Menopause-inclusive workplaces help retain highly skilled women, so why are there so few of them?

Tracy Gomes was a project manager for a well-known multinational company, working with clients and travelling extensively, when she started to experience anxiety and trouble sleeping.

Later, her periods became so heavy she needed iron infusions to treat severe anemia, and soon she was making regular hospital visits. Then came the extreme water retention, up to 12 pounds in a week.

“And that was just perimenopause,” she said.

However, Gomes didn’t know it then, nor did her health practitioners. It was only when her cycle became irregular that her symptoms were finally attributed to the beginning of menopause.

“At that point, my sleep was so disturbed that it affected my work. I wasn’t functioning. I started to see a decline in my ability to travel for work and also my ability to function effectively,” she said.

“I lost my concentration, had mind fog, all of that stuff, but also a lot of anxiety, a kind of terrible anxiety that I never had before.” 

After two leaves of absence and years of seeking treatment, Gomes lost her job at 54.

Her experience isn’t a unique one.

A 2023 report by the Menopause Foundation of Canada found ten per cent of Canadian women leave the workforce due to unmanaged menopause symptoms, while Deloitte Canada estimates menopause symptoms cost women in Canada $3.3 billion in lost income annually.

Women between the ages of 45 and 55 are Canada’s fastest-growing working demographic, accounting for roughly two million workers, but advocates say menopause is still swept under the rug in most workplaces.

“This is a group of employees that employers can’t afford to lose,” said Sandra Vlaar Ingram, chair of the Menopause Foundation of Canada’s menopause inclusive workplaces committee and author of the Menopause and Work In Canada report.

“They are really at a peak moment in their careers where they’ve got a lot of experience, a lot of expertise, knowledge, and wisdom to share.”

Menopause costs employers $237 million per annum in lost productivity, according to Deloitte Canada. At the same time, an estimated 540,000 missed workdays are attributed to menopause management each year—an unsurprising number given that 75 per cent of women say menopausal symptoms interfere with their daily lives.

One-third of women surveyed by the foundation also said menopause symptoms negatively impacted their performance at work. At the same time, one-quarter felt they had to hide their symptoms in the workplace.

“Menopause also has been kind of mired in ageism and sexism throughout history, and that goes with the territory with a lot of women’s health issues,” Ingram said, adding women can face multiple barriers in accessing healthcare and employment supports.

Hot flashes and beyond

Common menopause symptoms include low energy, hot flashes, insomnia, muscle and joint pain, depression, anxiety and bladder control issues, which Ingram said can make early morning starts a challenge.

“But there are appropriate accommodations for this,” Ingram said. “For instance, if someone is up all night with night sweats, maybe there’s an opportunity for them to start later in the day, and maybe that is something that can be inscribed in workplace policy.”

Ingram also suggests employers examine their benefits packages through a menopause lens to see if there is room for refinement. 

Allied health professionals, like pelvic floor therapists, are often not covered by standard benefit plans but may provide relief from some genitourinary symptoms associated with menopause, such as sexual dysfunction, chronic pelvic pain and frequent, painful urination, she said.

“I think one of the biggest things for employers to understand is it doesn’t have to be complicated,” Ingram said, adding the first step is to normalize conversations about menopause.

According to the foundation, 87 per cent of working people experiencing menopause believe their employer doesn’t provide menopause support. 

A further 70 per cent wouldn’t feel comfortable speaking to someone in human resources about menopause.

“We’re making great strides in this area, but it’s a subject that is so taboo and has been so stigmatized for such a long period of time,” said Deborah Garlick, founder of Henpicked, an online community for “women who weren’t born yesterday,” and Menopause Friendly UK, which offers employers Menopause Friendly Accreditation.

To earn the accreditation, an organization must address menopause in five areas: culture, policies and practices, training, engagement and work environment.

However, the first step is providing managers and employees with accurate information about perimenopause and menopause, information even many healthcare providers are unable to provide to their patients.

The biggest misconception Garlick encounters, one that has a direct bearing on the workplace, is the myth that menopause only affects those in the “grandma” stage of life.

“When you explain that, for so many women this starts in their late thirties, early forties, the penny starts to drop that, actually, this is a large part of the workplace that’s being affected,” she said.

Menopause symptoms may also affect transmen and women undergoing specific medical treatments at any age. And, for some people, perimenopause lasts as long as 14 years.

Race affects a person’s experience of menopause as well.

A 10-year American study co-authored by Dr. Siobhan Harlow, an epidemiologist at the University of Michigan School of Public Health, found Black women often experience menopause earlier and have more severe symptoms—including heavy, unpredictable bleeding—than white, Chinese or Japanese women.

The same study found Latino women also experience earlier menopause and have more vasomotor symptoms, like hot flashes.

“I’m from a Caribbean family, and we didn’t talk about women’s reproductive health when I was growing up,” Gomes said. 

“I wish I had known all this information at the beginning.” 

Coffee, cake and information

“There’s not a lot of good information out there,” said Karla Rawluk, community connections co-ordinator at the South Winnipeg Family Information Centre. 

“The first thing you see when you look online is a lot of stuff about how to get rid of belly fat, and I’m like, that’s not my biggest problem.”

To help combat stigma and misinformation, the centre started hosting monthly menopause cafes last year, which are open to people of all ages and genders. 

There are no formal speakers or experts at these events—the first of which was held in Scotland in 2017, modelled after so-called Death Cafes—just people talking, listening and sharing their experiences over coffee or tea, and maybe some cake.

The many shortcomings of the healthcare system are a frequent topic of discussion, Rawluk said, adding people are frustrated so little research has been done in this area.

“So many of the women that come to our cafes say very clearly, I’ve talked to my doctor, and they don’t know any more than I do,” she said. “And that boggles my mind.”

Attendees might not leave with all the answers they hoped for, but Rawluk said menopause cafes empower people to speak to their friends, family and colleagues about menopause’s impact on them.

It’s also giving women the tools and confidence to raise the issue of menopause in their workplaces, she said.

“Menopause is a certainty for all women, yet many women struggle in silence due to a lack of understanding and support, both in healthcare and in the workplace,” said Dr. Michelle Jacobson, a menopause specialist at Women’s College and Mount Sinai Hospital in Toronto.

“Closing the menopause knowledge gap at work is critical.”

With that in mind, the Menopause Foundation of Canada launched its Menopause Works Here campaign last year. 

It offers free tools and resources to help employers create more inclusive workplaces for women who are perimenopausal, menopausal, and postmenopausal. 

Under the program, workplaces must commit to considering menopause in workplace design, practices and policies and to “fostering a menopause-inclusive culture that supports breaking the stigma of menopause at work.”

Inclusion in action

Vlaar said about 50 organizations are registered, and many more have expressed interest in the last few weeks. 

While the UK and Australia have outpaced Canada in menopause inclusion, Canada is making up for lost time, she said.

L’Oréal Canada is one of the businesses that’s worked with the foundation and embraced the creation of a menopause-inclusive workplace.

Chief diversity, equity and inclusion officer Marie-Evelyne Francois said gender equity was the first DEI pillar the company established some two decades ago, noting that 70 per cent of staff are women, more than 30 per cent of whom are over 40.

“If they cannot come as their authentic self at work, then how can they feel that they belong?” Francois said. 

“We felt it was extremely important to tackle this topic and to ensure that when women go through any of their hormonal phases, they know that they will have all the support they need.”

This spring, the company held focus groups to understand its employees’ needs better and identified three key priorities: awareness, education, and representation.

Based on these findings, L’Oréal hosts conferences for all employees, focused on debunking common menopause myths and creating an environment where people of all genders feel comfortable discussing the issue.

An employee resource group, supported by a share-and-care program, also offers employees telemedicine support and access to mental health resources, which are 100 per cent covered by employee benefits.

When women feel safe and empowered speaking to their managers or human resources, Francois said accommodations can be made, allowing staff to manage their symptoms and continue doing the work they love.

“Our goal is to eliminate barriers to inclusion and all the biases that women face when they go through menopause,” she said. 

“We’re in a company that believes in this and has made it a priority.”

Environmental design can also help create menopause-inclusive workspaces. L’Oréal’s offices include “wellness rooms” where employees can ground themselves, rest, or cool off.

Dalhousie University in Halifax began including menopause in its wellness activities in 2022. It quickly expanded its efforts to include everything from manager training and support groups to new water coolers and increased flexibility.

The university’s Menopause Support Group meets monthly under the leadership of Shawna O’Hearn, the school’s director of global health and co-founder of the Menopause Society of Nova Scotia, with support from the school’s human resources department. 

It welcomes two or three dozen people for open discussion and guest speakers, like Janet Ko from the Menopause Foundation of Canada. 

“We do always tie our conversations back to how we can manage at work,” O’Hearn said. “What are the things we need to be working on at Dalhousie as individuals and as an institution?”

O’Hearn said women going through the transition of menopause are often “invisible or stigmatized.” 

But that’s beginning to change as more women enter leadership roles.

“And that’s not to say that this is a women’s issue; this is a systems issue,” O’Hearn said. 

“So how do we address the systems in which we work to ensure that women can show up to a workspace where they can feel that they can be their best selves?”

Menopause on the ballot?

In what might be a first, menopause has become a campaign issue in Nova Scotia’s upcoming general election, with Progressive Conservative incumbent Tim Houston promising to build Canada’s first Menopause Centre of Excellence.

“There are nearly 350,000 women in Nova Scotia over the age of 40 who are managing menopause, post-menopause or approaching menopause,” Houston said in a recently released statement. 

“Traditionally, these women have not received the attention they deserve from our health-care system.”

In response, the Nova Scotia Liberal Party promised to dedicate 50 per cent of the province’s research funding to women’s health.

“Canada has come a long way in a very short time, but there’s still a long way to go,” Ingram said. 

“I feel like there still is a lot of education to be done and a lot more work to be done before we get to the place where we can say we’re menopause inclusive.”

Today, Gomes is post-menopausal. However, she still struggles to manage her symptoms and is looking for a path to workforce re-entry.

“I don’t blame the company because they did their best to accommodate me based on what they knew,” she said. “I just don’t think they knew or understood the whole story because I didn’t know myself.”

With hindsight, if she’d had better information about menopause a decade ago, she would have been able to advocate for herself more effectively earlier in her journey.

“I don’t wanna say I’m a woman on a mission, but I just feel like we need to talk about it because the more informed women are, the better decisions, the better choices, you make,” Gomes said.

“And we start by removing the stigma.”