Virtually all women will experience perimenopause and menopause, yet the symptoms they experience frequently go undiagnosed, untreated, or undertreated. This has significant implications for their health, well-being, and productivity – at home and on the job.
Perimenopause and menopause are part of a natural transition that marks the end of reproductive years for women. While some people begin this life stage as early as their mid-30s, it most often begins when they are in their mid-40s. This phase is characterized by symptoms including longer or shorter menstrual cycles, hot flashes, night sweats, trouble sleeping, and urinary tract infections. Some women may experience mental and behavioral disorders such as anxiety and disruptions in mood, sleep, and cognition. The average age of menopause is 51 and is defined as the point at which a woman hasn’t had a menstrual period for 12 consecutive months.
Common symptom categories experienced during menopause
Perimenopause and menopause symptoms: common, yet often untreated
An Evernorth analysis of 1.5 million commercially insured women ages 40 through 64 found that more than half had experienced symptoms related to menopause. Despite this prevalence, only 8% of the women in our analysis had received a confirmed diagnosis of perimenopause or menopause.
Perimenopause/Menopause diagnosis status
This is significant because delays in diagnosis and treatment of symptoms bring discomfort, which can result in women seeking care and treatment that may not be evidence-based or appropriate. That can exacerbate symptoms and lead to unnecessary utilization of health care resources, such as emergency department visits and diagnostic testing, and can negatively impact job productivity. “Effective treatment of menopause and its symptoms requires a whole-person approach. This includes a comprehensive clinical assessment and exploring of all the evidence-based treatment options available,” said Dr. Calie Santana, medical director for innovation at Evernorth.
While menopause is almost universal among women, their providers are likely to have significant gaps in their knowledge about this stage of life. “Recent studies have shown that only 6.8% of medical residents said they were prepared to manage menopausal symptoms, while 20.3% did not receive any training on menopause during residency,” she said.
Implications for employers
“Undiagnosed, untreated, or undertreated menopause negatively impacts employers through lost workdays and higher medical expenses,” Dr. Santana said, noting that 60% of the women in the analysis held paying jobs. Symptoms can interfere with performance, productivity, and motivation in the workplace, which may require support from managers and employers. Employers are funding the cost of disengaged workers due to undertreated symptoms, which can amount to the equivalent of 18% of their annual salary, and the annual cost of lost workdays due to menopause symptoms has been estimated at $1.8 billion in the United States. Those expenses are in addition to the nearly $25 billion in annual medical costs (including out-of-pocket costs) that can be attributed to menopause.
Key takeaways: Improving care for women during perimenopause and menopause
The cost of menopause is more than physical, psychological, and emotional. While most women who live long enough will go through menopause, only a small percentage are properly diagnosed or treated.
“Employers, health plans, health systems, and care providers must identify and engage women with menopause symptoms early to improve health and outcomes,” Dr. Santana said. “This would include employers providing support, flexibility, and benefits to address menopause-related symptoms, equipping clinicians with appropriate skills or training to properly diagnose these symptoms early, as well as adopting an individualized or tailored approach in the diagnosis, investigation, and management of perimenopause and menopause.”
This article is part of a series by the Evernorth Research Institute that highlights critical issues affecting girls’ and women’s health across different life stages, from adolescence through menopause and beyond. The goal is to educate the general public, health care providers, employers, health plans, policymakers, and advocates about the most pressing concerns in women’s health so that together we can continue to drive meaningful change.
This work was created by the Evernorth Research Institute team. Artificial intelligence tools provided editorial assistance.
