Celebrities’ personal stories and updated data on the safety of hormone-replacement therapy (HRT) have helped drive awareness of menopause. Yet employers are uniquely positioned to do much more to lessen its impact on affected employees and in the workplace.
Two million Canadian working women are between the ages of 45 and 55, when menopause most often occurs. Unmanaged symptoms of menopause cost the Canadian economy an estimated $3.5 billion per year in lost productivity and lost income, according to the Menopause Foundation of Canada’s 2023 report, Menopause and Work in Canada. Its survey of Canadian women found that 32 per cent reported a negative impact on work performance and one in 10 left the workforce due to unmanaged symptoms.
Fortunately, treatment options took a big step forward in May 2024 when the Women’s Health Initiative, a series of clinical trials launched in the 1990s, confirmed that HRT is a safe and effective treatment for women under the age of 60. For more than 20 years prior to these findings, HRT had virtually fallen off the treatment list after earlier research had indicated increased risks of breast cancer and cardiovascular disease in women over 60.
Even before the Initiative’s statement in 2024, more women and their physicians were turning to HRT. Claims data from Manulife showed a 21 per cent increase from 2020 to 2023 in the number of women aged 45 to 65 using HRT. Yet utilization overall still suggests that many women may be missing the benefits of HRT—Manulife’s aggregate data also showed that only 13 per cent of women between the ages of 45 and 65 made a claim for HRT in 2023.
Menopause action plan
Greater awareness needs to start within the benefits industry, says Shannon McShane-Reed, Senior Vice-President, Group Benefits, Penmore Benefits and SmartChoice Benefits in Concord, Ontario. “There needs to be more education on this topic at industry conferences and webinars so that consultants are talking about it and plan sponsors are given materials that they can share, and strategies to support people.”
Stigma exists around menopause—a fear and embarrassment around speaking out about menopausal symptoms such as hot flashes and mood swings, notes McShane-Reed. As with all areas where stigma is a barrier, senior managers are key to turn the situation around. Organizations as a whole can play a huge part in normalizing conversation about the physical and psychological changes that accompany menopause and how to manage them.
“We need to start talking about it openly,” says McShane-Reed.
Lio Spagnuolo, President, Penmore Benefits and SmartChoice Benefits in Concord, Ontario, would like to see more tailored communications strategies from providers. “The carriers have to do more, the EAPs and the consultants,” he says. He agrees that needs to include education targeted to managers, followed up with communications—including sessions with expert speakers—for employees. “We need to make this a normal conversation.”
“It’s about supporting women every day,” says McShane-Reed. “And sometimes you just need someone to talk to.”
As with any health issue, managers should receive training on understanding the condition, how to sensitively communicate with employees and how to accommodate the symptoms of menopause.
For example, “encourage taking a break during a hot flash. Provide a fan to cool their workplace,” suggests Spagnuolo. Adds McShane-Reed: “To help manage mood changes, provide a quieter space to work in.”
When symptoms are more severe—such as depression, insomnia, heavy menstrual bleeding and urinary problems—facilitating access to health professionals who are certified menopause practitioners can be a huge support. Treatment may include medication, counselling, and changes in diet and exercise. Plan sponsors can work with their benefits advisor and/or employee assistance program (EAP) provider to compile and promote a list of menopause practitioners available in-person or virtually.
Plan sponsors can also encourage the use of health spending accounts to help pay for appointments. “If women are struggling, they can go see someone, and not just for the standard number of appointments with an EAP. More may be required,” says Spagnuolo.
Employers can also join the Menopause Foundation’s Menopause Work Here campaign, which includes a digital logo, educational materials and access to the Foundation’s speakers’ bureau.