‘Menopause is not a medical condition’: Experts call for better workplace support
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Rhode Island has become the first U.S. state to explicitly require employers to provide reasonable workplace accommodations for employees experiencing menopause. Canadian experts say the move is prompting an important conversation about whether workers in this country need more support, education and legal protections.
The law, which took effect June 24, adds menopause and related medical conditions as protected conditions.
Employers with four or more employees must work with staff to identify reasonable accommodations for menopause symptoms, such as hot flashes and night sweats, unless doing so would create an undue hardship
The legislation also bans employers from denying job opportunities because an employee needs menopause-related accommodations, or forcing workers to take leave if another reasonable accommodation is available.
Employers are also required to update workplace policies and notify employees of their rights under the new law.
‘Menopause is not a medical condition’
While Canada has no comparable legislation specifically addressing menopause in the workplace, experts say the conversation is gaining momentum as more employers recognize the challenges some workers face during the transition.
“Menopause is not a medical condition,” said Dr. Claudio Soares, executive director of the Canadian Menopause Society. “Menopause is a significant time in life that everybody who’s lucky to survive and live long enough will go through. But what we’re talking about is really having access to good quality of care in the workplace during the menopausal years.”
Health Canada describes menopause as a natural stage of life that marks the end of a person’s menstrual cycles. It typically happens between the ages of 45 and 55, when the ovaries no longer consistently produce the reproductive hormones estrogen and progesterone.
The Canadian Centre for Occupational Health and Safety says menopause most often has little or no impact on a person’s ability to do their job. However, it notes some people experience symptoms that can affect their health, attendance and performance at work.
According to the agency, symptoms such as hot flashes, night sweats, sleep disruption, headaches, muscle aches, anxiety and difficulty concentrating can contribute to fatigue, lower energy and reduced productivity in the workplace.
For some workers, those symptoms can make certain jobs especially difficult, said Dr. Alison Shea, a menopause and reproductive mental-health specialist and associate professor at McMaster University.
“If you are working in a high-heat environment or you don’t have access to air conditioning and you’re getting significant hot flashes, this can be very overpowering and really impossible to work in if you’re not getting active treatment for your hot flashes,” she said.
Shea said untreated anxiety, mood changes and irritability can also affect people at work, while urinary urgency or heavier menstrual bleeding during perimenopause may make regular access to washrooms more important.
Menopause may be a normal stage of life, but Shea added that does not mean it cannot have a significant impact on a person’s health, quality of life and ability to perform at work.
Cost of menopause
The impact extends beyond individual workers. A 2023 report from the Menopause Foundation of Canada estimated that unmanaged menopause symptoms cost the Canadian economy about $3.5 billion each year.
The report, which included an economic analysis by Deloitte Canada, estimated menopause contributes to roughly 540,000 lost workdays annually, with employers losing an estimated $237 million in productivity and women losing about $3.3 billion in income through reduced hours, lower pay or leaving the workforce.
The report also found many women struggle to manage menopause at work. About one-third of working women surveyed said their symptoms had negatively affected their job performance, while nearly one-quarter said they hid their symptoms at work.
Two-thirds said they would not feel comfortable discussing menopause with a supervisor, and nearly half said they would be too embarrassed to ask for workplace support.
Soares said creating workplaces where employees feel comfortable discussing menopause is just as important as any policy change.
“There’s probably a lack of awareness of the medical conditions that could happen,” he said. “Employers could be more aware, create a condition that women can actually express that they’re having those symptoms, and look for support without feeling that they are out of place.”
Support beyond legislation
While Rhode Island’s law requires employers to consider reasonable accommodations for menopause, both Soares and Shea said the bigger challenge in Canada is creating workplaces where employees feel comfortable asking for help.
“This is a time that might require additional support, and we should be feeling that they are empowered to bring this up to the employers,” Soares said, adding that “employers should be supportive and proactive in creating an environment that conversation can happen freely without feeling any kind of discomfort or embarrassment.”
Shea agreed that practical accommodations can make a significant difference, particularly for workers whose symptoms are affecting their daily responsibilities.
“I think being able to talk about it is a huge thing,” she said. “Being able to have an employer who is supportive, having tools in place, perhaps resources that they can turn to for information that they need, and having them understand that it’s OK to talk about it, that it’s a normal stage of life.”
Should Canada follow Rhode Island?
Neither expert said legislation alone is the answer.
Soares said legal protections can help encourage employers to act, but believes education and awareness are ultimately more important in breaking down the stigma surrounding menopause.
“The legal framework isn’t necessarily the one that will break down the barriers in the taboo and the stigma. I believe more in education and awareness,” he said.
Shea said she believes formal workplace protections could be beneficial, but only if they are accompanied by clear medical guidance.
“I think it is potentially a great thing to have,” she said, noting pregnancy accommodations provide one possible model. “If we were to set out specific guidelines, this would be helpful versus having it kind of an all or nothing.”
Shea said many people, including women themselves, underestimate how disruptive menopause symptoms can be until they experience them firsthand.
“I think unless you’ve gone through it or you’re partner to someone who’s going through it, I don’t think that you really understand how bad it can be for some people,” she said.
“The majority of women don’t realize it’s going to be as bad until they get into it themselves ... we need to do more education for everyone, including women themselves, because many women are blindsided.”
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