Why Menopause Support at Work Still Fails Women
Menopause support at work has expanded. New benefits, telehealth platforms, coaching programs, and workplace policies are more common than they were five years ago. And women are still leaving.
Not because they lack access. Because the support being offered creates its own cognitive burden, and no one is measuring the cost of that.
The Gap Between Access and Relief
On paper, many benefits packages look generous. In practice, women describe something else entirely.
"I had a great provider at first. Then she was gone. Then the next one was gone. I have had three different people in a few months."
"It feels like every appointment assumes I am a brand new patient, even though all my notes are right there."
What these women are describing is not care. It is system management. Instead of receiving steady support, they are tracking appointments, clarifying instructions between rotating providers, navigating platform gaps, and managing prescription logistics on their own time.
That work doesn't show up anywhere in utilization reports. But it is work.
The Hidden Tax on Executive Function
Executive function is not just memory or focus. It is the capacity to prioritize, integrate competing information, and make sound decisions under pressure. It is the core of what senior leadership requires.
When that cognitive reserve is being drawn down by healthcare coordination, the impact on performance is real, even if it is invisible on a dashboard.
Women in this situation describe managing lab timing and refill windows, navigating prescribing restrictions and licensing rules across state lines, handling pharmacy coordination for compounded medications, absorbing last-minute provider changes, and resolving unexpected costs and scheduling conflicts.
"I am spacing out my medication to make it last because I do not know when I will be able to get a refill."
"I was told I did not need labs again until January. Now I am being told I cannot get a refill without them."
Each of these moments requires attention, planning, and problem-solving. None of it is recognized as labor. All of it draws from the same reserve a woman uses to lead her team, close a deal, or make a call under pressure.
When the Woman Becomes the Integration Layer
As benefits systems scale and fragment, the responsibility for continuity shifts quietly onto the individual. She becomes the care coordinator, the compliance interpreter, the person who holds together systems that were never designed to connect.
"I feel like I have become an expert in rules I never wanted to know."
"I understand why the monitoring matters. I just cannot manage all of this on top of everything else."
This is not a resilience problem. It is a structural one. When institutions transfer the cognitive work of system coordination onto the individual, performance erosion is a predictable outcome, not a personal failing.
More options, without integration, can make this worse. Each new pathway added to a benefits package is another decision, another follow-up, another point of failure that the woman herself will absorb.
What Gets Coded as "Personal Reasons"
The downstream effect of sustained cognitive taxation without relief is rarely dramatic. It is incremental. It looks like quiet withdrawal, reduced visibility, scaled-back ambition, or a decision to step back before something breaks.
"I like my job. I am good at my job. I just do not have the energy to keep managing all of this too."
When women exit senior roles during perimenopause or menopause, the departure is typically recorded as personal. What goes unrecorded is the cumulative load of managing work, managing health, and managing systems that do not talk to each other. That is invisible attrition. And it is preventable.
For HR leaders, this is the gap that standard retention metrics cannot see. Exits coded as personal reasons are rarely about a single symptom or a single bad day. They are a rational response to sustained pressure with no structural relief in sight.
What Would Actually Help
The problem is not that women need more education or more grit. It is that most support systems are designed around the assumption of unlimited individual capacity.
Effective support reduces the cognitive load of accessing care, it does not add to it. That means continuity of provider relationships, integrated care coordination, and frameworks women can use to maintain their performance and authority without having to disclose their health status to do it.
That is the model The Peri Nation operates from. Not another platform to manage, but disclosure-independent support that meets women where they are, without requiring them to become experts in a system they never asked to navigate.
Until menopause support accounts for invisible cognitive labor, outcomes will continue to lag behind investment. The access exists. The missing piece is relief.
