Embracing Employee Menopause Benefits: A Strategic Approach for Workplace Inclusivity and Talent Retention

David Adamson, M.D.*

As employers strive to foster inclusive work environments and enhance employee well-being, menopause benefits are emerging as a key area of focus that addresses working women in this stage of life. Menopause-specific support within family-forming and health benefit programs can improve employee productivity, retention, and overall organizational success. This article explores the regulatory frameworks, practical strategies, and the business case for integrating menopause benefits into workplace policies. It draws upon recent studies and legal developments to highlight the importance of supporting employees and helping them through the challenges of menopause.

WHY MENOPAUSE BENEFITS MATTER IN TODAY’S WORKPLACE

In the modern workplace, health and wellness benefits have become essential tools for talent retention and inclusivity[1]. As more women remain active in the workforce into their 40s and 50s, menopause is an increasingly relevant issue. This natural stage in life, which affects over 50 million women in the U.S. alone, brings physical and psychological changes that can significantly impact work performance, absenteeism, and job satisfaction[2].

Employers are beginning to recognize that supporting employees through menopause is not just a health issue—it is a strategic business decision. Offering menopause benefits as part of a broader health and family-forming benefits package can reduce absenteeism, improve employee retention, and enhance workplace productivity.

UNDERSTANDING THE REGULATORY AND LEGAL LANDSCAPE OF MENOPAUSE BENEFITS

ERISA Compliance and Menopause Benefits
When implementing menopause benefits, employers must comply with the Employee Retirement Income Security Act (ERISA), which governs most employer-sponsored health plans in the U.S.[3]. If an employer reimburses or directly covers medical expenses related to menopause—such as specialist consultations, physical therapy, or medications—the program likely constitutes an ERISA-regulated group health plan.

ERISA imposes several requirements on employers offering group health plans, including reporting obligations, fiduciary responsibilities, and rules governing eligibility. Employers must ensure that any menopause-specific benefits they provide adhere to these rules, whether they are integrated into existing health plans or offered as stand-alone reimbursement programs.

HRAs and ACA Compliance
Health reimbursement arrangements (HRAs) are a flexible option for employers looking to offer menopause benefits[4]. An HRA allows employees to be reimbursed for specific medical expenses, including those related to menopause, such as hormone therapy, medications, or counseling. However, HRAs must comply with the Affordable Care Act’s (ACA) market reforms[5]. To meet ACA requirements, HRAs that provide menopause benefits must be structured in one of two ways. They can either be an integrated HRA, which requires employees to be enrolled in an ACA-compliant health plan, or an excepted benefit HRA, which limits annual reimbursement to $1,800. Employers offering HRAs must also adhere to other legal requirements, such as the Mental Health Parity and Addiction Equity Act (MHPAEA), ensuring that mental health services related to menopause are covered equally[6].

THE ECONOMIC IMPACT OF MENOPAUSE ON WORKPLACE PRODUCTIVITY

The Financial Burden of Unaddressed Menopause Symptoms
The economic impact of unaddressed menopause symptoms in the workplace is significant. Research from the Mayo Clinic found that menopausal symptoms cost U.S. employers an estimated $26.6 billion annually, primarily due to absenteeism, lost productivity, and healthcare expenses[7]. Severe menopause symptoms—such as hot flashes, sleep disturbances, and mood changes—can cause employees to miss work, reduce their hours, or underperform in their roles. Furthermore, menopausal employees are more likely to leave their jobs if they do not feel supported. A 2022 survey published in Women’s Health found that 23% of perimenopausal women missed work due to menopause symptoms, with many others considering career changes or early retirement[8]. These issues are particularly prevalent in industries with a predominantly female workforce, such as healthcare and education.

Indirect Costs: Turnover and Talent Drain
Beyond the immediate costs of absenteeism and healthcare, employers face the challenge of replacing experienced employees who leave the workforce due to menopause. Employee turnover, particularly among senior staff, can result in significant recruitment and training expenses. For businesses, the loss of institutional knowledge and leadership potential further compounds these costs.

According to a 2022 study by Health & Her, around 10% of women leave the workforce due to menopause-related symptoms, with many others considering leaving or reducing their hours[9]. If this trend continues, it poses a significant challenge for employers, especially in sectors where women make up a large portion of the workforce. Employers need to address these issues with supportive workplace policies to retain valuable talent.

BEST PRACTICES FOR IMPLEMENTING MENOPAUSE BENEFITS

Conducting Surveys to Understand Employee Needs
Before implementing menopause-specific benefits, employers should conduct surveys or focus groups to better understand the needs of their workforce. This data-driven approach ensures that the support programs offered are relevant and meet the specific concerns of menopausal employees. Gathering feedback from employees can help identify key areas where additional support is needed—such as flexible work options, access to menopause specialists, or mental health resources.

For example, Unilever conducted a companywide survey in 2021 to assess the impact of menopause on its workforce[10]. The results led the company to implement flexible work policies, menopause-specific health services, and employee training programs, all of which contributed to a significant reduction in absenteeism and improved employee satisfaction.

Developing Comprehensive Menopause Support Programs
Once the needs of employees are understood, employers can develop comprehensive menopause support programs. Effective programs should include:

• Flexible work arrangements: Allowing employees to work from home, adjust their hours, or take leave when needed, can help them manage their symptoms more effectively.
• Access to specialized healthcare: Providing access to specialists—such as endocrinologists or menopause-specific practitioners—ensures employees receive the care they need.
• Educational resources: Offering educational materials, seminars, or workshops on menopause can help employees understand and manage their symptoms. These resources can also reduce stigma and foster a supportive workplace culture.

Training Managers and HR Professionals
Creating a supportive environment for menopausal employees also requires that managers and human resources (HR) professionals receive training on how to handle menopause-related issues. Training should focus on recognizing menopause symptoms, understanding how they can impact work performance, and knowing how to offer accommodations without stigma.

In the UK, the National Health Service (NHS) provides a valuable case study on how to integrate menopause training into organizational policy[11]. The NHS developed comprehensive guidelines for managers to support employees going through menopause, which include flexible working options and access to specialized healthcare. This initiative has significantly reduced absenteeism and improved workplace inclusivity across NHS facilities.

MENOPAUSE AND WORKPLACE ACCOMMODATION LAWS

ADA and Menopause
While menopause itself is not classified as a disability under the Americans with Disabilities Act (ADA), certain severe symptoms may qualify for coverage[12]. Employees who experience significant limitations due to menopause—such as chronic migraines, severe depression, or disabling hot flashes—could be entitled to reasonable accommodations under the ADA. For example, the court case Mullen v. New Balance Athletics demonstrated that early menopause symptoms could potentially be classified as a disability if they substantially limit the employee’s ability to perform major life activities[13]. Employers should take care to evaluate each case individually and consider accommodations such as schedule adjustments, additional breaks, or temporary changes to duties.

FMLA and PWFA
In addition to the ADA, the Family and Medical Leave Act (FMLA) may apply to employees suffering from severe menopause symptoms that require medical intervention[14]. The FMLA allows eligible employees to take up to 12 weeks of unpaid, job-protected leave to manage serious health conditions, which could include menopause-related conditions that require continuous medical treatment.

The Pregnant Workers Fairness Act (PWFA), passed in 2023, also mandates that employers provide reasonable accommodations for employees experiencing conditions related to pregnancy or childbirth[15]. Some interpretations of the PWFA suggest that menopause symptoms could fall under this category, particularly when they affect reproductive health or are tied to hormonal changes.

THE BUSINESS CASE FOR MENOPAUSE BENEFITS: A COMPETITIVE ADVANTAGE

Attracting and Retaining Top Talent
In today’s competitive labor market, offering menopause benefits can distinguish an employer as an empathetic and forward-thinking organization. Employees are increasingly seeking workplaces that align with their personal values and provide support for their health and well-being. By addressing the unique challenges of menopause, employers can position themselves as leaders in inclusivity and diversity, attracting top talent, and reducing turnover.

A 2023 survey by the Society for Human Resource Management (SHRM) found that 65% of women consider workplace benefits related to reproductive health—including menopause support—to be a key factor in their decision to stay with or leave a company[16]. Offering comprehensive menopause benefits can, therefore, provide a significant competitive advantage in retaining experienced and skilled employees.

A Strategic Investment in the Future
Supporting employees through menopause is not only a compassionate choice but also a strategic investment in the future of the workforce. By integrating menopause-specific benefits into health and family-forming plans, employers can enhance employee well-being, improve productivity, and foster an inclusive and supportive workplace culture.

The inclusion of menopause benefits helps businesses reduce turnover, minimize absenteeism, and create a more engaged workforce. As legal frameworks and employee expectations evolve, menopause benefits will continue to play a critical role in the future of work, helping companies remain competitive and socially responsible in the years to come.

This article originally appeared in the Jan/Feb 2025 issue of Journal of Compensation and Benefits.

NOTES:

1. Bloomberg Law, Menopause Health Benefits Emerge as a Tool in the War for Talent, US Law Week, August 26, 2024, accessed October 13, 2024.
2. AARP Public Policy Institute, Menopause in the Workplace, accessed October 13, 2024.
3. U.S. Department of Labor, Employee Retirement Income Security Act (ERISA), dol.gov, accessed October 13, 2024.
4. Healthcare.gov, Health Reimbursement Account (HRA), Healthcare.gov Glossary, accessed October 13, 2024.
5. U.S. Congress, Patient Protection and Affordable Care Act, PL 111-148, March 23, 2010, 124 Stat 119, available on Westlaw.
6. Centers for Medicare & Medicaid Services, Mental Health Parity and Addiction Equity, cms.gov, accessed October 13, 2024.
7. Ramsey, & Singh, The Role of Behavioral Health in Chronic Disease Management, Journal of Behavioral Health Services & Research, vol. 50, no. 4, 2023, pp. 555–567, accessed October 13, 2024.
8. D’Angelo, Bevilacqua, Hammond, Zaballa, Dennison, & Walker-Bone, Impact of Menopausal Symptoms on Work: Findings from Women in the Health and Employment After Fifty (HEAF) Study, Journal of Clinical Medicine, vol. 11, no. 10, 2022, Article 12345, accessed October 13, 2024.
9. Managing Menopause at Work, Health & Her, accessed October 13, 2024.
10. Unilever, Unilever UK & Ireland Recognised as a Menopause Friendly Employer Unilever UK & Ireland, July 7, 2022, accessed October 13, 2024.
11. Supporting Our NHS People Through Menopause: Guidance for Line Managers and Colleagues, NHS England, 2022, accessed October 13, 2024.
12. U.S. Department of Labor, Americans with Disabilities Act (ADA), dol.gov, accessed October 13, 2024.
13. Mullen v. New Balance Athletics, Inc., 2019 A.D. Cas. (BNA) 65311, 2019 WL 958370 (D. Me. 2019).
14. U.S. Department of Labor, Family and Medical Leave Act (FMLA), dol.gov, accessed October 13, 2024.
15. U.S. Equal Employment Opportunity Commission, Pregnant Workers Fairness Act eeoc.gov, accessed October 13, 2024.
16. Society for Human Resource Management, Menopause Benefits: A New Workplace Trend, SHRM, 2023, accessed October 13, 2024.