Intended for healthcare professionals


How do I cope with the menopause at work?

BMJ 2023; 383 doi: (Published 07 November 2023) Cite this as: BMJ 2023;383:p2551
  1. Éabha Lynn
  1. BMJ editorial scholar

Menopause can interfere with your working life but there are ways to make symptoms more manageable, Éabha Lynn hears

Talk to someone you trust

Erin Duralde, medical director of women’s health—clinical effectiveness, One Medical, says, “Menopause is a time of transition which can bring relief, comfort, and self-confidence to many, although it may also be marked by new bothersome symptoms, which can be severe and life altering.

“Recent studies have shown as many as 15% of women experiencing menopause report it impacts their ability to work, with many missing work and some quitting as a result.1 Symptoms may begin as early as 10 years before your final menstrual period, and they may impact your ability to stay focused, confident, and comfortable at work.

“I encourage anyone affected to reach out to their GP or gynaecologist.

“Pharmaceutical treatments in the form of hormones or non-hormonal medications, along with supplements, complementary medicine, and lifestyle recommendations may be available. As a menopause specialist, I know how much we can do to support you through this transition.

“It may be helpful to have a frank discussion with someone you trust at work about what you’re experiencing. Ideally, you could talk directly to your manager and get accommodations that help you continue to work. Even when this isn’t possible, sharing with a work friend or engaging in employee assistance programmes may also help.”

Seek flexibility and understanding

Martha Hickey, department of obstetrics and gynaecology, University of Melbourne, Australia, says, “Most women are in paid work through the menopause and most are symptomatic. Overall, menopausal women don’t want to be identified as a ‘problem group’ at work. Many, however, would appreciate greater understanding and acknowledgement of the potential challenges.23

“This might take the form of education for managers, adaptability around uniforms, access to fans or the ability to alter workplace temperature, and the opportunity for breaks. For shift workers, sleep disturbance because of menopausal symptoms can be particularly problematic and these women may appreciate the option to change their work patterns.

“Managing at work is one of the main reasons women take hormone replacement therapy (HRT). While HRT may be the right choice for some, the workplace should be supportive for all employees.

“Stigma and lack of public discourse around menopause have contributed to low awareness among managers and other employees. This lack of understanding may create additional stress for women experiencing troublesome menopausal symptoms in the workplace.

“The organisation Menopause at Work offers free resources for employers4 who wish to better support their employees.

“The pandemic forced us to consider who was an ‘essential worker.’ We learnt that carers and those working in health and education are all essential. Most of these workers are women who will eventually experience menopause. Losing these skilled workers because of poor workplace support makes no sense and contributes to poverty in older age. Supporting these women to flourish in their jobs is the right decision for women, the workplace, and for our society.”

Don’t struggle in silence

Aaliya Goyal, GP with special interest in occupational health and wellbeing, says, “Women experience menopause in different ways, ranging from no symptoms to debilitating symptoms which may meet the legal definition of disability.5 Although the average age of menopause is 51, it can occur earlier especially in women from diverse backgrounds. Hormonal decline, leading to symptoms, can occur for four to eight years before menopause, so short term measures or time off work may not be useful, and a more structured, symptom based approach needs to be considered.

“Menopause can have physical effects, including hot flushes and urogenital problems, as well as mental health effects, including increased anxiety and mood changes. Women of menopausal age are often well established in senior roles, so there can be a considerable loss of confidence associated with suddenly being unable to concentrate, becoming more forgetful, or becoming less tolerant to stressful situations.

“If you are struggling, recognise that your symptoms could be because of menopause and seek help. This may be challenging, particularly for transgender colleagues. Those from diverse backgrounds may be less likely to recognise symptoms and seek support so look out for others who may be struggling too. Over 77% of the NHS workforce is female and a significant proportion are perimenopausal, so you are unlikely to be alone.

“Keeping a symptom diary may help you to identify triggers which you can then try to avoid. You can request to work flexibly6—for example, by starting later if you experience poor sleep. Normalise conversations with managers and suggest measures that may be helpful to you. These could be simple things like moving a desk closer to a window, having a locker for spare clothes, or having access to shower facilities. Encourage whole team education, regardless of gender and seniority, with signposting to resources including those from NHS England7 and education from the NHS Menopause Hub.8

“Don’t struggle in silence. Support is available, either through occupational health or your GP. Your workplace might also have menopause policies and risk assessments, menopause champions, and safe spaces for peer support such as menopause cafes.”