Menopause and work: symptoms, impact and solutions for companies

At a glance

• In Italy, 64.28% of working women aged 45 to 65 report experiencing menopause-related symptoms, and almost 70% report a moderate-to-high impact on their work performance.

• The most disruptive symptom at work is increased fatigue due to unrefreshing sleep, ahead of stress, difficulty concentrating and hot flashes.

• The estimated cost of days of absence alone is €112 million a year.

• 83.63% of working women say their organization has not undertaken any initiatives on the subject, and only 2.66% have discussed it with their employer.

• The most frequent request to companies is flexible working hours, followed by dedicated leave and remote working.

Source of the Italian data: the “Menopause and work” survey, October 2025, promoted by the parliamentary intergroup on menopause led by MP Martina Semenzato with Fondazione Onda ETS and ManuPausa, conducted by IULM University’s CECOMS research center among 1,576 working women.

Every September 7 marks World Menopause and Work Day, the international day dedicated to the relationship between menopause and the workplace, promoted by the European Menopause and Andropause Society (EMAS) since 2021. It is an opportunity to bring attention back to a subject that affects millions of working women worldwide and that, even today, remains on the margins of internal policies and wellbeing initiatives in many companies. On the same occasion, EMAS presented the Menopause and Work Charter, which calls for menopausal health to be recognized as part of company policies on wellbeing, gender and age.

Menopause is a natural stage of life, but for a long time its effects remained confined to the private sphere. Yet this stage often coincides with important professional years, when many women hold positions of responsibility, manage teams or are in the midst of their careers. Talking about menopause and work therefore means going beyond individual wellbeing, and it is increasingly necessary.

In particular, we will also discuss Italian data on work and menopause, available for the first time only since 2025. This article brings those data together and translates them into practical actions for people responsible for human resources, employee benefits and workplace health and safety.

Menopause and work: what the data tell us

The “Menopause and work” survey is the first national qualitative and quantitative analysis of the impact of menopause on professional life in Italy. It was promoted by the parliamentary intergroup on menopause led by MP Martina Semenzato, with contributions from Fondazione Onda ETS and ManuPausa, and conducted in August 2025 by IULM University’s CECOMS research center on a sample of 1,576 working women aged 45 to 65, with an average age of 54.

The sample consists of 79% employees and 21% self-employed professionals, and it is the first Italian study to include a specific focus on comparing these two groups.

The main findings:

• 64.28% say they are currently experiencing menopause-related symptoms. A further 22.65% experienced them in the past, and 13.07% are currently receiving hormone replacement therapy.

• 69.50% report physical symptoms of moderate-to-high intensity, 62.00% emotional symptoms and 63.55% cognitive symptoms.

• 68.90% report a moderate-to-high impact on their work performance: 54.50% a moderate impact and 14.40% a high impact.

Internationally, the most rigorous study available on the subject was published in 2023 in Mayo Clinic Proceedings by Faubion and colleagues: in a sample of 4,440 working women in the United States aged 45 to 60, menopause symptoms were associated with an estimated direct economic cost of $1.8 billion a year in lost working days alone, rising to $26.6 billion when related healthcare costs are included. It is the largest sample ever analyzed on this subject and therefore currently represents the strongest international reference figure.

Important signals also emerge in the United Kingdom. A Simplyhealth study of 2,000 working women found that 23% had considered leaving their job because of the workplace impact of menopause or menstrual symptoms, while 14% were already planning to do so. The same symptoms were also associated with difficulties in everyday professional life: 55% of respondents reported an impact on mood, 52% on concentration and 40% on productivity.

Which symptoms have the greatest impact at work?

The symptom with the greatest overall impact is increased fatigue in everyday activities due to unrefreshing sleep, with a mean score of 4.54 on a scale from 1 to 7. It exceeds both hot flashes (3.82) and joint pain (3.70), the two symptoms most commonly associated with menopause.

The complete ranking of symptoms by perceived intensity at work:

This finding has a direct operational consequence: a company policy that only addresses room temperature tackles the sixth symptom on the list and leaves the first five unaddressed. These concern sleep, cognitive load and stress management.

A difference also emerges between employment arrangements. Employees report higher scores than self-employed professionals for fatigue (4.67 versus 4.40), stress (4.39 versus 4.01) and difficulty concentrating (4.37 versus 4.10). Autonomy in managing one’s pace appears to partially reduce the perception of symptoms, making organizational flexibility an approach with measurable effects.

The hidden cost, estimated at €112 million in Italy

Based on INPS data on the average number of working women in Italy, weeks worked and average annual pay, the survey estimates the annual economic cost of days of absence related to menopausal symptoms alone at approximately €112 million.

The figure is calculated from the 14.30% of women who report having taken leave or sick days for these reasons, assuming that each instance of leave corresponds to an eight-hour day. It is therefore a conservative estimate, capturing reported absenteeism while excluding presenteeism, the component that is hardest to measure and probably the most costly.

Alongside the cost to the system, the survey measures an individual cost that affects organizations. 76.02% of working women say they have made no changes to their professional lives despite their symptoms, a condition the report describes as silent suffering. Among the 23.98% who did make a change:

• 30.09% reduced their hours or switched to part-time work;

• 23.46% increased their use of remote working;

• 18.25% gave up career progression opportunities;

• 6.64% changed jobs;

• 3.08% stopped working.

Projecting these figures across the whole sample, the report estimates a 4.89% loss of senior female leadership through giving up career progression, and 2.60% changing or leaving their jobs. For a company, this translates into turnover costs, loss of senior expertise and a narrowing pipeline of female talent at precisely the age when candidates for top positions are selected.

The corresponding finding is that the only change experienced as a positive adjustment is increased remote working, cited by 23.46% of those who made a change.

Organizational silence: why menopause is not discussed at work

The subject remains largely unspoken. Only 2.66% of working women have spoken directly to their employer about their symptoms, while 39.85% have discussed them with colleagues and 37.69% have told no one.

The reasons for silence, according to the report:

• 42.26% consider menopause a private matter;

• 16.50% fear appearing inadequate for their role, rising to 30.67% among middle managers;

• 15.82% consider it a subject that does not concern men;

• 9.09% cite embarrassment or shame, and 6.40% fear of judgment.

The pattern changes with job level and reverses a common intuition. Among executives, almost one in two (44.77%) has never discussed it with anyone, and only 2.13% have discussed it with their employer. There are no responses citing embarrassment, while professional fear stands at 19.05%: their silence is strategic. Manual workers talk to colleagues (40.24%) but almost never to their superiors (2.37%). Middle managers combine high organizational pressure with a perception of inadequacy, and appear to be the most exposed group.

Silence also extends to administrative procedures: among those who submitted a medical certificate for menopause-related absence, only 22.60% say the reason was clearly stated. In large organizations with more than 1,000 employees, the proportion of explicit certificates falls to 13.51%.

In terms of perceived support, only 11.12% of respondents say they received a high level of support from their employer, while 59.25% rate it as low. Support from colleagues is slightly higher (16.36%), suggesting that recognition of the subject remains dependent on individual relationships rather than structured policies.

The final figure completes the picture: 83.63% say their organization has not undertaken any initiatives on the subject.

What working women ask of companies

A distinctive feature of the Italian survey is the direct collection of respondents’ proposals. 57.74% made suggestions to their organization, and the tendency to propose ideas increases alongside the intensity of the perceived impact: those feeling worst also bring more concrete ideas.

The requests, in order of frequency:

• Flexible working hours, by far the most common request.

• Dedicated leave, understood as formal recognition of absences that are already being attributed to other reasons.

• Remote working, to manage symptoms from home when necessary.

• Understanding and empathy, meaning a nonjudgmental environment.

• Changes to the physical environment: climate control, access to facilities and rest areas.

Respondents primarily ask institutions for recognized leave and time off, easier access to consultations and treatments, information campaigns, financial support and recognition of the physical impact for social security purposes.

Menopause at work: what practical steps can companies take?

The following actions are ordered by their balance of impact and implementation complexity, and address the symptoms the survey identifies as most disruptive.

1. Train managers and supervisors. The aim is to give managers the tools to recognize a request, handle a conversation sensitively and know which forms of support the company already provides. Training also reduces the comments and jokes that fuel silence, directly addressing the 16.50% of working women who fear appearing inadequate.

2. Introduce flexible hours and remote working. This is the most frequent request and the only adjustment that working women experience positively. The data show that autonomy in managing one’s pace reduces the perception of symptoms, so flexibility addresses the organizational cause as well as the symptom.

3. Improve the physical environment. Access to water, the ability to adjust temperature, cooler workstations, less rigid dress codes, easy access to facilities, spaces to decompress and adaptive ergonomic solutions. These are low-cost measures with an immediate effect on hot flashes and joint pain.

4. Establish clear, confidential points of contact. HR, occupational health or other designated roles can become formal points of contact, with confidentiality guaranteed. With only 2.66% of working women speaking to their employer, the lack of a defined channel is itself a barrier.

5. Legitimize absences. The fact that only 22.60% of certificates state the real reason signals a transparency problem that makes the issue invisible even to those who would like to manage it. Structured leave based on specialist certification legitimizes the condition, as already happens for other stages of working life.

6. Ensure access to specialist support. Dedicated medical consultations, multidisciplinary care pathways and support programs included in employee benefit packages turn declared concern into a verifiable service.

7. Integrate menopause into existing policies. In most cases, there is no need to create a separate system: menopause can be included in existing wellbeing policies, employee benefit plans and risk assessments.

Every company has its own characteristics and constraints, just as every woman experiences this stage differently. An effective policy starts with an assessment conducted jointly with different company departments and internal stakeholders, measures a baseline and defines monitoring indicators.

Menopause and work in Italy: the regulatory framework

Italy currently has no legislation specifically dedicated to menopause in the workplace. However, existing references make the subject relevant to those responsible for health, safety and gender equality.

Article 28 of Legislative Decree 81/2008 requires risk assessments to cover all health and safety risks, including those related to gender differences, age and origin from other countries. On this basis, the health of working women aged 45–65 is among the factors that the risk assessment document can consider, in coordination with the occupational physician and the health surveillance provided for under Article 41.

UNI/PdR 125:2022, the reference practice underpinning gender equality certification, assesses organizations across several areas, including culture and strategy, human resource management, protection of parenthood and work-life balance. Structured policies on women’s health throughout their professional lives can contribute to an organization’s position on these indicators.

For companies subject to sustainability reporting obligations, information on their own workforce includes health and safety, work-life balance and inclusion measures: areas in which a menopause policy provides a documentable element.

At an institutional level, the parliamentary intergroup on menopause has brought the subject onto the public agenda and promoted the 2025 national survey, signaling a direction that organizations can act on in advance.

A practical example: Ingka Group (IKEA)

Ingka Group, the main group operating IKEA stores, has introduced global menopause guidelines that promote open dialogue and manager training to support employees in perimenopause and menopause. Operationally, the group has adopted measures such as flexible breaks, personal fans and remote working options.

The value of this example lies in the combination: low-cost environmental changes alongside management training and a written group-wide policy, rather than isolated initiatives left to the sensitivity of individual managers.

The Pausetiv program for companies

Pausetiv is the first digital platform with integrated specialist support dedicated to perimenopause and menopause, with a multidisciplinary model led by doctors, validated by a scientific committee and aligned with international IMS and EMAS guidelines.

The program for companies supports organizations throughout the process:

• Initial assessment, to measure the baseline among women aged 45–65 and identify real priorities rather than starting with ready-made solutions.

• Training for managers, HR and the workforce, tailored to their roles.

• Policy development and integration into existing employee benefit plans and management systems.

• Access to specialist support for working women, with multidisciplinary pathways covering gynecology, nutrition, psychology and physical activity.

• Monitoring indicators over time, to make the initiative measurable and reportable.

With 83.63% of working women saying they are unaware of any company initiatives on the subject, there is considerable room for differentiation for organizations that act now.

To understand how we can support your organization, write to aziende@pausetiv.com.

Menopause while working: how can you manage it?

Managing physical symptoms, fatigue, sleep changes, difficulty concentrating and professional responsibilities simultaneously requires, first of all, clarity about what is happening. Understanding which aspects have the greatest impact helps you explain your needs, assess which adjustments would be useful and approach potential conversations at work with better tools, while respecting your privacy and without any obligation to share more than you wish.

The PauseTest is an online assessment built on scientific criteria that analyzes five dimensions of wellbeing: hormonal balance, nutrition and metabolism, mental health, sleep and stress, physical activity, with an indication of the menopausal stage. It costs €4.99 and is a tool for initial assessment and awareness: it is not diagnostic and is not a medical device under EU Regulation 2017/745.

Take the PauseTest

Alternatively, you can book a free consultation with a Pausetiv specialist.

Disclaimer: the information in this article is intended solely for informational and educational purposes. It does not replace the advice, diagnosis or guidance of a doctor or healthcare professional. If you have questions or symptoms that cause concern, always consult a qualified specialist.

Frequently asked questions about menopause and work

When is World Menopause and Work Day, and why was it established?

World Menopause and Work Day takes place every year on September 7. It was launched in 2021 by the European Menopause and Andropause Society (EMAS), following the publication of its international recommendations on menopause in the workplace. The aim is to raise awareness of the impact menopause symptoms can have on professional life and promote better-informed workplaces that can support working women’s different needs.

Which menopause symptoms can cause the most difficulties at work?

Symptoms that can interfere most with everyday professional life include sleep disturbances and fatigue, hot flashes and sweating, memory and concentration difficulties, mood changes and musculoskeletal symptoms. This does not mean that everyone going through menopause will necessarily have problems at work: the intensity and combination of symptoms can vary greatly from person to person.

How can you tell whether difficulties at work are related to menopause?

It can be helpful to observe whether fatigue, difficulty concentrating, sleep changes or other changes have appeared alongside the menopausal transition, and how much they affect everyday life. If symptoms are persistent, intense or difficult to interpret, a discussion with a healthcare professional can help you understand their causes more clearly.

How much does menopause cost Italian companies?

The “Menopause and work” survey estimates the cost of days of absence related to menopausal symptoms alone in Italy at around €112 million a year, calculated using INPS data and the 14.30% of working women who report having taken leave for these reasons. The estimate excludes presenteeism and turnover costs, so the real cost is likely higher.

Is there a law on menopause in the workplace in Italy?

There is currently no legislation specifically dedicated to menopause. However, Legislative Decree 81/2008 requires risk assessments to consider gender differences and age, while UNI/PdR 125:2022 on gender equality certification assesses human resource management and work-life balance policies. The subject is also being addressed by the parliamentary intergroup on menopause.