Women Take Pay Cuts and Strugle Through Menopause at Work

Women across the United States are facing significant career setbacks, financial losses, and professional hurdles as they navigate the physical and mental impacts of menopause and perimenopause. According to recent surveys and studies, millions of workers experience symptoms that affect their daily productivity, leading many to scale back their ambitions or leave their jobs entirely.

The Hidden Workplace Impact

Four in 10 women who have experienced menopause or perimenopause state it has negatively affected their life or work, based on a survey of over 3,800 U.S. women conducted by Gallup and Melinda French Gates’ Pivotal. Among those respondents, roughly 28% felt limited in the effort they could give at work, 15% decided against pursuing a promotion or leadership role, 12% reduced their hours, and 10% took an extended leave or did not return to their jobs.

Jasmine Escalera, a career expert at resume builder site LiveCareer, notes that this challenge extends far beyond personal health. A 2023 study by the Mayo Clinic estimated that menopause symptoms drove $1.8 billion in lost work time per year in the U.S. alone. Perimenopause, the transitional period preceding menopause, typically begins in a person’s 40s and brings symptoms such as hot flashes, sleep issues, irritability, and lower energy, according to the Office on Women’s Health. This phase frequently collides with a time when women are breaking into leadership, approaching their peak earning years—often between ages 35 and 44, per Bureau of Labor Statistics data—or caregiving for aging parents and raising children.

Amy Terry, a 50-year-old from Michigan, began experiencing memory loss, low energy, and mental processing difficulties around 2020 while working as a director of programming at a health association. After struggling to find care amid pandemic strains, she learned she was experiencing perimenopause. By 2023, she quit her job to start independent consulting, a move that cost her employer-sponsored healthcare and resulted in an estimated 85% pay cut.

Navigating Stigma and Daily Strugles

Many women are unprepared for these transitions due to social stigma, poor health education, and the dismissal of women’s health issues. Mimi Wied, a 48-year-old from Brenham, Texas, experienced night sweats, sleeplessness, anxiety, and rage. Worried her irritability would impact visitors, she left her job as a museum docent for a secretarial role that paid roughly $20,000 less.

For Erin Levin, a 41-year-old high school English teacher in San Jose, California, perimenopause has brought brain fog, sleep difficulties, and heightened anxiety. As a single mother sharing custody of her child, scaling back financially is not an option. Levin explains that she maintains her appearance of having the same energy and skills as unaffected colleagues, stating she has to white-knuckle it.

Legislative Shifts and Future Hope

Some momentum is building around legislation and employer benefits to address these workplace challenges. Rhode Island enacted workplace protections for women experiencing menopause last year, and Illinois and Philadelphia adopted legislation taking effect in 2027 to provide accommodations. In September, Senators Kirsten Gillibrand and Rick Scott held the first congressional hearing devoted to menopause, while the International Organization for Standardization published the first standard for workplace policies supporting menstruation and menopause.

However, organizational support remains limited. A 2026 study from the Society for Women’s Health Research and The Fuchsia Tent found that around one-third of decision-makers say menopause support is currently in place or planned, while fewer than 10% of employees report their organization offers specific support. Terry, Wied, and Levin all reported needing to see multiple doctors before finding care and obtaining hormone replacement therapy.

Both Levin and Wied hope their daughters will face fewer obstacles when they reach this stage of life. Meanwhile, Terry continues to participate in research examining the mental health impacts of hormonal fluctuations, while managing her consulting work to regain solid ground.