For so long, women have suffered in silence with symptoms of perimenopause and menopause without support from employers. This affects not just the individuals, but it can also affect a company's bottom line. So why aren't more employers making an effort to support their employees navigating these changes?

Menopause is defined by going at least twelve months without a menstrual period. It most commonly occurs in the 50s, and the average age in the U.S. is 52. It may be a natural result of the aging process, induced by surgery or medication or related to an underlying health condition. That said, the transition period, aka perimenopause, which typically starts in the 40s or 50s can be marked by uncomfortable symptoms that can impact quality of life and work performance.

Here's what women's health experts have to say about how perimenopause and menopause can disrupt work life and how companies can better support their employees going through these changes.

While they're often brushed off as "just a part of the process," perimenopause and menopause symptoms can be incredibly disruptive to someone's workday and diminish their overall quality of life.

Dr. Jen Gunter, MD, Bay Area OB/GYN and Author of The Menopause Manifesto and Dr. Judith Joseph, MD board-certified psychiatrist, researcher, award-winning content creator and author of High Functioning are two of the practitioners leading the new "Magic Of Menopause" class offered on streaming on educational platform MasterClass, along with Halle Berry, Oscar-winning actor, director, producer, and founder of women's Longevity Community, Respin.

Dr. Gunter says, "Menopause can be disruptive for some women and not for others; just like pregnancy, there is a range of experiences. When women are having medical concerns, they may feel embarrassed to mention it."

Shawn Tassone, MD, PhD, aka America's Holistic Gynecologist and author of The Hormone Balance Bible, adds that even when they do mention the issues they're having, their concerns are often dismissed and requests for accommodations are not taken seriously, "In the medical industry, as in most industries, people simply don't listen to women. When they go to HR or complain to their bosses, even in cases where that HR person or boss is a female, they tend to get gaslit," or made to feel that they're asking for too much.

Again, while every woman's experience is different, some very common symptoms include difficulty focusing or concentrating due to lack of sleep, interruptions from hot flashes, and brain fog, says Dr. Gunter. "Women may also need more time from work to attend healthcare appointments. They could also miss work because of heavy bleeding, or bladder infections, or depression." Many women also experience mood changes, anxiety and decreased energy levels due to hormonal shifts, all of which can have a negative impact on work performance.

Dr. Joseph adds that changes in body composition and feeling like they are less capable of working at the capacity they're used to may also damage women's self- esteem, contribute to excessive worrying, and diminish quality of life, making it even harder to function. What's more, she says, is that "may shy away from projects, not go for leadership positions or step down. Others may perceive the individual as no longer being competent." This lack of understanding worsens the gender pay gap.

Demystifying the experience can be incredibly helpful, however, especially for those going through perimenopause and menopause. She explains "Our brains impact our bodies and our bodies impact our brains. Understanding the mind-body connection helps patients to know why they are experiencing mental and physical symptoms of perimenopause and menopause." Being able to understand why these changes are happening and what these changes mean can make them less likely to self-blame and to feel shame, she says.

For those working in an office, says Tassone, "it would be great for businesses to provide aid for women who need help. They could have a lecture series or pay for these women to have memberships in a program where they can benefit from learning from an expert." Tassone, who has worked with companies on setting up these kinds of initiatives, also suggests creating programs where women receive assistance paying for menopause-related healthcare visits and medications, if applicable. Dr. Gunter adds that period products in the office bathroom, adequate leave and ability to change the temperature can go a long way to support employees as well.

While some find that being able to work from home allows them to control better their environment (like keeping the thermostat at a comfortable temperature) and manage their energy, others may find it more challenging, especially if they're dealing with brain fog. All that alone time can begin to feel isolating as well.

Tassone says that in many ways, accommodations women may benefit from are similar to those working in an office, "but I think that it can be even more isolating, especially if they are expressing concerns about their symptoms but aren't being listened to by their house or their children or other at large employees." In addition to seeking the help of a healthcare provider with training to support them, he also recommends incorporating healthy everyday habits to help them feel better, such as engaging in more outdoor activities. "Even just walking in the sunshine and getting more grounded can help you feel a little better and work better."

Dr. Gunter adds that flexible working hours or environment, such as the option to work from home when needed if they are normally working in the office, can be helpful as well.

While he wishes that more companies were quick to validate menopause related concerns and provide support, he says, "I think women need to be their own best advocates." He also suggests that HR departments keep an up-to-date list of perimenopause and menopause symptoms to help them discern how to aid. If needed, he adds, they could request a doctor's note from the employee seeking help.

Dr. Joseph says, "Training employers and teams about physiology, biology and neurological changes will decrease stigma. Diverse workplaces benefit us all. Women should not be discarded because they are experiencing challenges, they should be supported. When a woman is in midlife she is often at the peak of her expertise and experiences and has so much to offer. We should recognize when she needs help, offer her training and executive skills training or organizational skills training and support her. The workplace should cover things like HRT, sleep interventions, and behavioral health services in their benefits plan to keep her in the workplace by supporting her."

Additionally, she says, "modifying workflow so that she is focusing on one thing of priority if she finds this beneficial may help until symptoms resolve. Some workforces have accommodations for things like ADHD and neurodivergence, and it would be helpful to have accommodations to support women who have the mental health symptoms of perimenopause and menopause that cause them to struggle. The same is the case for women who may develop severe depression and anxiety or other worsened mental health symptoms. They need support not shame."

Dr. Gunter says "Having managers aware of menopause and having education sessions can signal to women that it is safe to discuss if they need accommodations. Even being able to control the temperature in a room can be helpful...Studies tell us that many women are suffering from symptoms at work, so when workplaces get involved, it can be beneficial for all."