Women Shouldn’t Have to Hide Menopause Symptoms to Protect Their Careers

By Brett White PA-C | Cofounder, Heat Wave Health

Published October 3, 2026

How much does a woman have to conceal to remain someone her colleagues consider capable?

Imagine a CFO who spends Sunday rehearsing for a board meeting she once would have prepared for in an afternoon. She knows the business. Her judgment is sound. But after weeks of interrupted sleep, she no longer trusts her concentration.

On Monday, she delivers. Nobody sees a problem.

She sees the hours it took to make sure they wouldn’t.

This is an illustrative scenario, not a patient account. It captures the dilemma at the center of this discussion: a woman can still be doing excellent work while experiencing symptoms that deserve medical attention. And when symptoms do affect her performance, she should be able to acknowledge that without having her professional future reduced to them.

The Gap We Need to Address

I came across the article, Women’s experiences of menopause at work and performance management, while doing professional development reading. As a cofounder of Heat Wave Health, I kept returning to the question underneath it: Why should a woman have to explain a medical concern to someone with power over her career before she feels able to get support?

Beck et al. (2021) helped introduce a university menopause policy, then examined what it had not resolved: concerns about disclosure, stereotypes about older women, and performance-management practices that could undermine support. One participant described performing highly while privately struggling and feeling inadequate.

That account stayed with me. Her work remained strong. Her experience of doing it had become distressing. How long should she have to sustain that discrepancy before it warrants care?

And why are we so ready to reach for a corporate policy as the answer?

Employers can protect privacy, allow flexibility, and make care easier to access. But a policy does not qualify anyone in HR or management to interpret symptoms, assess treatment, or decide what a woman’s health means for her capabilities. Authority over someone’s work is not expertise in her health.

That boundary matters in a public conversation crowded with confident medical claims. The Menopause Society (n.d.) emphasizes individual assessment when weighing hormone therapy’s benefits and risks. A blanket warning, a blanket promise, or a workplace briefing cannot do that work.

Consider what disclosure asks of a woman already worried about herself: explain a difficulty she does not fully understand to someone who may later decide whether she is ready for greater responsibility. Her caution is reasonable.

What troubles me is that she may keep working harder to avoid that conversation—and mistake the strain for evidence that she is no longer good enough.

A woman should not have to choose between being believed about her symptoms and being trusted with her work. That is why I am writing this. She deserves access to clinical expertise before a health concern becomes a conclusion about her future.

Symptoms Have Consequences

The answer is not to insist that menopause never affects work. That asks symptomatic women to deny their experience in order to defend their competence.

Sleep disruption, difficulty concentrating, and other symptoms can interfere with working life. Some women maintain their results through additional effort. Others miss work or reconsider responsibilities. These experiences deserve attention without becoming assumptions about every woman in midlife.

Dr. Heather Hirsch (2025) addresses the career consequences in Menopause at work: The hidden crisis no one talks about. She describes how symptoms can extend into missed work, disrupted advancement, and financial losses. Her discussion asks us to consider what happens when difficulties persist beyond an uncomfortable meeting or a bad week.

The economic evidence gives that concern weight. In a Mayo Clinic study of 4,440 respondents, 10.8% reported missing work because of menopause symptoms during the preceding year. Researchers estimated an annual US cost of $1.8 billion from missed workdays. That estimate was extrapolated from a self-reported survey; it was not an audited national total (Faubion et al., 2023).

For an individual woman, the calculation is more immediate.

Can she sustain this schedule? Why does familiar work require so much preparation? Does she actually want fewer responsibilities, or does she want relief from the symptoms making those responsibilities harder?

Those questions should be explored before she concludes that her ambition has expired.

An Employer’s Response Cannot Replace Clinical Care

Workplaces have responsibilities. The way they handle privacy, flexibility, and opportunity matters. But a manager’s willingness to discuss menopause does not equip that manager to assess it.

Nor should a woman have to disclose sensitive information at work before she can begin seeking help.

Someone approaching partnership, managing a region, or leading a clinical department may have good reasons to be selective about that disclosure. She knows her organization. She knows whose judgment affects her opportunities. Encouraging openness without acknowledging those realities is inadequate advice.

Beck et al. (2021) argue that policies need deeper changes in organizational practice to be effective. Their paper does not suggest that a policy guarantees trust.

Women should have access to care while those institutional shortcomings remain unresolved. They should not have to wait for an employer to become knowledgeable, or volunteer their own health history as the material for its education.

An Explanation Should Lead Somewhere

Recognizing perimenopause as a possible explanation can change the questions a woman asks about herself.

“I’m becoming unreliable” becomes “My concentration has changed, my sleep is disrupted, and I need to understand why.”

That is a more precise statement. It also creates the possibility of action.

Perimenopause should be considered through an appropriate assessment, rather than assumed to explain every difficulty. A useful consultation should examine the symptoms, their timing, relevant medical history, and other possible contributors. It should give the patient an opportunity to describe what daily functioning now requires.

Then there should be a treatment conversation with substance.

The Menopause Society (n.d.) identifies hormone therapy as the most effective treatment for bothersome hot flashes and night sweats. Its guidance calls for weighing individual benefits and risks, taking account of health history, age, symptoms, and preferences. Treatment may require adjustment and reevaluation.

That does not promise that a prescription will resolve every concern. It establishes that women have reason to seek an informed discussion of treatment.

Which symptoms are we addressing? What improvement is reasonable to expect? How will we assess the response? What happens if the first approach is insufficient?

A woman accustomed to making consequential decisions deserves clear answers about her own care.

Women Can Help Without Taking Control

A trusted colleague cannot make a diagnosis. She can make it easier to seek one.

When a woman says that something has changed, we can listen without answering that everyone is tired. We can share a useful resource or the name of a clinician. We can protect her privacy.

We can also continue treating her as someone with a future.

A request for support should not silently remove her from consideration for the assignment, the promotion, or the leadership role. Ask what she wants. Let her participate in decisions that affect her career.

The same woman can need treatment and want greater responsibility. Our conversations should be able to accommodate both.

This Is Where Care Has to Become Concrete

As a cofounder of Heat Wave Health, I believe our responsibility is to make the next step more useful than another article telling women they deserve support.

Desirae’s work begins with an individual clinical evaluation: symptoms, medical history, medications, and the patient’s priorities. Care can include hormone or nonhormonal treatment when appropriate, follow-up visits, and secure communication between appointments. The plan is reviewed as the patient’s response and needs change.

That continuity matters. A woman should have somewhere to return with the details: her nights are better, her concentration is still troubling her, a treatment has caused a side effect, or the original plan is not doing enough.

Bring those details. Bring the questions you have been reluctant to ask. You do not need to establish the diagnosis yourself, and you do not need a poor performance review to justify seeking care.

The CFO who delivered on Monday still deserves an assessment of what happened on Sunday—and during the weeks before it.

Her ability to conceal the effort is no reason to leave her making it alone.

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References

Beck, V., Brewis, J., & Davies, A. (2021). Women’s experiences of menopause at work and performance management. Organization, 28(3), 510–520. https://doi.org/10.1177/1350508419883386

Faubion, S. S., Enders, F., Hedges, M. S., Chaudhry, R., Kling, J. M., Shufelt, C. L., Saadedine, M., Mara, K., Griffin, J. M., & Kapoor, E. (2023). Impact of menopause symptoms on women in the workplace. Mayo Clinic Proceedings, 98(6), 833–845. https://doi.org/10.1016/j.mayocp.2023.02.025

Hirsch, H. (2025, August 21). Menopause at work: The hidden crisis no one talks about. Substack. https://heatherhirschmd.substack.com/p/menopause-at-work-the-hidden-crisis

The Menopause Society. (n.d.). Hormone therapy. https://menopause.org/patient-education/menopause-topics/hormone-therapy