By Contributor,Elizabeth Pearson

Copyright forbes

Perimenopause can strike women anytime between the ages of 30-55 years old—when many feel they are in their career primes.

If an employee told you they were experiencing brain fog, insomnia, massive mood swings, and migraines you would likely modify your expectations for their work performance, right? You may think they have a health issue they need to tend to, and you may even have sympathy for them. But what if the thing afflicting them is a taboo subject like perimenopause or menopause? Conversations about this life transition would be helpful to come of out of the preverbal closet because perimenopause is almost certain to affect 100% of women by or before the age of 54. Employers would be smart to openly acknowledge and put support plans in place to ensure their female workforce doesn’t unfairly get silences and cut out of all the good projects and promotions.

If you’re unfamiliar with perimenopause, it’s the transitional phase leading up to menopause—often beginning for women in their 40s, though sometimes earlier, and brings a set of physical and cognitive changes that can directly affect work performance, productivity, and confidence. Despite impacting half the population, the workplace dialogue around menopause is still taboo.

When you consider how openly organizations now encourage conversations about parental leave, mental health days, and even fertility support, the silence around menopause is striking. But silence has consequences. Without a shared vocabulary and supportive structures, many women feel isolated, wondering if they’re failing in their roles or losing their edge—when in reality they are navigating a completely natural stage of life.

Symptoms That Show Up at Work

Perimenopause is often unpredictable. Hormonal fluctuations can hit you like a bus and affect not just your physical comfort, but also focus, memory, and emotional stability. It’s not surprise that those symptoms are likely to affect your work. Here’s how:

Brain fog and forgetfulness

A sharp, articulate communicator may suddenly forget key talking points in a presentation or misplace meeting notes, creating the impression of being a bit of a ‘disaster’—unprepared or disorganized.

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Insomnia and sleep disruption

A sweaty and restless night can make it harder to concentrate during high-stakes negotiations or maintain patience in team squabbles.

Hot flashes

Imagine leading a client pitch while suddenly flushing, sweating, and feeling a racing heartbeat. The physical discomfort and self-consciousness can make it super hard to stay composed.

Mood swings and heightened anxiety

Tasks that once felt manageable might now trigger stress or irritability, maybe even tears, which can no doubt affect team dynamics and your reputation.

Some women experience almost debilitating fatigue, which can make long travel days, board meetings, or public appearances feel like running a marathon

Joint pain or migraines

Chronic discomfort can make long hours at a desk or frequent travel increasingly hard to bear.

Note that none of these symptoms mean a professional is less capable. But in the context of competitive workplaces where “presence” and “poise” are currency, experiencing these physical and cognitive shifts without acknowledgment can damage confidence and visibility.

The Career Costs of Silence

The stigma around menopause intersects with persistent workplace bias. Women in mid-career and senior leadership roles already navigate stereotypes about aging, capability, and stamina. Admitting you’re struggling with memory or dealing with fatigue can feel like playing into those biases. Consequently, many women push through silently, shouldering symptoms in isolation—sometimes at the expense of their health and performance.

This silence can even influence career decisions. Some women may decline stretch projects, avoid public-facing roles, or even step back from leadership aspirations because the unpredictable nature of their symptoms makes them feel unreliable. The lack of open dialogue also means managers and organizations miss the chance to offer small, practical tweaks that could make a significant difference.

How to Advocate for Yourself at Work

While every workplace has its own culture, there are strategies for navigating these conversations with both professionalism and honesty:

Prepare your language

Frame the conversation to your boss and focus on performance and solutions. For example: “I’m navigating a health transition that sometimes impacts my energy and focus. Here’s what could help me continue to be my best.”

Request flexible arrangements

Flex time, hybrid schedules, or occasional work-from-home days can alleviate pressure on days when symptoms are particularly intense.

Request an adjustment to your workload

Shifting high-focus tasks to mornings, when energy is higher, or batching writing and analysis work during symptom-light days can help maximize productivity.

Ask about wellness resources

Some organizations already offer health benefits that include hormone therapy specialists, integrative medicine consults, or counseling services, but employees often don’t know to ask.

Build allyship

HR teams and progressive leaders increasingly recognize menopause as a workplace equity issue. Surfacing the topic contributes to long-term cultural change that can support not only you, but also the colleagues coming after you.

Reframing Advocacy as Leadership

Having the courage to name perimenopause in professional spaces is itself an act of leadership. It challenges outdated workplace models that were never designed with women’s life stages in mind, and it opens the door for policies that recognize wellness as integral to sustainable career performance.

It also places you in the driver’s seat of your own career narrative. Rather than letting unexplained lapses or cancelations define how colleagues perceive you, addressing the reality head-on demonstrates self-awareness, communication skills, and leadership maturity.

A Promising Future

As conversations about women’s careers grow more nuanced—with attention on parental leave, caregiving, mental health, and diversity pipelines—perimenopause must be part of the dialogue. It isn’t a weakness, and it isn’t an ending. It’s a transition, one that millions of high-achieving professionals are navigating right now. Workplaces that create space for candid conversation and small, flexible adjustments can retain top talent and foster loyalty during a life stage when many women feel the urge to step back.

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