A Working Woman’s Guide to Menopause
Alicia* had been preparing for a big presentation for weeks. As she stood in front of management, about to begin, a rush of heat swept through her body. She could feel sweat stains appearing on her blouse, and makeup stinging her eyes. “I was mortified,” she recalls. “I know I shouldn’t be ashamed, but in front of my boss and peers, sweating through my clothes, I felt so exposed.”
Was it a sudden burst of anxiety? A hot flash? An increased sensitivity to stress brought on by her recent trouble sleeping? Hard to say, given that Alicia is in her late 40s and all these symptoms—and so many more—are part of perimenopause.
Menopause is a profound health transition, and one that’s only now beginning to enter the broader cultural conversation. The wild hormonal fluctuations a woman experiences in the years leading up to menopause impact every system in the body—and yet, because of a historical lack of emphasis on the subject in medical training, it can be surprisingly hard to find trusted, practical guidance on treatment options and support.
“I wish there was some sort of Menopause 101—we never learned about this in health class,” says Alicia. “Is this going to get worse? Do I ride it out or seek treatment? I’m terrified how this will play out.”
She’s not alone in feeling this way. Statistics show that 17 per cent of women contemplate leaving the workforce during the years around menopause, often at their professional peak, because they don’t have support for their symptoms. “Access to the right experts at the right time can be a game-changer,” says Jennifer Foubert, assistant vice-president and head of product and growth for group benefits at Manulife Canada. “When we don’t talk about menopause, businesses can lose valuable employees who feel they have to suffer in silence or step away.”
It’s not just hot flashes in presentations. Other common symptoms, like memory lapses, difficulty concentrating, joint and muscle pain, anxiety, depression and fatigue, can easily be mistaken as “dropping the ball” or “lacking drive” by a manager who isn’t knowledgeable about women’s health.
The average age of menopause in Canada is 52, yet symptoms can begin nearly a decade earlier as part of perimenopause, affecting not just physical health but also energy, confidence and mental health—all of which can impact performance at work. The upside: With the right information, expert support and a bit of workplace flexibility, you can be better equipped to manage the symptoms, keep your career on track and feel more like yourself. Here are expert recommendations for where to start.
What to ask yourself
“Women often just keep trucking along without pausing to ask: How is my body really feeling?” says Dr. Farzana Haq, a Menopause Society–certified practitioner and physician lead for Women’s Health at Cleveland Clinic Canada, medical director for Manulife Canada’s Group Benefits. As a first step to demystifying their symptoms, she recommends patients do a head-to-toe mental scan and ask what feels different than 5 or 10 years ago—and then think about how that is impacting their energy, mood, work and social life.
- Symptoms: What am I experiencing that is disruptive to my daily life, and how has that changed over time?
- Severity: How often do these symptoms show up, and how severe are they?
- Health history: Am I up to date on paps, mammograms, bloodwork and other routine checks?
- Support: Have I told my partner/friends/colleagues what I’m experiencing so I can lean on them if I need to?
- Habits: How am I prioritizing sleep, movement, nutrition and stress management?
“Too many women ignore or explain away what they’re experiencing,” Dr. Haq says. Some symptoms of perimenopause and menopause, like hot flashes and insomnia, are widely recognized. Others, such as dizziness, skin dryness and heart palpitations, are less obvious but can be equally disruptive. “You don’t have to feel this way. The first step is acknowledging that your symptoms are real and valid.”
What to ask your doctor
“Menopause is not just about symptom management,” Dr. Haq emphasizes. “It is also about health optimization—protecting your heart, bones and brain for the decades ahead.”
She recommends going into doctors’ appointments armed with a plan: “Write down your symptoms, top concerns and what you want from the visit. Even if everything can’t be covered in one appointment, you’ll have a plan.”
- Baseline: Could these symptoms be perimenopause, or should we rule out other issues (heart, iron or thyroid issues)? What tests should I do now—bone density, cholesterol, bloodwork, pap, mammogram?
- Lifestyle: Are there lifestyle changes I can make that will significantly improve my symptoms—exercise, strength training, changes to my diet? What habits should I start now to continue to build long-term health as these hormonal changes continue?
- Options: What are my treatment choices—menopausal hormonal treatment (MHT), non-hormonal options and supplements? If hormone therapy fits my profile, what are the benefits and are there any risks for me?
- Plan: How would we start, monitor and adjust treatment—and what’s the long-term plan? What can I do to reduce long-term risks such as osteoporosis, heart disease and dementia?
- Mind: What supports are available for sleep disruption, anxiety and depression, and brain fog?
Unfortunately, many women can feel brushed off or are told their symptoms are “just stress” or “just aging,” even though hormonal changes raise long-term risks for heart disease, osteoporosis and diabetes. “Education and self-advocacy are critical,” says Shyna Asaria, a registered nurse and consultant for Maven Clinic, a virtual service that specializes in women’s and family health. “We hear from women who are told their symptoms are nothing to worry about. Having the language to describe what you’re experiencing—and the confidence to push for answers—can change your care.”
If you feel your concerns aren’t taken seriously, Asaria suggests naming it and pressing for next steps: “You can say, ‘Maybe it isn’t perimenopause, but I don’t feel like myself. What can we test, and who else can I see?’ If needed, ask for a referral to someone with menopause expertise.”
What to ask at work
Symptoms of perimenopause and menopause often show up most visibly on the job: a hot flash in a boardroom, fatigue during a long project, brain fog in a meeting. More than half of women ages 45 to 55 experiencing menopause symptoms say it had a negative impact on their work, and 40 per cent of women reported that they did not feel supported at work while going through high levels of pain and discomfort due to menopause.
Foubert notes many employers are beginning to add menopause-specific benefits, but employees may not know what’s already available to help manage symptoms. “A lot of people assume they’re on their own, but there may be more resources than they realize.”
Here’s what to ask at work about the services and support that might be available to you—and how you can advocate for more support if needed:
- Coverage: Does our benefits plan include menopause-related care, medications or access to digital health services? What other practitioners—dietitians, personal trainers, massage therapists—are included in our plan who might offer services helpful to this life stage?
- Flexibility: Can I adjust hours or deadlines, or work from home, during symptom flares?
- Well-being: What wellness programs, counselling and peer groups are available through our organization?
- Mental health: What access do I have to therapists, counsellors and other mental health supports?
- Confidentiality: How will my privacy be protected if I disclose my health needs?
- Growth: What training and leadership steps are in place to make sure I can continue to advance in my career during this life stage?
Foubert notes it’s in businesses’ best interest to support and retain employees going through this life stage, especially considering the wealth of knowledge and depth of experience these women have accumulated.
Providing access to experts is a key part of this support—and it’s why Manulife now offers access to the Maven virtual clinic as an option within their group benefits plan. Eligible plan members and their eligible dependents (who are at least 16 years of age) get 24/7 access to clinicians and practitioners with expertise in midlife health, who can arm them with solid information and tips on how to navigate doctors’ appointments and treatment options. After engaging with Maven’s services, 36 per cent reported reduced hot flashes, and 41 per cent said their sleep problems reduced.
“There’s a variety of ways organizations can listen to women’s needs and make changes,” says Foubert. “And I really encourage women to leverage these resources and options where they are available to them, as well as seek information around what is available.”
*Name has been changed for anonymity.
The information in this article is not to be relied on for medical advice for specific situations. Individual circumstances may vary. Always speak to a medical professional for medical advice.