Menopause in the workplace: how to discuss your symptoms and what employers can do

One in four women experiences menopause symptoms so severe that their work and daily functioning are significantly impacted. 35% hide their symptoms in the workplace. And a growing number of women are leaving the workforce prematurely—not because they want to, but because the combination of untreated menopause symptoms and work pressure becomes unsustainable.

This is not a private issue. It is a societal challenge that affects employers, managers, and women themselves.

Which symptoms have the greatest impact on work?

Not all menopause symptoms are equally visible at work—but their impact is real:

• Concentration problems and brain fog: difficulty focusing, forgetting what was just discussed, and slower thinking during meetings. This is particularly noticeable in roles that require cognitive sharpness.
• Fatigue: chronic sleep deprivation due to night sweats leads to an exhausted woman who has to perform during the day as if she had slept well.
• Hot flashes: a hot flash in the middle of a presentation, meeting, or client call is no minor inconvenience—it is visible, hot, and sometimes accompanied by flushing and sweating. Women feel vulnerable and self-conscious about it.
• Mood swings and irritability: the line between being calm and suddenly becoming emotional or irritated has become thinner. In a work context, where professionalism is the norm, this feels especially vulnerable.
• Anxiety and self-doubt: for some women, self-confidence drops significantly. They doubt their own abilities, even though the objective quality of their work has not changed.
• Urinary incontinence: a silent but impactful symptom. Fear of an accident keeps women away from meetings, travel, or other activities.

Why women stay silent

Women hide menopause symptoms at work for several reasons:

• Fear of not being taken seriously or being perceived as "too old"
• Shame—the menopause is still a taboo subject, especially in professional environments
• Uncertainty about whether symptoms are "severe enough" to discuss
• Lack of confidence that the employer can or will do anything about it

As a result, women compensate for their symptoms by working harder, hiding mistakes, or avoiding tasks that make them feel insecure. This drains extra energy—and worsens the exhaustion.

What BHRT can do for your performance at work

Well-managed BHRT has direct, measurable effects on the symptoms that impact work:

• Fewer hot flashes—even during the day
• Better sleep → more energy and cognitive sharpness during the day
• More stable mood → fewer unwanted emotional reactions
• Improved concentration and word retrieval
• More self-confidence—women describe it as "being myself again at work"

Many women who start at Menovia report that the improvement in work performance and job satisfaction is one of the most unexpected and valuable effects of the treatment.

How to approach the conversation at work

You are not obligated to discuss your symptoms. But if they are affecting your work, an open conversation with your manager or HR can be helpful. How do you go about it?

Prepare yourself. Think about the concrete adjustments you need—not what your diagnosis is. "I function better if I can work in a cooler room" is more concrete and actionable than "I suffer from hot flashes."

Frame it professionally. Treat it as you would any other health issue—factual, solution-oriented, and without unnecessary details about your medical situation.

Think about what you need:

• Flexible working hours—some women function better in the morning than in the afternoon
• Options to work from home on more difficult days
• A cooler workspace or a fan
• Permission for short recovery breaks during severe hot flashes
• Understanding for temporary concentration issues

What employers can do

Employers who take the menopause seriously reap the benefits. Research shows that women going through menopause are loyal, experienced employees who remain fully productive with the right support. Policies don't have to be complex:

• Raising awareness among managers and HR about the impact of menopause
• Providing a confidential space for employees to discuss health issues
• Flexibility as a standard policy — not an exception
• Normalizing mental health and recovery time
• Referring to specialist care — including for hormonal health

Rights and legal framework

In the Netherlands, the Working Conditions Act (Arbowet) provides protection: employers are required to provide a healthy and safe working environment. Menopausal symptoms may qualify for workplace adjustments via the company doctor, similar to other chronic health issues. The company doctor can act as a bridge between employee and employer without sharing medical details.

If symptoms lead to absenteeism, you as an employee are entitled to support under the Gatekeeper Improvement Act (Wet Verbetering Poortwachter). Early identification and treatment — including BHRT — is therefore also economically sound: it prevents long-term absenteeism.

The bigger picture

Women aged 45 to 60 are in their most powerful professional years — experienced, with established networks and leadership roles. This is precisely the period when menopause hits. That doesn't have to be a conflict — provided symptoms are taken seriously and treated.

Menopause is not the end of your career. With the right medical guidance — and an understanding employer — you can navigate this phase and continue to grow. At Menovia we treat women who want to keep functioning — at work, at home, and in their lives. Read more about how the process works.