Menopausal symptoms impact a quarter of the working women in the U.S., and a Mayo Clinic study found that menopause costs $1.8 billion in lost working time, which includes the loss of employees who retire early from its symptoms and related stigmas. California’s Select Committee on Reproductive Health met with a member of the British Parliament, among others, to gain a better understanding of how to support menopausal folks in the workplace on March 4.
Asm. Rebecca Bauer-Kahan (D-San Mateo), committee chair, said 73 percent of women who have menopausal symptoms like hot flashes, night sweats, sleep disturbances and mood swings are untreated, which is in part due to the fact that only one in five obstetrics and gynecology (OB/GYN) residents are trained in menopausal treatment.
“We cannot tell women to just suffer through it. We cannot give people a pill and say deal with it. We have to break down the stigma, speak openly about menopause, and build solutions together to give women what they deserve as they go through this critical transition,” Bauer-Kahan said, adding that this life phase should be celebratory for women.
Parliament Member Carolyn Harris III spoke about her experience advocating for menopausal treatment in politics, an effort which she began in 2017 after local grassroots organizations reached out to her. Harris said there are over 40 menopause symptoms, and women see 10 to 15 providers, on average, before menopause symptoms are brought into question.
“I wanted something that would get attention globally,” Harris said.
Harris attempted to pass legislation that would make hormone replacement therapy (HRT) free for women. HRT prescriptions are free in Wales, Scotland, and Northern Ireland, but not in England, she noted. Harris heard from menopausal patients who couldn’t afford HRT prescriptions, and that women were paying about $50 a month for them. Harris helped Parliament pass legislation to cap the annual HRT fee for menopausal treatment at $20 per year.
“Once we’d done that, we literally opened up a can of worms because from then on, countries from across the world started asking us what more they could do to support the women in their country,” Harris said.
Without medical support, 80 percent of menopausal women walk away from jobs, and 10 percent of menopausal women leave the workforce completely, according to Harris. She noted a 16 percent rise in suicide for menopausal women who are unaware that they’re in menopause or unable to get provider support due to a lack of knowledge.
Harris said third party individuals can now act as moderators between employers and employees in England. Some employers are working to establish contracts for the workers, and unions can help with the cause, she said.
California-based pharmaceutical manufacturer Genentech recently began providing free menopausal benefits to its employees and their spouses. Melinda Morimoto, senior benefits director at Genentech, said the initiative has helped reduce stigmas and normalize conversations around individual health journeys.
“We were able to leverage an existing relationship that we had with our health plan to very quickly implement menopause benefits through a telehealth company called Maven, who specializes in women’s health,” Morimoto said.
The benefit was launched in March 2023. It provides educational articles, symptoms and treatment options, lifestyle remedies, and chat access to specialists. Genentech employees and partners hosted two webinars for the initiative, which discussed manager training, menopause symptoms, and how leaders can better support menopausal women in the workplace.
Morimoto said Maven has been used by 700 Genentech employees since its launch, and has received a 4.9 (out of five stars) rating, on average. She said the benefit has made a statement: that women at the company are cared for and valued.
Omisade Burney-Scott—creator of the Black Girl’s Guide to Surviving Menopause exchange, and a longtime reproductive justice advocate—the experiences of Black women in the reproductive field of medicine. She said gynecology has historically been a man’s field and has served as a way to oppress women.
“We also must not forget that the father of gynecology, (J. Marion Sims), coined his expertise and the newly developing field by practicing on enslaved Black women without anesthesia or anything given for their pain.”
— Burney-Scott
The Black Girl’s Guide to Surviving Menopause launched in 2019, which was delayed due to a lack of resources on the topic. Burney-Scott said less than three percent of OB/GYNs are considered experts on menopause, and only 30 percent of medical students receive some sort of education for it.
“Menopause is a highly individualized, physical, cultural, and political experience,” Burney-Scott said. “There is no one-size-fits-all.”
Menopause doesn’t always occur when people are in their forties or fifties. Black women are more likely than white women to experience surgical menopause, which creates a stark and sudden reduction in hormones and worse menopausal symptoms. Burney-Scott said oppressive systems contribute to the symptoms and effects of menopause, and that it occurs in more people than just those who identify as women.
Burney-Scott said she would love to see California create equitable and safe workplaces for people of all ages and gender identities. She emphasized the need to minimize workplace disruption so women are not pushed out of employment and end up food or housing insecure.
Marcy L. Karin—a law professor and the director of the Legislation and Civil Rights Clinic at the University of the District of Columbia’s David A. Clarke School of Law—most workplaces are not designed to meet all menstruation, perimenopause, or menopause needs.
“Employers have prevented uniform modifications that would allow women to wear darker clothes that could hide menstrual leaks or stains from heavy sweating,” Karin said. “And, they’ve been denied bathroom breaks that cause workers to be subjected to harassment, shame, and other indignities when they soaked their clothes with urine, menses, or sweat.”
Some non-menstruating bosses may not consider menstrual concealment, Karin said.
“Some worker’s bodies don’t meet the male ideal norm.”
— Karin
The number of menstruating and menopausal women who are being pushed out of the workplace is increasing, Karin said, and she believes there should be laws in place to help increase worker protections for a wide range of lived experiences.
Readers interested in learning more about health policy in California can register to attend the 2024 Northern California State of Reform Health Policy Conference, which will be held on April 16. An “Insights into the California Legislature” panel will be held at 2:15 p.m.