Perimenopause Is Murdering Our Careers

Build your arsenal. Prepare for battle.

Woman experiencing hot flashes at work, perimenopause symptoms Alliance Images | Canva

Fluffy jokes about hot flashes and irritability did not prepare me for wanting to die.

The highest rate of suicide among American white middle-aged women is between 45–64. My darkest year was 48, the muddy trough in a decade-long, symptom crap-wich. That year, there were three international moves, a layoff, and a new career. Coupled with worsening but undiagnosed peri-menopause symptoms, I walked away from my job. I couldn’t see any other option.


Like me, 25% of women have crippling menopause symptoms that reduce their quality of life and 17% of women have quit or considered quitting. Even though all women go through menopause, very few employers offer workplace support or programs. Women suffer in silence, and employers have a responsibility to step up and support their workforce. Women have a right to demand it.

@beingmarcellahill Women are losing work hours and quitting their careers because they can't find anyone to help them with menopause symptoms! Why aren't companies recognizing this and creating the solutions to keep their most valuable people?! #hrt #hormonetherapy #perimenopause #hotflashes #csuitewomen #careerwomen #womenshealth #emplpyeebenefits #marcellahill ♬ original sound - Marcella Hill

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My symptoms started at 40. A slow trickle, soon a surging river, coursed stronger with time. Hair loss, insomnia, anxiety, depression, joint pain, dry skin, racing heart, panic attacks, weight gain — up and down, then down, down, down.

A multitude of doctors, but no diagnosis. The symptoms overlapped between depression, anxiety, long-Covid, chronic stress, perimenopause, and autoimmune disease. My labs were always normal.

At 47, things were desperate. I chalked it up to stress, but my anxiety and depression morphed into a boundless fury that would not abate. A (once) confident woman with a successful career, I was collapsing. Simple tasks felt arduous and catastrophic. A tidal wave of self-doubt plagued every decision. I felt small, incapable, weathered, and spent.

I started Hormone Replacement Therapy (HRT), an increasingly common treatment for menopause symptom relief. HRT was a saving grace that relieved about 65% of my symptoms. My mood swings though blunted, once triggered, were (still) destructive. There were long drives to scream in the car with a death metal playlist. I prayed to exorcise the relentless wrath.


White-knuckled, untethered, and (self)muzzled. That’s how I felt.

At 48, I was at the precipice of my career. Decades into a carefully curated career, I moved to my dream company — a bespoke leadership consulting firm that I had pursued. The work we did was important and purposeful, but I felt like a fraud — a shadow of who I had once been. In November 2023, I resigned.

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I wasn’t the only quitter

Of the 34 symptoms associated with perimenopause, I have 27. Though the research is sparse, menopause is associated with lower employment rates. The symptom number, type, and severity contribute to lowered employment participation. Compared to vasomotor symptoms (like hot flashes), psychological symptoms have the worst impact on employment.


In Canada, women over 40 make up 25% of the workforce, yet, between the ages of 45–59, there is a 14% drop in work participation. Certainly, there are a plethora of factors.

Women still manage the bulk of child and age-related parental care. Then there is the “broken rung,” a term coined by McKinsey to describe the ongoing obstacles women face for leadership promotions. The 20% wage gap between men and women’s pay is also a persistent thorn. And let’s not forget the impact of return-to-office mandates, which reduce flexibility, a key benefit that women want and need to thrive.

Menopause symptoms can last up to 14 years. Let that sink in. If you have middle-aged friends, make a mental note of how they’re doing. Many of my friends are having a rough go. Some are on medical leave, have short-term disability, or have reduced their hours. One friend, a senior executive, checked herself into a psychiatric facility. A few, like me, walked away. Those with pensions or high-earning spouses retired early.

These are talented, well-educated women with a lot of give. I can’t think of one who isn’t affected by peri-menopause-related symptoms. Thankfully, there is (finally) much-needed dialogue with celebrities like Oprah, Halle Berry, and Stacy London openly talking about menopause.


The true cost of leaving your career

The vignette below is not only a worry but a mirror:

Laura was in her 40s at the height of her career when she developed debilitating fatigue. Later when she also developed joint pain, the doctor said a lot of women her age have similar problems; there was no mention of perimenopause. Work became impossible, so at the age of 44, Laura resigned from her estate administration position with a private bank. — Menopause Foundation of Canada

Laura’s story highlights an all-too-common reality for women. Women are often medically gaslit, and doctors, including OBGYNs, receive inadequate menopause training if any at all. If the medical profession cannot support women, it’s no surprise that employers are ill-equipped too. For the most part, menopause is still taboo.

In the story above, Laura doesn’t get a happy ending. After resigning, Laura developed crippling anxiety. Her doctor told her that anxiety and menopause were not related. It wasn’t until she started having hot flashes that she found a menopause specialist and was prescribed HRT. By then it was too late for Laura to restore her career. She now works part-time in retail, at a fraction of her former salary, with no benefits, security, or pension. It’s not a stretch to stand in Laura’s shoes. In my case, I’m hyper-aware that for every month I’m off, I lose more of my edge and relevance.


While employers lose out, ultimately, it’s women who lose the most, not only in terms of paying for direct costs of symptom management but also lifetime earnings, career progression, pension, and benefits.

According to US AARP research, women spend over $13 billion annually on menopause symptom relief. I spent thousands chasing relief. Over the years, I saw my family doctor, an endocrinologist, two OBGYNs, a neurologist, and a psychologist. A functional doctor finally pieced it together.

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Companies need to step up

When I resigned, my company knew I was struggling with peri-menopause. They were sympathetic, but since I was an independent contractor, there were no benefits or programs to support me. I could have reduced my hours, but I decided to walk away.


I had the financial means to quit. Most don’t. Does ur workplace have support for peri and menopausal women?? #menopause #menopausesymptoms #menopausesupport #menopausehealth #greenscreen @Marcella Hill @Dr. M.C. Haver @👩🏻‍⚕️Heather Hirsch MD ♬ love nwantinti (ah ah ah) - CKay

Women aged 45–64 make up nearly 20% of the US labor force — 100% will go through menopause. On the one hand, women are reluctant to talk about their menopausal symptoms at work. On the other hand, menopausal complaints and symptoms are so prevalent that it’s time to break the silence.

Companies like Microsoft and Adobe are rolling out menopause benefits like access to HRT, webinars, education, counseling services, flexible work, and menopause leave. It’s about time. Their workforce is on the line.


The dawn always breaks

Seven months into a career break, I emerged from my cocoon. A year after starting HRT, I met a functional doctor who diagnosed me with sub-clinical hypothyroidism. Bio-identical thyroid supplementation, along with HRT, has brought me back to (nearly) 100%.

Each day is a blessing. Now that I feel better, I’m ready to work again. This time I’ll be careful to choose a company that offers flexible benefits.

Life looks different than it did before. I no longer take my health for granted. There is an arsenal of tools that I carefully assembled. Ask any menopause expert, and you’ll hear variations of the following lifestyle changes:

  • HRT
  • Bio-identical, low-dosage thyroid support (many women have undiagnosed thyroid disease)
  • Reduced alcohol
  • Daily exercise, including weights, yoga, and cardio
  • Sleep hygiene routines (magnesium glycinate, sleep mask, ear plugs, black-out curtains)
  • Gut support with probiotics and daily fermented foods like yogurt, sauerkraut, and kombucha
  • A network of women who’ve got your back
  • Daily meditation
  • A high-protein diet rich in plant-based foods
  • A doctor who will listen
  • Therapy

Peri-menopause has been a (w)reckoning. There was a period when I did not know if or how I would survive. I am grateful to have had the means to take a break.

On the other side, peri-menopause is a time of rebirth. You must awaken or be consumed by the darkness. I (felt like and) fought like crazy. A new me arose from the ashes. She’s similar to the old me but a lot wiser and stronger.

If you are struggling, let these words be a candle. On the coldest night, at all costs, protect your flame. When your flame grows stronger, use it to light another’s.In the meantime, talk to other women. Share your stories and break the silence. Demand better from your employers.

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Tracy Collins is exploring retirement at 49. Splitting her time between Canada and Mexico, she writes about travel, food, midlife, mindfulness, and financial independence.