HR guide to global workplace menopause support

As the conversation around menopause and perimenopause gains momentum, there’s an increasing recognition of the need for workplace support for employees experiencing these life stages. However, our survey of 2,892 full-time employees from eight regions who are experiencing or have experienced the menopause transition¹ finds that awareness, support, and stigma levels vary drastically across the globe.

A scan of the landscape shows that in the United Kingdom and Australia, proactive measures are being implemented, with organizations developing specific menopause policies² and training programs. Meanwhile, in the United States, conversations about menopause are beginning to gain traction, although cultural discomfort continues to make open discussions challenging.³ Canada is also making progress, providing guidelines for employers,⁴ but further access to medical support and workplace adjustments are required to reach the levels of menopausal support of other countries.

While some regions are at the forefront of de-stigmatizing menopause in the workplace, others have considerable work to do on this issue that affects the roughly 300+ million women aged 45-59 who are working around the world.⁵

Workplace attitudes and stigma around menopause vary across regions, but desire for support is high everywhere

Workplace attitudes and stigma surrounding menopause vary across regions, reflecting cultural differences and levels of support available to employees experiencing this natural transition. Despite these differences, a large majority of respondents (84%) across all eight regions — Australia, Canada, France, Germany, the Netherlands, Sweden, the United Kingdom, and the United States — agree that there should be more workplace support for employees going through perimenopause and menopause.

However, the prevalence of stigma differs widely. More than one-third (36%) of employees across regions perceive a stigma against discussing menopause at work. This sentiment was particularly strong in Australia (45%), Germany (43%), and the UK (39%).⁶

At the same time, in the UK and the US, more than two-thirds of employees said their company culture is supportive of menopausal employees.⁷ This contrast highlights that while some workplaces are making progress in supporting menopausal employees, others lag behind, revealing a dual narrative, even within the same regions.

Around the world, employees are hiding menopausal symptoms at work

More than 1 in 3 (36%) employees perceive a stigma against discussing menopause at work. For this reason, it’s unsurprising that almost three-quarters of respondents (71%) report that they have hidden their menopause symptoms at work. The highest levels of secrecy were in Germany (81%), Australia (78%), the Netherlands (79%), and the UK (77%).⁸

About 34% of respondents had not disclosed their menopause symptoms to anyone at work. This was most common in France (45%) and Canada (41%).⁹

Of the employees who did not share their symptoms, their reasons for secrecy varied by region¹⁰:

• Personal Issue: In every region, the notion that perimenopausal and menopausal symptoms are personal issues was the number one reason that employees did not share their status with anyone. This perception was highest in Germany (78%), Sweden (76%), and the US (76%).
• Negative Perceptions: In Sweden (15%) and Australia (13%), menopausal employees were particularly worried about being perceived negatively by colleagues.
• Embarassment: In France (27%) and Australia (17%), many respondents felt embarrassed discussing menopause.

Some employees highlighted their reason for secrecy surrounding their symptoms was linked to ageism, and the fear that talking about this stage of life may make them appear older than their colleagues. These cultural sensitivities must be considered when developing global HR policies to ensure they are effective and supportive across different regions.

Menopause policies and support help keep highly skilled women in leadership roles and prevent premature exits

Effective menopause policies are crucial in retaining highly skilled women, particularly those in leadership roles who might otherwise consider leaving the workforce due to menopause-related challenges.

Menopausal employees report a similar pattern of being particularly likely to make job-related decisions based on menopausal support, and many are considering leaving their jobs due to inadequate support during menopause,¹¹ have quit a job due to lack of perimenopause and menopause support,¹² or have declined job opportunities because of the lack of menopause support in the workplace.¹³

As we show further on in this report, implementing comprehensive support measures — such as flexible work options, health benefits that cover menopause-related treatments, and workplace adjustments — can prevent premature exits and retain top talent.

Regional leaders and laggards in menopausal support

How workplaces support menopausal employees is dependent on a complex set of factors including workforce demographic trends, cultural norms, and workplace regulations. HR leaders can look to specific regions as pacesetters to understand how expectations for support and benefits may evolve.

• Leading regions: While much work still needs to be done around the world, the UK and Australia have emerged as leaders in addressing menopause in the workplace. These regions are setting the standard by introducing a range of supportive measures, including paid time off for menopausal symptoms, flexible working arrangements, and educational programs aimed at raising awareness.¹⁴
  Recognizing the significant impact that menopause can have on employee health and productivity, both public and private sector organizations in these regions are actively working to reduce the stigma associated with menopause.¹⁵They often incorporate training for managers and employees, equipping them to handle menopause-related issues with sensitivity and understanding, which fosters a more inclusive and supportive work environment.
• Growing demand, lagging response: In the United States and Canada, response to the demand for menopause support in the workplace has been slower. While benefits such as medical insurance coverage and workplace accommodations are being offered by some organizations, these types of support are not yet widespread. Cultural factors and a lack of standardized policies contribute to this slower uptake.¹⁶Similarly, in Germany and France, cultural stigma around menopause still hinders open discussions, which in turn delays the development and adoption of supportive workplace practices.¹⁷
• Opportunity for growth: Regions such as Sweden and the Netherlands are beginning to see a shift in awareness about the importance of menopause support, driven by broader societal conversations around gender equality and workplace inclusion.¹⁸ However, the implementation of specific policies remains inconsistent. This creates a significant opportunity for companies in these regions to take the lead by developing and adopting comprehensive menopause support frameworks. By doing so, organizations can not only address an important aspect of employee health but also position themselves as pioneers in workplace inclusion, setting an example for others to follow.

Employee expectations for menopausal support vary across regions

Employee expectations for menopause support in the workplace vary widely across regions, reflecting different cultural attitudes, healthcare systems, and levels of awareness.

In many regions, the number one benefit employees want is a formal menopause policy, including the UK (68%), Australia (66%), Canada (61%), Germany (61%), the Netherlands (61%), and France (40%).

Why? This may be due to a lack of clear workplace guidelines and cultural reluctance to openly address menopause, prompting employees to seek structured policies for support.

In the US, where healthcare is often tied to employment, employees prioritize access to insurance coverage for menopause-related care (62%).

Meanwhile, in Sweden, where there is a strong focus on healthcare access and public health insurance covers all employees, employees most value access to menopause-health professionals to address their specific medical needs (50%).

For HR leaders, understanding these regional differences is crucial for developing effective policies that meet employees’ needs and support talent retention.

What employees want vs. what companies offer: The menopause edition

1. Medical insurance covering menopause treatments and therapies

• What employees want: In Canada and the US,¹⁹ there is a strong desire for medical insurance to cover menopause-related treatments and therapies, including hormone replacement therapy (HRT) and other supportive interventions. While it’s unsurprising that the US exhibits this expectation, given its reliance on private healthcare insurance, it may be surprising that Canada shares a more similar outlook with the US than with Europe. Despite Canada’s nationalized healthcare system, which aligns with European models, the demand for comprehensive insurance coverage for menopause-related care remains high (58%), contrasting with the generally lower expectations seen in European regions, which range from 34% to 41%.
• What companies offer: The current insurance policies in these regions vary widely and depend on whether healthcare insurance is provided nationally — with employees reporting medical insurance of this kind in the US (31%)²⁰— but great variance in what is covered. Some employers offer comprehensive coverage, and others provide minimal or no coverage for menopause-related healthcare.

2. Time off and flexible working policies

• What employees want: Employees in Australia and the UK²¹ expressed a strong desire for time off and flexible working policies specifically designed to support employees experiencing menopause.
• What companies offer: While organizations in Australia and the UK have begun to implement some policies,²² there is still a gap between what is offered and what employees want. For example, the UK published its first menopause in the workplace guidance,²³ supporting both employers and employees in understanding their rights and obligations. And while flexible working arrangements have become more common, specific time off for menopause symptoms is still rare.

3. Adjustment to the working environment

• What employees want: Many employees in Canada, Australia, the US, and the UK²⁴ advocate for adjustments to the working environment, such as the availability of cooling rooms or improved ventilation to manage physical symptoms like hot flashes.
• What companies offer: While some workplaces have made environmental adjustments, the availability of such facilities is inconsistent and not universally adopted. Approximately one-quarter of workplaces in the UK, the US, and Australia offer environmental adjustments.²⁵ In the UK, the EHRC (Equality and Human Rights Commission) menopause in the workplace guidance²⁶ may encourage organizations to explore different ways of supporting employees of this demographic.

4. Menopause awareness and education sessions

• What employees want: Employees in the UK²⁷ show a strong desire for menopause awareness and education sessions aimed at all employees, not just those experiencing menopause. This approach seeks to foster a supportive and understanding workplace culture.
• What companies offer: Some organizations in these regions have started offering awareness sessions, but these initiatives are not yet widespread or standardized so there is much opportunity for growth. These sessions are currently most common in the UK.²⁸

5. Access to menopause health professionals

• What employees want: Access to specialized menopause health professionals is a priority for many employees — and particularly those in Canada.²⁹ This includes direct access to doctors, nurses, and counselors with expertise in menopause management.
• What companies offer: While some companies provide access to such professionals through employee assistance programs (EAPs) or healthcare plans, this is not uniformly available. This kind of support was reported to be most prevalent in the UK and the US.³⁰

Supportive policies, such as flexible working arrangements, access to specialized healthcare, and educational programs, not only attract job seekers but also signal a company’s broader commitment to gender inclusion and employee well-being.

The key to differentiation lies in the comprehensiveness and innovation of these programs, demonstrating that the organization goes beyond basic support to offer tailored solutions.

In a competitive talent market, offering such progressive and region-specific menopause support can be a deciding factor for talent, especially in regions with a higher demand for such programs.

For menopausal employees in mid-to-senior career stages, these policies are particularly meaningful, as they often face the challenge of managing menopause while maintaining their career trajectory. Offering robust menopause support can therefore differentiate an organization in a competitive talent market, demonstrating that it values and invests in the long-term health and success of its employees.

Forward-thinking organizations understand that providing support for perimenopausal and menopausal employees is both a moral and business imperative. As companies operate globally, it’s crucial to recognize that the response to menopause varies across cultures, legal frameworks, and workplace norms.

Tailored support ensures inclusion, improves employee well-being, and helps retain top talent in a diverse workforce. By fostering an understanding, flexible, and globally sensitive approach, companies can enhance employee loyalty, preserve productivity, and maintain a competitive edge in today’s global market.

Here are a few steps HR benefits leaders should consider:

• Understand legal obligations: Familiarize yourself with local laws regarding employee health, wellness, and gender equity. Assess whether your organization’s current policies align with the legal requirements of each region, especially concerning menopause-related support. Make adjustments where necessary to ensure compliance and avoid potential legal risks. In addition to your legal obligations, evaluate the accessibility and coverage of menopause-related healthcare services in each region. Identify gaps between your organization’s offerings and local healthcare systems. Then adjust employee benefits packages accordingly to ensure employees have access to necessary support, no matter where they’re based
• Adapt to cultural norms. Conduct cultural audits in regional offices to better understand local attitudes toward menopause and how they may impact employees’ willingness to seek support. Experiment with partnering with local health professionals, wellness organizations, and support groups to enhance the resources available for perimenopausal and menopausal employees. Tapping into region-specific knowledge ensures your support strategies are more effective and relevant to employees’ needs. This strategy also creates an open dialogue that resonates with local norms and promotes an inclusive and supportive environment.
• Tailor communication strategies. Effective communication about menopause requires more than just translating materials — it demands cultural sensitivity and regional relevance. Research local attitudes toward menopause to ensure that messaging is respectful and appropriate. Involve HR teams and employee resource groups to help tailor educational materials, aligning them with cultural norms and language preferences, ensuring employees feel comfortable engaging with the information. Additionally, diversify communication methods based on regional preferences, such as formal workshops, peer support groups, or anonymous online resources. Establish feedback loops to assess how well these efforts resonate, allowing continuous improvement and ensuring employees feel supported and included, regardless of location.

How to cite: Smith, E. & Robotham, K. (2024). HR guide to global workplace menopause support. Catalyst.

Endnotes

1. We surveyed 2,892 full-time employees in a variety of industries, with top representation from business and professional services (n = 151), education (n = 372), finance, banking and insurance (n = 185), government and military (n = 183), healthcare and medical (n = 455), manufacturing (n = 201), and retail (n = 184) industries in Canada (n = 569), the United Kingdom (n = 641), the United States (n = 647), Australia (n = 520), France (n = 107), Germany (n = 157), the Netherlands (n = 90), and Sweden (n = 161). Our sample was mostly cisgender women (100%, n = 2,868) with some representation of other genders (<1%, n = 8). Almost half of the respondents were White (48%, n = 1,110) and our sample included representation from other racial and ethnic identities as well (e.g., Asian, Black, Indigenous, Latine, or multiracial employees; 52%, n = 1,214). Most respondents identified as heterosexual/straight (90%, n = 2,535), and our sample represented other sexual identities as well (e.g., asexual, bisexual, gay, lesbian, pansexual, or queer employees; 10%, n = 282). Almost half of the respondents were between the age of 40-50 years (45%, n = 1,305), and the rest were between the age of 51-79 years (55%, n = 1,587). Note that participants could skip demographic questions, so totals may not equal 100% or total sample size.
2. In the UK, “under the Equality Act 2010, workers are protected from discrimination, harassment and victimization on the basis of protected characteristics including disability, age, and sex. If menopause symptoms have a long term and substantial impact on a woman’s ability to carry out normal day-to-day activities, these symptoms could be considered a disability. If menopause symptoms amount to a disability, an employer will be under a legal obligation to make reasonable adjustments” Menopause in the workplace: Guidance for employers. (2024, February 22). Equality and Human Rights Commission; In the UK, “all employees will have a day one right to request flexible working, and no longer have to wait six months as previously. There is also a commitment to make improvements to health and safety guidance to help employers support menopausal employees – this is not yet published but the commitment has been made” Hundle, J. (2024, March 12). Menopause in the workplace: what organizations need to know about employment law Menopause friendly UK; Menopause in the Workplace. New South Wales Government.
3. Making menopause work: Employer guide (2024). The Menopause Society; Blum, D. (2024, September 13). What could a menopause-friendly workplace look like? The New York Times.
4. Creating a menopause inclusive workplace: A playbook for employers. (2023). Menopause Foundation of Canada.
5. “In 2020, 47% of the 657 million women globally aged between 45 and 59 contributed to the workforce.” Dennis and Hobson. (2023). Working well: Mitigating the impact of menopause in the workplace — A narrative evidence review. Maturitas, 177, 107824.
6. A chi-square analysis revealed that the percentage of people who report that at their company there is a stigma against talking about menopause differed by their region of work, χ²(7) = 47.57, p < .001. Examination of adjusted residuals revealed Australia (4.8) differed significantly from what was expected.
7. A chi-square analysis revealed that the percentage of people who report their company culture to be supportive of menopausal employees differed by their region of work, χ²(7) = 76.93, p < .001. Examination of adjusted residuals revealed the UK (4.0) and the US (2.3) differed significantly from what was expected.
8. A chi-square analysis revealed that the percentage of people who have hidden their menopause symptoms differed by their region of work, χ²(28) = 63.17, p < .001. Examination of adjusted residuals revealed Germany (2.7), Australia (3.5), and the UK (3.9) differed significantly from what was expected.
9. A chi-square analysis revealed that the percentage of people who they haven’t told anyone about their menopause symptoms at work differed by their region of work, χ²(7) = 37.87, p < .001. Examination of adjusted residuals revealed France (-2.3) and Canada (-3.9) differed significantly from what was expected.
10.   A chi-square analysis revealed that the reasons people did not disclose their menopause symptoms to others at work differed by their region of work, χ²(28) = 69.93, p < .001.
11.  A chi-square analysis revealed the percentage of people who are considering leaving their jobs because of a lack of support for employees going through perimenopause and menopause differed by their region of work, χ²(7) = 103.77, p < .001.
12.   A chi-square analysis revealed employees who have quit a job because of a lack of support for employees going through perimenopause and menopause differed by their region of work, χ²(7) = 107.24, p < .001.
13.   A chi-square analysis revealed employees who have declined a job opportunity because of a lack of support for employees going through perimenopause and menopause differed by their region of work, χ²(7) = 86.72, p < .001.
14.   Menopause and the Equality Act 2010 [Video]. (2024, February 22). Equality and Human Rights Commission; Making workplace adjustments and preventing discrimination [Video]. (2024, February 22). Equality and Human Rights Commission; Conversations about the menopause [Video]. (2024, February 22). Equality and Human Rights Commission; Working with menopause: a webinar for managers and employees [Video]. (2023, July 28). New South Wales Government.
15.   Menopause in the workplace: Guidance for employers. (2024, February 22). Equality and Human Rights Commission; Menopause in the workplace. (2024). New South Wales Government.
16.   Blum, D. (2024, September 13). What could a menopause-friendly workplace look like? The New York Times; Making menopause work: Employer guide. (2024). The Menopause Society; Creating a menopause inclusive workplace: A playbook for employers. (2023). Menopause Foundation of Canada.
17.   The data demonstrates that “country plays a crucial role in determining menopause-related time-off entitlement, as the proportions of respondents with different entitlements significantly vary between the US and Germany.” (see page 38). Full-time and part-time workers reported significantly less menopause-related time-off entitlement in Germany (see Table 10) Yun, J. (2024). Menopause across cultures and contexts: A comparative study of symptoms, supportive networks, and workplace experiences in Germany and the USA [Masters Dissertation, Hamburg University of Applied Sciences Faculty of Life Science]; “Over one-third of respondents in Germany felt that more menopause support would not have had an impact on their well-being.” Feelings of whether more menopause support in the workplace would have had a positive impact in the United Kingdom, Germany, Spain, and Italy as of 2021. (2023, February 16). Statista.
18.   The Nordic Menopause Whitepaper. (2024). Astellas. See pages 31-33 for details specific to Sweden; NN invests in platform Vi to support working women through menopause. (2024, January 10). NN.
19.   A chi-square analysis revealed that the demand for medical insurance to cover menopause-related treatments and therapies by respondents’ region of work, χ²(7) = 141.88, p < .001. Examination of adjusted residuals revealed Canada (5.7) and the US (8.5) differed significantly from what was expected.
20.   A chi- analysis revealed medical insurance that covered menopause treatments offered by organizations differed by respondents’ region of work, χ²(14) = 189.17, p < .001. Examination of adjusted residuals revealed the US (6.1) differed significantly from what was expected.
21.   A chi-square analysis revealed that the demand for enhanced time off and flexible working policies differed by respondents’ region of work, χ²(7) = 72.08, p < .001. Examination of adjusted residuals revealed Australia (3.2) and the UK (4.6) differed significantly from what was expected.
22.   A chi-square analysis revealed the menopause policies offered by organizations, such as flexible working, differed by respondents’ region of work, χ²(14) = 111.19, p < .001. Examination of adjusted residuals revealed Australia (4.7) and the UK (6.1) differed significantly from what was expected.
23.   In the UK, “under the Equality Act 2010, workers are protected from discrimination, harassment and victimization on the basis of protected characteristics including disability, age, and sex. If menopause symptoms have a long term and substantial impact on a woman’s ability to carry out normal day-to-day activities, these symptoms could be considered a disability. If menopause symptoms amount to a disability, an employer will be under a legal obligation to make reasonable adjustments” Menopause in the workplace: Guidance for employers. (2024, February 22). Equality and Human Rights Commission; In the UK, “all employees will have a day one right to request flexible working, and no longer have to wait six months as previously. There is also a commitment to make improvements to health and safety guidance to help employers support menopausal employees – this is not yet published but the commitment has been made” Hundle, J. (2024, March 12). Menopause in the workplace: what organizations need to know about employment law. Menopause friendly UK.
24.   A chi-square analysis revealed that the demand for adjustments to the working environment differed by respondents’ region of work, χ²(7) = 38.82, p < .001. Examination of adjusted residuals revealed the UK (2.2) differed significantly from what was expected.
25.   A chi-square analysis revealed that organizations offering adjustments to the working environment differed by respondents’ region of work, χ²(14) = 58.11, p < .001. Examination of adjusted residuals revealed the UK (2.8) differed significantly from what was expected.
26.   Menopause in the workplace: Guidance for employers. (2024, February 22). Equality and Human Rights Commission.
27.   A chi-square analysis revealed that the demand for menopause awareness and education sessions for all employees differed by respondents’ region of work, χ²(7) = 40.24, p < .001. Examination of adjusted residuals revealed the UK (5.8) differed significantly from what was expected.
28.   A chi-square analysis revealed menopause awareness and training sessions by organizations differed by respondents’ region of work, χ²(14) = 126.29, p < .001. Examination of adjusted residuals revealed the UK (8.6) differed significantly from what was expected.
29.   A chi-square analysis revealed that the demand for access to specialized menopause healthcare professionals differed by respondents’ region of work, χ²(7) = 33.48, p < .001. Examination of adjusted residuals revealed Canada (3.3) differed significantly from what was expected.
30.   A chi-square analysis revealed access to menopause health professionals offered by organizations differed by respondents’ region of work, χ²(14) = 112.46, p < .001. Examination of adjusted residuals revealed the UK (3.8) and the US (2.5) differed significantly from what was expected.