Now’s The Time to Bring Up Menopause At Work

Being the chief people officer for the biotech giant Genentech was stressful enough, but last year, Cori Davis could tell that something more than just stress was starting to affect her. She kept waking up at night covered in sweat, making it difficult to get a good night’s sleep; during the day, she pushed through exhaustion to get her work done. A visit to Genentech’s campus health care confirmed her sneaking suspicion: she was going through menopause.

A few years ago, she might have kept that to herself. But there’s been a revolution in the world of women’s health in the last year, with women starting to talk about menopause and how it affects them in the workplace. So when Genentech’s women professionals group came to Davis last fall asking for ways to destigmatize menopause and support women in the workplace, Davis wasn’t shy about talking about her own health challenges. In March of 2023, Genentech, which has 13,500 employees, rolled out a new employee benefit to support women going through menopause, and Davis shared her experience when presenting it to employees.

“Our hope is that people understand there’s no shame in going through menopause, and the more comfortable we can all become in discussing this perfectly normal part of life, the less taboo the topic will be for all of us,” says Davis. Genentech’s menopause benefit gives employees and their spouses and partners 24/7 access to menopause specialists, a drop-in menopause support group, and on-demand video chat and messaging with doctors, nurses, and coaches specializing in menopause.

Genentech is one of many companies starting to adopt menopause benefits as they work on recruiting and retaining female employees. Years after companies started covering fertility treatments, they’re now expanding health benefits to cover menopause as Millennials begin to enter perimenopause, the prequel to menopause, which can start in a woman’s 30s and last as long as a decade, and can be characterized by increased anxiety and depression, sleep troubles, and hot flashes. Around 20% of the workforce is in some stage of menopause transition, according to Let’s Talk Menopause, a nonprofit trying to change the conversation about the subject.

Genentech isn’t the only company now acknowledging menopause directly in its benefits package. Menopause-specific benefits are still hard to find, but as companies partner with third-party menopause care providers like Gennev and Peppy, they are making inroads. Companies offering menopause-specific benefits include those in the tech sector like Adobe and Nvidia, as well as firms in other fields like Bank of America and Bristol Myers Squibb, the pharmaceutical giant based in New York.

The drive for menopause benefits in the U.S. follows a similar push in the United Kingdom; in 2021, the U.K .House of Commons’ Women and Equalities Committee undertook an inquiry on whether more should be done to help women going through menopause at work. That was driven in part by labor shortages; by one estimate, 300,000 in the U.K. have left jobs in the past five years because of their menopause symptoms. The U.K. awareness effort led to dozens of British companies, including big-name brands like HSBC UK, being certified as menopause-friendly by Henpicked, a third-party group; now, one in four British businesses have a menopause policy, according to one recent survey. The menopause push in the U.K. started as an effort to destigmatize menopause and make it something that women and men can talk about and get support as women go through it. “I just thought I was a dried old prune when I hit menopause at 41 because of gendered ageism, but attitudes have really changed in the past two to three years when we started talking about menopause over here,” says Rachel Lankester, who runs Magnificent Midlife, a British company that consults with women and companies on menopause policies.

For people who have studied menopause for a long time, the new commitment to talking about menopause at work in the U.S. feels like a sea change akin to the moment in 1978 when it became illegal for companies to treat pregnant women differently from other workers. That gradually led to employers accommodating pregnant and breastfeeding women at work—today, many workplaces now have rooms for women to pump breast milk.

“The Baby Boomers may not have been that keen to talk about menopause in the workplace, but this younger generation most certainly is and they’re not going to be okay with having to deal with this at work,” says Stephanie Faubion, director of the Center for Women’s Health at the Mayo Clinic. “It’s where we were with pregnancy and lactation in the 70’s.”

Another reason companies are taking menopause seriously these days is that doing so can help their bottom line. Menopause costs an estimated $1.8 billion in lost work time a year and $26.6 billion in medical expenses, according to a study Faubion and her colleagues at the Mayo Clinic published in April. Nearly 11% of the 4,440 women aged 45 to 60 who responded to the survey said they’d missed work in the past year because of menopause symptoms, with psychological symptoms including anxiety and depression being the most common cause.

Part of the reason women are struggling so much with menopause, Faubion says, is that there’s no laboratory test that can tell a woman whether she’s in perimenopause or menopause, and so women blame their symptoms—weight gain, anxiety, depression, hot flashes—on something else. What’s more, after a 2002 study was inaccurately reported as showing no benefits to hormone replacement therapy (HRT), prescriptions dropped and many doctors stopped getting trained in how to treat menopause, Faubion says. “You have a whole generation of doctors that have no idea how to prescribe HRT and a whole generation of women who don’t have education about it.”

That’s why many companies are focusing their menopause policies on educating women and their colleagues about menopause, and encouraging people experiencing symptoms to seek treatment. That kind of education helped women in the U.K. combat ageism, says Lankester.

Lankester likes to use the example of whales, who go through menopause and then become the leaders of their pods to show why talking about menopause can help combat ageism. “The end of my fertility became the most fertile time of my life—I was clear and focused,” says Lankester, who went through menopause at 41. “If we can get some of those things across as part of this awareness raising, I think we’ll be doing women a good service.” Nearly two-thirds of women want menopause-specific benefits, according to a recent survey of 2,000 women conducted by Bank of America and the National Menopause Foundation, but only 14% said they thought their employer recognized the need for menopause-specific benefits.

That said, even some of those who argue for the need of such benefits are not always sure what they should actually look like. One menopause consultant suggested to me that employers could give women refrigerators and fans for their desks to help them cool off in case of hot flashes—but that type of gift might signpost to her colleagues that a woman is experiencing menopause, which could exacerbate discrimination or make her feel stigmatized.

Experts say a better option might be insurance coverage for HRT, which could help both women stay healthier and their employers save money.If women with symptoms are put on HRT, for instance, they may gain less weight and be less likely to develop hypertension or other weight-related problems, says Jill Angelo, the CEO of Gennev, a telehealth company that provides resources for women going through menopause. And that would be in addition to the potential relief HRT can offer women experiencing more acute menopause symptoms.

HRT can have negative side effects, but things have changed since the problematic 2002 study. Nowadays, clinicians typically prescribe lower doses and for shorter periods of time, which can still help while reducing the risk for side effects. Indeed, some European companies have already begun to cover HRT, and others have started to give women days off specifically to cope with menopause.

There are signs that the U.S. is catching up. Seven years ago, when Angelo founded Gennev, potential investors usually hadn’t even really heard about menopause, and prospective partners all seemed to have other priorities. But in the last 12 to 18 months, she says, “the conversation around menopause in the workplace has really started to fire up.”

One reason why might be that, in the wake of the #MeToo movement, more workplaces have created diversity and inclusion groups to support women and other historically underrepresented groups. They’ve also become more conscious about putting more women in leadership roles.

“We’ve had so many women say I’d finally feel heard, I feel accepted,” Davis says, about Genentech’s new menopause benefit. “I do think that feeling of belonging and inclusion is something that goes a long way to retention.”