She can run a board meeting on four hours of sleep; she can present a quarterly forecast while her face is on fire. She can field a hostile question in a room full of people who report to her, smile, answer it well, and then go sit in her car for ten minutes because she can’t remember the last thing she said.  If you’re the leader living this, you already know. If you work alongside her, you may have noticed the signs and said nothing because you weren’t sure it was your business. Both of you are right to take this seriously. Let’s talk directly about menopause and women in leadership.

What’s actually happening when menopause occurs in women in leadership

Perimenopause and menopause show up in the body and in the brain. Hot flashes, disrupted sleep, brain fog, mood shifts, joint pain, and a memory that suddenly feels unreliable. For most women, this hits between their late 30s and mid-50s. That is also the decade when many of you are running your largest teams, managing your highest-stakes relationships, and carrying the most institutional weight you’ve ever carried.

The numbers confirm what you already know from experience. Roughly a quarter of the U.S. workforce is in some phase of the menopause transition at any given time, and more than three-quarters of women work through it and for years after. Nine in ten women thirty-five and older experience symptoms, on average, five different ones at once. This is not a fringe issue quietly affecting a handful of people. It is happening across nearly every leadership team in the country, right now.

The timing is not kind for women in leadership who are in menopause. The symptoms are not minor. Most workplaces have built no language for any of it, so the people experiencing it manage quietly, and the people around them guess.

If you’re leading through this, you may be rescheduling meetings instead of naming the reason, keeping a spare blazer in the office for the days a hot flash soaks through, or writing everything down because you no longer trust your memory in the room, with no explanation offered.

If you work with her, you may have noticed she seems different lately. More tired. Sharper edges some days, slower to respond on others. You don’t need a diagnosis. You need to know that whatever it is, your job is not to speculate about it.

The real cost of staying quiet

For the leader: here’s what staying silent actually costs you.

• Energy you need for the work itself. Hiding a symptom takes effort. Managing the cover story takes effort. That effort comes out of the same account as your strategic thinking, your patience with your team, and your ability to be present in the moments that matter.
• Credibility you don’t need to spend. Many leaders stay quiet because they believe disclosure reads as weakness. The opposite is usually true. A leader who can name what’s happening and still deliver builds more trust than one who disappears into vague excuses.
• It costs your team a model worth following. If you are quietly pushing through, the people watching you are learning that this is what leadership requires. Some of them eventually face this exact transition themselves. What you do now becomes the example they remember. And the cost is not hypothetical. One in four women has either turned down or stopped pursuing a leadership opportunity because of menopause symptoms. Two in five have considered leaving a job or have left one for the same reason. Those are not numbers about women who couldn’t handle the work. They are numbers about women who stepped back because no one made staying easier.

Part of the problem is that almost nobody is talking about it where it would help most. Most HR leaders say they discuss menopause with employees. Almost none of those employees agree that a conversation has actually happened. That gap is where careers quietly stall.

For the colleague: silence costs you something, too. If you fill the gap in information with assumptions, “she’s having an off year,” “she’s checked out,” “something’s wrong with her judgment lately,” you will misjudge a strong leader at the exact moment she needs your support, not your speculation.

What menopause in women in leadership is not

For the leader: this is not a call to overshare. You do not owe your team a symptom list. You do not need to discuss this in a town hall. Real talk does not mean no boundaries.

For the colleague: this is not an invitation to ask her directly, comment on her symptoms, or treat what you’ve noticed as something to manage on her behalf. Curiosity is not the same as support.

This is a call to stop treating menopause in women in leadership as a personal failure to hide, and a call for the people around it to stop treating it as something to whisper about. It is a biological transition, not a performance problem.

What the leader can actually do

• Name it to the people who need to know, not everyone. A trusted peer, your assistant, your chief of staff, the colleague who covers for you when you step out. You do not need an announcement. You need two or three people who understand what’s going on so you are not managing the symptom and the secrecy at the same time.
• Build in the support you need, on the record. If you need the temperature in your office lowered, ask for it. Need fifteen minutes between back-to-back meetings? Block it. If brain fog is real for you right now, write things down in the meeting itself instead of trusting your memory afterward. None of this needs an explanation attached.
• Talk to your doctor like you’d talk to a strategic advisor. Hormone therapy, sleep support, and other treatments exist and many are effective. Too many high-performing women treat this as something to endure instead of something to manage with the same rigor they’d apply to any other health issue affecting their performance.
• Decide what you’re willing to say, and say it on your terms. Some women choose to mention it directly: “I’m in perimenopause, and some days that means I need to step out.” Others keep it private and build the support system above instead. Both are valid. What’s not valid is silence driven by shame instead of by choice.

What the colleague can actually do

• Give her the same grace you’d want for any health transition. You wouldn’t speculate openly about someone managing a chronic illness or recovering from surgery. Extend the same restraint here.
• Take her at her professional word. If she says she needs to step out, needs a minute, or needs the room cooler, that’s the information you need. You don’t need the reason behind it.
• Don’t let one off day rewrite your view of her. A leader having a hard morning is not evidence of declining judgment. If you find yourself building a narrative about her competence based on something you’ve noticed physically, stop and check that against her actual track record.
• If you’re in a position to shape the environment, shape it. Flexible scheduling, temperature control, and a workplace culture where stepping out doesn’t require justification help everyone, not just her.

The leadership lesson underneath this

Leaders spend their careers telling the people around them to bring their whole selves to work, to ask for what they need, to treat health as part of performance and not separate from it. Menopause in women in leadership is the test of whether that applies to her too, and whether the people around her actually believe it.

Neither of you has to make this a platform. Both of you have to stop pretending it isn’t happening.

Pause. Think. Grow. Strategically.™

Sources

AARP Research, “The Economic Impact of Menopause: A Survey of Women 35+ and Employers,” January 2024.
Foreign Policy Analytics / Bayer, “The Health and Economic Impacts of Menopause: United States,” 2025.
Society for Women’s Health Research, Menopause Workplace Resource Guide.
Governor Bob Ferguson, Office of the Governor (Washington State), Executive Order announcement, 2026, citing Society for Women’s Health Research data.
Bank of America / National Menopause Foundation, “Menopause in the Workplace” report, 2024.