After age 50, too many women reduce their working hours, become trapped in lower-quality jobs, or drop out of the labor market altogether. Part-time employment becomes more common as women age. The gender gap is widening. For women, this means lower lifetime earnings and significantly lower pensions. Many call this phenomenon the “menopause grief,” a midlife equivalent of the motherhood grief. And, in fact, research suggests that women’s incomes fall in the years after they are diagnosed with menopause.
But while menopause clearly plays a role, there is a risk of attributing these economic setbacks too strictly to biology. Doing so not only oversimplifies women’s lived realities, but also medicalizes what are fundamental social and organizational problems. Menopause matters. But he rarely acts alone.
A convergence of pressures and setbacks
Middle age is often the most demanding stage of women’s lives. Menopause tends to coincide with a series of other “life shocks” that disproportionately affect women. Caring responsibilities intensify: elderly parents begin to need support, while many women still help their children or even their grandchildren. The “sandwich generation” falls between bottom-up and top-down attention.
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Meanwhile, serious health risks are increasing, including breast cancer and chronic diseases. Divorce is also common in midlife and has significant financial and emotional consequences. The death of a parent is another major shock that occurs frequently in midlife and is largely invisible in work thinking: grief doesn’t fit into a few days of leave, but often brings with it lasting exhaustion and difficulty concentrating.
Add to this the increasing exposure to age discrimination in the workplace, and it’s clear that menopause is rarely the only culprit. Yes, symptoms like fatigue, hot flashes, or brain fog can make it harder to keep a job. But menopause comes at a time of cumulative stress. It does not create inequalities. Amplify those that already exist.
When work refuses to adapt
Many jobs are still designed for a worker who is infinitely available, physically resilient, emotionally stable and largely free of caring responsibilities. The symptoms of menopause clash with these unrealistic expectations.
Instead of redesigning work (adjusting schedules, reducing unnecessary presenteeism, offering autonomy, improving ergonomic workplaces and conditions, or recognizing fluctuating abilities), organizations are implicitly asking women to adapt their bodies. And when they can’t, the “options” available are to reduce hours, step away from responsibility, turn down promotions, accept less visible roles, or leave the job altogether.
From the outside, this looks like an individual preference. That is why the pain of menopause is exactly like the pain of motherhood. Neither is caused simply by biology. Both are the result of the collision between life stages and rigid work systems built around uninterrupted, masculine professional norms.
Grief is also reinforced by stereotypes. Menopause is still associated with emotional volatility, decline, and loss of competence. Many women fear being perceived as less trustworthy or less ambitious. Some avoid high visibility projects. Others turn down leadership roles or customer-facing positions simply because they fear exposure. Menopause stereotypes are like sexism on steroids.
Economically, the pain of menopause represents a massive loss of human capital. Women in their 40s, 50s, and 60s tend to have the highest levels of skills, institutional knowledge, and professional experience. When they reduce hours or leave work prematurely, organizations lose leadership potential, mentorship, and experience.
The danger of medicalizing inequality
There is a growing push to frame menopause primarily as a health problem that requires medical solutions: more awareness campaigns, more diagnoses, more treatments.
Don’t get me wrong: better healthcare really matters. Too many women suffer unnecessarily due to lack of information, poor medical support or persistent fears around hormone therapies. For those with severe symptoms, treatment can be life-changing.
But there is a real risk in making menopause the central explanation for economic inequality in midlife. When lower incomes or stagnant careers are primarily blamed on hormonal changes, the role of workplaces, the sexual division of unpaid labor, insufficient care infrastructure, age discrimination and broader social, political and corporate issues are obscured.
It suggests that if women simply managed their symptoms better, the problem would go away. Many times we medicalize social problems. For example, we prescribe antidepressants without addressing poverty, violence, overwork or isolation.
Hormone therapy can relieve hot flashes and prevent osteoporosis (and that’s a lot). But it won’t pay the rent, restart a stalled career, restore lost pension rights or make up for years of unpaid care work. Pills do not solve age discrimination. They do not erase structural inequality.
Let’s redesign work so that it has a long life
1. Design jobs for sustainability. Most jobs are still based on an ideal worker who is always available, endlessly energetic, and free of responsibilities outside of work. This model breaks down with long working lives. Companies should rethink workloads, schedules, and performance expectations to allow for capacity fluctuation over time. Focusing on results rather than presence, reducing unnecessary urgency, and normalizing lower intensity periods would make racing more sustainable.
2. Make flexibility the norm. When flexible working is treated as an exception, it carries invisible penalties (slower progression, reduced visibility). To avoid turning flexibility into a career trap, companies should offer autonomy over hours and location by default and ensure that flexible workers are not sidelined.
3. Face age discrimination head-on. Many career setbacks for women in midlife are inseparable from age discrimination. Employers should track salaries, promotions and evaluations by age and gender, challenge stereotypes in leadership cultures and ensure there are development opportunities throughout careers.
4. Recognize care as a normal reality at a stage of life. Midlife is often when caring responsibilities peak (for aging parents, sick relatives, or extended family), yet workplace policies continue to focus on early parenthood. Companies should expand support to include flexibility in aged care. When caregiving is ignored or treated as a personal inconvenience, many women quietly reduce hours or leave.
5. Openly address menopause. Raising awareness and training managers can reduce stigma and improve support. But if rigid schedules, long hours, and unforgiving performance patterns persist, women will have to manage symptoms within broken systems. Menopause initiatives must go hand in hand with reforms in employment design, flexibility and inclusivity, or they risk becoming tokenistic rather than effective.
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