ISO 45010: what the standard says about menopause at work and how to apply it in Italy

Why menopause is becoming a workplace health and safety issue

A manager with twenty years of experience wakes up at three in the morning for the third time in a week. At nine, she has a budget meeting. She struggles to recall names, rereads the same slide three times and keeps her jacket closed to hide a hot flash. None of her colleagues would think to connect that day to a hormonal transition, and she will tell no one.

It is a scene repeated every day in thousands of Italian organizations. In Italy, more than 17 million women are going through perimenopause and menopause, and those aged 45 to 60 are among the fastest-growing groups in the workforce. They are the professionals with the most experience, the strongest relationships and the deepest knowledge of the company: the hardest people to replace. Yet according to the national survey by Fondazione Onda ETS and IULM University, 37.7% have never discussed their symptoms with anyone, and just 2.7% have discussed them with their employer.

The result is a phenomenon companies see only through its effects: accumulating absences, fluctuating performance, declined promotions and resignations without a clear explanation. The issue remains invisible precisely where it would be easiest to act.

Until now, every organization that wanted to act had to build everything itself, without a shared reference to draw on. Since September 2026, that reference has existed, and it has the same status as the standards that already govern workplace safety. It signals that the issue has ceased to be a private matter and has become an organizational responsibility, with practical guidance and indicators to measure. Here is what the standard says and how to put it into practice in an Italian company.

In brief

On 7 September 2026, ISO published ISO 45010, the first international standard dedicated to menstruation and menopause in the workplace. It applies to organizations of every sector and size and works alongside ISO 45001 on occupational health and safety management systems. It tells companies what to do in four areas: the workplace and work organization, culture and manager training, the handling of health data, and measuring results. In Italy, where the issue affects more than 17 million women and no dedicated legislation exists, it is currently the only operational reference available.

What ISO 45010 is

ISO 45010 gives organizations guidance on developing policies and practices that support the menstrual and menopausal health and experience of people at work. It applies to any organization, regardless of size or sector, and can be adapted to each company’s specific needs.

The standard makes three points at the outset that change how companies approach the issue.

Menstruation and menopause are physiological processes

The document defines them as life course experiences rather than medical conditions, and recognizes that many people manage them independently, without needing any support from their employer. Organizations act to reduce stigma and remove obstacles, not to medicalize a physiological stage of life.

It explains when to involve qualified professionals

The standard focuses on organizational policies, practices and adjustments, and refers all health-related matters to qualified sources, including professional and reliable external providers. Andropause is outside its scope, although it acknowledges that many recommendations may also be useful in that case.

It connects to existing management systems

Its only normative reference is ISO 45001:2018, and Annex G contains a correlation matrix showing, clause by clause, how to integrate the two documents. The standard also refers to ISO 53800 on gender inclusion, ISO 25550 on age inclusion and ISO 25551 on support for people with caring responsibilities.

The figures behind the standard

The document opens by explaining why this issue needs attention now: by 2030, more than 1.2 billion women worldwide will be menopausal or postmenopausal, and 1.8 billion have a menstrual cycle every month. A huge proportion of the workforce experiences, or will experience, these changes while working.

The relationship between work and symptoms goes both ways. Symptoms affect the experience of work, engagement and turnover; at the same time, the type of work, the demands of the role and the perceived support from managers influence the frequency and intensity of the symptoms themselves. A lack of knowledge or support has measurable consequences: presenteeism, absenteeism, disengagement and additional turnover costs.

The standard also lists the documented benefits of good practice: greater engagement, better health and a longer healthy working life, more aware leadership cultures, stronger diversity and inclusion goals, and the ability to attract and retain talent with lower attrition and training costs.

What it asks companies to do in practice

The standard translates the issue into four areas of action. The first two are within reach of any organization. Almost all organizations stop at the other two.

The workplace and work organization

These are the lowest-cost measures with an immediate impact: adjustable temperature and ventilation, unrestricted access to toilets, fresh water, a quiet space to recover for twenty minutes, flexible hours and hybrid work on difficult days, adaptable breaks, and breathable fabrics where uniforms are worn. Many companies discover that they already have half of these measures in place, without ever putting them into a system or communicating them.

Company culture, managers and policies

This is where the success of everything else is decided. Companies need to provide information to the entire workforce, including men; managers who can receive a request without embarrassment and know where to refer it; and a written policy explaining what the company offers and who to contact. Without these three elements, adjustments remain individual concessions that depend on the sensitivity of a particular manager and disappear as soon as that manager changes.

Health data, the most sensitive issue

The standard is clear on this point. No one can be required to disclose their symptoms. Any apps or digital solutions offered must be optional, and the data must not be shared with company functions. Telling a manager does not authorize that manager to tell HR.

Information about menstrual and menopausal health may constitute health data, so in Italy it falls within the scope of the GDPR: legal basis, privacy notice and impact assessment. This is why a program run entirely in-house exposes an organization to more risk than it might imagine, and why the clinical pathway should be kept separate from the company and managed by external providers and organizations.

Measure before and after

The standard calls for an initial snapshot: the workforce by gender and age, existing policies, absences, retention and departures, alongside the cost of doing nothing. The turnover figure is clear: replacing someone costs between six months and two years of their salary, with two years applying to senior roles, precisely the group in question. On top of that is the organizational knowledge that walks out of the door and does not come back.

What is happening in other countries

United Kingdom: from voluntary action to a requirement

The Employment Rights Act 2025 is the first British law to explicitly mention menopause. Since 6 April 2026, companies have been able to publish action plans on menopause and the gender pay gap voluntarily; in 2027, this becomes mandatory for employers with 250 or more employees, with publication alongside gender pay gap data.

Spain and corporate action

Spain introduced state-funded menstrual leave legislation in 2023. In the private sector, multinationals such as Santander, Tesco, IKEA, Adobe, Diageo, AstraZeneca and IBM have adopted global menopause policies, often without yet adapting them for their Italian branches.

The situation in Italy

In Italy, more than 17 million women are going through perimenopause and menopause, and those aged 45 to 60 are among the fastest-growing groups in the workforce.

The legal framework: a parliamentary motion, not yet a law

Italy currently has no legislation dedicated to menopause, nor ministerial guidelines defining a uniform care pathway. Unlike pregnancy, menopause is managed without national recommendations and largely by private providers, with substantial disparities in access to care between regions.

To date, therefore, Italy has no menopause legislation. What does exist is a parliamentary process: a motion to protect and support women in menopause, submitted to the Chamber of Deputies in 2023 by Martina Semenzato and replicated in the Senate, covering seven points:

• local referral centers for prevention and personalized care

• dedicated health pathways for peri- and postmenopause

• screening programs and improved diagnostics

• psychological support and protection of mental health

• information on hormone replacement therapy, supplements, nutrition and physical activity

• tax deductions for treatments and supplements

• national awareness and training campaigns

The motion led to the creation of a parliamentary intergroup on menopause, chaired by Semenzato and made up of members from different political parties. Its aim is to serve as a multidisciplinary observatory open to clinicians, associations and companies. That work produced two documents that now serve as Italian reference points on the issue: the paper on personalized care presented at Montecitorio in May 2025 with Fondazione Onda ETS, and the national “Menopause and Work” survey of October 2025.

An approved parliamentary motion makes a political commitment on the part of the government, but does not have the force of law or create obligations for employers. The result is that the issue has gained institutional recognition while companies still lack an operational reference. That is exactly the gap ISO 45010 fills.

What the Italian data say

The national “Menopause and Work” survey, promoted by the parliamentary intergroup on menopause with Fondazione Onda ETS and Manupausa and conducted by IULM University among 1,576 working women aged 45 to 65, found that:

• 70% report physical symptoms, 62% emotional symptoms and 64% cognitive difficulties

• almost 70% report a moderate to high impact on performance, while only 14% have requested leave

• 37.7% have never discussed it with anyone, and only 2.7% have discussed it with their employer

• almost one woman in ten reports a major impact on her career, including giving up progression opportunities, changing jobs or reducing her hours

The survey describes a work culture that is still poorly equipped to listen and offer practical adjustments, where everything depends on individual relationships instead of structured policies.

Tools already available

UNI/PdR 125:2022. The reference practice for gender equality certification is the tool recognized by Italian lawmakers: more than 12,000 certified organizations and 64 bodies accredited by ACCREDIA. Measures supporting employees in menopause provide useful evidence in several areas assessed for certification, which can bring social security contribution relief and advantages in public tenders.

Menstrual leave. Draft law A.C. 1523 provides for up to three days a month of paid leave for certified dysmenorrhea. It was assigned to the Chamber’s Social Affairs Committee in April 2026, but has not yet become law.

ISO 45010 therefore arrives in a gap: it gives Italian companies an international reference they can use now, without waiting for legislation to develop.

When symptoms affect work: what the standard asks for

There is a passage in the standard that anyone designing a company program should read twice. When symptoms are severe enough to significantly impair working life, there may be an underlying condition. Some people hide their discomfort; others do not realize that medical support might help their symptoms, or do not recognize the signs of entering menopause or being in perimenopause.

The standard asks managers to refer people to qualified sources: HR, occupational health, a trained contact person, trade union representatives, or professional and reliable external providers.

It therefore places qualified support among the resources an organization makes available, alongside policies and adjustments: access to specialist expertise on symptoms, treatments and prevention of long-term risks, from osteoporosis to cardiovascular risk. A complete company program brings together both the organizational and specialist dimensions.

How to get started in six steps

1. Take a snapshot of the starting point

How many people in the company are aged 40 to 60, in which roles, and what has happened to absences, promotions and departures over the past two years? Without this baseline, no result can be demonstrated to management. Can be managed internally by HR and management control.

2. Open the conversation

An information session for the entire workforce, including men. It is the step that breaks the silence and makes everything that follows usable. Organized internally, with content from an authoritative external source.

3. Train people managers

Managers and HR need to know how to recognize a difficulty, receive a request without intruding, and understand the point beyond which the issue is outside their expertise. Requires external specialist training.

4. Provide access to confidential clinical support

Symptom assessment, menopause specialists, a personalized plan and prevention of long-term risks. Participation is voluntary and data remain outside the company, which receives only aggregated figures on use. Must be external: no company function can take this on.

5. Write the policy and address privacy

What the company offers, who to contact, how information is handled, who is responsible and when the document will be reviewed. Handled internally for the organizational aspects, with legal counsel or a DPO and clinical expertise for the rest.

6. Measure

Use of services, workplace climate, absences, retention among those aged 45 to 60, and exit interview findings. Compare with the initial snapshot after six and twelve months. Can be managed internally.

What you can manage in-house and what is better entrusted to external providers

Three of the six steps can be handled with resources you already have. The other three are where company programs stall, and it is worth understanding why.

The clinical component. No HR function can assess symptoms, advise on treatment or manage prevention of cardiovascular and osteoporosis risk. The standard itself refers organizations to qualified professionals and reliable external providers.

Confidentiality. People do not tell the person who decides their promotions about their symptoms. An internally managed program starts with low participation by design, and a service no one uses is a cost with no return.

Compliance. Collecting employees’ health information without a legal basis, a privacy notice and an impact assessment exposes the company to risk. Keeping the clinical pathway outside the company addresses the issue at its root.

Frequently asked questions about ISO 45010

Is ISO 45010 mandatory?

No. It is a guidance standard, so it contains recommendations rather than binding requirements. There is currently no obligation to comply in Italy.

Can a company obtain ISO 45010 certification?

The document provides guidance and does not provide for third-party certification like ISO 45001. The measures taken can, however, strengthen existing certifiable programs, starting with UNI/PdR 125:2022.

Where is it best to start?

With a snapshot of the current situation: existing policies, workforce by gender and age, and data on absences and retention among those aged 45 to 60. Without that starting point, the impact of any measures cannot be demonstrated to management.

Does it apply to small businesses too?

Yes. A specific section is dedicated to small and medium-sized businesses, with low-cost, high-impact solutions: free and credible resources, public incentives, collaboration with nonprofits, and extending existing practices on flexibility and training.

Does it only cover menopause?

No. It covers menstruation, menstrual health, perimenopause and menopause. Andropause is outside its scope.

Who should be responsible within a company?

The document is addressed to senior leaders, managers, HR, health and safety professionals, in-house health staff, wellbeing and D&I leads, and even architects and interior designers working on workplace spaces.

How does it relate to ISO 45001?

ISO 45001 is the only normative reference cited, and ISO 45010 contains a correspondence table showing how to include the issue in existing management systems: analysis of the organization’s context, health and safety policy, risk assessment and monitoring. If you already have a certified system, that is the place to start.

The first practical step

Before starting any project, it helps to understand where your organization stands. We have prepared a self-assessment checklist based on the points in ISO 45010. It takes ten minutes to complete and shows which conditions you already have, which are missing and where to start.

Pausetiv is Italy’s first digital platform dedicated to menopause with integrated clinical support. We support companies with everything they cannot handle internally: training for managers and HR, an individual and confidential clinical pathway with menopause specialists, policies and measurement of results. Participation is voluntary, and companies receive only aggregated data on use.

Request the checklist or a 30-minute call: aziende@pausetiv.com

Sources

1. ISO, ISO 45010:2026, Occupational health and safety management, Menstruation and menopause in the workplace, Guidance, 7 September 2026

2. ISO, ISO 45001:2018, Occupational health and safety management systems

3. Open Access Government, ISO 45010 has been put into place to support menstruation and menopause, September 2026

4. Fair Play Talks, New Global Workplace Standard Aims to Close Menopause and Menstruation Support Gap, 9 September 2026

5. Acas, Employment Rights Act 2025

6. Osborne Clarke, Gender pay gap and menopause action plans: what UK employers need to know, March 2026

7. Fondazione Onda ETS, Menopause and Work survey, 2025

8. Fondazione Onda ETS, full report in PDF

9. Department for Equal Opportunities, UNI/PdR 125:2022 reference practice

10. InfoScuola24, Menstrual leave: what draft law A.C. 1523 proposes, August 2026