Menopause, a career killer? How brain fog, hot flashes and fatigue are driving one in 10 women out of the workforce

Like a lot of perimenopausal women, Joan Davis (not her real name), a senior manager in Toronto, is starting to notice changes in her body — and her brain.

“I have a combination of brain fog and forgetfulness that I’m not used to,” said Davis, who describes her symptoms as “pretty severe.” (Perimenopause, the period prior to the end of menstruation, can kick in as early as the mid-30s and is associated with depression and other mood disorders.) “I don’t think it’s impacted my work yet, partly because I’ve had the luxury of working from home. Now that we’re starting to go back to the office, I’m worried that people will be able to notice it more.”

Davis says her own experience with perimenopause has made her think back to the stalled careers of a half-dozen or so women she’s worked with over the past decade. She wonders how many of them hit that “glass ceiling,” in part because they were also quietly dealing with brain fog and other potentially career-limiting symptoms experienced before and during menopause.

Davis’ concerns aren’t such a stretch. According to the Menopause Foundation of Canada, one in 10 women will leave the workforce because of their menopause symptoms. For most of us, it will happen when we need to be firing on all cylinders at work.

“There’s a real overlap between when menopause tends to happen and the moment when a lot of women are poised for leadership positions that could take their careers to the next level,” said Sonia Kang, Canada Research Chair in Identity, Diversity and Inclusion, and an associate professor at the Rotman School of Management. “If they’re also experiencing common menopausal symptoms like depression, fatigue or anxiety, it could prevent them from making it to top-tier positions, even though they were on that trajectory.”

It turns out that menopause is an epic equity issue.

One-quarter of people in the workforce in Canada are over the age of 40, which means that a significant percentage of working women are either entering or already in their perimenopausal years, said Janet Ko, president and co-founder of the Menopause Foundation of Canada. “It makes sense for companies to start considering how they can support women better during this stage of their lives.”

Losing women with experience and expertise hurts organizations for all of the obvious reasons. It’s also bad for the health of our society, since countries with greater gender equality prosper.

Still, it can be an uphill battle to get accommodations for menopause written into official policy. In late January, the British Parliament rejected a proposal for a pilot “menopause leave” project on the grounds that it could “discriminate against men.”

What would a menopause “leave” look like? Probably more like a series of thoughtful accommodations, as opposed to a prescribed period of time off, because menopause — and perimenopause — is frustratingly unpredictable.

“The perimenopausal years can last anywhere from seven to 10 years,” said Ko. “While every woman’s experience is different, most tend to have some pretty significant hormonal fluctuations then.” Some women continue to have symptoms well past menopause. “We know of women in their 70s who are still having hot flashes.”

Oh. Good.

Rotman’s Sonia Kang said that some of the resources (such as mental health support) needed to deal with symptoms of menopause already exist in many workplaces. She suggests that what’s needed is an open culture in which people can discuss and be made aware of all the options. Many women are afraid to talk about menopause at work, for fear that they will face more discrimination, thanks to the intersection of age and gender discrimination.

A “Pausitivity” campaign in the United Kingdom aims to tackle the stigma associated with menopause. The movement is already making a difference — the head of the U.K.’s National Health Service recently advised that women be given the options of cooler uniforms and access to fans in the workplace.

Amanda Thebe, a Toronto fitness and health professional and author of the book “Menopocalypse,” who has recently been acting as a consultant to employers trying to make workplaces more “pausitive,” said this is exactly the kind of thinking we need more of.

“Sometimes it’s small accommodations, like creating a cooler work environment or an office with dedicated quiet spaces,” said Thebe. “Sensitivity to noise is a common symptom during menopause, so it’s helpful to have a place people can go to so they can get away from Bobby eating his noisy lunch one desk over.”

Including Bobby (and other men) in the process of addressing menopause at work is key to making important changes, said Thebe.

“I’ve found when men are brought into the conversation, they’re not going to be dismissive,” she said. “They actually want this information so they can support their women colleagues, an elite workforce with decades of knowledge.”

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