The workplace health gap: menstruation, fertility, and menopause

A senior data engineer I will call Priya spent eighteen months scheduling her hardest review meetings for the second week of her cycle. Not because the work was lighter then, but because for a few days each month the cramps and the brain fog made her doubt she could hold a room. She never mentioned it. She told her manager she “preferred mornings,” moved things quietly, and absorbed the cost herself. When she finally left for a competitor, her exit interview listed “growth” and “compensation.” The real reason — that she was tired of running her career around a body nobody at work would acknowledge existed — did not make the form.

Multiply Priya by the share of any workforce that menstruates, goes through fertility treatment, or reaches menopause, and you are no longer describing a personal inconvenience. You are describing a structural drain on talent that most companies cannot see, because the people living it have learned not to say a word. For teams in data, ML, and engineering — where women are already a minority and every experienced one is hard to replace — that blind spot is not neutral. It is attrition with the cause filed off.

Three stages, one silence

Start with how common this is, because the instinct is to treat it as an edge case. It is not.

Deloitte’s Women @ Work 2025, a global survey of 7,500 women across 15 countries, found that about 24 percent — roughly one in four — were dealing with health challenges tied to menstruation, menopause, or fertility. These are not exotic conditions. They are the ordinary biology of a large fraction of the working population, distributed across every team, every seniority level, every sprint. The engineer debugging a pipeline through period pain, the analyst stepping out for a fertility clinic appointment she described as a “dentist thing,” the staff-level architect quietly riding out hot flashes in a glass-walled meeting room — they are all in the building right now, and most of their colleagues have no idea.

What unites the three stages is not the symptoms, which differ wildly, but the silence. Each sits behind a wall of workplace taboo thick enough that disclosing feels riskier than coping alone. And the same Deloitte survey put a number on that fear: nearly 90 percent of the women polled believed a manager would think less of them if they disclosed a mental-health challenge. Sit with that figure. It is not that women lack the words. It is that the expected price of using them — being seen as less committed, less reliable, less promotable — looks higher than the cost of suffering in silence. So they pay in silence, and the organisation never learns it is being charged.

Why the silence is expensive, not just sad

It would be easy to file this under “be kind” and move on. The harder, more useful point is that the silence has a price tag, and a retention curve.

The clearest data comes from menopause, the stage that tends to land squarely on women at the peak of their experience and earning power — often their forties and fifties, exactly when a company has invested the most in them and can least afford to lose them. A survey of more than 8,000 women by Korn Ferry and Vira Health found that about 28 percent had either quit or seriously considered quitting because of menopause symptoms. Up to 40 percent reported missing workdays in a given month. These are not people who disliked their jobs. They are people whose bodies were sending a monthly signal that work had no language to receive, so the signal eventually resolved into a resignation.

Scale it up and the economy notices. AARP has put the global productivity loss from menopause symptoms at roughly $150 billion. Treat that headline number with the usual caution — it is a modelled estimate stitched together from absence, reduced output, and lost earnings, and different studies draw the boundary differently — but even discounted heavily it describes a real hole. The striking part is not the precision; it is that an effect this large is so rarely named in any planning meeting, budget review, or retention strategy. A company will spend months war-rooming a 5 percent dip in a funnel metric while a double-digit chunk of its most experienced women quietly headed for the door over something it never measured.

The awareness gap is the actual problem

Here is the finding that reframes everything, and the one I would put on a slide if I had only one.

The issue is rarely that support is impossible to build. It is that the support, where it exists, is invisible. Survey work compiled by benefits providers such as Carrot and OLLY suggests that only about 11 to 14 percent of women are aware of any menopause-related benefit at their employer. Set that against the roughly 24 percent grappling with these health challenges in the first place, and the shape of the failure becomes obvious: the need is roughly double the awareness. Even at companies that have technically introduced something — a policy buried in a benefits portal, an employee resource group with a quiet mailing list — most of the people it was built for do not know it is there.

That gap is good news disguised as bad, because awareness is far cheaper to fix than biology. You cannot legislate away a hot flash or a miscarriage. You can, however, make sure that the woman experiencing one knows, without having to ask a soul, exactly what flexibility and care her employer offers — and that her manager knows how to respond without flinching. The whole problem narrows from “how do we cure these conditions” to “how do we stop pretending they are not happening.” That is a communications and culture problem, and those are solvable on a quarter’s timeline.

What “support” actually looks like

The temptation, once a company decides to act, is to reach for a flashy headline benefit. Menstrual leave is the usual candidate, and it is worth understanding honestly rather than treating as an obvious win.

Several countries — Spain most prominently in recent years, alongside long-standing schemes in parts of Asia — have introduced forms of menstrual or menopause leave, and a small but growing number of employers have followed. The intent is humane. But the design is genuinely tricky: a leave policy that singles out a specific biological event can, depending on culture and rollout, either destigmatise it or quietly mark the people who use it. The lesson from the data is not that dedicated leave is wrong, but that the headline policy is the easy part and the surrounding culture is the hard part. A benefit announced with fanfare and then attached to a faint whiff of “less committed” can do less good than a flexible-sick-day norm that no one has to explain.

What tends to actually move the needle is less photogenic and more structural. Flexibility that does not require a confession — the ability to work from home, shift hours, or step away for an appointment without itemising why — covers fertility treatment, a heavy period, and a bad menopause day equally, without forcing anyone to label themselves. Quiet, real clinical access through health coverage matters more than an app. Private space and basic temperature control turn out to be infrastructure, not luxury. And manager training is the load-bearing wall: a manager who can hear “I need to adjust my schedule this week for a health reason” and respond with “of course, what do you need” rather than a raised eyebrow does more for retention than any portal. The throughline across all of it is the same — support that works lets people get what they need without having to broadcast a diagnosis to a room that has already told them, in a hundred small ways, that it would judge them for it.

Why this lands hard on data and tech teams

For a general audience this is a fairness and retention story. For ours, it is sharper, because of where we start from.

Women are already underrepresented across data science, ML, and engineering, and the pipeline thins at exactly the seniority where these health stages bite hardest. The fertility years overlap with the climb from mid-level to senior; menopause arrives around the staff-and-principal tier that takes a decade-plus to reach. So when an experienced woman in a data org leaves over a health issue nobody would discuss, the team does not just lose a person — it loses one of the few senior women it had, at the exact level it is hardest to hire into, and the representation numbers everyone claims to care about tick down one more notch. The cost compounds in a way it simply does not on a team that started balanced.

Our culture makes it worse in a specific way, too. Always-on engineering norms, the implicit pressure to be perpetually responsive, the lingering instinct to read flexibility as a lack of seriousness — these are the exact conditions under which someone managing cyclical symptoms or fertility treatment learns to hide rather than ask. A team that prides itself on “intensity” without examining what that intensity quietly excludes is, often without meaning to, running Priya’s playbook for her: cope alone or get out. The fix is not lowering the bar. It is decoupling the bar from the assumption that everyone clears it from an identical, never-fluctuating body.

The move

If you take one thing from the numbers, let it be the shape of them: a quarter of women affected, nearly nine in ten afraid to say so, double-digit exits over menopause alone, and single-digit awareness of any help. The bottleneck is not biology and it is not money. It is silence, and silence is the cheapest thing on that list to break.

So break it where you can reach it. If you lead a team, make the path obvious before anyone has to walk it nervously — say plainly that health-related flexibility exists, that it does not require an explanation, and that nobody’s promotion case will quietly carry a mark for using it. If you set benefits, audit not just what you offer but whether the people it is for can find it, because a benefit at 12 percent awareness is mostly a line item, not a lifeline. And if you are the one running your career around a body your workplace refuses to name, know that the discomfort you have been absorbing as a private tax is, in the aggregate, one of the larger and most fixable leaks of experienced talent in the modern workforce. It was never a niche benefit. It was always retention. The companies that figure that out first will keep the Priyas the rest are still busy losing.