A public employer partnered with Washington Health Alliance to destigmatize perimenopause and menopause, identify barriers to care, and close gaps in employee benefits. Over six months, WHA facilitated four virtual employee resource group (ERG) sessions open to all employees and their beneficiaries — drawing 545 total registrations and 115 unique attendees at a 46% attendance rate.
The results were measurable. Participants reporting they were "very comfortable" discussing menopause rose from 39% to 63% by the final session, while those "not at all comfortable" fell to zero. Key barriers surfaced through the process included symptom dismissal, difficulty finding experienced providers, time constraints, and insurance coverage gaps. The initiative produced a replicable framework that the Public Employer is now building on, including exploration of a standing ERG and targeted care navigation improvements.
Why This Initiative Matters
Menopause and perimenopause affect a substantial portion of the working population and can present symptoms — hot flashes, sleep disruption, cognitive difficulties, mood changes, and fatigue, among others — that materially impact performance and wellbeing.
Studies and reviews link these symptoms to increased absenteeism, presenteeism, reduced job satisfaction, and women leaving work entirely. Employer support is often uneven, and formal policies are uncommon.
A Mayo Clinic study estimates more than a $1.8 billion cost impact on employers annually due to lost work attributable to menopause symptoms.
Research shows that people keep their absences private when they are absent because of menopause symptoms, and many who are unsupported at work — by employers, managers, and colleagues — feel that their symptoms have a negative effect on their ability to do their jobs.
With these issues in mind, Washington Health Alliance, sponsored by Astellas, approached a public employer purchaser member of WHA to conduct an employee resource group to bolster dialogue, uncover and address friction points, and ensure public employees can manage their perimenopause and menopause symptoms with adequate, appropriate support.
What WHA Set Out to Accomplish
- Increase employee awareness of perimenopause and menopause symptoms and available resources.
- Develop an understanding of the barriers and constraints experienced by Public Employer employees and beneficiaries in the perimenopause and menopause life stages.
- Improve care and benefit navigation for a whole-health approach to care for employees and beneficiaries experiencing perimenopause and menopause.
- Destigmatize this life stage for people experiencing perimenopause and menopause, and empower them to self-advocate at work and with their care providers.
Host four webinars over six months with sustainable attendance figures. Assess the needs of the attendees through follow-up surveys. Create a replicable framework to continue the dialogue and support policy work.
How the Initiative Was Structured
To address stigma and increase understanding, WHA worked with the Public Employer to establish easy-to-access digital sessions designed to open a two-way dialogue on menopause and perimenopause in the workplace.
Sessions took place every two months between May and November, made available to all Public Employer employees and their beneficiaries. The guiding idea: sessions would incrementally expand the conversation while uncovering the issues faced by participants.
During each session, live polls provided real-time assessment of material comprehension and audience understanding. After each session, attendees were surveyed to gauge effectiveness in educating, reducing stigma, and improving benefit navigation understanding. Between sessions, WHA staff met with Public Employer staff to review survey and poll results and refine messaging for subsequent sessions.
What the Initiative Produced
Reach & Engagement
The series generated substantial and sustained participation for a sensitive workplace topic. More than two-thirds — 69% — of attendees came back for two or more sessions, a signal of strong unmet need and of the psychological safety WHA helped create for these conversations.
Comfort Discussing Menopause and Perimenopause
During the final session, attendees were asked in a live poll to assess their comfort level discussing this topic. The shift across the series was significant.
"Very comfortable" responses climbed from 39% to 63% — a 24-percentage-point gain — while those reporting "not at all comfortable" dropped from 4% to zero by the final session.
Increased comfort is a prerequisite for help-seeking behavior, self-advocacy with providers, and open communication with managers — all of which reduce the productivity and retention costs of untreated symptoms.
| Comfort Level | Session 1 | Session 4 | Change |
|---|---|---|---|
| Extremely comfortable | 26% | 25% | −1 pp |
| Very comfortable | 39% | 63% | +24 pp |
| Comfortable | 39% | 13% | −26 pp |
| Somewhat comfortable | 9% | 0% | −9 pp |
| Not at all comfortable | 4% | 0% | −4 pp |
Raising Awareness
Attendees were asked during the first two sessions whether they felt more informed about the signs and symptoms of perimenopause and menopause after each session.
Source: live session polls, Sessions 1 and 2. Session 1 figures round to 99%.
By Session 2, 85% of attendees reported feeling at least somewhat more informed — up from 61% after Session 1.
Assessing Barriers to Care
Attendees were asked after Sessions 3 and 4 whether they had experienced barriers to care, and if so, what those barriers were. Symptom dismissal and difficulty accessing appointments were the most frequently cited barriers — and both are levers that employers and health plans can pull through network adequacy standards, appointment access improvements, and clinician training.
| Barrier | Session 3 | Session 4 |
|---|---|---|
| Time constraints | 15% | 6% |
| Lack of experienced providers — Health Plan 1 | 15% | — |
| Lack of experienced providers — Health Plan 2 | 4% | — |
| Symptom dismissal | 12% | 17% |
| Difficulty getting an appointment | 12% | 17% |
| Confusion around hormone replacement therapy (HRT) | 8% | — |
| Not currently enrolled in plan | 4% | — |
| Stigma | 4% | 6% |
| Social taboos | 4% | 11% |
| PCP said no care needed (asymptomatic) | 4% | — |
| Finding providers who specialize in menopause | 4% | — |
| Misdiagnosis | — | 6% |
| Conflicting advice from professionals/doctors | — | 6% |
| Medication not covered by insurance | — | 11% |
| No barriers experienced | 15% | 22% |
Select Highlights
Perceived employer support is a measurable outcome — and a meaningful one for retention, satisfaction, and trust, especially among mid-career women. Informed employees are also more likely to use appropriate benefits, improving both health outcomes and benefits ROI for employers.
In Their Own Words
"I appreciate the time and effort put into this series and that it was open to all employees: male, female and all levels and positions. I appreciate how supportive it was, the information, and not creating a worse stigma, but letting women be supported and heard. Thank you."
"I appreciate the availability of this topic. I felt seen. Thank you!"
"I have a coworker who is struggling with symptoms associated with menopause. I spoke with them about the session, and they were very interested. They are going to sign up for the next session and watch the recording."
"This series was very time appropriate and informative."
What Did Not Go Perfectly
Opening a workplace conversation about menopause for the first time came with practical hurdles. Naming them honestly is part of what makes this framework replicable for other employers.
- Scheduling: Public employees work varied shifts and do not all have computer access during standard business hours. Lunch-hour scheduling helped but did not fully resolve access issues.
- Recording access tracking: Webinar recordings were provided after each session, but technical issues limited the ability to track who accessed them and measure the extended reach of the initiative.
- Anonymity assumption: The platform and first session were designed with participant anonymity based on an assumed preference. Participant feedback indicated anonymity was unnecessary. Removing it reduced platform friction and increased engagement for subsequent sessions.
- Beneficiary reach: Sessions were open to employees and their beneficiaries, but it is unclear how broadly beneficiaries accessed the sessions or what additional barriers they may have faced.
What This Initiative Taught Us
- Education prompted action: participants were motivated to track symptoms, talk with friends and family, and reach out to clinicians — demonstrating that awareness programming converts to behavior change.
- Participants showed the strongest interest in nutritional counseling and structured fitness programs; vitamins, supplements, and hormonal prescription medications followed as the next most-selected options.
- Barriers beyond stigma were significant: time constraints, difficulty finding clinicians with menopause expertise, and confusion about hormone therapy all emerged as meaningful friction points that education alone cannot resolve.
- Robust interest in continued learning helped alleviate stigma. By the final session, attendees expressed more comfort and reported sharing articles, tools, and provider recommendations with others in their networks.
A Forward-Looking Framework
Based on the findings and participant feedback, WHA recommends the following actions for the Public Employer and for other purchasers considering a similar initiative.
Sources
- O'Neill MT, Jones V, Reid A. Impact of menopausal symptoms on work and careers: a cross-sectional study. Occup Med. 2023;73(6):332-338. pmc.ncbi.nlm.nih.gov/articles/PMC10540666
- Furst J. Mayo Clinic study puts price tag on cost of menopause symptoms for women in the workplace. Mayo Clinic News Network. Published April 26, 2023. newsnetwork.mayoclinic.org
- Chartered Institute of Personnel and Development. Menopause in the Workplace: Employee Experiences in 2023. CIPD; 2023. cipd.org
Presenting sponsor
WHA Member Organizations
Aetna, Kaiser Permanente, Midi Health, Visana Health
Non-Member Organizations
Gennev, University of Washington
Special thanks to the Public Employer member for trusting WHA with their most valuable assets — their employees.