The Invisible Challenge in Working Life: Menopause

Why do women often have to cope with menopause symptoms on their own during the years when their professional experience, knowledge, and decision-making abilities may be at their peak?

As a physician who has been working in women's health for many years, I have talked and listened a great deal about menopause. Hot flashes, night sweats, sleep problems, bone health, vaginal dryness, hormone therapy…

However, in recent years, another issue has increasingly caught my attention during my conversations with women going through menopause:

Working life…

I have increasingly heard similar statements from women who work intensively, carry significant responsibilities, hold managerial positions, or work in professions where mental performance is particularly important:

“Doctor, I wasn't like this before.”

In fact, this statement was one of the reasons that led me to think more deeply about the relationship between menopause and working life.

Sometimes a hot flash occurs right in the middle of an important meeting. In some women, this may be accompanied by palpitations, migraines, heavy or irregular bleeding, fatigue, and mood changes.

Then another very important issue may arise: A woman may begin to question her own professional competence. In my practice, women tell me;

“I can't think as quickly as I used to.”

“I forget words during meetings.”

“Because I can't sleep at night, I can't focus on anything the next day.”

Some women say, “I'm beginning to lose confidence in myself.”

Can Perimenopause and Menopause Symptoms Affect Working Life?

Of course, it would not be correct to attribute every one of these complaints to menopause. Other possible causes, ranging from thyroid disorders and anemia to depression and sleep disorders, should also be evaluated.

However, scientific studies now show that perimenopause and menopause may be accompanied by sleep disturbances, vasomotor symptoms such as hot flashes and sweating, fatigue, mood changes, and concentration and memory complaints, all of which can affect the working lives of some women. I think there is an important distinction here: A woman does not lose her knowledge, intelligence, or the professional experience she has accumulated over the years. Sometimes, the symptoms she experiences simply make it more difficult for her to use her existing capacity as comfortably as before.

These are not the same thing, and I believe both women and employers need to understand this distinction.

What Does Science Tell Us?

Menopause and working life are no longer discussed solely in terms of women's personal experiences. A systematic review published in 2025 that evaluated 29 studies found moderate-to-high-quality evidence linking overall menopause symptoms, psychological symptoms, vasomotor symptoms, and poor sleep quality with reduced productivity at work. An association between vasomotor symptoms and work absenteeism was also reported. When we consider everyday life, these findings are not particularly surprising.

How realistic is it to expect a woman who wakes up repeatedly at night because of hot flashes, does not get enough sleep, and needs to make important decisions the following morning to perform as though nothing has happened?

The Impact of Menopause Symptoms on Working Life: Noteworthy Figures From the United States

A study conducted by Mayo Clinic and published in Mayo Clinic Proceedings evaluated 4,440 working women between the ages of 45 and 60. Of these women, 13.4% reported experiencing at least one adverse work outcome because of menopause symptoms. In addition, 10.8% stated that they had missed work because of menopause symptoms within the previous 12 months.

One of the findings I found most striking was related to symptom severity. Women with the most severe menopause symptoms were approximately 15.6 times more likely to report an adverse work outcome than women with the least severe symptoms. Researchers estimated that the annual cost to the US economy of workdays lost due to menopause symptoms alone was approximately $1.8 billion.

So this is not simply about a woman's hot flashes. Behind those hot flashes there may also be sleep loss, concentration difficulties, work absenteeism, career decisions, and ultimately an economic impact.

Menopause and Workplace Productivity in Türkiye

We now also have data from Türkiye. I believe this is one of the most encouraging aspects of the subject from Türkiye's perspective. A Turkish study published in the Journal of Occupational and Environmental Medicine in 2026 evaluated 144 working postmenopausal women. The study reported that age, field of work, and particularly menopause-related psychological and urogenital symptoms were significant determinants of workplace productivity. The model used in the study explained 45.9% of the total variance in work productivity. The researchers also highlighted the importance of organizational support and menopause-sensitive workplace policies. This study is particularly important to me because we can now begin to ask another question in Türkiye:

Alongside the question, “How do we treat a woman going through menopause?”

we also need to ask, “How can we protect a woman's potential in working life during menopause?”

Why Is the UK Talking About Menopause-Friendly Workplaces?

In some countries, this discussion began earlier than it did in Türkiye. The United Kingdom is one of the most notable examples.

In its 2026 guidance, NHS Employers addresses menopause not only as an individual health issue but also as an organizational issue that concerns the workplace.

According to the 2023 CIPD research cited by NHS Employers, 67% of participants experiencing menopause symptoms reported that menopause had negatively affected their work.

In March 2026, NHS Scotland published an official Menopause and Menstrual Health Policy for employees and managers. When you look at the recommended adjustments, most of them are actually quite simple:

• Flexible working hours or location when necessary,
• more frequent short breaks,
• easy access to drinking water and toilets,
• appropriate ventilation or access to a fan,
• reasonable adjustments to clothing and uniforms,
• providing managers with information about menopause,
• a safe and confidential environment for discussions between employees and their managers.

So the question is no longer simply, “What is menopause?” One of the key questions is now:

“How can we support an employee who is going through menopause and whose symptoms are affecting her work?”

What Is the Career Hormonal Adaptation Period?

I call this period the “Career Hormonal Adaptation Period.” This is not an established or officially recognized medical term. I use this expression to describe the particular period when the most experienced and professionally powerful years of a woman's career coincide with perimenopause and the menopausal transition.

I call it the Career Hormonal Adaptation Period because the timing is particularly striking. Perimenopause generally does not coincide with the beginning of a woman's career, but rather with the years when her professional experience may be at its highest. A woman between the ages of 45 and 55 may already have 20 to 30 years of professional experience.

She may be the CEO of a company. She may be a hospital administrator. She may be an academic, teacher, lawyer, engineer, or entrepreneur. Perhaps, after years of hard work, she has finally reached a position where she is genuinely involved in important decisions. And at exactly that time, she may begin experiencing sleepless nights, hot flashes, heavy bleeding, migraine attacks, or concentration problems. She may then ask herself:

“Am I getting older? Am I no longer as good as I used to be?” I believe this is one of the most critical points. Because the problem is not always age. It is not a loss of ability. Sometimes the problem is unrecognized and unmanaged menopause symptoms.

When I use the term “Career Hormonal Adaptation Period,” this is exactly what I mean: She is still the same woman; her knowledge is the same, her experience is the same, and her leadership capacity is the same. However, while her body is going through a hormonal transition, certain symptoms may temporarily make it more difficult for her to access and use that capacity as comfortably as before.

When this period is appropriately evaluated, other underlying medical causes are excluded, and the symptoms are genuinely associated with perimenopause or menopause, many complaints can be managed with individualized treatment and support. Therefore, this is not necessarily a period in which a woman should withdraw from her career.

On the contrary, it can be viewed as a period of adaptation in which her body adjusts to a new hormonal balance while she continues her career.

Therefore, menopause is increasingly being considered not only a health issue but also an issue of age and gender equality.

How Can Companies in Türkiye Support Employees Going Through Menopause?

So what can companies in Türkiye do? I believe it is time for human resources departments and company managers in Türkiye to ask themselves:

“How are we supporting our employees who are going through menopause?” There is an important point I would particularly like to emphasize here. This approach should not mean giving women going through menopause “special privileges.” On the contrary, it should mean creating an environment in which an employee who has developed expertise over many years, gained valuable experience, and made significant contributions to her organization can protect her health and ability to function effectively.

Moreover, not every woman experiences menopause in the same way. Some women go through this period with almost no noticeable symptoms. In others, symptoms can significantly affect daily life and work performance. Therefore, what I advocate is not a rigid “menopause protocol” to be applied to everyone.

It is a scientific, individualized approach that does not stigmatize women. Major investments may not always be necessary.

The first step may simply be to create an organizational culture in which menopause can be discussed openly. Providing basic education for managers and human resources teams, considering flexible working options when necessary, adjusting workplace temperature, facilitating access to breaks and toilets, and directing employees to appropriate medical resources can all be valuable starting points. However, we must avoid creating another problem in the process:

We should not create a new stereotype that a woman going through menopause is necessarily a less productive employee. Such an approach could turn the problem we are trying to solve into a new form of discrimination.

Should Working Life Also Be Discussed During a Menopause Assessment?

There is another question that we, as physicians, may need to start asking. The more I researched this topic, the more I began to reflect on it in terms of my own medical practice.

When a woman comes for a menopause assessment, we ask about hot flashes. We ask about her sleep. We evaluate bleeding patterns, sexual health, bone health, and cardiovascular risks. But perhaps there is another question we should routinely ask:

“Are these symptoms affecting your work?” I believe this simple question can sometimes open a very important door. When a woman does not understand the reason behind the changes she is experiencing, she may begin to assume that the problem lies in her own abilities.

However, following an appropriate assessment, many symptoms can be managed by addressing sleep problems, making lifestyle adjustments, considering menopausal hormone therapy in suitable patients, using non-hormonal treatments when appropriate, and applying other necessary medical approaches. Of course, treatment is not the same for every woman.

Menopausal hormone therapy is not automatically prescribed to every woman either. Age, time since menopause, symptoms, medical history, and individual risk factors should all be evaluated together.

Menopause Should Not Be an Invisible Barrier to a Woman's Career

Perhaps we have been asking an incomplete question for years: “How will a woman get through menopause?” I no longer believe this question is sufficient on its own.

Instead, I prefer to ask:

“What can we do to ensure that a woman does not lose some of the most experienced years of her life and career because of menopause symptoms?”

Menopause is not a disease. But this statement should not lead us to ignore the fact that menopause-related symptoms can significantly affect the lives of some women. On the one hand, we should not unnecessarily label women as “patients.” On the other hand, we should not dismiss symptoms that impair quality of life by simply saying, “It is a natural process; it will pass.”

I believe the appropriate approach lies somewhere between these two extremes. The concept of a menopause-friendly workplace is increasingly being discussed around the world.

Scientific data on this subject are also beginning to emerge from Türkiye. I believe the next step is to discuss this issue not only in obstetrics and gynecology consultation rooms, but also in companies, human resources departments, universities, hospitals, and boardrooms.

Because when a woman reaches the age of 50, she has not reached the end of her career.

On the contrary…

She may have only just entered one of the most valuable periods of her professional life.

And menopause should not become an invisible barrier standing in the way of those years.