Two years ago, I attended the HLTH conference and heard the word menopause discussed openly in a professional setting for the first time. As I listened, I took notes and sent resources to my sister, who had shared some of what she was experiencing. I didn’t recognize that I needed the same information for myself.
I was already in perimenopause.
Last month, I brought together four women for a conversation about perimenopause, menopause and the workplace: Tinsley English, Founder of The Three G Consulting Group and Author of Leading Through the Pause: The High Achiever’s Guide to Staying Confident Through Menopause; Shelly Brown, Associate Director, National Partnerships at Oscar Health; Stacey Mennillo Dieterle, Head of Go To Market, Women’s Health at Sword Health; and Rebecca Bernier, National Employee Benefits Career Development Advisor at USI Insurance Services.
The panel brought together leadership, health plan, women’s health and employee benefits perspectives. It was clear that women are navigating this stage of life in very different ways, often without recognizing what is happening or knowing where to turn for support.
The Signs Don’t Arrive in One Recognizable Package
One panelist described symptoms that initially appeared to be anxiety, followed by joint pain and brain fog. Another consulted multiple healthcare providers while experiencing disrupted sleep, hair loss and unexplained weight changes, yet continued to be told that her test results were normal. We also heard about irregular periods, memory changes, dry eyes, urinary symptoms and changes in confidence.
For me, one of the signs was pimples. My sister noticed them before I did.
These experiences are not intended to create another symptom checklist. They demonstrate how varied and seemingly unrelated the signs can be. Women may seek care from several different providers without anyone connecting those experiences to perimenopause.
Recognition and Diagnosis Remain a Challenge
A 2026 Milliman claims analysis found that only about 25% of commercially insured women ages 40 to 64 had received a menopause diagnosis, suggesting that menopause remains underdiagnosed within this population.
Part of the challenge is timing. Menopause is clinically confirmed after 12 consecutive months without a menstrual period, but perimenopause can begin years earlier. During that transition, symptoms may emerge long before a woman or her healthcare provider connects them to hormonal changes.
Access to informed care can also be inconsistent. Women may consult several healthcare providers before their symptoms are recognized as part of the menopause transition, adding to the confusion and delaying appropriate support.
The larger message from the panel was not that women should diagnose themselves. It was that we need enough information to recognize when something has changed, document what we are experiencing and continue asking questions when the answers we receive do not address how we feel.
This Is Happening During Women’s Most Influential Career Years
Perimenopause and menopause often coincide with the years when women are leading teams, growing businesses and reaching senior levels within their organizations.
Symptoms can appear at work as difficulty concentrating, disrupted sleep, missed meetings, additional medical appointments or difficulty recalling information that once came easily. Without understanding what is happening, women may begin questioning their own abilities, and others may misinterpret those changes as disengagement, burnout or diminished capability.
During our webinar, 54% of attendees said they would not feel comfortable telling their direct manager that a menopause symptom was affecting their work. That response underscores why employers may not recognize the extent of the issue within their own workforce.
The business implications are measurable. A Mayo Clinic study estimated that menopause symptoms account for approximately $1.8 billion in lost work time annually in the United States, and $26.6 billion when medical expenses are included. Research from the Society for Women’s Health Research also found that one in four women considered not pursuing or chose not to pursue a leadership opportunity because of menopause.
This is not only a women’s health issue. It is a workforce, healthcare spending, productivity and retention issue.
Support Is Expanding, but It Remains Fragmented
The panel highlighted several ways support is beginning to evolve.
Shelly described Oscar Health’s menopause-focused insurance plan, which is designed to reduce financial barriers for specified services such as additional OB-GYN visits, certain laboratory services and bone-density screening. The plan is available in parts of the individual market and may also be accessed through an employer-sponsored individual coverage arrangement, depending on geography and eligibility.
Stacey discussed Sword Health women’s health support, including virtual clinical guidance, movement and nutrition resources, pelvic health care and support across life stages. Sword’s Bloom offering is available through participating employers and health plans.
Rebecca added an important benefits perspective, employers may already have resources that can help. Medical coverage, behavioral health services, an EAP, virtual care and other existing programs may provide parts of the support women need. Before adding another solution, employers should understand what is already available, where meaningful gaps remain and whether employees can easily find and use those resources.
That last point matters. A benefit does not provide value simply because it appears in a benefits guide.
A Framework for Women Navigating This Stage
Tinsley shared the LEAD framework from Leading Through the Pause:
- Listen: Pay attention to what has changed and document symptoms or patterns that were not present before.
- Educate: Understand the differences between perimenopause, menopause and postmenopause.
- Advocate: Ask questions and advocate for yourself with healthcare providers, within your workplace and in your personal relationships.
- Design: Consider what you want the next chapter of your life and career to look like.
The framework moves women from confusion toward awareness and action without suggesting that every woman’s path or treatment will be the same.
What Employers Can Do Now
Employers do not necessarily need to begin by purchasing another solution. A practical starting point is to:
- Review what the medical plan, EAP, behavioral health, virtual care and existing women’s health resources already cover.
- Work with your broker or benefits consultant to identify gaps and evaluate additional options.
- Examine whether employees know where to find available support and how to access it.
- Train managers to respond appropriately without asking them to diagnose employees or provide medical advice.
- Create space for education through benefits communications, employee resource groups and broader workplace wellbeing programs.
- Evaluate women’s health investments through the same business lens used for other benefits – access, utilization, outcomes, healthcare spending, productivity and retention.
I believe that most employers care. The challenge is translating that intention into benefits, communication and workplace practices that women can actually use.
Also, the goal is not to require women to disclose deeply personal health information at work. It is to create an environment where women can understand what may be happening, find appropriate care and access support without having to navigate every part of the experience alone.
Thank you to Tinsley, Shelly, Stacey and Rebecca for contributing their perspectives, expertise and experiences, and to everyone who joined us and helped move this conversation out of a whisper.
