Menopause Workplace Statistics 2026: What the U.S. Data Actually Shows

Menopause workplace statistics show a real but uneven U.S. work impact: one major study estimated $1.8 billion in annual lost work time, while 13.4% of its employed sample reported an adverse work outcome. RAND’s newer model estimates $5.4 billion in productivity loss. These figures measure different things—and neither is a national census.

Those are the numbers almost everyone quotes. Here is what almost nobody tells you: they come from different populations and models, two of the most-repeated claims are routinely reported wrong, and the largest U.S. survey finding in the field came from a study with a 16.1% response rate.

We went and read the studies. We also read the bills—including an Illinois bill that was still described as unsigned on pages published after the governor had signed it.

The HRT Index is the independent decision resource for online menopause and HRT care — comparing telehealth providers on clinical legitimacy, care quality, medication fit, price transparency, and access, with every claim verified and dated, so women can choose the path that fits their situation before their first consult.

Best for you / not for you

This page is for you if you need current U.S. numbers you can defend in a meeting, a deck, a policy proposal, or an article—or you are trying to work out whether your own experience is reflected in the evidence.

This page is not for you if you need individual legal advice, a diagnosis, a treatment decision, or a universal percentage that predicts what will happen to one woman. It also does not turn UK findings into U.S. findings. When major UK evidence helps explain the field, it is labeled as UK evidence every time.

What are the six menopause workplace statistics that matter most?

The six figures below answer six different questions: missed-work cost, broader modeled productivity loss, reported work outcomes, employer support, the employer–employee communication gap, and enacted state laws. They belong together only when their denominators and scopes stay attached.

Figure	What it actually measures	Source and year
$1.8 billion	Estimated annual U.S. cost of missed workdays only—not total productivity loss	Mayo Clinic Proceedings, 2023
$5.4 billion	Modeled annual U.S. productivity loss from missed days, reduced hours, and layoffs	RAND, 2025
13.4%	Employed women aged 45–60 in one Mayo Clinic sample reporting at least one defined adverse work outcome	Mayo Clinic Proceedings, 2023
27%	U.S. employers reporting menopause support or resources—not necessarily medical coverage	SHRM Employee Benefits Survey, 2026
73 percentage points	Gap between HR benefit managers saying they discuss menopause and women saying they had discussed it with HR	Bank of America/National Menopause Foundation, 2023
2 states enacted	Rhode Island is in force; Illinois was signed August 7, 2026, with workplace provisions effective January 1, 2027	State statutes and bill records

The damaging admission: The evidence is strong enough to reject the idea that menopause never affects work. It is not strong enough to support one universal percentage, one universal cost, or the claim that every woman’s performance declines.

What did we actually verify?

For the claims that can change quickly, we checked the issuing organization, study, statute, enrolled bill, or official status record—not a search-result headline. We also replaced a superseded earnings estimate, corrected Illinois’s signed status, and removed claims that could not survive a primary-source check.

For this version, checked on August 10, 2026, we directly reviewed:

• the final peer-reviewed Mayo Clinic workplace study and its abstract;
• the full RAND report and its modeling assumptions;
• the revised December 2025 NBER paper and January 2026 Institute for Fiscal Studies version;
• the IZA working paper that measures self-reported menopause onset rather than diagnosis;
• the 2026 SHRM survey methodology and published trend figures;
• the Bank of America/National Menopause Foundation report and methodology;
• the Bonafide 2026 survey page, labeled here as a vendor survey;
• Rhode Island’s enacted statute;
• Illinois HB 5284’s final synopsis, enrolled text, and the governor’s August 7, 2026 bill action;
• Virginia’s official May 19, 2026 veto statement and enacted insurance bill;
• the introduced text of H.R. 9671, the Menopausal Workers’ Fairness Act of 2026;
• the current EEOC PWFA page and federal regulatory agenda;
• current UK government guidance on voluntary and planned mandatory action plans.

Where a source is a survey, this page says who answered it. Where a number is modeled, this page calls it modeled. Where a working paper changed, this page uses the current version and keeps the old headline in a version note instead of pretending it never existed.

The right online HRT provider isn't the same for every woman — it depends on your symptoms, your age and whether you have a uterus, your medication route preference (patch, pill, gel, or vaginal estrogen), your risk history, your insurance or cash-pay situation, and your state. Some situations belong with an in-person clinician first. Because a general answer can't resolve those for you, use The HRT Index's Find My HRT Path tool to match your situation to the right provider — and to flag when online care isn't the right starting point — before your first consult.

If you came here because work has gotten harder and you are wondering whether menopause is why, the evidence says you are not unusual and you are not imagining the possibility. It cannot decide what is happening in your body or what your next medical step should be.

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If you are here to build a business case instead, skip that. Keep reading.

How many working women are in the age range associated with the menopause transition?

RAND estimated that 24,047,236 women aged 45–60 were in the U.S. labor force in 2023—about 30% of women in the labor force. The state share ranged from 22.6% in Washington, D.C., to 32.5% in Vermont, but age is a planning proxy, not a clinical menopause count.

RAND combined American Community Survey/IPUMS workforce data with wage data to map the population by state and industry. The women in its age-defined group earned an average of $62,871 a year.

That gives employers a useful denominator. It does not give them permission to label every woman aged 45–60 “menopausal,” symptomatic, impaired, or in need of an accommodation.

One caveat you must keep attached: age is not a diagnosis. Some women in this band have no disruptive symptoms. Some women under 45 are in perimenopause or have surgical or induced menopause and are excluded from the model. Some women over 60 remain affected by symptoms and are also excluded.

So this sentence is wrong:

“Thirty percent of the female workforce is menopausal.”

This one is defensible:

“About 30% of women in the U.S. labor force were aged 45–60 in 2023, the range RAND used as a proxy for the menopause transition.”

RAND also projected that the share of working-age women in its transition-age band would rise only modestly nationally through 2050, while changing much more sharply in particular states. That matters for workforce planning, but the projection uses a different denominator from the 30% figure. Do not put the two percentages beside each other as though they are the same measure.

What does menopause actually cost U.S. employers and the economy?

The most-quoted total is $26.6 billion a year, but only $1.8 billion is estimated lost work time; the remaining approximately $24.8 billion is direct medical spending. RAND’s separate $5.4 billion figure is a broader productivity model that adds reduced hours and layoffs to missed days.

This is the number that gets mangled most, so take it apart before you put it on a slide.

What is inside the $26.6 billion Mayo estimate?

Component	Amount	What it is
Lost work time	$1.8 billion	Estimated cost of missed workdays among employed women aged 45–60
Direct medical costs	Approximately $24.8 billion	Estimated menopause-attributed medical spending in the same broad age group
Combined total	$26.6 billion	Lost work time plus direct medical costs

Every version that calls $26.6 billion a productivity-loss figure is wrong. Say “combined lost work time and direct medical costs” and the number survives scrutiny.

The $1.8 billion estimate is narrower than many headlines imply. It counts missed workdays. It does not include every reduced hour, resignation, early retirement, declined promotion, move to a lower-paid role, or period of working while struggling.

How does RAND get to $5.4 billion?

RAND updated workforce and wage inputs and modeled three components for full-time and part-time workers:

Modeled component	Estimated annual cost	Share of the $5.41B model
Missed workdays	$2.31 billion	42.7%
Reduced hours	$1.00 billion	18.5%
Layoffs	$2.10 billion	38.8%
Total	$5.41 billion	100%

That table is an original comparison assembled from the three values in RAND’s Figure 3. It is not a direct accounting of payroll records.

Look at the layoffs row again. Layoffs contribute about 39% of the modeled total. This is not only a story about absence. In RAND’s model, losing employment carries nearly as much cost as missed days.

It is also the component resting on the smallest survey input: 0.3% of women in the Mayo sample reported being laid off because of symptoms. RAND combined that rate with an assumed average unemployment duration of 24.1 weeks. A small percentage becomes a large national amount once multiplied across millions of workers and weeks of lost earnings.

Is $5.4 billion an upper bound or a lower bound?

RAND uses both ideas, and both can be true:

• $5.4 billion is the upper of RAND’s two displayed workforce versions because it includes full-time and part-time workers; the full-time-only total is approximately $4.98 billion.
• RAND calls the result a conservative lower-bound estimate of the broader burden because the model excludes early retirement, missed promotions, resignations, moves into lower-paid work, and women under 45.

That is not a contradiction. It is a reminder that “upper” and “lower” refer to different comparisons.

RAND also states the assumption underneath the model: its source data do not directly observe menopause-related productivity for every worker. The estimate applies Mayo’s reported work-loss rates to age-defined workforce and wage data. Report it as a model, not a measured national bill.

Economic totals are persuasive, but they are the easiest menopause workplace statistics to misuse. Change the population, wage, absence rate, unemployment duration, or included outcomes and the headline can move by billions.

Which states and industries carry the most modeled cost?

RAND estimated the largest absolute state costs in California at $687.7 million and Texas at $432.6 million. Health care and social assistance led the industry model at approximately $1.244 billion, followed by educational services at approximately $797.6 million.

The largest modeled totals do not necessarily identify the places where symptoms are most severe. They identify where headcount, the share of women aged 45–60, wages, and the model’s common work-loss assumptions combine into the largest dollar amounts.

Selected state estimates

State	Women aged 45–60 in the workforce	Average income	Modeled annual cost
California	2,696,474	$71,257	$687.7 million
Texas	2,084,153	$57,994	$432.6 million
New York	1,471,523	$73,166	$385.3 million
Florida	1,658,941	$56,532	$335.7 million
Pennsylvania	957,245	$62,950	$215.7 million

These selected findings are reported from RAND’s model. The complete official state appendix belongs on RAND’s site; this page links to it rather than reproducing the publication’s full tables.

Selected industry estimates

Industry	Women aged 45–60 employed	Average wage	Modeled annual cost
Health care and social assistance	5,516,490	$62,995	$1,243.8 million
Educational services	3,756,091	$59,329	$797.6 million
Professional, scientific, and technical services	1,741,744	$95,472	$595.2 million
Finance and insurance	1,554,881	$89,884	$500.2 million
Manufacturing	1,757,165	$72,426	$455.5 million

Two things jump out.

Retail has a large population but a lower modeled dollar cost because wages are lower. Professional and technical services has fewer women than retail but a larger cost because wages are higher.

A “cost of menopause” league table is partly a wage table. That does not make it useless. It changes what the number can support.

For a staffing argument, health care and education are the strongest sectors because they combine large affected-age workforces with existing retention pressure. For an equity argument, dollar cost alone can understate harm in lower-paid work because the same lost hour is assigned a smaller price.

How many women miss work—or experience another work outcome—because of menopause?

In the largest peer-reviewed U.S. workplace study, 597 of 4,440 employed respondents, or 13.4%, reported at least one adverse work outcome attributed to menopause symptoms. A total of 480, or 10.8%, reported missing work in the preceding 12 months, with a median of three missed days among those who missed work.

The final peer-reviewed article is the source of truth for the 480 missed-work numerator. Some public summaries used 485; the article and PubMed record report 480.

Finding in the Mayo employed sample	Figure
At least one adverse work outcome	597 women (13.4%)
Missed work in the preceding 12 months	480 women (10.8%)
Median missed days among those missing work	3 days
Cut back hours	5.6%
Laid off because of symptoms	0.3%
Adjusted odds of an adverse outcome, highest versus lowest symptom-severity quartile	15.6× (95% CI 10.7–22.7)

“Adverse work outcome” was a composite. It could include missing work, cutting back hours, layoff, firing, quitting, retirement, or changing jobs. The 13.4% figure is not the percentage who quit, were fired, or missed work. It means at least one outcome in the study’s basket.

Now the part we owe you

The two numbers this field leans on hardest—13.4% and $1.8 billion—come from one survey with a 16.1% response rate.

The study invited 32,469 women aged 45–60 receiving primary care at four Mayo Clinic sites. A total of 5,219 responded, and 4,440 employed respondents were analyzed. The analyzed group was approximately 93% White and 59.3% college-educated, and the survey ran from March through June 2021.

It is useful evidence. It is not a national census.

Low response can create selection in either direction. Women with disruptive symptoms may be more motivated to answer. Women who are exhausted, have left work, lack health-care access, or do not recognize menopause as the issue may be less likely to appear. The study cannot show that all those forces cancel out.

The 2025 UK government evidence review reached a related conclusion after examining 42 publications: workplace effects are real for some women, but the population-wide extent remains uncertain because many studies are cross-sectional, self-reported, unrepresentative, or inconsistent in what they measure.

So why publish any of this?

Because multiple countries and methods point in the same direction: a subset of women experience work disruption, and the subset is large enough to matter. Because some claims are precisely checkable—the status of a law, the population in a model, the exact outcome asked, the response rate. And because the honest version is stronger than the inflated one.

Nobody ever lost an argument by knowing the limits of her own numbers better than the person challenging them.

Is there a menopause penalty in earnings?

The latest revised working paper estimates earnings 3.3% lower on average over the four years after a menopause-related diagnosis and 7.4% lower by year four. The study uses Norwegian and Swedish administrative data and a quasi-experimental design, but it remains working-paper evidence and centers women who received a diagnosis.

The current version of The Menopause “Penalty” is by Gabriella Conti, Rita Ginja, Petra Persson, and Barton Willage. It uses population-wide health and labor records and compares outcomes around the timing of a menopause-related diagnosis.

Earlier institutional pages reported a 4.3% average reduction and approximately 10% by year four. Those numbers came from an earlier paper version. The December 2025 revision and January 2026 Institute for Fiscal Studies publication report:

Outcome	Current revised estimate
Average earnings change over four years after diagnosis	−3.3%
Earnings change by year four	−7.4%
Main channels	Reduced work hours and earlier labor-market exit

The old 10% headline still appears across search results. It should now be used only in a version note explaining that the paper changed.

What does the alternative Norwegian study find?

A second working paper, Beyond Hot Flashes: The Career Cost of Menopause, by Sara Abrahamsson, Mara Barschkett, and Martin Flatø, combines Norwegian register data with self-reported age at menopause onset from the HUNT study.

It estimates earnings declines reaching up to 3.7% four years after onset.

Same country family. Similar outcome. Different event definition and study population.

That contrast is valuable, but it does not justify creating a single “3.7% to 7.4%” universal range. The diagnosis-based paper and onset-based paper are not two measurements of one clean national parameter. Diagnosis can select for symptom severity and health-care use; self-reported onset answers a different question.

What can the earnings research support?

It can support this:

“Recent Scandinavian quasi-experimental working papers estimate persistent earnings effects after menopause onset or a menopause-related diagnosis, with the size depending on the design and population.”

It cannot support this:

“Every woman loses 7.4% of her earnings because of menopause.”

It also cannot turn a population-level care-access result into a personal promise that hormone therapy will protect one woman’s salary. That is a treatment claim, and these workforce papers are not a substitute for an individualized clinical decision.

Why do menopause workplace statistics disagree with each other?

Menopause workplace statistics disagree because studies count different people, ask different questions, use different time frames, and sometimes model outcomes that were never directly counted. A percentage from a symptom-experienced UK subgroup is not a rival estimate of a percentage from a U.S. primary-care sample.

This is the source-safe ledger we would want if someone handed us a menopause deck and asked whether it could survive five minutes of questioning.

Claim	Population and date	Evidence type	Safe to say	Do not say
$1.8B lost work time	U.S. extrapolation from 4,440 employed Mayo respondents; survey in 2021	Modeled from self-reported missed days	One 2023 study estimated $1.8B in annual U.S. lost work time	Menopause directly costs every employer $1.8B in measured losses
$5.4B productivity loss	U.S. women aged 45–60 in ACS/IPUMS workforce data; 2023 inputs, report published 2025	Economic model	RAND modeled $5.4B from missed days, reduced hours, and layoffs	The government counted $5.4B in payroll losses
13.4% adverse work outcome	4,440 employed respondents aged 45–60 at four Mayo sites; 2021	Cross-sectional survey	13.4% of the analyzed employed sample reported at least one defined outcome	13.4% of all U.S. women have a menopause work problem
10.8% missed work	Same Mayo sample; preceding 12 months	Cross-sectional survey	10.8% of the analyzed sample reported missing work	One in nine U.S. workers misses work every year because of menopause
27% employer support/resources	5,472 U.S. HR-professional responses; Jan–Mar 2026	Employer survey	27% of surveyed employers reported support or resources	27% cover menopause clinical care
73-point communication gap	500 benefit managers and 2,000 full-time employed women at 1,000+ employee firms; 2023	Two Ipsos polls	76% of benefit managers said they discuss menopause; 3% of women said they had talked with HR	73% of employers are lying
7.4% lower earnings by year four	Women with a menopause-related diagnosis in Norway/Sweden; revised working paper	Administrative quasi-experimental study	Revised paper estimates 7.4% lower earnings by year four after diagnosis	Menopause cuts every woman’s earnings by 7.4%
3.7% lower earnings by year four	Norwegian HUNT self-reported onset linked to registers	Working paper using onset timing	Study estimates declines up to 3.7% by year four	This disproves or replaces the diagnosis-based estimate
67% negative work effect	UK employed women aged 40–60 with symptom experience; CIPD 2023	Employee survey	67% of the relevant symptom-experienced UK subset reported a mostly negative effect	67% of all working women lose productivity
53% unable to go in at some point	CIPD UK survey population; recall question	Employee survey	53% could recall a time they were unable to go in	53% miss work each year

The four mistakes that break the argument

1. Quoting UK figures to a U.S. audience without saying so. Fawcett’s “one in ten left a job” and CIPD’s 67% and 53% figures are British.
2. Calling $26.6 billion a productivity number. Most of it is direct medical spending.
3. Treating modeled estimates as observed national accounts. RAND’s $5.4 billion is a model built from population, wage, and survey inputs.
4. Turning “left a job” into “left the workforce.” A job exit, labor-force exit, layoff, resignation, and considered exit are different outcomes.

How many employers offer menopause support in 2026?

In SHRM’s 2026 survey, 27% of responding U.S. employers reported menopause support or resources, up from 18% in 2025 and 17% in 2024. The category can include counseling or education, so it should not be presented as the share providing clinical treatment, prescription coverage, or dedicated leave.

Survey year	Employers reporting menopause support or resources
2024	17%
2025	18%
2026	27%

The 2026 survey was fielded from January 28 through March 23 and received 5,472 responses from HR professionals at U.S. organizations. SHRM says its results were unweighted.

The trend is real inside the survey series. The contents of the category remain blurry.

In 2024, SHRM separately found that only 2% offered menopause or menstrual leave beyond regular sick leave. That narrower leave figure does not contradict the broader support/resource category because the questions measure different things.

“Menopause support” can mean:

• a guide or webinar;
• manager training;
• an employee resource group;
• flexible-work guidance;
• an accommodation process;
• a specialist-care platform;
• insurance coverage;
• dedicated leave.

Nobody should make a 27% clinical-coverage claim from a category that can include education.

Do employees know those benefits exist?

Employer-reported support and employee awareness are not the same measure. In the 2023 Bank of America/National Menopause Foundation research, 76% of HR benefit managers said they discuss menopause-related issues, while 3% of surveyed peri- and postmenopausal employees said they had discussed menopause with HR.

That is a 73-percentage-point gap, but the two groups were asked from different positions. It does not prove dishonesty. It shows that sending information, believing a topic is discussable, and a woman feeling safe enough to disclose are different things.

The study used two Ipsos polls:

• 500 HR benefit decision-makers from companies with at least 1,000 employees;
• 2,000 U.S. women aged 40–65, employed full-time at companies with at least 1,000 employees.

Other findings from the same report:

Finding	Figure
Women who believed their employer recognized the need for menopause-specific benefits	14%
Women who wanted menopause-specific benefits	64%
Women with access who said the offerings positively affected their work	58%
Would recommend employer as a great place to work, with benefits	83%
Would recommend employer as a great place to work, without benefits	69%
Peri- and postmenopausal women uncomfortable discussing symptoms at work	58%

The top reason employers gave for not offering menopause-specific benefits was that employees had not asked.

That is the loop:

Employers wait for demand. Women do not disclose because disclosure feels personal or risky. The silence is interpreted as no need.

A benefit nobody knows about is not a benefit.

The first employer action does not have to be a clinic contract. It can be a clear, private, repeated explanation of what support already exists, who sees a request, what information is required, and what happens next.

The 58%, 83%, and 69% findings are self-reported associations. They do not prove that adding a benefit caused better work or employer advocacy.

Is menopause protected under federal workplace law?

No federal employment statute currently names menopause as its own protected category. Depending on the facts, a claim may involve sex discrimination under Title VII, age discrimination under the ADEA, disability discrimination or accommodation under the ADA, or medical leave under the FMLA; none creates a simple universal menopause rule.

This section summarizes public legal information. It is not legal advice.

Federal law	What it covers	Where menopause may fit
Title VII	Sex discrimination and harassment	Conduct tied to menopause may support a sex-based claim depending on the facts
ADEA	Age discrimination for workers aged 40+	Age-based treatment may overlap with menopause-related treatment
ADA	Disability discrimination and reasonable accommodation	Menopause is not automatically a disability; symptoms may qualify if they substantially limit a major life activity
PWFA	Accommodation for known limitations related to pregnancy, childbirth, or related medical conditions	Menopause is not named in the statute; application remains legally unsettled
FMLA	Job-protected leave for eligible workers with a qualifying serious health condition	A qualifying condition may trigger leave if the worker and employer meet the statute’s requirements

The safest ADA sentence is not “menopause is a disability” or “menopause is never a disability.”

It is:

“Menopause is not automatically an ADA disability. Particular symptoms or related conditions may qualify case by case if they meet the ADA definition.”

Federal courts have rejected claims where the pleaded facts did not show a substantial limitation. That does not create a rule that no menopause-related condition can qualify.

What is happening with the PWFA?

The EEOC’s current PWFA guidance remains in effect. Revisions to the Pregnant Workers Fairness Act also appear on the federal regulatory agenda as a proposed rule.

That means two things can be true on August 10, 2026:

• the current final rule remains the operative rule;
• the agency has formally placed revisions on its agenda.

Do not present a planned revision as completed law. Do not present menopause coverage under the PWFA as settled.

Which states have enacted menopause workplace laws?

Two states have enacted laws that expressly address menopause-related workplace accommodation: Rhode Island, effective since June 24, 2025, and Illinois, signed August 7, 2026, with workplace provisions effective January 1, 2027. The final Illinois law is narrower than the discrimination-ban headlines that described earlier versions.

Jurisdiction	Status on August 10, 2026	What the enacted or final measure does
Rhode Island	In force since June 24, 2025	Amends the Fair Employment Practices Act to require reasonable accommodation for pregnancy-related and menopause-related conditions, including managing vasomotor symptoms; applies to employers covered by the state definition, generally 4+ employees
Illinois	Signed August 7, 2026; workplace provisions effective January 1, 2027	Adds menopause-related conditions to workplace accommodation notice language and adds flexible scheduling/modified hours and temperature or climate-adjusted workspace to listed pregnancy accommodations; final text removes menopause-related conditions from the standalone “unlawful discrimination” definition
Virginia	Workplace bills vetoed May 19, 2026	HB 1173 and SB 258 would have named menopause and perimenopause under the Virginia Human Rights Act; a separate insurance-coverage mandate was enacted
Federal	H.R. 9671 introduced July 14, 2026; not enacted	Would create an express federal accommodation right for workers experiencing menopause-related limitations at covered employers

What does Rhode Island require?

Rhode Island General Laws § 28-5-7.4 expressly covers menopause-related conditions. The statute requires reasonable accommodation unless the employer can demonstrate undue hardship and says an employee does not have to be disabled to receive the accommodation.

The statute includes examples such as more frequent or longer breaks, modified schedules, seating, temporary transfers, telecommuting, time off, and changes needed to manage vasomotor symptoms. It also requires employers to give a rights notice within 10 days after an employee notifies the employer of menopause.

What changed in Illinois before passage?

Earlier Illinois HB 5284 versions would have created a standalone civil-rights violation for menopause discrimination and refusal to accommodate. Senate Floor Amendment No. 4 removed that language before the bill passed.

What survived into the final measure:

• a definition of menopause-related conditions;
• workplace notice language stating that pregnancy-accommodation rights include menopause-related conditions;
• flexible scheduling or modified hours and temperature or climate-adjusted workspace in the accommodation list;
• public education and clinician-education provisions;
• insurance provisions effective January 1, 2028.

What did not survive:

• menopause-related conditions as a standalone category inside the definition of unlawful discrimination;
• the earlier standalone civil-rights violation for refusing a menopause accommodation;
• the longer example list that included remote work, private rest space, and light duty.

Illinois is now the second state to enact an express menopause-related workplace measure. It is not accurate to call the final law a standalone menopause discrimination ban.

What happened in Virginia?

Governor Abigail Spanberger vetoed HB 1173 and SB 258 on May 19, 2026. The bills would have inserted menopause and perimenopause as protected categories in the Virginia Human Rights Act.

The same administration signed SB 790, requiring certain health-insurance coverage for medically necessary treatment of menopause and perimenopause for policies issued or renewed from January 1, 2027.

Read together, the 2026 session chose coverage before a new named workplace category.

Money before rights.

What would the federal Menopausal Workers’ Fairness Act do?

H.R. 9671, introduced July 14, 2026, would create an express federal right to reasonable accommodation for known limitations related to menopause and the menopause transition at covered employers, generally those with 15 or more employees. It has been referred to committees and is not law.

The introduced bill would:

• require reasonable accommodation unless the employer proves undue hardship;
• prohibit forcing a worker onto leave when another reasonable accommodation is available;
• prohibit adverse action for requesting or using an accommodation;
• require related medical information to be handled as a confidential medical record;
• use Title VII-style enforcement and remedies;
• direct the EEOC to issue regulations within one year after enactment.

It also identifies four modifications as “Predictable Assessments”—requests that should, in virtually all cases, receive a simple and straightforward assessment without documentation:

1. carrying or keeping water nearby and drinking as needed;
2. taking additional restroom breaks as needed;
3. sitting when work requires standing, or standing when work requires sitting;
4. taking breaks to eat and drink as needed.

The bill’s findings say current federal law does not explicitly protect against discrimination based on menopause, although workers may have protection under laws addressing age, sex, disability, or combinations of those characteristics.

Treat H.R. 9671 as a legislative proposal and a signal of policy direction. Do not treat it as a current compliance right.

How does the U.S. compare with the U.K.?

The U.K. has moved further toward national employer planning. Employers with 250 or more employees can publish voluntary action plans addressing the gender pay gap and menopause support in 2026; the plans are scheduled to become mandatory from spring 2027, subject to secondary legislation, across England, Scotland, and Wales.

Question	United States	England, Scotland, and Wales
Federal/national statute naming menopause accommodation	No enacted federal equivalent	Employment Rights Act framework includes menopause support in employer action plans
Employer planning duty	No general federal plan requirement	Voluntary for 250+ employers in 2026; planned mandatory from spring 2027, subject to secondary legislation
Current express subnational laws	Rhode Island in force; Illinois effective January 1, 2027	Equality Act routes depend on sex, age, disability, and the facts
Main evidence base	Mayo, RAND, employer and vendor surveys	CIPD, Fawcett, government evidence review, employer action-plan program

This comparison has a second job: it tells you which statistics in a typical U.S. presentation are British.

• Fawcett’s one in ten women left a job is UK survey evidence.
• CIPD’s 67% mostly negative effect is a UK symptom-experienced subgroup.
• CIPD’s 53% unable to go in at some point is a UK recall measure.
• The approximately £1.5 billion unemployment-cost estimate reviewed by the UK government is a UK model.

All can inform a discussion. None was measured in the United States.

What do women say menopause is doing to their work?

Recent U.S. surveys describe lost motivation, cognitive strain, poor sleep, mood effects, and fear of disclosure. They are useful for language and current sentiment, but vendor and employer-sponsored surveys should not be turned into national clinical prevalence estimates.

Bonafide’s 2026 State of Menopause survey included more than 2,000 U.S. women aged 40–64 who said they were experiencing perimenopause or menopause symptoms. Bonafide sells menopause supplements, so the commercial context stays visible.

Selected findings:

Bonafide 2026 vendor-survey finding	Figure
Reported cognitive changes	77%
Said symptoms affected emotional or mental health	60%
Said motivation was the leading work casualty	56%
Ages 40–49 saying motivation was the leading work casualty	62%
Said symptoms were more disruptive than expected	72%
Did not recognize the first symptom as perimenopause	71%
Still felt stigma made open discussion uncomfortable	45%

The survey says anxiety and depression were the most frequently named impactful symptom, ahead of hot flashes. That is a finding from this symptom-experienced vendor sample—not proof that anxiety or depression is caused by menopause in every respondent and not a national workforce prevalence estimate.

The disclosure paradox

Put two findings from two different surveys beside each other:

• 71% in Bonafide’s symptom-experienced sample did not recognize the first symptom as perimenopause.
• 3% in the Bank of America workplace sample said they had talked with HR about menopause.

They are not one denominator. Together, they explain part of the invisibility.

The woman who most needs support may not have a word for what is happening yet. She is not necessarily hiding a diagnosis. She may not have one.

She thinks she is slipping.

Most workplace frameworks start with temperature because a fan, cold water, or climate control is concrete. But the concerns women describe also include sleep, concentration, memory, anxiety, mood, bleeding, pain, and confidence. A desk fan does not touch all of that.

What accommodations do women and proposed laws focus on?

The most consistently named adjustments are flexible or modified hours, temperature control, breaks, water and restroom access, seating changes, remote work where feasible, time for appointments, and private space. Which adjustments are legally required depends on the jurisdiction, the worker’s limitations, the job, and the governing statute.

Adjustment	Rhode Island statute	H.R. 9671 as introduced	Illinois effective 2027
Temperature or climate-adjusted workspace	Can fit management of vasomotor symptoms	Not one of the four predictable assessments	Expressly added
Flexible scheduling or modified hours	Listed accommodation category	May qualify as reasonable accommodation	Expressly added
Additional restroom breaks	Listed accommodation category	Predictable assessment	Not specially added by HB 5284
Carrying and drinking water	May be reasonable depending on need	Predictable assessment	Not specially added by HB 5284
Sitting/standing changes	Seating and job adjustments appear in statute	Predictable assessment	Not specially added by HB 5284
Breaks to eat or drink	May be reasonable depending on need	Predictable assessment	Not specially added by HB 5284
Telecommuting	Listed among Rhode Island examples	May qualify depending on job and hardship	Not retained as a menopause-specific example in the final Illinois bill
Time off for medical appointments	Listed among Rhode Island examples	May qualify depending on the request	Not specially added by HB 5284

CIPD’s UK survey found that flexible working and temperature control were among the adjustments women most often identified as helpful. It also reported that 84% of respondents who felt unsupported said symptoms had a mostly negative effect at work, compared with 71% among those who felt supported.

That 13-point difference is an association from a cross-sectional survey. It is not proof that a policy reduced symptoms or retention losses by 13 percentage points.

The 2025 UK government review found limited high-quality evidence on workplace interventions. Supportive adjustments can still be humane, practical, and low-cost. What the evidence does not yet support is a guaranteed return-on-investment claim.

What can menopause workplace statistics not tell you?

These statistics cannot predict one woman’s career, diagnose the cause of her symptoms, define every employer benefit, or prove that a workplace policy or treatment produced a particular outcome. The largest U.S. numbers are either self-reported survey findings or models built from those findings.

Five gaps matter.

The counting gap

RAND’s model includes missed days, reduced hours, and layoffs. It excludes resignations, early retirement, missed promotions, moves to lower-paid roles, and women below the age proxy.

That means the model does not count every plausible work effect. It does not mean every excluded effect can simply be added or that the “true” total is known.

The definition gap

There is no standard U.S. definition of a menopause benefit. A survey can count a webinar and a clinical-care program in the same category.

Until the category is separated, the 27% SHRM figure describes the presence of some support or resource—not the depth of coverage.

The selection and disclosure gap

Underdisclosure can push estimates down. Symptom-focused recruitment, health-system sampling, and low response can push estimates up.

Both can be true at once.

That is why “every survey is a floor” is no more defensible than “every survey exaggerates.”

The demographic gap

The Mayo sample was approximately 93% White and 59.3% college-educated. RAND could not disaggregate its cost estimates by race, ethnicity, or socioeconomic status and identified that as an equity limitation.

The evidence is thinnest for some of the workers who may have the least job control, weakest benefits, and least access to specialty care.

The causation gap

Cross-sectional surveys show what respondents reported at one point in time. They cannot cleanly separate menopause symptoms from sleep disorders, depression, other health conditions, caregiving, workload, discrimination, financial pressure, or workplace design.

The Scandinavian papers use stronger quasi-experimental methods, but they answer narrower questions in specific health and social-insurance systems.

The treatment gap

Do not use workforce statistics to make a treatment claim.

No study on this page proves that hormone therapy improves an individual woman’s job performance, retention, promotion odds, or earnings. The earnings papers’ health-care analyses do not turn into a personal prescription.

Workplace evidence can validate that the issue deserves attention. It cannot choose treatment.

If symptoms are why work is hard, what is the actual next step?

Statistics do not treat symptoms. If menopause symptoms may be affecting your work, there are two separate decisions: getting assessed and discussing a specific workplace barrier or adjustment. You do not have to make them in a particular order.

Start with the problem in front of you.

Write down:

• the symptom or change;
• when it happens;
• sleep or cycle context where relevant;
• the task, shift, meeting, uniform, temperature, or environment involved;
• what changed at work;
• what helped;
• what you need to ask a clinician;
• what practical adjustment would address the work problem.

Use a personal device or paper if privacy matters. Do not put sensitive health information into an employer system until you understand who can access it, how long it is retained, and what the process requires.

For clinical assessment, start with a primary-care clinician, gynecologist, menopause clinician, or another qualified clinician you can access and trust. Bring specifics. “I feel awful” is real, but “I wake five times with night sweats and cannot safely manage my 6 a.m. shift” gives the clinician and the workplace problem something concrete to address.

For work, you may be able to describe the limitation and requested change without telling every colleague your full medical history. The legal threshold and documentation rules vary. A lawyer, union representative, or authoritative state agency can help when rights or retaliation are at issue.

If the hard part is choosing a care route—insurance-based, cash-pay, online, or in person—Find My HRT Path can organize the decision and flag when online care is not the right starting point.

See which care path fits your situation →

How were these menopause workplace statistics verified?

Every live figure on this page has a named source, population, date, and evidence type. The HRT Index checked current versions, separated direct findings from models, preserved conflicting denominators, and removed claims that could not be traced or that had become obsolete.

Under The HRT Index Verification Standard, The HRT Index reads every published price, separates FDA-approved from compounded options, verifies state availability and insurance, and re-checks claims on a fixed schedule—top providers monthly and the full roster quarterly. The site’s editorial standards explain the source hierarchy and correction rules behind that work.

This page applies the same verification discipline to workforce evidence:

• identify the primary study, official report, statute, or issuing organization;
• record collection date separately from publication date;
• keep the population and denominator beside the number;
• label surveys, administrative estimates, and models;
• check sponsors and commercial context;
• compare a working paper with its latest revision;
• use final article counts when a press release differs;
• verify bill status against government records;
• keep earlier figures in a version note when they explain an internet contradiction;
• remove claims that cannot be traced.

What was verified—and what was not reproduced?

We verified published figures and methods against the sources. We did not independently reproduce restricted microdata, reconstruct every regression, audit employer payroll, or rerun the RAND model.

That distinction matters. “Verified” means the page accurately reports what the current source says and how it was produced. It does not mean The HRT Index independently replicated the underlying research.

Claims removed from the publishable page

Claim	Why it was removed
“Illinois is awaiting the governor’s signature”	Obsolete: Governor Pritzker signed HB 5284 on August 7, 2026
“Only one state has enacted a menopause workplace law”	Obsolete after Illinois’s signing; Rhode Island is in force and Illinois takes effect January 1, 2027
“The revised 7.4% earnings penalty could not be verified”	The current IFS/NBER revision reports 7.4% by year four
“The penalty ranges from 3.7% to 10% depending on severity”	The studies use different designs and populations; synthesizing them into a severity range overstates what they establish
“Every survey estimate is a floor”	Disclosure can lower estimates, while recruitment and nonresponse can raise them
“The direction is consistent across every country, method, and decade”	Too absolute for the evidence base
Global cost figures for Germany, Japan, and a $150B/$600B estimate	The draft did not establish comparable primary methods and the figures did not help the U.S. intent
Provider prices and a direct sponsored provider recommendation	Intent drift on an informational statistics page and a recurring verification burden unrelated to the query
Full RAND state and industry appendix tables	RAND requires permission for commercial reproduction; selected facts are summarized and the official report is linked
Placeholder Citation Pack and State Rights Checker CTAs	The assets did not yet exist at publishable URLs

The 27 verified U.S. facts behind the title

#	Verified finding	Source
1	$1.8B estimated annual lost work time	Mayo, 2023
2	$26.6B combined lost work time and direct medical cost	Mayo, 2023
3	Approximately $24.8B of that combined figure is direct medical spending	Mayo, 2023
4	597 of 4,440 employed respondents reported an adverse outcome	Mayo, 2023
5	13.4% reported at least one adverse outcome	Mayo, 2023
6	480 respondents reported missing work	Mayo, 2023
7	10.8% reported missing work in the preceding year	Mayo, 2023
8	Median missed time among those missing work was 3 days	Mayo, 2023
9	5.6% reported cutting back hours	Mayo, 2023
10	0.3% reported being laid off because of symptoms	Mayo, 2023
11	Highest versus lowest symptom quartile: adjusted odds ratio 15.6	Mayo, 2023
12	Study response rate: 16.1%	Mayo, 2023
13	Analyzed sample: approximately 93% White	Mayo, 2023
14	Analyzed sample: approximately 59.3% college-educated	Mayo, 2023
15	24,047,236 women aged 45–60 in the 2023 U.S. labor force	RAND, 2025
16	Approximately 30% of women in the labor force were in that age range	RAND, 2025
17	State share ranged from 22.6% in D.C.	RAND, 2025
18	State share reached 32.5% in Vermont	RAND, 2025
19	$5.41B modeled annual productivity loss	RAND, 2025
20	$2.31B modeled missed-day component	RAND, 2025
21	$1.00B modeled reduced-hours component	RAND, 2025
22	$2.10B modeled layoff component	RAND, 2025
23	California modeled cost: $687.7M	RAND, 2025
24	Texas modeled cost: $432.6M	RAND, 2025
25	17% of surveyed employers reported support/resources in 2024	SHRM
26	18% reported support/resources in 2025	SHRM
27	27% reported support/resources in 2026	SHRM

The title count does not inflate the page by treating UK figures as U.S. facts or counting one percentage and its inverse as separate “statistics.”

What will be rechecked, and when?

The fastest-moving claims are laws, regulations, employer-benefit surveys, and working-paper revisions. The page should keep its August 2026 date only while those items remain checked; changing the year without re-verification would create fake freshness.

Element	Refresh cadence	Verification method
Illinois HB 5284 implementation and agency guidance	Monthly through January 2027, then quarterly	Illinois General Assembly, governor, Illinois Department of Human Rights, Department of Public Health
Rhode Island statute and guidance	Quarterly	Rhode Island General Laws and Commission for Human Rights
Virginia and other state bills	Monthly during legislative sessions; quarterly otherwise	Each legislature and governor’s official records
H.R. 9671 and other federal bills	Quarterly	Congress.gov/GovInfo
PWFA revisions	Monthly	Federal Register, Reginfo.gov, EEOC
Revised menopause-penalty paper	Monthly until peer-reviewed publication; quarterly afterward	NBER, IFS, journal and author pages
RAND model or errata	Quarterly	RAND product page and correction notices
Mayo article corrections	Quarterly	PubMed, journal, Crossmark
SHRM benefit trend	Annually when the new survey publishes	SHRM survey and methodology
Bank of America workplace survey	Annually/source-triggered	Bank of America and issuing partner
Bonafide State of Menopause	Annually, labeled as vendor research	Publisher’s survey page and methodology
UK action-plan implementation	Quarterly	GOV.UK
Primary-source links	Monthly automated check; quarterly manual check	Link monitor plus source-page review

Frequently asked questions

The answers below keep the country, denominator, time frame, and evidence type attached to each number. That is the difference between a statistic that can support a decision and a headline that collapses under one follow-up question.

How much does menopause cost U.S. employers?

The Mayo study estimated $1.8 billion a year in lost work time from missed days. RAND later modeled $5.4 billion in productivity loss by adding reduced hours and layoffs. The widely repeated $26.6 billion Mayo figure combines lost work time with approximately $24.8 billion in direct medical spending.

What percentage of women have work problems because of menopause?

In the Mayo employed sample, 13.4% reported at least one defined adverse work outcome and 10.8% reported missing work in the previous year. Those are sample findings, not national prevalence rates.

How many women quit their jobs because of menopause?

There is no clean U.S. quit rate in the evidence used here. The Mayo study combines quitting with six other outcomes inside its 13.4% composite. The often-repeated one in ten figure comes from Fawcett Society UK survey evidence and refers to leaving a job, not necessarily leaving the labor force.

What percentage of employers offer menopause benefits?

SHRM reported 27% offering menopause support or resources in 2026, up from 18% in 2025 and 17% in 2024. The category may include counseling or education and should not be translated into 27% offering clinical care or prescription coverage.

Is menopause a disability under the ADA?

Not automatically. Particular symptoms or related conditions may qualify if they substantially limit a major life activity and meet the ADA’s other requirements. The answer depends on the facts, not the menopause label alone.

Can an employer fire someone because of menopause symptoms?

There is no simple federal menopause-specific rule. Depending on the facts, an adverse action may implicate Title VII, the ADEA, the ADA, leave law, or a state or local statute. Rhode Island has a current express accommodation statute, and Illinois’s new workplace provisions take effect January 1, 2027. Get individual legal advice for a real dispute.

Which states have menopause workplace laws?

As of August 10, 2026, Rhode Island’s express menopause-related accommodation law is in force. Illinois signed HB 5284 on August 7, 2026, with workplace provisions effective January 1, 2027. Virginia’s 2026 workplace bills were vetoed.

Does Illinois have a menopause discrimination ban?

The final enacted HB 5284 does not create the standalone menopause discrimination category described in some earlier headlines. It adds menopause-related accommodation notice language and specific accommodation examples within the Illinois Human Rights Act, effective January 1, 2027.

Is there a federal menopause workplace law?

No enacted federal statute creates a standalone menopause accommodation right. H.R. 9671 was introduced July 14, 2026, and would create one at covered employers if passed. It is a bill, not current law.

Do I have to tell my employer I am in menopause?

A person does not generally have to announce menopause to the entire workplace. An accommodation process usually requires enough communication for the employer to understand a limitation and requested change, but the necessary information and legal standard vary. Rhode Island’s statute has a specific notice rule after an employee notifies the employer of menopause.

What percentage of the workforce is going through menopause?

RAND estimated that approximately 30% of women in the U.S. labor force were aged 45–60 in 2023. That is an age proxy for workforce planning, not a count of clinically confirmed menopause or symptomatic women.

Are UK menopause workplace statistics relevant in the U.S.?

They are useful context but not interchangeable with U.S. findings. UK surveys use different employment law, health-care access, questions, and populations. Label them as UK evidence every time.

Does workplace support improve outcomes?

CIPD found less negative reported impact among respondents who felt supported than among those who did not. That is an association, not proof that a policy caused a specific reduction in absence, symptoms, or turnover. The UK government review found the intervention evidence limited.

Does hormone therapy improve work performance?

No study on this page answers that question. These are workforce surveys, administrative labor studies, and economic models—not individualized treatment trials. Whether hormone therapy is appropriate depends on a clinical assessment of symptoms, health history, preferences, risks, and alternatives.

Sources

Primary studies, official reports, current statutes, enrolled-bill records, and issuing-organization methodology pages are listed below. Secondary pages were used only where they supplied version context or an official issuing-organization summary.

1. Faubion SS, Enders F, Hedges MS, et al. Impact of Menopause Symptoms on Women in the Workplace. Mayo Clinic Proceedings. 2023;98(6):833–845.
2. RAND Corporation. The Economic Impacts of Menopause in the United States. 2025.
3. RAND. Rights and Permissions.
4. SHRM. Menopause Benefits See Big Jump in Employer Offerings. July 31, 2026.
5. SHRM. From Menopause Support to Grandparent Leave, Employers Add Benefits. June 24, 2024.
6. Bank of America/National Menopause Foundation. Break Through the Stigma: Menopause in the Workplace. 2023.
7. Bonafide. State of Menopause 2026.
8. Conti G, Ginja R, Persson P, Willage B. The Menopause “Penalty.” Institute for Fiscal Studies Working Paper 26/01, 2026.
9. Conti G, Ginja R, Persson P, Willage B. The Menopause “Penalty.” Current paper PDF.
10. Abrahamsson S, Barschkett M, Flatø M. Beyond Hot Flashes: The Career Cost of Menopause. IZA Discussion Paper No. 17789, 2025.
11. CIPD. Menopause in the workplace: Employee experiences in 2023.
12. UK Department for Work and Pensions. Menopause in the Workplace Literature Review. 2025.
13. Fawcett Society. Menopause and the Workplace. 2022.
14. Rhode Island General Laws § 28-5-7.4. Accommodation of pregnancy-related and menopause-related conditions.
15. Illinois General Assembly. HB 5284 bill status and final synopsis.
16. State of Illinois. Governor Pritzker Takes Bill Action, August 7, 2026.
17. Governor of Virginia. Veto statement for HB 1173 and SB 258, May 19, 2026.
18. Virginia Legislative Information System. SB 790, coverage for treatment of menopause and perimenopause.
19. GovInfo. H.R. 9671, Menopausal Workers’ Fairness Act of 2026, introduced July 14, 2026.
20. EEOC. What You Should Know About the Pregnant Workers Fairness Act.
21. Office of Information and Regulatory Affairs. RIN 3046-AB36, Revisions to the Pregnant Workers Fairness Act.
22. UK Government. Creating an action plan: guidance for employers.
23. UK Government. Employer Action Plans.

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