Menopause costs American women an estimated $1.8 billion in lost working time per year, according to a Mayo Clinic study published this week. The paper examined how hot flashes, night sweats, mood swings and the myriad other symptoms associated with this time of life affect women in the workplace. It’s the largest study of its kind to have been done in the United States.
Researchers surveyed more than 4,000 participants at four Mayo Clinic sites in Minnesota, Arizona, Florida and Wisconsin. Roughly 15 percent said they had either missed work or cut back on hours because of their menopause symptoms, which the study classified as “adverse work outcomes.” Those who reported the very worst symptoms were 16 times more likely to report such outcomes than those with the least severe symptoms. A little over 1 percent said that their symptoms had become so debilitating that they either quit their jobs or were laid off in the preceding six months.
“We took that data and extrapolated it based on the work force in the U.S., and that’s how we arrived at the estimated annual loss,” said Dr. Juliana Kling, a co-author of the study and chair of the Women’s Health Internal Medicine division at Mayo Clinic in Scottsdale, Ariz. There are, according to U.S. census data, more than 15 million women ages 45 to 60 in the workplace.
Though a majority of survey participants were white, the researchers found that menopause can have a greater effect on Black and Hispanic working women, Dr. Kling said. “Black women tended to have more menopausal symptoms,” she said. “And higher percentages of Black women and Hispanic women reported adverse work outcomes related to menopausal symptoms compared to white women.”
Several other studies have arrived at conclusions similar to those of the Mayo Clinic study. A smaller survey by the corporate health benefits provider Carrot Fertility found that roughly 20 percent of women took time off from work because of menopause. Researchers at the University of Southampton in England analyzed data from a longitudinal study of over 3,000 women and found that those who reported at least one disruptive menopausal symptom at the age of 50 were 43 percent more likely to have left their jobs by the age of 55.
The findings underscore the physical, economic and social challenges women face as they age, enduring sometimes debilitating physical changes while navigating the discomfort of discussing menopause with younger or male colleagues, said Dr. Ekta Kapoor, a co-author of the study and an endocrinologist at Mayo Clinic in Minnesota. “The topic of menopause is taboo in general but even more so at the workplace,” she said. “I’ve heard from women that they don’t want to come across as a ‘complainer’ at work or they’ll bring up menopause and people will roll their eyes.” This, Dr. Kapoor added, can exacerbate the psychological challenges.
The economic loss calculated by the Mayo Clinic study is likely an underestimate, Dr. Kapoor said, because the women surveyed have access to health insurance and potential treatments for their symptoms, which is not the case for many Americans.
The findings “affirm what patients tell me,” said Dr. Makeba Williams, an associate professor of obstetrics and gynecology at Washington University School of Medicine in St. Louis. (Dr. Williams was not involved with the research.) One of her patients, for example, is a university professor who was so troubled by the brain fog she had during the transition to menopause that she decided to stop teaching advanced level courses, Dr. Williams said. “Her symptoms had gotten so bad, she could not find the next word when lecturing. That story can come in many different versions. Women see in their day-to-day lives that their productivity is impacted.”
But most Americans don’t have the ability to choose to cut back on work the way some women in the study did, Dr. Williams said. “Many women don’t have the privilege of saying I’m just not going to teach this course — because maybe if you don’t show up, you will not have a job, and that has economic and personal financial impact too.”
Two years ago, when Grace Ward was a 44-year-old supervisor at a local library in Kalamazoo, Mich., she started getting intense migraines for the first time in her life — a symptom, she later realized, of perimenopause, the transition to menopause.
“For two to three days a month, I had to keep my head down. The sensitivity to light was just obnoxious,” she said. She also experienced “wild” mood swings and hot flashes that kept her awake at night and she began menstruating twice a month — all of which made her “markedly tired.”
Ms. Ward used up her sick days to take time off work and eventually “my managers were starting to question whether I was still up to it.” That’s when she decided to resign.
“I thought it would be better to leave than be fired,” she said. “It’s horrible that we — as women — have to work through this craziness. I routinely feel bad for us.”