For years, Madhu Kapoor was the colleague people counted on. She worked in HR, moved into recruitment and then front-line operations. She had spent eight or nine years in demanding roles, attended breakfast meetings and earned the respect of the people around her. She never expected to leave work.
Then, gradually, her body began to change.
“I started suffering from insomnia,” Madhu recalls. “Every night, I was awake from two o’clock to at least six in the morning.” She had night sweats, joint pain and weekly migraines. Her periods continued, and she didn’t immediately connect the changes to perimenopause. “You know something’s happening, but you don’t know what. You try to carry on, and that was me.”
Madhu, now a Workplace Menstruation and Menopause Consultant, menopause doula and founder of M for Menopause, says the symptoms affected her work as well as her life at home. “They affected every area of my life: home, my children, my partner and work”, she said. At appointments, she says, nothing was diagnosed. She kept trying to be the person everyone knew, even as her health and confidence were shifting.
“I didn’t spend months planning to leave employment,” she says. “It was literally an overnight decision.” She felt unsupported and burnt out, and left a job she had never imagined giving up. The month she resigned, she was told she was perimenopausal, after years of trying to explain what was happening.
Her story puts a human face on a workplace issue often reduced to a policy line or an awareness-day post. Menopause can be gradual, unpredictable and different for every person. When workers feel they must hide what is happening, employers may see only the missed meeting, the request to adjust a schedule or the resignation.
The cost of silence
One in six mid-life women have considered leaving employment because of menopause, while 82% of those who have left say they would have stayed with better workplace support.
Responding to this statistic, Rajal Patni, founder of digital health and social care company Cassi, sees a gap between general wellbeing programmes and women’s specific health needs. “These figures reveal a costly gap in workplace wellbeing for women,” she says. “Workplace benefits are often one-size-fits-all, with little recognition of women’s specific health needs.”
That gap can carry consequences beyond a difficult day at work. Madhu says symptoms may affect confidence, performance and willingness to pursue training or promotion and this workplace impact is easy to misread. A person dealing with poor sleep may struggle to concentrate. A migraine can linger after the worst pain has passed. A hot flush can arrive in a meeting, drawing attention to sweating and discomfort just as the person is expected to speak or make decisions. Symptoms may fluctuate, so a hard day does not erase years of expertise.
Madhu stresses that women do not suddenly lose their skills, knowledge or value because they are going through menopause. But if they fear being judged, they may not tell a manager what is affecting them, or what adjustment could help. “Don’t ignore it. If you don’t feel comfortable talking to your line manager, see if there’s somebody else you can speak to”, she advises.
She remembers wondering how to talk about her health with a young male manager. “I remember having a manager who was about the same age as my eldest daughter, who was in her 20s then. I thought, “How am I going to tell him? How am I going to have this conversation with a young man?” It’s difficult; it’s not easy”, she recalls.
That silence can become a management blind spot. As Rajal puts it, when boards and HR teams fail to recognise menopause’s effects, “women reducing their hours, missing out on promotion or simply leave.” Employers lose experienced colleagues; workers may lose income and opportunities.
Support that works beyond a policy
A written menopause policy can help explain available support, but it cannot create trust by itself. People need to know whom they can approach, and managers need the confidence to respond with empathy and flexibility. Rajal argues menopause should be part of board-level discussions, while Madhu says change has to start with leadership if open conversations are to spread through an organisation.
Practical steps do not need to be elaborate. Managers can ask what would make work more manageable, listen without demanding unnecessary personal details, and discuss reasonable flexibility around schedules or work settings. Organisations can make clear how employees request support and where they can turn if they do not feel comfortable speaking to their direct manager.
The details should be shaped with employees, since needs differ. One person may benefit from flexibility after a poor night’s sleep; another may need a cooler or quieter workspace, or time to attend an appointment. The point is not to assume what anyone needs, but to make it easier to ask.
That approach also means avoiding stereotypes. Menopause is commonly associated with a particular age, but people’s experiences and timelines vary. Madhu notes that younger workers can also face significant menstrual health conditions, including endometriosis, PCOS and adenomyosis. Inclusive conversations about periods and menopause can help employees raise health concerns without having to fit a stereotype first.
For South Asian women, Madhu says, the available UK evidence and assumptions deserve closer attention. She cites an average menopause age of 51 in the country but for women from India, Pakistan and much of South Asia may experience menopause at 46 or 47 and employers should not assume one age or one pathway applies to everyone. Madhu calls for more UK-based research and conversations that account for cultural attitudes as well as individual health.
“Silence isn’t strength,” she says. For Madhu, the subject is not limited to one month of awareness campaigns. Severe symptoms can affect daily life throughout the year, while the willingness to discuss them may depend on whether colleagues and managers make room for the conversation.
Care, data and choice
Rajal sees digital health tools as one possible part of the support mix. Symptom tracking can help someone notice patterns and prepare for a more informed conversation with a healthcare professional or manager. She suggests voluntary digital check-ins, such as simple prompts about mood, energy or symptoms, paired with anonymised information that can help employers understand where support may be needed.
The safeguards matter as much as the technology. Participation should be voluntary, personal health information should be protected, and employers should not use individual symptom data to judge performance. Digital tools can make information and peer support easier to reach, Rajal says, but they work best when they complement practical policies and human support.
“Menopause deserves the same practical recognition”, she says. Her ambition is a specific women’s health policy that employees can count on, instead of support being left to chance or the discretion of one manager.
Madhu’s own experience shows what can happen when help arrives too late. She says she is in a good place now and is glad of the work she has gone on to do. But she also believes many women could stay in employment if organisations made it easier to speak up and seek support before reaching a breaking point.
For employers, the case is both human and practical: experienced workers have knowledge, relationships and skills built over years. Retaining them means treating menopause as a normal workplace health conversation, giving managers the tools to respond, and making support visible before someone has to choose between their health and their job. A conversation will not resolve every symptom. It can, however, be the point at which an employee no longer has to face the change alone.
