The Hidden Cost of Menopause at Work: Sickness Absence, Presenteeism and Productivity Loss
Most organisations with 50 or more employees have at least a dozen women currently managing perimenopause or menopause symptoms at work. A proportion of those women are taking sickness absence and recording it as something else. Some are at their desks, present in every meeting, and functioning at a fraction of their capacity. A small number have already quietly decided this is not sustainable and are looking for the exit.
None of this shows up cleanly in a spreadsheet.
That is the problem this article addresses - not menopause as a wellbeing issue or a diversity initiative, but menopause as a measurable, documented, quantifiable cost that most organisations are absorbing without realising it.
Menopause is not an edge case. It is a workforce-wide financial exposure. And the data makes that uncomfortably clear.
The Numbers in One Place
£191m annual absenteeism cost to the UK economy from menopause
(NHS Confederation / London Economics, 2024)
£22.4m annual presenteeism cost - widely considered an undercount
(DWP Literature Review, 2025)
£1.5bn direct economic impact of menopause-related unemployment in the UK
(NHS Confederation, 2024)
60,000 women in the UK currently out of work due to perimenopause or menopause
(NHS Confederation, 2024)
17% of women with symptoms have considered leaving work due to lack of support
(CIPD, 2023)
9.4 days average UK sickness absence per employee per year - the highest in 15+ years
(CIPD, 2025)
The Numbers Most HR Teams Have Never Seen
Let’s start with what the research actually shows.
The 2025 UK Government Menopause in the Workplace Literature Review, published by the Department for Work and Pensions, put the annual economic cost of menopause to the UK at approximately £191 million in absenteeism, £22.4 million in presenteeism, and £1.5 billion in direct economic impact from unemployment women who have left the workforce altogether because managing symptoms alongside work became unmanageable.
The NHS Confederation’s 2024 Women’s Health Economics report estimated that around 60,000 women in the UK are currently not in employment as a direct result of perimenopause or menopause symptoms. That figure is not a projection. It is an econometric estimate based on British Cohort Study data.
And this is before you factor in the cost to individual employers of managing absence, covering shifts, losing institutional knowledge, and running recruitment processes to replace experienced mid-career women who leave because no one made the adjustments that would have kept them.
For the full picture of what this means for workforce risk and retention strategy, Menopause at Work: Why It’s a Business Risk covers the strategic and financial case in detail.
Why Your Absence Data Is Probably Telling You the Wrong Story
Most organisations track sickness absence through Bradford Factor scores, trigger point systems, and return-to-work interviews. These systems do exactly what they were designed to do: they record frequency and duration of absence, generate alerts and prompt management conversations.
What they were never designed to do is capture the real reason someone is absent.
When a woman calls in sick because a hot flush kept her awake until 3am, or because her anxiety symptoms are so acute she cannot get out of the house, or because her brain fog has left her unable to draft a straightforward document that would ordinarily take her twenty minutes - she rarely records “menopause” as the reason. She says migraine. Or stress. Or a stomach issue. Because the alternative is disclosing something she is not sure her manager will understand, in a culture that has not made it safe to disclose.
ACAS is explicit on this: menopause-related absences should be recorded separately from other sickness absence. Measuring them against an individual’s overall attendance record could constitute unfair treatment or discrimination under the Equality Act 2010. But you cannot record them separately if women are not disclosing them. And women will not disclose if the culture does not make it safe
The result is a systematic undercounting. Your absence data does not show you a menopause problem. It shows you anxiety, insomnia, musculoskeletal pain and stress. The underlying cause is invisible.
The CIPD’s 2023 Menopause in the Workplace report, based on a survey of over 2,000 UK working women aged 40-60, found that more than half (53%) had been unable to go into work at some point due to menopause symptoms. Two-thirds (67%) said their symptoms had a mostly negative effect on their work. The Women and Equalities Committee’s 2022 parliamentary inquiry heard that 31% of women surveyed had taken time off directly because of symptoms and that those who do take long-term absence manage an average of 32 weeks of leave across their career.
The CIPD’s Health and Wellbeing at Work 2025 report found that average UK sickness absence has now reached 9.4 days per employee per year - the highest level in over fifteen years, rising from 7.8 days in 2023 and 5.8 days pre-pandemic. Menopause is a contributing factor that currently sits in the “unattributed” column of most HR datasets
The Three Layers of Productivity Loss
Understanding what menopause actually costs an organisation requires looking at three distinct mechanisms. They compound. They interact. And only one of them - the most visible - is even partially captured by standard absence management.
Layer One: Sickness Absence
This is the layer organisations are most likely to be tracking, and still probably undercounting. The UK Government’s 2025 literature review, analysing Reproductive Health Services data, found that women with severe menopause symptoms take an average of seven days of leave per year specifically attributable to those symptoms. That is nearly an entire working week, per affected employee, per year - and it is concentrated in the 45–55 age group that forms a significant portion of experienced, senior and specialist workforces.
The miscoding problem makes accurate measurement difficult. But the cost is real whether or not it appears in your reports.
Layer Two: Presenteeism
This is the larger cost, and the harder one to see.
Presenteeism - being physically or virtually present while operating significantly below capacity - is consistently described in the research literature as the greater productivity drain. A 2023 study published in Mayo Clinic Proceedings (Faubion et al., doi: 10.1016/j.mayocp.2023.02.025) surveyed 4,440 employed women aged 45–60 and found that 13% had experienced an adverse work outcome directly related to menopause symptoms - including reduced hours, role changes, and quitting. Approximately 11% had missed days of work because of symptoms. The study estimated the annual cost to the US economy of menopause-related lost productivity at $1.8 billion in missed workdays alone, with total economic impact - including medical costs - at $26.6 billion.
The UK context is no different in kind. The 2025 DWP Literature Review estimates £22.4 million in presenteeism costs annually in the UK - but this figure is widely considered an undercount, given how difficult presenteeism is to measure in standard surveys.
The CIPD’s 2023 menopause report found that 67% of women experiencing symptoms reported psychological effects including memory loss, reduced concentration, anxiety and loss of confidence. These are not peripheral inconveniences. They are direct impairments to professional performance in any role that requires thinking, communication, decision-making or leadership.
The woman in the meeting who is double-checking everything, staying two hours late to redo work she couldn’t concentrate on during the day and quietly skipping the pitch she’d normally have led - she’s there. She’s counted as present. Her cost is invisible.
Layer Three: Talent Loss
The third layer is the most irreversible - and carries the longest tail of cost.
CIPD research (2023) found that around one in six women (17%) had considered leaving work due to a lack of support with menopause symptoms, and a further 6% had already left. Women who felt unsupported by their employer were more than twice as likely to have considered quitting and around five times more likely to have actually left, compared with those who felt supported.
The NHS Confederation’s 2024 economic analysis estimated that approximately 60,000 women in the UK are currently not in employment because of perimenopause or menopause. The Women and Equalities Committee heard evidence that around 900,000 women have left jobs in the UK due to menopause symptoms.
Each departure carries compounded cost: recruitment, onboarding, the learning curve of a replacement, and the loss of institutional knowledge and client relationships that cannot be replicated from a job description. Menopause and Career Confidence: Staying in the Room When Your Body Is Telling You to Leave explores what this experience looks like from the inside - and why women at peak career stage are walking away from organisations that could have kept them.
Most organisations have no reliable way of measuring how exposed they are to these risks. Before making decisions about policies, training or awareness initiatives, it helps to understand where the gaps actually are. Assess your organisation's menopause readiness using the Workplace Menopause Readiness Assessment.
This Is Also a Legal and Compliance Issue
The productivity argument is compelling on its own. But for organisations that need a compliance frame, the legal picture adds urgency.
Under the Equality Act 2010, menopause symptoms that have a substantial and long-term adverse effect on normal day-to-day activities may constitute a disability, triggering an employer’s duty to make reasonable adjustments. Employment disputes in this area can also engage sex and age discrimination protections. Tribunal case law is developing rapidly: in 2023, Direct Line was ordered to pay nearly £65,000 to a former employee after failing to make reasonable adjustments when her role was affected by menopause symptoms.
ACAS guidance recommends that employers record menopause-related absences separately from other absence, conduct sensitive return-to-work conversations, offer workplace adjustments proactively, and provide a route for employees to speak with someone other than their line manager if they prefer. These are not optional best practice suggestions. They are the baseline that protects both employee wellbeing and organisational legal exposure.
The Employment Rights Act 2025 has made the timeline concrete. From 6 April 2026, employers with 250 or more employees can voluntarily publish Equality Action Plans that must include at least one action related to menopause support. From spring 2027, this becomes mandatory - with compulsory plans due by April 2028. The organisations building genuine capability now, rather than retrofitting compliance at the last minute, will have a measurable head start. What the Employment Rights Act 2025 Means for Menopause at Work covers the full legislative timeline and what it requires from employers at each stage.
The organisations seeing the greatest improvements in retention, manager confidence and employee wellbeing are taking a structured approach rather than relying on policy alone. Explore what effective menopause support actually looks like in practice.
What the Evidence Says About What Works
Here is the important counterpoint to everything above: the productivity losses described are not fixed. They are significantly reduced - in some cases eliminated - by specific, identifiable interventions.
The 2023 CIPD Menopause in the Workplace report found that employees who felt supported by their employer, manager, and colleagues had significantly better outcomes on every measure: workplace experience, symptom impact at work, confidence, intention to stay and career progression. Women who felt unsupported were around five times more likely to have left work entirely.
The most valued adjustments, according to CIPD survey data, are not expensive. Flexible working arrangements - particularly around start times for those managing sleep disruption. The ability to control temperature or access a fan. More breaks when needed. A confidential point of contact that is not a direct line manager. These are largely structural and cultural changes, not significant financial outlays.
Manager capability is the linchpin. Women who felt their manager handled menopause-related conversations sensitively were significantly less likely to consider leaving. Building that capability requires more than awareness. It requires structured training that gives managers the language, the confidence, and a practical framework for having these conversations well. Menopause Manager Training: What It Is, What It Covers, and Why It Changes Outcomes explains what good training looks like and why it directly affects retention and absence data.
If you are a manager yourself - or want to give your managers a practical starting point - the free Menopause Manager Guide gives you the foundations: what menopause means in a work context, how to have the conversation, and what adjustments to consider. It is a resource you can use immediately, before any formal training is in place.
It is also worth noting that creating a disclosure-safe culture has a secondary benefit: better data. Women who feel safe naming menopause as the reason for absence will do so. That means HR teams finally get accurate absence attribution - which enables targeted support, not just aggregate absence management.
Where to Start: Seven Practical Steps
If you are reading this and recognising your organisation in what is described above, here is what to do with it.
Audit your absence recording. Are menopause-related absences being captured separately? If not, your data is incomplete and your risk exposure is unmanaged.
Train your managers - not just in menopause awareness, but in how to have sensitive, non-judgmental conversations that create the psychological safety women need to disclose. What good menopause manager training covers and why it directly changes outcomes.
Give managers an immediate resource. The free Menopause Manager Guidegives managers the practical foundations they need to handle these conversations before any formal training is in place.
Introduce or review your menopause policy. CIPD data shows 46% of organisations had some provision by 2023, up from 30% the year before. If yours is not one of them, the gap in your duty of care is growing.
Create a confidential alternative to the line manager route — an HR contact, occupational health pathway, or menopause champion. Not everyone will feel safe talking to their manager first.
Audit physical working conditions: temperature control, rest facilities, access to natural light, and flexible start times for those managing sleep disruption. The CIPD data shows these are the adjustments women value most.
Build toward your Equality Action Plan. Voluntary from April 2026, mandatory from 2027. What the Employment Rights Act 2025 requires from employers - and when.
The cost is there whether you measure it or not. The question is whether you act on it before it becomes a tribunal, a vacancy, or a retention crisis.
The organisations that move now build genuine capability - in management practice, in culture, in data - that cannot be retrofitted quickly when a deadline arrives or a case is filed. For a complete overview of the support, resources and guidance available, Menopause at Work: Support, Resources and Guidance for Employers is the place to start.
Before investing in training, policies or awareness campaigns, first measure how menopause-ready your organisation really is. The Workplace Menopause Readiness Assessment identifies the capability gaps that most organisations never discover until they become retention, absence or compliance problems.
References
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