Across industries, employers are grappling with how to support a workforce whose health needs are becoming more complex and more visible. And yet some of the most consequential life changes shaping modern ways of working remain largely invisible.

Menopause is one of them.

For many women, the menopause transition – covering perimenopause and menopause – brings changes that quietly or debilitatingly affect sleep, concentration, confidence, and physical comfort. A manager may notice a once-high performer struggling with fatigue. A team may experience rising absenteeism or disengagement. An experienced and dynamic leader may consider stepping back. What rarely appears in the data, however, is the underlying cause or how to address it.

Menopause does not show up clearly in claims experience data or benefits utilization dashboards. It rarely appears as a discrete diagnosis that can be easily extracted or identified as a population health need. Instead, it shows up indirectly in patterns of burnout, turnover, lost productivity, and strained workplace relationships across some of the most experienced segments of the workforce.

This invisibility helps explain a paradox many employers face. Roughly one in five workers is estimated to be in the menopause transition today, and approximately 1.3 million women in the United States enter menopause each year. Yet this transition has historically remained peripheral in workplace health, benefits, and policy conversations, not because it is rare or unimportant, but because it has been difficult for organizations to see and address within the systems they use to manage workforce health.

That invisibility was reinforced by a long-standing research gap. Following early 2000s NIH guidance that discouraged the use of hormone therapy, the menopause transition received limited clinical research attention for nearly two decades, leaving employers, clinicians, and workers alike with few evidence-based frameworks for understanding or addressing its impact.

That reality is now beginning to shift. Over the past few years, new research, growing public dialogue, and increased employer engagement have started to bring this transition out of the shadows and into the center of workforce health conversations. As expectations rise, the absence of clear frameworks is becoming a liability rather than a gap, exposing employers to inconsistent experience, leadership friction, and avoidable attrition.

The Evolving Landscape of Menopause at Work

Since the 2023 debunking of that flawed NIH study conclusions, the menopause transition has become more visible in public and workplace dialogue. Workers are increasingly speaking up about their experiences. Media coverage has expanded. Employers who once felt unsure whether menopause belonged in workplace health conversations are now far more willing to engage.

This shift matters. It reflects a growing recognition that menopause impacts workforce participation, retention, and equity, particularly among experienced and highly skilled employees whose leadership and institutional knowledge are critical to organizational stability.

At the same time, this surge in visibility has not always been accompanied by clarity. As interest has grown, so has a patchwork of pilots, point solutions, and vendor offerings, often launched without a shared definition of what meaningful support should look like. When RMH Compass first began integrating menopause into the Performance Standard in 2023, there was no emerging set of workplace norms to anchor against. Employers were experimenting, but few had a way to evaluate whether those efforts were reaching workers in a consistent, usable way.

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While more organizations now offer some form of menopause-related support, far fewer employees know what exists, how to access it, or whether it can be used safely and without stigma. The gap is acutely felt among mid-market employers—roughly 250,000 U.S. companies that collectively employ 65–70 million workers—whose lean HR teams struggle to translate emerging expectations into consistent experience. These HR teams aren’t able to consistently unpack reimbursement data to confirm whether existing benefits truly meet menopause-related needs.

This gap between intent and impact is not a failure of commitment. It is a reflection of how difficult it is to manage something that does not show up cleanly in traditional data. Health care claims and benefits utilization reports rarely capture the cognitive, emotional, and physical effects of the menopausal transition. As Kacy Fleming, an award winning workplace wellbeing and women’s health expert and the former Head of Global Wellbeing at Takeda explains ”leaders may see rising burnout, disengagement, or turnover without ever seeing menopause as the underlying driver, and/or being nervous to broach the topic with direct reports. Instead they say nothing, and the employee often continues to feel alone and poorly resourced.”

“Because the symptoms are poorly understood, and the solutions are fragmented, employees remain unaware and unlikely to utilize available resources.”

—Kacy Fleming, Founder & CEO of The Fuchsia Tent

**Kacy Fleming,**
Founder and CEO
The Fuchsia Tent LLC

Kacy Fleming is a leader in workplace menopause support and advises employers on benefits and workforce health. Her work has influenced best practices for supporting employees through menopause.

Fleming’s recent research explains this gap and potential solutions. “Fleming explains that “most companies already have some combination of benefits and wellbeing offerings that address menopause. Because the symptoms are poorly understood, and the solutions are fragmented, employees remain unaware and unlikely to utilize available resources. In addition, when leaders embrace compassionate leadership — a framework that combines empathy with aligned action— it benefits all employees including menopausal women. By not singling menopause out, women are more likely to seek help, and compassionate dialogue paves the way for complex conversations about everything from health transitions, and caregiving to performance management. Without that shared language and structure, good intent doesn’t consistently translate into experience.”

This challenge reflects a broader pattern in workplace health. Awareness without structure rarely produces consistent experience. What is new, and what RMH Compass has sought to advance, is the ability to bring structure to a part of the reproductive and maternal health life cycle that has been present but unaddressed until now.

Dr. Gillian Goddard
Board-Certified Endocrinologist

Dr. Gillian Goddard is a recognized expert in menopause and women’s hormonal health, offering an evidence-based perspective on the role of menopause care in women’s health and work participation.

What Meaningful Menopause Support Requires

Meaningful menopause support cannot be reduced to a single benefit, vendor, or training program. It is shaped by the interaction between health coverage, workplace policies, leadership capability, and organizational culture.

As Dr. Gillian Goddard, practicing physician and author of The Hot Flash, notes, “Current research tells us that women who receive treatment and support for their menopause symptoms continue to thrive in the workplace. That’s great news for women and employers. We know which medical treatments are effective for the most common menopause symptoms. It’s critical that future research focuses on identifying what types of workplace support are most effective.”

Her perspective underscores an important inflection point. While clinical understanding of menopause has advanced, the workplace context has lagged behind. Knowing which medical treatments work is necessary, but not sufficient, if employees cannot access care, feel safe disclosing needs, or rely on consistent support at work.

From Conversation to Consistency

The latest RMH Compass Performance Standard, released in January 2026, captures the emerging norms, establishing a shared baseline that connects benefits, workplace conditions, leadership practices, and employee experience. Our Standard allows organizations to see whether menopause support is present in practice across the full-spectrum of potential workplace interventions, encouraging organizations to adapt with implementation guides and other resources.

“When developing the RMH Compass Performance Standard, we identified a lack of clear best practices for managing the impact of menopause at work. Our standard helps employers support employees through this transition, offering mid-sized companies a practical, ready-made solution to act quickly.”

—Flory Wilson, Founder & CEO of RMH Compass

Within the RMH Compass Performance Standard, menopause is intentionally embedded across all three pillars of impact, reflecting how support must show up in benefits, workplace conditions, and policy to be meaningful in practice. The standard looks at whether employees can access appropriate menopause care through health benefits and telehealth pathways, whether day-to-day work environments allow for flexibility in dress, temperature, and rest to accommodate symptoms, and whether paid leave policies clearly permit time away from work for reproductive and maternal health needs, including perimenopause and menopause.

Together, these elements move the menopause transition out of the margins and into the systems that shape ways of working, ensuring support is accessible, usable, and applied consistently rather than relying on informal accommodations or individual discretion.

Practical Steps for Employers Getting Started

For employers beginning or formalizing this work, the first step is often assessment. RMH Compass offers a free benchmark to assess the quality and comprehensiveness of existing health benefits and workplace policies and accommodations.

We pair our standards with practical guidance and implementation resources, including just released “Putting Into Practice” guides for our new menopause practices.

Rooting this work in the business imperative is critical – HR leaders need to make a clear, compelling case for the investment in menopause support at work. RMH Compass’s Why It Matters: Supporting the Menopause Transition in the Workplace brief outlines the business case for action.

Looking Ahead

Workplace menopause support will be shaped not by goodwill alone, but by employers who can operationalize menopause support with the same rigor they apply to other workforce risks. As additional norms and best practices for supporting workers through the menopause transition emerge, RMH Compass will capture that evolution in our performance standard.

Standards play a critical role in that shift. They reduce uncertainty, normalize engagement with complex health transitions, and ensure menopause is not left to individual employees to navigate alone. RMH Compass equips employers to take action – whether it’s a first step or comprehensive adoption – to support the reproductive health needs of its workers.