Struggling with concentration during a big client meeting or breaking into a heavy sweat while presenting to investors can undermine any professional. But for women experiencing menopause, the time when menstrual periods permanently cease, there’s a real anxiety that these symptoms will erode their careers, leading to a premature exit from the workforce. It doesn’t help that menopause is historically under-discussed, especially in the office.
“[Women are] not talking about their menopause symptoms at the workplace unless they’re talking to a group of huddled women who are the same age,” says DC ob-gyn Tamika Auguste.
This year has seen new movement toward establishing workplace accommodations for menopause. High-profile advocates such as Melinda French Gates are calling for protections in professional settings, and the issue is making its way into state and national legislation. It’s a departure from the silence that typically surrounds a life stage most women go through before retirement.
Menopause typically begins around age 45 to 55—also the time when women are holding executive positions, says James A. Simon, an ob-gyn and reproductive endocrinologist in DC. Symptoms, which include fatigue and memory trouble, can create issues at work for women in any role, notes Simon, but can be particularly debilitating for those in charge. For Tina Zhang, an internist and codirector of the Johns Hopkins Women’s Wellness and Healthy Aging Program, two problems stand out: “Sleep concerns are one of the most common issues that we see in our menopause practice. Another symptom women complain about is brain fog.” Without workplace acknowledgment of the underlying issue, it can appear that an individual is simply underperforming, when in reality the environment is not well suited to a common biological process.
“If an organization wants to really have diverse leadership, I think this needs to be part of the conversation in terms of how they support their women leaders through this,” says Auguste. “The fact that menopause is being looked at as ‘This is an ailment, we need to have accommodations’ is the right move.”
A brief from the Women’s Bureau at the Department of Labor lists a few ideas for employers: flexible policies such as telework, the ability to layer clothing when there are dress codes, and uniforms made with materials that allow for airflow. But unless organizations take it upon themselves to integrate those policies, broad change is going to require mandates.
Earlier this year, the Virginia House and Senate sent bills to Governor Abigail Spanberger that would have made menopause and perimenopause—the transition into menopause—protected categories under the state’s Human Rights Act. Span-berger vetoed the bill on the grounds that protections for age and sex already cover those groups. She recommended a study on the subject, including a call for how best to accommodate menopausal women in the workforce and a look at current policies. Meanwhile, Maryland passed a law that went into effect this summer incentivizing health professionals—not just ob-gyns—to undergo continued training on menopause and perimenopause and requiring private insurers, nonprofit health service plans, and HMOs to cover evaluation and related costs.
The idea of workplace accommodations for menopause is also permeating national legislation. In July, US representative Debbie Dingell introduced the Menopausal Workers’ Fairness Act. The legislation ac-knowledges the gap in workplace protections for women experiencing menopause and how that disparity makes it harder for them to remain in the workforce; calls for accommodations based on common symptoms (hot flashes, stiff muscles, urinary incontinence); and stops employers from forcing women to take leave due to menopause-related symptoms when an accommodation is available. While the bill is still in committee, the fact that the conversation is happening at all is a victory.
Daniella Byck joined Washingtonian in 2022. She was previously with Outside Magazine and lives in Takoma.
