Health insurance has been a standard since the 1940s and 1950s. In recent decades, wellness plans that offer meditation apps and gym memberships have become commonplace, and fertility benefits have also started appearing more frequently.
The latest employer-provided plan making waves? Menopause care.
Menopause is a natural decline in a woman’s reproductive hormones marked by the cessation of periods. This typically happens in their 40s or 50s, with the average age in the United States being 51, according to the Mayo Clinic. Roughly 1.3 million U.S. women enter menopause each year, and around 20 percent of the workforce is in a phase of menopause transition.
As Gen Xers and millennials approach this life stage, more are advocating for greater educational resources, medical care and employer support.
Shifting expectations
Ask the average person what menopause looks like and you’ll likely hear about hot flashes and night sweats. But for Robyn Cohen, SVP of Universal Media and the founder of W Collective, a dramatic change in emotions alerted her. Trips to the doctor and some deeper research concluded she was experiencing perimenopause, the transitional phase between a woman’s reproductive years and menopause, which may start several years beforehand.
Millennials — the largest workplace demographic in the U.S. — are swiftly approaching the perimenopause phase. According to a 2023 survey and report from global fertility care platform Carrot Fertility, 80 percent of respondents cited menopause as a workplace challenge. Another company report found that millennials are more informed about menopause’s potential impact on their career and likely to ask for menopause support from their employer.
“A lot of these women are at the peak of their careers or in leadership positions, and the money that you would lose with that person not getting support — not being as productive, or even choosing to retire early or switch jobs entirely — is going to be a higher cost to you,” says Asima Ahmad, chief medical officer and co-founder of Carrot Fertility.
One 2023 Mayo Clinic study found that 11 percent of people miss work due to menopausal symptoms, and a previous study from 2012 found one-third of women experiencing menopausal symptoms also experience depression. Carrot’s “Menopause in the Workplace” report also listed loss of concentration, criticism for perceived performance and lowered confidence due to stigma as ways menopause has interfered with work.
The intersection of work and menopause
Cohen feels she was inadequately prepared for perimenopause and menopause and how it can impact the workplace.
“Your level of energy, your level of focus — these are all diminished,” Cohen says. “Even questioning your confidence, your work style or your leadership style. You’re starting to feel more insecure.”
Managing these symptoms without support or trusted resources can negatively affect workplace satisfaction and productivity. Jeanne Falk, a board-certified OBGYN and integrative medicine physician with Intermountain Health, says this can lead to an unhealthy cycle.
“I feel like women would feel a lot more confident and supported if they knew they could balance their time between in-office and working remotely.”
— Robyn Cohen
“One of the classic things you hear people talk about is horrible hot flashes and that they can’t sleep,” Falk says. “Even if we just take sleep deprivation, that sets up people for not performing well on so many levels because you feel exhausted all the time.”
Perimenopause can be an even more difficult time for women because of its unpredictability. The symptoms may come and go, making it hard to plan. A woman may feel normal for a month or two, then experience a difficult cycle with little sleep and irritability. She might start reaching for a quick energy boost through caffeine or simple carbs. These solutions don’t work long-term because they spike blood sugar and may lead to additional weight gain, Falk says, which adds to stress.
Some of the more visible symptoms can also be embarrassing, says Falk.
“Even menstrual bleeding can be crazy,” she continues. “Women can go from nothing to having sudden massive blood loss, and being in a workspace where that may or may not be at a convenient time can add additional stress.”
Cohen also believes ageism is a significant factor and a stigma to overcome. She says companies should be aware of the different “cycles” of a woman’s life and equates menopause to an “internal hormonal rollercoaster ride.”
Finding medical and workplace support
When Cohen’s doctor recommended antidepressants, Cohen was frustrated and couldn’t believe it was the only way to manage. She did a deep dive into perimenopause symptoms and treatments, eventually finding alternative options.
Access to reliable information and specialized medical care can prevent symptoms from becoming too troublesome. However, comprehensive care is tricky to come by. Only a fraction of medical residents — 31.3 percent — receive specialized menopause training and education.
After practicing for several years, Falk returned for a fellowship in integrative medicine for more in-depth training after noticing a gap in answers surrounding menopause care. Intermountain’s Park City Lifestyle Medicine & Wellness Center, where Falk practices, now offers the Menopause Wellness Package to provide a comprehensive approach to support women throughout menopause. Patients visit with an exercise physiologist and a dietician in addition to Falk, offering a holistic approach beyond medication.
“Yes, we do talk about hormones and what may or may not be contributing to how they’re feeling. But we also really take a deep dive into the other areas going on with sleep and stress, and different areas that can be impactful in those arenas,” Falk says.
Cohen encourages employers to understand the different phases of a woman’s life and the various needs that accompany them. Caring about employee’s health, she says, is the best investment because it creates a successful environment.
“Investing in the health and wellness of your employees will naturally go much further,” Cohen says. “[Employers] should care because it’s about knowing someone feels safe and protected.”
Women report being hesitant to ask for menopause support for several reasons, including stigma, not wanting to do it alone, not being sure who to ask, or working in a male-dominated industry. When surveyed, 64 percent of women say they’d like to see menopause benefits such as an official policy, covered hormone therapy, access to health professionals and menopause awareness sessions.
Even smaller employers who may not be able to offer large medical packages have the power to create supportive environments. Examples include offering temperature-controlled rooms, personal fans or workspaces, and flexible schedules.
Cohen says employers have a chance to become “trailblazers” when it comes to menopause support and consider what a supportive work environment looks like. She says flexibility is central to supporting women in every phase of life, including menopause.
“I feel like women would feel a lot more confident and supported if they knew they could balance their time between in-office and working remotely,” Cohen says. “If you’re having one of those days where your hormones are out of whack and you need to work from home, there shouldn’t even be a question about it.”
Just as access to vision, dental and retirement plans have become the norm, Ahmad hopes that menopause benefits will someday be an expectation. Employers who embrace this movement only stand to benefit.
“This is the perfect time for employers to show how much they value their employees,” Ahmad says. “This is the time to create change and provide support for your employees for lifelong hormonal health. Show that you are being proactive and leading this initiative and this movement, and that you’re not just going to be one of the people that follow afterward.”
