Lack of menopause awareness, support leaves some women ‘blindsided' at work

Globe and Mail

13 hours ago

Janet Ko was in her early 40s when she first started experiencing brain fog, body aches, joint pain and palpitations so intense that she ended up in an emergency room thinking she was having a heart attack.
Never having heard the word 'perimenopause,' Ms. Ko didn't associate her symptoms with the transition into menopause (when menstrual periods cease permanently). So, at the height of a thriving corporate career, she left her executive level job to deal with what she thought was burnout.
'I was blindsided by menopause at the height of my professional career as a senior vice president,' says Ms. Ko, who now understands she was experiencing perimenopausal symptoms. 'It was a long and winding path to finding health and wellness.'
Ms. Ko didn't leave the workforce completely, but she resigned from her role and did not work at such a senior level again. Though it steered her off course in her professional life, the experience led Ms. Ko to co-found the Menopause Foundation of Canada, a platform to help other women avoid the struggles that she faced on her menopause journey.
'Had I been able to connect the dots and had I been able to get care and treatment, I know the trajectory of my career would have been very different,' she says.
While conversations about menopause are less taboo than in the past, menopause is still largely seen as a women's health issue rather than a workplace issue that affects productivity and diminishes opportunities for advancement.
In 2023, the Menopause Foundation of Canada released a report called Menopause and Work in Canada that quantified the economic impact of the unmanaged symptoms of menopause, such as hot flashes, sleep disturbances, brain fog, anxiety, depression, heart palpitations, vaginal dryness, bladder control issues and joint pain, at a staggering $3.5-billion.
'That's in lost productivity, missed days of work, and also in women in their peak earning years leaving money on the table because they're reducing hours, leaving the workforce altogether or taking a lesser role,' Ms. Ko says.
A landmark 2024 study into the health and economic impacts of women in British Columbia found that menopause symptoms influence how well people feel at work. Thirty-two per cent of participants said that the presence of menopause symptoms affected their job in some way, while 24.8 per cent reported missing days of work in the last 12 months due to menopause symptoms. Nearly one in 10 (9.4 per cent) respondents reported having to turn down a job promotion or career advancement in the last six months due to menopause symptoms.
The B.C. study confirmed what many women across Canada have been sounding the alarm about for years: They don't understand their symptoms or how to manage them, especially at work.
'They might find that they're unable to wear the same clothes because they've got discomfort in their vulva and in their vagina, and they might be peeing frequently which might become bothersome or obvious at work,' says Dr. Michelle Jacobson, menopause specialist at Women's College and Mount Sinai Hospitals in Toronto and the co-founder of Coven Women's Health.
'Some women get joint pain, they get a breakdown in their muscle tissue and tendinopathies, especially in their hips and their buttocks. And that can make it very hard to stay seated in a chair, whereas they may not have had a problem before,' she says.
Dr. Jacobson adds that women's struggle to understand their symptoms is exacerbated by the fact that many healthcare practitioners receive little to no menopause education or training. As well, there was a sharp decline in the use of hormone replacement therapy (HRT) – which can be a treatment for menopause symptoms – after a widely-publicized study, the Women's Health Initiative, came out in 2002.
The study found that hormone therapy after menopause raised the risk of heart disease, stroke, blood clots, brain cancer and dementia, but those findings have been challenged in recent years. For example, Dr. Jacobson points out that the women who were enrolled in the study were not necessarily representative of women suffering from menopause. The average age of participants in that study was 63 – women who were likely well out of menopause when they started hormone therapy – meaning the study findings don't necessarily apply to women in their 40s or 50s.
'The way the study was publicized is that hormone therapy was dangerous,' Dr. Jacobson says. 'This led to a real decline in prescribing and a real decline in education around menopause because it sort of felt [like] there was no safe way to treat this.'
When it comes to support for menopause in the workplace, there have been some improvements in Canada. From support groups to information sessions to benefits packages that now include menopause-related resources, organizations across industries are beginning to understand that the proverbial 'change of life' is a transition whose solutions can't be relegated to the home.
Shawna O'Hearn, director of community engagement in the faculty of medicine at Dalhousie University in Halifax and co-founder and director of the Menopause Society of Nova Scotia, organizes a monthly support group at the university for anyone interested in menopause, whether they are going through it or not.
'We've also been training managers and trying to ensure that it's not only those that come to the support group that are part of the conversation, but that we're actually thinking about it from an equity lens,' Ms. O'Hearn says.
Dalhousie has an accessibility and accommodation team that is trained in understanding how to support both managers and staff who may be going through the menopause journey.
'Many of our benefits packages are starting to include things like specific recognition of mental health counseling for individuals going through menopause, [coverage for] the cost of menopause hormone therapy [and] the cost of pelvic health physiotherapy,' she says.
Creating a comprehensive menopause plan can be an effective way to support employees. Companies like IKEA, L'Oreal, BMO, PWC and Sun Life are taking their own steps to tackle this issue by engaging with resources like the Menopause Foundation of Canada's Menopause Works Here campaign, which includes a free menopause-inclusive workplace playbook and a five-step action plan. To date, 150 companies have joined the Foundation's campaign.
Dalhousie's multi-pronged approach is a great example of how applying a robust and inclusive solution to women's health needs at work can lead to better outcomes overall.
'People retention is higher, workplace productivity is higher,' Ms. O'Hearn says. 'There's a significant reduction in the cost that is associated with leaves and sicknesses and absences, because people are starting to know: 'I can talk to the manager, I can modify my work environment or my work priorities and I know [how] to talk to my health care provider to get the proper supports to be healthy and well again.''
That last point — being able to advocate for oneself — is key to enacting change on a systemic level, and arming women with those skills is something Ms. Ko, Ms. O'Hearn and Dr. Jacobson all prioritize in their work.
'It could be somebody [with] hot flashes who says, 'This polyester uniform is not comfortable for me. Can we find a way to get a breathable fabric that would be more comfortable?'' Ms. Ko says. 'It could be somebody who says, 'I'm really struggling with sleep at night, so rather than starting at 7:30 or eight in the morning, can my schedule begin at nine?''
Despite the positive changes happening in some organizations, both Ms. Ko and Dr. Jacobson agree that we are still very much in the beginning stages of menopause care in the workplace, and that there is so much more that can be done.
'This stage of life has largely been ignored,' says Ms. Ko. 'That's an injustice that we need to change, particularly when you think about not just the impact to one's own personal health, but to the impact to the economy and to society overall. This is an issue that demands urgent attention and action.'
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