Menopause is having a moment. Oprah Winfrey opened up last year about being misdiagnosed when she was experiencing heart palpitations, which were likely early symptoms of menopause. In May, Halle Berry went to Capitol Hill to support new bipartisan legislation, The Menopause Research and Equity Act, that calls for the National Institutes of Health to allocate funding for menopause research.
This public discourse and research are sorely needed—especially given that research on women’s health issues is woefully underfunded and women were historically excluded from clinical trials. But beyond research, we need to address gaps in education and understanding when it comes to health professionals and menopause.
Many healthcare providers lack the appropriate training about menopause and symptom management. For instance, less than a third of OBGYN residency programs have a dedicated menopause curriculum. Even fewer OBGYNs-in-training spend dedicated time in a menopause clinic, meaning that residents may rarely see females during their menopause years, instead focusing their training on younger women during pregnancy, or women later in life with gynecological cancers. In a survey of medical trainees in family medicine, internal medicine, and obstetrics, one in five never had a lecture on menopause during residency. Moreover, only 6.8% of clinicians felt comfortable managing the symptoms of menopause.
That means most women are left to fend for themselves to find information about menopause and the hormonal ramifications of this change. It’s no wonder they feel uncomfortable and stigmatized discussing menopause with their providers.
One setback in the understanding and treatment of menopause came from the NIH-funded Women's Health Initiative. In clinical trials from 1993-1998, study participants were prescribed hormone therapy, but the results showed that it increased the risk of breast cancer and cardiovascular disease. What got lost in the conversation about hormone therapy is that the women in these trials were post-menopausal, and given their ages, the risks outweighed the benefits; however, hormone therapy has since been shown to be safe and helpful at managing symptoms early in menopause. Nevertheless, a whole generation of clinicians avoided prescribing hormone therapy and women feared taking them.
Healthcare professionals need more training on recognizing symptoms of menopause—including hot flashes, insomnia, night sweats, difficulty concentrating, and heart palpitations—and an up-to-date understanding of remedies for these symptoms. While specialized menopause clinics excel in this work, it’s on all of us to provide evidence-based care to the two million women entering menopause in the US each year.
But what happens when the largest healthcare workforce in the country is going through this major life change themselves? Nearly 90% of nurses are women and the median age of RNs is 46—meaning that many nurses are working during the transition to menopause, known as perimenopause, and through menopause, which occurs on average at age 52.
Recent research reveals that nurses may struggle with menopausal symptoms in the workplace—and that it may impact their ability to care for patients. A 2023 study shows that many feel too embarrassed to discuss symptoms with their managers for fear of being perceived as old or unable to cope. Forgetfulness was a common concern, leading some nurses to feel less confident caring for their patients or worried about making errors. Fatigue has driven many nurses to leave clinical settings or take prolonged periods of absence from work.
These symptoms and missed work days can hurt productivity, and overall, cost American women $1.8 billion in lost work time each year. To address these issues, the Menopause Society recently launched an initiative, Making Menopause Work, to help employers create “menopause-responsive workplaces” that support women during this transition. As women, nurses and educators, we feel that this is a hallmark change in the right direction.
What could menopause-friendly workplaces for nurses and other healthcare workers look like? Organizations can create policies and practices that address issues like flexible working hours, including breaks and shorter shift length, sick leave and even temperature control and breathable uniforms or scrubs for contending with hot flashes. Workplaces can designate a “menopause champion” to reduce stigma, raise awareness, and provide continuing education about the complexities that perimenopause and menopause entail. More broadly, healthcare leaders can foster supportive environments where workers feel safe engaging in meaningful conversations. From our personal experiences, we have found our colleagues ready to discuss this topic and share their journeys through menopause.
Workplaces that offer this type of support can help mitigate disruptions in workflow and lower the risk that nurses in their 40s and 50s—who bring decades of experience to their roles—will be driven from their jobs by their symptoms. Menopausal women will no longer be relegated to hiding their symptoms; instead, they will be valued for the knowledge and wisdom that comes with aging.
Theresa Bucco, PhD, RN, and Karla Rodriguez, DNP, RN, are nurses and professors at NYU Rory Meyers College of Nursing.