Menopause at work: a practical guide for HR leaders and managers

Why menopause is a workplace issue

Women in their late 40s and 50s are often among an organization’s most experienced people, and many are at the height of their careers. That is also when perimenopause and menopause usually happen: most women reach menopause between 45 and 55, at an average age of about 51 to 52 (ACOG; National Institute on Aging).

In the Mayo Clinic study of more than 4,400 working women aged 45 to 60, about 13% reported at least one adverse work outcome because of menopause symptoms, such as missing days, cutting hours, quitting or retiring, and about 11% had missed work in the previous year. Women with the most severe symptoms were far more likely to be affected (Faubion et al., 2023). Mayo Clinic puts the total yearly cost at $26.6 billion once medical expenses are included (Mayo Clinic News Network).

There is also a gap between what employers think and what employees feel. In a 2023 Bank of America survey, 76% of HR benefit managers said they discuss menopause with employees, but only 3% of peri- and postmenopausal employees said they had talked to HR about it, and 64% of women wanted menopause-specific benefits (Bank of America, 2023). In the UK, CIPD found that two-thirds of working women with symptoms said menopause had a mostly negative effect on them at work, 17% had considered leaving because of a lack of support, and 6% had left (CIPD, 2023).

What employees may be dealing with

Symptoms vary widely from person to person. The ones most likely to show up at work are:

• Hot flashes and night sweats. Between 60% and 80% of women have them at some point in the menopause transition (SWAN). In the long-running SWAN study, frequent symptoms lasted a median of 7.4 years (Avis et al., 2015).
• Poor sleep and fatigue, often driven by night sweats, which can affect concentration the next day.
• Trouble concentrating or remembering (often called brain fog).
• Anxiety, low mood or irritability.
• Heavier or unpredictable periods during perimenopause.
• Joint aches, headaches and other physical symptoms.

Many women don’t connect these symptoms to perimenopause at first, and many won’t want to talk about them at work. In the Bank of America survey, 58% of peri- and postmenopausal women said they didn’t feel comfortable discussing symptoms at work, and 32% feared being seen as old (Bank of America, 2023). That is why a visible policy and trained managers matter more than any single benefit.

The legal picture

This is general information, not legal advice. Check your obligations with employment counsel for each location where you have staff.

• U.S. federal law. Menopause isn’t a named protected category, but comments or decisions made because of menopause can amount to sex or age discrimination, and in some cases symptoms can rise to the level of a disability that requires reasonable accommodation under the ADA (The Menopause Society, 2024). The Pregnant Workers Fairness Act covers conditions related to pregnancy or childbirth; the EEOC’s 2024 rule doesn’t list menopause as a covered condition (89 FR 29096).
• State law. Since June 2025, Rhode Island has required employers to reasonably accommodate menopause-related conditions unless that would cause undue hardship, and to give employees written notice of the right (R.I. Gen. Laws § 28-5-7.4). Other states may follow, so review this list each year.
• United Kingdom. Menopause isn’t a standalone protected characteristic under the Equality Act 2010, but treatment linked to symptoms can be discrimination on grounds of age, sex, disability or gender reassignment. From 2027, employers with 250 or more workers must publish a menopause action plan (Acas; Acas).

In practice, the safest route in the U.S. is to handle menopause-related requests through your existing reasonable-accommodation (interactive) process, and to train managers not to make comments about age or menopause (The Menopause Society, 2024).

Practical accommodations that help

Many adjustments are simple and inexpensive. CIPD found flexible working and temperature control were the measures employees rated most helpful, yet only about a quarter of organizations offered them (CIPD, 2023). This table draws on guidance from CIPD, Acas, the Faculty of Occupational Medicine and The Menopause Society.

Agree adjustments with the employee, write them down, and review them: CIPD suggests at least once a year, and sooner if symptoms change (CIPD). Acas also suggests recording menopause-related sickness absence separately, so it doesn’t trigger standard absence processes unfairly (Acas).

Policy template

A short, plain policy tells employees that it’s fine to ask for help and tells managers what to do. In CIPD’s survey, only about a quarter of employees said their organization had a menopause policy or other stated support (CIPD, 2023). Copy this template, fill in the bracketed parts, and have it reviewed for your locations.

[COMPANY NAME] MENOPAUSE SUPPORT POLICY
Owner: [HR CONTACT] · Approved: [DATE] · Next review: [DATE + 12 MONTHS]

1. Purpose
[Company name] wants everyone to be able to do their best work at every stage of life. Perimenopause and menopause can bring symptoms that affect sleep, concentration, comfort and wellbeing at work. This policy explains the support available and how to ask for it.

2. Who this policy covers
All employees [and contractors/workers], whatever their role, hours or length of service. It covers anyone experiencing perimenopause or menopause symptoms, including symptoms caused by surgery or medical treatment, and trans and non-binary colleagues. It also covers employees supporting a partner or family member.

3. What we mean
Perimenopause: the years before menopause when hormone levels change and symptoms often begin.
Menopause: the point 12 months after a person’s last period.
Postmenopause: the years after menopause; some symptoms can continue.

4. Our commitments
- Treat menopause as an ordinary health and wellbeing topic that people can raise without embarrassment.
- Train people managers to hold supportive, confidential conversations.
- Consider reasonable adjustments promptly and in good faith.
- Keep health information confidential and share it only with the employee’s consent or where the law requires it.
- Not tolerate harassment, jokes or disadvantage linked to menopause, age or sex.

5. Asking for support
You can talk to your manager, another manager you trust, HR at [CONTACT] or [EMPLOYEE ASSISTANCE PROGRAM / OCCUPATIONAL HEALTH]. You do not need a diagnosis or a doctor’s note to start a conversation. Your manager will agree any changes with you, record them in a short confidential note that you can see, and check in with you after [4–6] weeks. Where your needs may be a disability or a medical condition covered by law, we will also follow our [REASONABLE ACCOMMODATION PROCESS].

6. Examples of support
- Workplace: desk fan or desk near a window or vent, control over heating and cooling, easy access to cold drinking water and restrooms, a quiet space for short breaks.
- Uniforms: breathable fabrics, layers and spare items where uniforms are required.
- Flexibility: adjusted start and finish times, remote or hybrid days, extra short breaks, temporary changes to shift patterns or duties.
- Ways of working: written notes or agendas for meetings, reminders and planning tools, temporarily adjusted deadlines or workload.
- Time off: time to attend medical appointments under [POLICY].

7. Absence
Menopause-related absence is handled under [ABSENCE POLICY]. Managers will take menopause symptoms into account and consider adjustments before any formal absence process.

8. Roles
Employees: raise concerns early if you can, and tell us what helps.
Managers: listen, agree adjustments, keep notes confidential and follow up.
HR: support managers, keep this policy current and signpost benefits.
[Benefits/EAP provider]: confidential support, available at [CONTACT].

9. Benefits and resources
[List health plan coverage for menopause care, EAP, any menopause benefit or clinician directory, and intranet resources.]

10. Related policies
[Flexible working] · [Absence] · [Reasonable accommodation] · [Equal employment opportunity and anti-harassment] · [Health and safety]

11. Review
HR reviews this policy every 12 months, using anonymous employee feedback.

This template is a starting point, not legal advice. Have it reviewed for your locations and workforce before adoption. Source: tryamie.com/learn/menopause-at-work

Manager conversation guide

Most employees will go to their line manager first, so the quality of that conversation matters. Managers don’t need medical knowledge. They need to listen, keep it confidential and agree practical next steps.

Before the conversation

• Find a private place and enough time. Offer a video call or a walk if that’s more comfortable.
• Read your menopause policy and know what adjustments and benefits you can offer.
• If you’re raising it because of a change in performance, focus on the work and on support. Don’t guess at causes.

Opening lines that work

• “I wanted to check in. How are things going for you at the moment, at work and generally?”
• “Thanks for telling me. What would be most helpful right now?”
• “Which parts of the day or which tasks are hardest at the moment?”
• “Is there anything about the workplace, like temperature, breaks or your schedule, that we could change?”

During the conversation

• Listen more than you talk. Let them describe things in their own words.
• Ask what would help. Employees usually know what makes the difference.
• Agree specific, practical adjustments and a date to review them.
• Point to support: your EAP, health plan benefits and HR.
• Ask who, if anyone, they want told, and what.

What to avoid

• Don’t diagnose, or ask about their age or medical history.
• Don’t joke, or make comments about menopause, age or “hormones.”
• Don’t share anything with the team without their consent.
• Don’t assume one conversation is enough. Symptoms change over time.

Afterwards

• Write a short, confidential note of what you agreed and share it with the employee.
• Put the adjustments in place quickly. Small delays can undo a good conversation.
• Follow up in four to six weeks, then at regular one-to-ones.
• If needs are significant or ongoing, involve HR and your formal accommodation process.

Benefits options

Benefits are where the gap between employers and employees is widest. In the Bank of America survey, fewer than one in three women knew what menopause benefits were available to them (Bank of America, 2023). Adoption is growing fast: SHRM counted 17% of employers offering menopause support when it first measured it in 2024 and 27% in 2026 (SHRM, 2024; SHRM, 2026).

Options to review, roughly from least to most investment:

1. Check your health plan. The Menopause Society recommends that employers review plans for adequate, affordable coverage of menopause care (The Menopause Society, 2024), including visits, FDA-approved hormone therapy and nonhormone treatments. It calls hormone therapy the most effective treatment for hot flashes and night sweats and also recommends several nonhormone options (2022 position statement).
2. Brief your EAP. EAPs can offer free, confidential assessments, short-term counseling and referrals (The Menopause Society, 2024). Ask your provider what menopause support it offers and tell employees.
3. Help people find knowledgeable clinicians. Employees can find a clinician who holds The Menopause Society’s certified practitioner credential through the Society’s directory.
4. Education. Awareness sessions for all staff and training for managers are recommended by The Menopause Society, Acas and CIPD. The Menopause Society also runs an employer program with policy templates, an accommodations menu and manager training (Making Menopause Work).
5. Virtual care and specialist vendors. Some employers add a menopause vendor or virtual care benefit offering education, specialist care and mental health support (KFF, 2025). Online clinics are another route for employees to get care on their own schedule. Amie, which publishes this guide, is one of these: its licensed clinicians treat menopause symptoms online, in all 50 states. Compare several options on clinical quality, coverage and cost before you choose.
6. Leave and flexibility. Make clear how existing sick leave and flexible-working policies apply to menopause, and decide whether you want anything more.

How to know it’s working

Keep measurement light and anonymous. Useful signals include:

• Pulse-survey questions such as “I would feel comfortable asking my manager for menopause-related support.”
• The number of managers trained, and how they rate their confidence afterwards.
• Uptake of adjustments and benefits (counted only, never named).
• Retention and exit-interview themes for employees over 45.
• Menopause-related absence, if you record it separately (Acas).

Review the policy and the numbers once a year, and update this page’s legal section as laws change.

Printable HR checklist

Use this checklist to plan your rollout. Tick items on screen, or print it for your next HR or benefits meeting.