Abstract
This dissertation critically examines the effectiveness of workplace menopause policies and identifies the key predictors of staff utilisation. Drawing upon a comprehensive literature synthesis of 50 peer-reviewed papers, the review addresses a timely concern as increasing numbers of women remain economically active during their menopausal transition. The findings reveal that workplace menopause interventions demonstrate modest benefits for employee wellbeing and symptom management; however, evidence supporting improvements in objective work ability and productivity remains limited. Key predictors of policy utilisation include organisational awareness, supportive workplace culture, managerial training, flexible working arrangements, and the reduction of stigma surrounding menopause disclosure. Significant barriers persist, including lack of awareness regarding available support, discomfort discussing symptoms with managers, and concerns about discrimination. The review identifies substantial gaps in high-quality evaluation research, particularly regarding casual workers and intersectional factors such as ethnicity and socioeconomic status. These findings have important implications for organisations seeking to develop effective, evidence-based menopause support strategies that balance employee wellbeing with operational considerations whilst avoiding unintended discriminatory consequences.
Introduction
The demographic composition of the contemporary workforce has undergone significant transformation over recent decades, with women now representing an increasingly substantial proportion of employees across all sectors and occupational levels. In the United Kingdom, women aged 50 to 64 constitute one of the fastest-growing segments of the labour market, with approximately 4.4 million women in this age group currently in employment (Office for National Statistics, 2023). This demographic shift has brought renewed attention to the intersection of reproductive health and occupational wellbeing, particularly regarding the menopausal transition.
Menopause, defined as the permanent cessation of menstruation following twelve consecutive months of amenorrhoea, typically occurs between the ages of 45 and 55, coinciding with a period when many women occupy senior positions or possess substantial professional expertise (Faubion et al., 2023). The menopausal transition, or perimenopause, may extend over several years and is characterised by a constellation of symptoms including vasomotor disturbances such as hot flushes and night sweats, cognitive changes affecting concentration and memory, mood alterations, sleep disturbances, and musculoskeletal discomfort (Safwan et al., 2024). Research consistently demonstrates that these symptoms can negatively impact work performance, attendance patterns, and career progression for affected women (Griffiths, MacLennan and Hassard, 2013; O’Neill, Jones and Reid, 2023).
The economic and personal implications of inadequate workplace support for menopausal employees are considerable. Studies indicate that approximately one in four women have considered leaving employment due to menopausal symptoms, whilst others report reduced working hours, declined promotions, or experienced diminished job satisfaction (Faubion et al., 2023). The potential loss of experienced, skilled workers represents not only an individual concern but also a significant organisational and societal challenge, particularly in sectors such as healthcare where workforce retention is paramount.
In response to these concerns, a growing number of organisations have implemented workplace menopause policies or integrated menopause support into broader employee wellbeing strategies. The United Kingdom has emerged as a leader in this domain, with numerous employers developing formal policies and the British Standards Institution publishing guidance on menstruation, menstrual health, and menopause in the workplace (Howe et al., 2023). Professional bodies including The Menopause Society and the European Menopause and Andropause Society have issued consensus recommendations advocating for workplace accommodations (Rees et al., 2021; Faubion et al., 2024).
Despite this increased policy attention, the evidence base supporting the effectiveness of workplace menopause interventions remains nascent and methodologically limited. Understanding both the outcomes of such policies and the factors that predict whether employees utilise available support is essential for developing evidence-based approaches that genuinely benefit working women whilst avoiding potential unintended consequences.
Aim and objectives
The primary aim of this dissertation is to critically evaluate the effectiveness of workplace menopause policies and identify the factors that predict staff utilisation of such support measures.
To achieve this aim, the following objectives have been established:
1. To synthesise existing evidence regarding the effectiveness of workplace menopause policies on employee wellbeing, symptom management, and work ability outcomes.
2. To identify and analyse the organisational, managerial, and individual factors that predict whether staff members utilise available menopause support provisions.
3. To examine barriers that impede policy utilisation and explore potential unintended consequences of workplace menopause interventions.
4. To identify gaps in the current evidence base and propose priorities for future research in this domain.
5. To develop evidence-based recommendations for organisations seeking to implement effective menopause support strategies.
Methodology
This dissertation employs a systematic literature synthesis approach to address the research objectives. The methodology draws upon established principles of narrative evidence review, which are particularly appropriate for synthesising heterogeneous evidence from diverse study designs and contexts (Dennis and Hobson, 2023).
Search strategy
A comprehensive literature search was conducted across multiple academic databases, including Semantic Scholar, PubMed, and associated repositories, encompassing over 170 million research papers. The search strategy employed targeted queries focusing on the effectiveness of workplace menopause policies and predictors of staff utilisation. Eight distinct search groupings were utilised to capture foundational theoretical frameworks, policy effectiveness studies, predictors of uptake research, critical perspectives, adjacent constructs relating to menstruation and pregnancy, and citation network expansion.
Selection criteria
The initial search identified 1,126 potentially relevant papers. Following systematic screening of titles and abstracts, 411 papers proceeded to full eligibility assessment. Application of inclusion and exclusion criteria resulted in 292 papers meeting eligibility requirements, from which 50 papers were ultimately included in the final synthesis. Inclusion criteria specified peer-reviewed publications addressing workplace menopause policies, interventions, or support mechanisms, with particular attention to effectiveness outcomes and utilisation predictors. Papers were excluded if they focused exclusively on clinical treatments without workplace relevance, lacked empirical data or systematic review methodology, or were not available in English.
Data extraction and synthesis
Data extraction followed a structured protocol identifying study characteristics, intervention types, outcome measures, key findings, and methodological limitations. Given the heterogeneity of included studies—encompassing randomised controlled trials, quasi-experimental designs, cross-sectional surveys, and qualitative investigations—a narrative synthesis approach was adopted rather than meta-analysis. This approach enables the integration of diverse evidence types whilst acknowledging the varying methodological rigour across the literature (Rodrigo et al., 2023).
Quality assessment
Each included paper was assessed for methodological quality, considering factors such as sample size, study design, measurement validity, and potential biases. The evidence strength for key claims was rated on a ten-point scale, with accompanying reasoning to support transparency in the synthesis process.
Literature review
Prevalence and impact of menopausal symptoms in the workplace
The menopausal transition affects the majority of women, with approximately 75 to 80 percent experiencing symptoms of varying severity (Kopenhager and Guidozzi, 2015). Research consistently demonstrates that menopausal symptoms can significantly impact occupational functioning. Faubion et al. (2023) found that menopausal symptoms negatively affected work performance, attendance, and career progression for substantial proportions of affected women. Similarly, O’Neill, Jones and Reid (2023) reported that menopausal symptoms were associated with reduced work ability and increased presenteeism across multiple occupational settings.
The workplace environment itself can exacerbate symptom severity. Inadequate temperature control, limited access to bathroom facilities, and inflexible scheduling have been identified as environmental factors that compound symptom burden (Hardy, Griffiths and Hunter, 2017). Griffiths, MacLennan and Hassard (2013) conducted a large-scale electronic survey of UK employees, revealing that working conditions significantly influenced how women experienced and managed their symptoms, with many reporting that workplace factors made their symptoms more difficult to tolerate.
Effectiveness of workplace menopause policies
The effectiveness of workplace menopause interventions has been examined across multiple outcome domains, though the evidence base remains limited in both quantity and methodological rigour.
Wellbeing and symptom management outcomes
Most studies report that workplace menopause interventions improve subjective wellbeing and symptom management. Dennis and Hobson (2023) conducted a narrative evidence review concluding that workplace interventions demonstrated benefits for women’s mental health and empowerment, though effects on objective work outcomes were less consistent. Rodrigo et al. (2023) systematically reviewed workplace-based interventions, finding that programmes incorporating self-help cognitive behavioural therapy, yoga and meditation, health promotion activities including consultations and coaching, and educational workshops showed modest improvements in symptom severity and presenteeism.
Taniskidi et al. (2025) conducted a scoping review of workplace non-hormone interventions, confirming that such programmes could effectively reduce symptom burden and improve quality of life measures. These findings align with broader evidence supporting psychoeducational approaches for menopause symptom management in non-occupational settings.
Work ability and productivity outcomes
In contrast to wellbeing outcomes, evidence supporting improvements in objective work ability and productivity remains limited. Dennis and Hobson (2023) noted that whilst wellbeing improvements were consistently reported, translation into measurable work performance gains was not reliably demonstrated. Taylor et al. (2025) systematically reviewed observational studies examining menopause and work performance, concluding that whilst associations between symptoms and reduced performance were evident, intervention effects on productivity measures remained unclear.
Geukes et al. (2023) evaluated a workplace educational intervention on menopause using a quasi-experimental design, finding improvements in knowledge and symptom self-management but limited effects on work ability scores. These findings suggest that whilst policies may enhance subjective experience, their impact on organisational productivity metrics requires further investigation.
Awareness and education programmes
Awareness programmes targeting both employees and managers have demonstrated effectiveness in increasing knowledge about menopause and available support (Rodrigo et al., 2023). Schei and Abernethy (2023) evaluated demographic characteristics and workplace experiences of UK employees using an employer-provided menopause application, finding that digital resources could effectively increase awareness and engagement with support services.
Predictors of policy utilisation
Understanding why some employees utilise available support whilst others do not is essential for effective policy implementation. Research has identified several key predictors of uptake.
Organisational culture and openness
Utilisation is substantially higher in organisations demonstrating openness about menopause and willingness to discuss reproductive health matters. Alzueta et al. (2024) examined challenges and support systems for navigating menopause at work, finding that workplace culture significantly influenced whether women felt able to access available support. Organisations where menopause was normalised and discussed openly reported higher rates of policy engagement.
Hobson and Dennis (2023) conducted workplace focus groups with NHS staff investigating factors underpinning the menopausal experience, concluding that organisational openness was a critical predictor of whether staff felt comfortable seeking assistance. Participants emphasised that cultural acceptance of menopause as a legitimate workplace concern was prerequisite to utilisation.
Managerial training and support
Managerial awareness and training emerge as consistent predictors of policy utilisation across multiple studies. Hardy, Griffiths and Hunter (2017) investigated women’s perspectives on employer and line manager support, finding that trained managers who demonstrated understanding and willingness to accommodate were strongly associated with increased uptake. Conversely, untrained managers or those perceived as unsympathetic deterred women from seeking support.
The gender and age of managers may also influence utilisation patterns. Several studies indicate that women report greater discomfort discussing symptoms with male managers or those perceived as significantly younger, potentially limiting engagement with support provisions (Steffan, 2020; Adelekan-Kamara et al., 2023).
Flexible working arrangements
Access to flexible working arrangements—including modified schedules, remote working options, and break flexibility—consistently predicts policy utilisation (Alzueta et al., 2024). Women are more likely to engage with support systems when practical accommodations are available and accessible without excessive bureaucratic barriers.
However, recent research has raised concerns about potential negative consequences of flexibility. Potočnik, Steffan and Zheng (2025) examined flexible work as a double-edged sword, noting that whilst flexibility may support symptom management, it could also result in reduced hours, lower pay, and diminished career progression if not carefully implemented.
Physical environment modifications
Supportive physical environments—including temperature control mechanisms, access to rest areas, and adequate bathroom facilities—predict engagement with workplace support (Hardy, Griffiths and Hunter, 2017). Women in environments where environmental modifications are possible and implemented report higher satisfaction with organisational support and greater willingness to utilise available provisions.
Barriers to policy utilisation
Despite increasing policy availability, significant barriers to utilisation persist across organisational contexts.
Awareness and information gaps
Lack of awareness about available support remains a fundamental barrier. Many women report being unaware that their organisation offers menopause-specific policies or accommodations (Steffan, 2020). Poor communication about available resources, unclear policy documentation, and insufficient promotion of support services contribute to underutilisation even where provisions exist.
Stigma and disclosure concerns
Stigma surrounding menopause represents a persistent barrier to policy engagement. Beck, Brewis and Davies (2019) examined women’s experiences of menopause at work, finding that many women actively concealed their symptoms due to concerns about being perceived as less capable or professional. The association of menopause with ageing, femininity, and perceived diminished competence creates reluctance to seek formal support.
Steffan (2020) investigated the contradictory nature of identity talk in managing menopause at work, revealing that women navigated complex identity negotiations when considering disclosure. Many preferred informal self-management strategies rather than formal policy engagement to maintain professional identities.
Fear of discrimination
Concerns about discrimination and negative career consequences deter utilisation. Adelekan-Kamara et al. (2023) examined factors underpinning improved menopausal experience in the workplace for doctors, finding that professional women particularly feared that disclosure would undermine perceptions of competence or limit advancement opportunities. These concerns were especially pronounced in competitive or male-dominated occupational contexts.
Inadequate tailoring
Policies that fail to accommodate diverse job roles and contexts may be underutilised. Brown et al. (2023) conducted qualitative interviews with female ambulance staff, highlighting that support mechanisms designed for office-based workers were often unsuitable for frontline or shift-based roles. The mismatch between policy provisions and occupational realities limited practical utility.
Critiques and potential unintended consequences
Whilst workplace menopause policies are generally well-intentioned, several scholars have raised concerns about potential negative consequences.
Reinforcement of stereotypes
Carter, Davis and Black (2021) questioned whether menopause workplace policies represented progress or potential regression, arguing that mandatory or blanket policies could inadvertently reinforce stereotypes about women’s capabilities during mid-life. By emphasising menopause as a workplace problem requiring special accommodation, policies risk positioning menopausal women as inherently impaired or less capable.
Walker-Bone and Davis (2025) similarly cautioned that poorly designed policies could perpetuate gendered and ageist assumptions, potentially creating new forms of discrimination whilst attempting to address existing inequities. The framing of menopause as a medical condition requiring workplace intervention may medicalise a natural life transition unnecessarily.
Economic consequences of accommodations
Potočnik, Steffan and Zheng (2025) examined potential economic consequences of flexible work accommodations, noting that reduced hours or modified duties could have long-term financial implications for women’s earnings and pension accumulation. Accommodations intended to support women may inadvertently disadvantage them if they result in lower income or reduced career progression.
Equity concerns
Targett and Beck (2021) analysed menopause as a wellbeing strategy, highlighting that organisational approaches may not address inequities experienced by different groups of women. Concerns about gendered ageism and racism in policy implementation suggest that benefits may not be equitably distributed across the workforce.
Intersectional considerations
The literature increasingly recognises that menopausal experiences and policy engagement vary according to intersecting social identities and employment circumstances.
Occupational context
Experiences differ substantially between occupational settings. Healthcare workers face particular challenges due to physical demands, shift work, and uniform requirements (Hobson and Dennis, 2023; Cronin et al., 2023). Emergency services personnel report distinct barriers related to operational demands and workplace culture (Brown et al., 2023; Prothero et al., 2025).
Precarious employment
Yoeli, Macnaughton and Mclusky (2021) reviewed menopausal symptoms and work among women in casual, informal, or precarious employment, finding that these workers were frequently excluded from formal support mechanisms. The absence of employment protections, limited access to occupational health services, and financial pressures to continue working despite symptoms created particular vulnerabilities for this population.
Ethnicity and socioeconomic status
Limited research addresses how ethnicity and socioeconomic status influence menopausal experiences at work and policy utilisation. Adelekan-Kamara et al. (2023) noted that minority women may face additional barriers to disclosure and support-seeking due to cultural factors and experiences of workplace discrimination. This represents a significant gap in the current evidence base.
Gaps in evidence and evaluation
Despite increased policy adoption, rigorous evaluation of workplace menopause interventions remains notably absent. Dennis and Hobson (2023) emphasised that few interventions have been evaluated for design-process or outcomes using robust methodologies. Most evidence derives from small-scale studies, cross-sectional surveys, or qualitative reports with limited generalisability.
Howe et al. (2023) conducted a critical global scoping review of policies supporting women’s menstruation and menopause at work, concluding that whilst policy proliferation has occurred, evidence-based evaluation frameworks are lacking. High-quality randomised controlled trials or longitudinal cohort studies examining causal relationships between policy implementation and improved outcomes are rare but essential for establishing best practices.
Discussion
The synthesis of evidence presented in this dissertation reveals a complex picture regarding the effectiveness of workplace menopause policies and the factors predicting their utilisation. Whilst the findings demonstrate that such policies can yield meaningful benefits for employee wellbeing and symptom management, the translation of these improvements into measurable gains in work ability and productivity remains insufficiently demonstrated.
Effectiveness in context
The consistent finding that workplace menopause interventions improve subjective wellbeing outcomes aligns with broader evidence supporting psychosocial approaches to symptom management. Interventions incorporating cognitive behavioural elements, educational components, and practical accommodations appear most effective, suggesting that multi-component approaches addressing both psychological and environmental factors offer greatest benefit (Rodrigo et al., 2023; Taniskidi et al., 2025).
However, the limited evidence for productivity improvements warrants careful consideration. This finding may reflect several possibilities: genuine absence of productivity effects, inadequate measurement of relevant outcomes, insufficient follow-up periods to detect delayed benefits, or complexity in the relationship between wellbeing and performance that defies simple linear assumptions. Future research employing more sophisticated outcome measurement and longer-term follow-up may help clarify these relationships.
The apparent disconnect between wellbeing improvements and work ability outcomes also raises questions about policy objectives. If organisations implement menopause policies primarily to enhance productivity, current evidence provides limited support for this rationale. However, if policies are framed as employee support initiatives promoting dignity and inclusion, the wellbeing evidence provides stronger justification.
Understanding utilisation patterns
The identification of consistent predictors of policy utilisation—organisational openness, managerial training, flexible arrangements, and supportive environments—has important practical implications. These findings suggest that policy availability alone is insufficient; implementation quality and contextual factors substantially determine whether provisions benefit intended recipients.
The centrality of managerial support aligns with broader human resource management literature emphasising line manager roles in policy enactment. Organisations seeking to maximise policy effectiveness should prioritise manager training and development, ensuring that supervisors possess both knowledge about menopause and skills in supportive conversation and reasonable adjustment implementation.
The persistence of stigma-related barriers despite policy availability highlights the limitations of formal mechanisms in addressing deeply embedded cultural attitudes. Policy implementation must be accompanied by broader cultural change initiatives that normalise menopause as a legitimate workplace concern without problematising affected women.
Navigating potential unintended consequences
The concerns raised about potential negative consequences of workplace menopause policies merit serious consideration. The tension between providing support and reinforcing stereotypes represents a genuine dilemma requiring careful navigation. Policies framed around deficiency or impairment risk positioning menopausal women as problematic, whilst absence of recognition may leave women without needed support.
Resolution of this tension likely requires individualised approaches that recognise diversity in menopausal experiences rather than assuming universal support needs. Not all women experience significant symptoms; not all who experience symptoms require workplace accommodations; and those who do may have varying needs. Blanket policies risk both over-medicalising some women’s experiences and inadequately supporting others.
The economic concerns about flexible work arrangements highlight the importance of ensuring that accommodations do not inadvertently disadvantage women. Organisations must guard against scenarios where symptom-related flexibility results in reduced earnings, limited opportunities, or marginalisation of affected employees.
Addressing evidence gaps
The identification of substantial gaps in the evidence base has significant implications for both research and practice. The absence of high-quality evaluation research means that organisations currently implement policies without robust evidence regarding effectiveness, optimal design features, or potential unintended consequences.
The particular neglect of casual workers and intersectional factors represents both a knowledge gap and an equity concern. Women in precarious employment may experience the most severe consequences of inadequate support yet are least likely to benefit from current policy developments. Research and policy attention must extend beyond professional and permanent employment contexts to address the needs of more vulnerable workers.
Implications for organisational practice
Based on the evidence synthesis, several recommendations for organisational practice emerge. First, organisations should conceptualise menopause support as a component of broader employee wellbeing strategies rather than isolated policy interventions. Integration with existing health promotion, flexible working, and diversity initiatives may enhance coherence and reduce potential stigma.
Second, implementation quality requires attention equal to policy design. Investment in manager training, communication strategies, and environmental modifications likely determines whether formal provisions translate into practical benefits. Third, organisations should establish mechanisms for monitoring policy utilisation and outcomes, contributing to the evidence base whilst enabling continuous improvement.
Fourth, individualised approaches respecting diversity in experiences and needs should be prioritised over standardised provisions. Fifth, organisations must remain vigilant regarding potential unintended consequences, monitoring for signs that accommodations inadvertently disadvantage affected employees.
Conclusions
This dissertation has systematically examined the effectiveness of workplace menopause policies and identified factors predicting staff utilisation, addressing an increasingly important concern as workforce demographics continue to evolve.
Regarding the first objective—synthesising evidence on policy effectiveness—the review concludes that workplace menopause interventions demonstrate modest benefits for employee wellbeing and symptom management. However, evidence supporting improvements in objective work ability and productivity outcomes remains limited, indicating that current policies may not reliably deliver the organisational performance benefits sometimes anticipated.
The second objective—identifying predictors of utilisation—has been substantially achieved. Organisational awareness, supportive culture, managerial training, flexible working arrangements, and supportive physical environments emerge as consistent predictors of policy engagement. These findings emphasise that policy availability alone is insufficient; implementation quality and contextual factors substantially determine whether provisions benefit intended recipients.
The third objective—examining barriers and unintended consequences—reveals persistent challenges including stigma, disclosure discomfort, discrimination concerns, and inadequate tailoring to diverse occupational contexts. Potential unintended consequences including stereotype reinforcement and economic disadvantage from accommodations warrant ongoing vigilance.
The fourth objective—identifying evidence gaps—highlights substantial deficiencies in the current knowledge base. High-quality evaluation research is notably absent, and particular gaps exist regarding casual workers, intersectional factors, and long-term outcomes. These gaps limit confidence in current recommendations and indicate priorities for future investigation.
The final objective—developing recommendations for practice—has informed the discussion section, proposing evidence-based approaches emphasising integration with broader wellbeing strategies, implementation quality, individualised approaches, and outcome monitoring.
The significance of these findings extends beyond individual organisations to broader societal considerations regarding gender equality, workforce participation, and healthy ageing. As populations age and women’s labour force participation continues to increase, effective workplace support for the menopausal transition will become increasingly important for economic productivity, social inclusion, and individual wellbeing.
Future research priorities should include high-quality randomised controlled trials examining specific intervention components, longitudinal studies assessing long-term outcomes, investigation of casual and precarious workers’ experiences, and examination of intersectional factors influencing policy effectiveness and utilisation. Such research will strengthen the evidence base, enabling organisations to implement genuinely effective, equitable support that benefits both employees and organisations whilst avoiding unintended negative consequences.
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