Perimenopause and menopause are critical stages for women’s health. They’re part of a natural transition that marks the end of reproductive years. Given menopausal symptoms are caused by estrogen fluctuations, these symptoms can also affect trans men and non-binary people.
For an employer, understanding perimenopause and menopause is essential to supporting employees before, during, and after this life stage. Such an understanding can inform a comprehensive plan design that meets employees’ medical, emotional, and mental health needs.
What is menopause?
Menopause is the point at which a person hasn’t had a menstrual period for 12 consecutive months. After that time, that person is considered postmenopausal. On average, menopause happens around age 51. Surgical menopause, meanwhile, happens abruptly at any age after the ovaries are removed surgically.
But natural menopause doesn’t happen all at once. It follows a lead-up period known as perimenopause. Perimenopause can start at different ages. Signs often appear during a person’s 40s. But some may notice changes as early as their mid-30s. It usually lasts about three or four years.
Perimenopause is characterized by changing hormone levels. People may experience a variety of symptoms during this time. These include:
- Rising and falling estrogen levels
- Lengthening or shortening menstrual cycles
- Menopause-like symptoms such as hot flashes and trouble sleeping
Perimenopause and depression/anxiety
Perimenopause can affect the mind along with the rest of the body. It increases the risk of anxiety and depression, conditions that can impede job performance and productivity.
- Hormonal changes can cause mood swings
- Physical symptoms, such as hot flashes, can contribute to anxiety
- These stressors can lead to depression
About 40% of patients in perimenopause experience mood symptoms like those of premenstrual syndrome (PMS), the American College of Obstetricians and Gynecologists reported.
People facing perimenopause and menopause may be dealing with life issues that add to the strain. They may be caring for aging parents. Or they may be caring for children or have children leaving home. Or – given the rising average age of people giving birth for the first time – they may be trying to start a family.
Today, the average age of new mothers in the U.S. is 27, according to a 2024 report from the Centers for Disease Control and Prevention (CDC). Similarly, the mean age at first birth was 27.3 in 2021, compared with 25.6 in 2011. By comparison, it was 21.4 in 1970.
Meeting menopause needs with appropriate coverage
Employers should take a proactive approach to supporting employees during perimenopause and menopause. They should recognize both bring stressors that can affect job performance.
A 2023 Mayo Clinic study found menopause-related symptoms can have a negative impact in the workplace, with 13.4% of respondents reporting at least one adverse work outcome. Respondents reported these challenges:
- Missing work in the most recent 12 months (10.8%)
- Cutting back on hours in the most recent six months (5.6%)
- Experiencing more than one adverse work outcome (4%)
Researchers estimated the annual cost associated with lost productivity due to menopause symptoms to be $1.8 billion in the United States. Although physical symptoms – such as hot flashes and night sweats – contribute to the negative effects, psychological symptoms also play a large role.
Addressing health care needs
Employees may hesitate to discuss perimenopause or menopause with their employer when it affects job performance. They may feel shame or worry about discrimination. As a result, some may try to manage the symptoms on their own, rather than seek help.
It’s also common for employees not to know about the behavioral health benefits available to them. The Evernorth Research Institute 2024 Health Care in Focus study found such a gap in awareness. While 27% of employees didn’t believe their employer-sponsored insurance had behavioral health coverage, 89% of employers said they did offer such coverage.
This is where employers can step in. They can communicate behavioral health benefits to employees and make it as easy as possible for them to locate resources. They can also offer mental heath days and take other measures to help.
Employers can further close the gap by encouraging use of behavioral health benefits. This may be through personalized education or broader communication about plan offerings. Either way, employers should seek to drive engagement in behavioral health.
Delivering an inclusive benefit plan
Employers have made progress offering more comprehensive behavioral health benefits. But there remains the opportunity to design plans more inclusive of reproductive health needs. And employees are looking for support. A 2024 study by market research firm Ipsos on behalf of Evernorth found 64% of respondents expect access to menopause coverage.
As employers develop their plans, it’s critical they deliver clear information about new benefits. They should also serve as advocates for employees with changing health care needs.
Evernorth Health Services offers services for people in a variety of life stages. These include conception and pregnancy, as well as include perimenopause and menopause. In addition, Evernorth Behavioral Health solutions to promote mental health and emotional well-being during transitional and often-times challenging periods.
By creating a supportive workplace and offering a comprehensive benefits package, employers not only can help drive productivity, but also promote better health outcomes.
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