After Bloomberg News suggested recently that “millions of women” are leaving the workforce because of menopause, a wave of fury rippled across social media. Not surprisingly, many women were dubious. “It’s the climate of businesses who see anything about women’s lives an excuse to make things harder for them at work, and older women as less decorative & therefore worthless,” one woman tweeted. “I’ve never heard of anyone leaving the workforce due to menopause. Maybe b/c everyone I know HAS to work,” tweeted another.

I was one of the initial skeptics. I flippantly tweeted that age discrimination surely was a much bigger problem. Although that’s likely true, it doesn’t mean menopause isn’t an issue in the ongoing battles over age and gender in the workplace.

Most middle-aged women find menopause to be an unpleasant experience at least part of the time. Three out of 4 women suffer sudden — and sometimes embarrassing — hot flashes. Brain fog is real. Most women in menopause experience at least occasional insomnia.

Those symptoms can impact both job performance and our attitudes toward work. A 2014 survey by Working Mother Media and Pfizer found that almost half of women said they believed their symptoms made their work life more difficult, with 1 in 5 saying they altered their schedule over it. A 2020 study found that the more issues women experienced with menopause, the more their job performance suffered.

But symptoms, and their effects, are complicated. A 2018 study published in Women’s Midlife Health found that experiencing hot flashes at work increased intent to leave … but that work outcomes were much more correlated with job stress and lack of support. Which means it’s not just hot flashes.

Women routinely report more job stress than men, not simply because of issues with work-life balance but also due to interactions with customers and colleagues. Studies show that women need to prove themselves again and again at work, while men’s competence is assumed. As Jen Gunter, author of “The Menopause Manifesto,” told me, “If you are really struggling with symptoms while some dude is being told he’s brilliant, and when you say the same thing it’s too harsh, you might just say ‘screw it’ and walk out the door.”

This brings me back to age discrimination. A 2017 National Bureau of Economic Research study of hiring practices found that older women are more likely to experience discrimination in the hiring process than their male peers, and that women’s aging looks may be to blame. “Evidence suggests that physical appearance matters more for women,” the study found, “and that age detracts more from physical appearance for women than for men.”

Age discrimination begins to impact women years before menopause — one study pegged it at age 40 for women. Many workplace experts believe it’s not uncommon for middle-aged workers to attempt to hide their age in hopes of seeming younger to those in charge of hiring and firing. “Older employees are in the closet today in much the same way gay employees used to be,” Ruth Finkelstein, executive director of the Brookdale Center for Healthy Aging at Hunter College, told the Wall Street Journal in 2019.

And few things say “aging worker” like menopause, which the average woman experiences in her early fifties.

At least in some places, there’s been a shift in acknowledging this. As it became more common to openly address women’s practical reproductive issues, some countries including Britain and a number of U.S. states no longer charge tax on tampons, and menstrual supplies are increasingly offered free at schools and workplaces. Menopause has gotten attention, too, at least in Britain. There is a movement to increase protections for women who need help managing their menopause symptoms on the job; London Mayor Sadiq Khan recently announced that he would like to implement a “menopause policy” for city government employees, while some companies are, according to Bloomberg News, offering workers scheduling flexibility, as well as company-sponsored support groups.

But in too many U.S. workplaces the subject goes undiscussed. Seeking accommodations for menopause — or even acknowledging it — is often tantamount to putting a target on your back. Age discrimination remains extremely hard to prove. Although the House passed a bill last week addressing age discrimination, it’s unlikely to get a vote in the Senate.

Since private employers are not required to offer sick pay and paid family or medical leave, it’s not surprising that this health-related issue goes under-addressed. Maybe if all that changed, women would find it easier to manage menopause on the job — with no special pleading required.

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