Your Best Women Are Quietly Disappearing. Perimenopause Is Why.
Perimenopause costs U.S. companies $26.6 billion a year. Your most experienced women are burning out, downshifting, and leaving during the exact years they should be running things. Here's what the research says, and what you can actually do about it.
Hi Besties.
We are tired. Not checked out. We are not less ambitious. We are managing up to 72 symptoms, most of them invisible, while running your teams, closing your deals, and pretending everything is fine. The research is damning. The silence is optional. The good news is it is not happening to men and you can quote me.
Let me tell you about a woman I know.
She's 47. VP of Operations at a company she's spent twelve years building. She's the person her CEO calls when something is actually on fire. Now maybe she has lost that fire. She seems distracted or harder to read. She also has a new found short fuse. SHE IS TIRED.
What her company doesn't know, and what she hasn't told anyone, is that she hasn't slept through the night for months. That she spent her last meeting convinced she was having a heart attack or dementia, or new found anxiety. Maybe she couldn't remember what the meeting she was leading was about, right after she stood in the parking garage for three full minutes trying to remember where she'd parked. Thank you Find My. Not everyone has all or any of these symptoms but if you are her I am guessing you have some. The crazy part is women are so powerful that most of us just handle whatever it is until it starts affecting things like her goals, dreams and yes, job.
Not because she's losing it because her estrogen is crashing, her progesterone is gone, and nobody, not her doctor, not her HR department, not a single leader at her company, has ever said the word perimenopause to her out loud. It kind of feels like boxing shadows. How does one explain this. Our careers are usually based on being strong and all of these things can leave you feeling weak and companies are paying for it.
She's every third woman in perimenopause. One out of three.
Since we are in work mode lets talk stats.
$26.6B Annual cost to U.S. companies in lost productivity and healthcare. (Mayo Clinic Proceedings, 2023)
20% of the entire female U.S. workforce is between ages 45 and 54. (U.S. Bureau of Labor Statistics)
76% of women ages 40 to 49 say perimenopause has hurt their job performance. (Bonafide State of Menopause, 2024)
15% of companies have any menopause benefit at all. (Mercer Survey, Spring 2024)
The Leadership Pipeline Has a Leak. Nobody's Named It.
I mean how does anyone know if we don't? But besties, this is changing.
There's a conversation happening in boardrooms right now about why women aren't breaking through to senior leadership at the rate everyone expected. People are talking about bias, childcare, flexible work, sponsorship gaps. All real. All worth fixing.
But there's one factor nobody's naming.
Women ages 45 to 54 make up 20 percent of the female U.S. workforce. That's not a footnote. That's your directors, your VPs, your senior managers. The women with fifteen years of institutional knowledge. The ones who train everyone else. The ones who have seen every market cycle and still show up. For starters.
They are also, statistically, in the middle of the most physiologically disruptive transition of their adult lives.
And your company has no idea.
"The effect of menopause on working women in midlife is a potentially unrecognized reason for the leaky leadership pipeline and the paucity of women in senior leadership positions." Mayo Clinic Proceedings, 2023
That's not my line. That's the Mayo Clinic. From a peer reviewed study. The institution you put on every healthcare vendor pitch deck just said your leadership pipeline problem might be a perimenopause problem. Woah.
And most HR departments have never read it.
What's Actually Happening in Her Body and in Your Conference Room.
Perimenopause isn't just hot flashes. It isn't just the thing that happens right before a woman turns fifty. It can start in a woman's late thirties. It can last seven to fourteen years and across that entire stretch, it can produce up to 72 documented symptoms across 12 body systems. Sleep disruption. Anxiety. Brain fog. Joint pain. Mood dysregulation. Heart palpitations. All sourced from peer reviewed research. That doesn't include the dry inside of my nose so can I dare say 73?
The ones that hit work hardest? The invisible ones. The cognitive ones.
More stats for you smart little cookies. Between 62 and 67 percent of women experience cognitive symptoms during perimenopause, including difficulty concentrating, losing their train of thought, forgetfulness, and challenges with multitasking. (Reuben et al., International Neuropsychological Society, 2025)
Longitudinal studies find measurable declines in verbal memory and learning as women transition through perimenopause. Changes not explained by age alone. (Maki & Jaff, Menopause Journal, 2024)
Work stress and financial stress are independently associated with worse cognitive outcomes during perimenopause. Meaning a high pressure work environment actively amplifies symptoms. (ScienceDirect systematic review, 2022)
Read that last one again. Who is not stressed at work? I mean unless you are a yoga teacher or someone with a random no stress job, that is all of us.
A high pressure work environment makes symptoms worse. The jobs with the most at stake are the ones hardest to survive without support. Your most ambitious women, in your most demanding roles, are the ones most at risk. So how can they be supported?
72 percent of them are hiding it. Not because they're not resilient. Because they've learned, over decades, that showing anything other than fine at work has consequences. So relatable.
72% of menopausal women hide their symptoms at work. Only 31% feel comfortable talking about it.
The Money Because Sometimes That's What Actually Gets People to Listen.
I didn't build KRUUSH to pitch to corporations. I built it because perimenopause blindsided me and many of my friends and I just started talking. The more I talked the more I realized that MY FRIENDS were suffering. Some worse than others but most didn't know why. It almost sounded like they were giving up, this was life now. Back to KRUUSH. I have spent many years in business building brands and everyone was inspired by women. I just love humans. I love business and I see a need. Call me crazy and I just may be but even writing this feels good. The idea of helping feels good. Back to business.
The Mayo Clinic estimates perimenopause costs U.S. companies $1.8 billion in lost work time annually. Add healthcare costs and the number climbs to $26.6 billion per year. Globally, AARP research puts worker productivity losses at $150 billion, with related healthcare costs exceeding $600 billion.
Stanford researchers followed women who sought care for menopause symptoms and found they were earning 10 percent less four years later. Primarily because they cut back hours or moved to less demanding roles. Not because they stopped caring. Because they were managing something alone that nobody helped them manage.
54% of women going through menopause considered changing jobs or cutting hours to cope. (Carrot Fertility Survey)
1 in 10 women have declined a job opportunity because the company had no menopause support. (Catalyst Global Survey, 2024)
10% earnings decline four years after seeking menopause care, due to reduced hours or role changes. (Stanford SIEPR, 2025)
You know what replacing a senior leader costs. Anywhere from 50 to 200 percent of their annual salary when you account for recruiting, onboarding, and the institutional knowledge that walked out the door with them. The woman who downshifted or quietly left because nobody acknowledged what she was going through? That exit had a price tag. It just never showed up in a line item labeled perimenopause.
What Black Women and Women of Color Are Facing And Why This Isn't a Monolith.
I want to say this clearly, because too much of the conversation around menopause centers one experience and calls it universal.
Research published by the Mayo Clinic found that Black women are nearly three times more likely to report an adverse work outcome related to menopause than their white counterparts. Hispanic women also reported higher rates of work disruption. Research has also shown that Black women tend to experience longer menopausal transitions and more severe vasomotor symptoms on average.
Any workplace program that doesn't account for this, that treats menopause as one experience with one solution, isn't doing the work. It's checking a box.
What 84 Percent of Women Are Actually Asking For
A Catalyst survey of nearly 2,900 full time employees across eight countries found 84 percent agreed their workplaces needed more menopause support. These weren't women asking for special treatment. Here's what they actually said they needed:
Flexible work arrangements and time off options. Adjustments to the physical environment like temperature control and private spaces. Medical insurance that covers menopause related care. Access to menopause informed healthcare professionals. Education and awareness for everyone, not just the women going through it.
Notice what's not on that list. A pity policy. A special program that makes women feel marked. What they're asking for is basic: be seen, be supported, and stop making this a secret they have to keep to protect their career. This goes back to why we need data. Another driver for me.
The Honest Reason Companies Haven't Moved on This
It's not malice. In my experience, it's usually one of three things.
The first is that nobody in the room is going through it yet or nobody who is, is willing to say so. Perimenopause is still treated as something embarrassing. A women's issue whispered about rather than a workforce issue addressed head on. It feels dismissive and daunting. Perimenopause rhymes with game over when you read everything on the internet. That does not feel sexy. It feels scary.
The second is that companies are waiting for the category to feel mainstream enough to justify the budget. Meanwhile, as of spring 2024, only 15 percent of companies surveyed by Mercer had any menopause benefit at all. First movers in this space will have a talent advantage that compounds.
The third is that they don't know where to start. Which is the one I can actually help with.
What Actually Works. Based on the Data, Not a Vendor Pitch.
Name It. The single highest ROI action any company can take costs nothing. Say the word perimenopause in a leadership meeting, put it in your wellness communications or add it to your sick leave policy as a qualifying reason. Normalize it. The research on what happens when workplaces normalize menopause conversations shows the same thing every time: women stay longer, perform better, and trust their employers more. Naming it doesn't make it bigger. Silence makes it bigger. And lonelier.
Educate Managers First. The research on what perimenopausal women want from their managers is consistent: they want their manager to know what's happening, even if they don't want to discuss it themselves. That requires managers to have basic literacy. Not medical training, just the understanding that a 46 year old who seems off might be managing something real, that flexible scheduling is a legitimate accommodation, and that "she seemed distracted" is not a performance review. Women can carry babies, we work, and we don't want to now carry the burden of our hormones making adulting that much harder too.
Fix the Healthcare Gap. Only one in five OB/GYNs in the U.S. is trained in menopause care. Your female employees over 40 are probably not getting the information they need from their existing providers. Telehealth HRT platforms have made specialized menopause care more accessible than it's ever been. If your benefits package doesn't include a pathway to menopause informed care, you are leaving your employees to figure it out alone and that will cost the company money. Investing in women will not only benefit us, it will benefit the companies. Win/win.
Give Them the Data. The women going through this often don't have the language for it yet. They don't know their brain fog is hormonal. They don't know their panic attacks might be perimenopause. They don't know that the anxiety keeping them up isn't a character flaw. It's estrogen fluctuation. Information is the first intervention. It doesn't require a doctor's appointment or a benefits overhaul. It just requires someone to tell the truth clearly and source it properly.
"For every woman at the director level who gets promoted, two female directors are choosing to leave their company."— McKinsey, Women in the Workplace Report
That's from McKinsey. Two leave for every one who rises. The pipeline doesn't just have a leak. It has a rupture and at the exact moment it's rupturing, the women walking out the door are statistically most likely to be in perimenopause. That's not a coincidence. That's a policy failure we've been calling a pipeline problem.
Here's What I Know for Certain
The woman in the parking garage trying to remember where she parked? She went home that night and searched for answers and we all know that usually lands us on WebMD. She found KRUUSH. She took the symptom checklist and checked 34 of 72 boxes. I checked 22. She downloaded the tracker and started logging her data. Thirty days later she walked into her doctor's office with a month of evidence and walked out with answers she'd been waiting two years for.
She doesn't need her company to fix her hormones. She needs someone to tell her the truth about what is happening. She needs the information to exist somewhere she can find it. And she possibly needs help.
Your companies can't afford to keep losing us.
On a final personal note. As someone who has run and owned companies, I get it. How do you quantify something that is unique and often invisible to the eye? (Minus the hot flashes.) A pregnancy is visual and perimenopause is not, but I can assure you it is real. Companies will benefit from at least trying to recognize it because time has shown it is here to stay.
Hugs and health
Amber
SOURCES:
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Mayo Clinic Proceedings. "Impact of Menopause Symptoms on Women in the Workplace." 2023. Faubion SS et al.
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AARP Research. "The Economic Impact of Menopause." January 2024.
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Bonafide. "State of Menopause Survey." 2024.
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Mercer. Benefits survey data, Spring 2024.
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Catalyst. "Menopause Workplace Support: Global Survey." October 2024.
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Stanford SIEPR. Petra Persson. "Menopause and the Economics of Work." March 2025.
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McKinsey & Company. "Women in the Workplace 2023."
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Reuben C, et al. Journal of the International Neuropsychological Society. 2025.
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Maki PM, Jaff NG. Menopause Journal. 2024;31(7):647–649.
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ScienceDirect. Systematic review on cognition in perimenopause. Maturitas, 2022.
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U.S. Bureau of Labor Statistics. Female workforce age distribution, 2022.
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Carrot Fertility. "The Cost of Menopause in the Workplace."
DISCLAIMER (small text): KRUUSH is a wellness content platform, not a healthcare provider. Nothing in this article constitutes medical advice. All statistics are sourced from peer reviewed research or named surveys, cited above. Individual experiences vary. Always consult a qualified healthcare provider for medical decisions.
Ready to bring this conversation to your company? KRUUSH is building resources for HR and DEI leaders who are done watching this problem get labeled something else. Get in touch
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Health Notice: KRUUSH is a wellness content platform, not a healthcare provider. The information on this page is for educational and informational purposes only and isn't a substitute for professional medical advice, diagnosis, or treatment. Always talk to your healthcare provider before making health decisions. Full terms.