connected my symptoms to perimenopause. Without answers, I left a career I loved, unaware that effective treatments existed.
This lack of medical support feeds directly into workplace loss. Without proper care, women struggle to maintain performance. Workplaces, in turn, fail to recognize what’s happening and provide no accommodations. The result is a cycle of neglect where women are left unsupported on both fronts, and careers end not because women lack ability, but because the systems around them refuse to adapt.
Read more: Medical Feminism: Exposing the Bias in Women’s Health
What Workplaces Should Do
A supportive workplace is not about lowering standards; it is about removing unnecessary barriers so employees can meet them.
1. Policy and Structure: Include menopause in wellbeing and inclusion policies. Offer flexible hours, remote options, and clear access to medical benefits. Integrate menopause into sick leave and appointment policies so women are not penalized for seeking care.
2. Education and Training: Train managers to understand what menopause looks like and how to respond appropriately, because many times women are afraid to speak up about their symptoms at work, for fear of ageism. When leaders know the signs, they stop misinterpreting symptoms as disengagement or incompetence.
3. Environmental Adjustments: Simple changes like access to cooler spaces, desk fans, quiet rooms, and flexible uniforms can dramatically improve comfort and focus.
4. Confidential Support: Create private channels for employees to request adjustments without fear of judgment. Confidentiality builds trust, and trust encourages retention.
5. Culture Change: Normalize discussion of menopause. This does not mean forcing disclosure, but fostering an environment where the topic is not taboo. Awareness campaigns, internal communications, and employee resource groups can all help shift culture.
What Women Can Do for Themselves
While systemic change is critical, there are steps women can take now to protect their health and careers.
- Track symptoms to identify patterns and triggers. This data can support medical consultations and workplace discussions.
- Seek evaluation from a doctor who specializes in menopause; treatment options, including hormone therapy, can restore function and confidence.
- Communicate with your employer about adjustments that could make a difference, whether that’s flexible hours, quieter workspaces, or temporary workload changes.
These are practical solutions to a temporary but significant challenge.
The Economic Case
Supporting menopausal employees is not just about fairness, it is about business sense. Retaining skilled staff reduces turnover costs and preserves leadership pipelines. Productivity improves when employees are equipped to manage their health. A menopause-inclusive workplace is a competitive advantage in attracting and keeping talent.
Change will not happen on its own. Workplaces must recognize menopause as a workplace issue, not a personal inconvenience. For employers, this means taking immediate steps: review your policies, train your managers, and create an environment where women do not have to choose between their health and their careers. For employees, it means demanding better—not quietly accepting a system that ignores you.
I walked away from a career I loved because no one acknowledged what was happening to me. That silence cost me years of earning power and professional fulfillment.
Read: Is This Normal?” And Other Midlife Body Mysteries
It is time to break that silence. If you are an employer, start the conversation today. If you are an employee, share this article with HR, with colleagues, with anyone who can help shift the culture. Menopause is not optional. Support should not be either.
It is also time for policies, education, and cultural change that allow women to thrive through every stage of life. The cost of silence is too high, for women, for businesses, and for society.
If you liked this article, you might find these other articles worth to read:
- How Menopause Affects Marriages and What Saved Mine
- MHT and Mounjaro: Finding Balance in Midlife
- When Your Body Says ‘No Thanks’ to Exercise
- Breaking the Silence Around Menopause Hormone Therapy
- 8 Quiet Ways to Dismantle the Patriarchy
- Menopause Support for Husbands: What You Need to Know
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