United States

Country Context

The United States, the largest economy in the world, with a GDP of USD 27.7 trillion, was home to 343.5 million people in 2023. Each year, an estimated 1.3 million women in the U.S. enter menopause. Menopause generally occurs between the ages of 45 and 55 in the U.S., and the average age of menopause is 52. However, research indicates that Black and Latina women are more likely to experience menopause earlier than White women, creating the potential for greater health risks and the need for tailored health care. By 2060, an estimated 90 million women in the U.S. will be postmenopausal, reflecting an aging population and longer life expectancy, and necessitating targeted health and labor policy interventions to safeguard not only women’s health and well-being, but also U.S. economic productivity.

FIGURE 1

Female Labor Force Participation Throughout the Menopause Transition

The significant decrease in female labor force participation rates after age 55 could indicate difficulties remaining in the workplace during and following menopause.

Sources: U.S. Bureau of Labor Statistics via FRED, U.S. Bureau of Labor Statistics via FRED, World Bank, U.S. Department of Labor, U.S. Bureau of Labor Statistics

Much like other high-income countries, menopausal and postmenopausal women represent a significant and growing segment of the U.S. working population. As of 2024, roughly a quarter of the U.S. workforce was in some phase of menopause transition, with 76.8 percent of women between the ages of 45 and 54 active in the labor force. However, without proper support, menopause can impact productivity and workforce participation. A Mayo Clinic survey found that 13.4 percent of women aged 45 to 60 in the United States reported at least one adverse work outcome, such as lost productivity or absenteeism. In comparison, approximately 10.8 percent of women reported missing work due to menopause symptoms. The resulting lost productivity is estimated to cost the U.S. economy USD 1.8 billion annually. Effective treatment for menopause is therefore a matter of economic security, in addition to a critical component of women’s health throughout the life course.

Policies and Programs

While the United States lacks an overarching national policy on menopause, policy discussions around menopause have gained momentum in recent years. Multiple bills with bipartisan support were introduced in 2023 and 2024, during the 118th Congress, to enhance menopause care and research, though none has been enacted into law as of 2025. The Advancing Menopause Care and Mid-Life Women’s Health Act (S.4246/H.R.8233) seeks to expand health care access and provider education, while the Menopause Research and Equity Act of 2023 (H.R.6749) calls for the National Institutes of Health to evaluate the results and status of menopause research. The WARM Act of 2023 (H.R.6743) seeks to amend the Public Health Service Act to include public awareness of menopause and related chronic conditions. Meanwhile, legislation such as the Improving Menopause Care for Veterans Act of 2024 (H.R.8347) aims to address the menopause-related care needs of veterans. While promising, these bills need to be passed and enacted in order to fulfil their intended vision to improve health, equity, and the economy.

In March 2024, President Biden issued an Executive Order on Advancing Women’s Health Research and Innovation, which committed USD 200 million in funding for women’s health research. However, of this funding, only USD 13 million was dedicated to menopause research. While research funding for menopause remains insignificant, interviews undertaken by FP Analytics in 2025 underscored that the U.S. National Institutes of Health remains an international leader in menopause research, with many countries relying on U.S. studies for information and data on menopause and its impacts on health and economic output. For example, interviewees in the U.K. and Canada cited recent research in the U.S. on Black and Asian women’s experiences of menopause as compared to those of white women, which does not yet exist in their own countries. Nevertheless, the future of federally funded research on menopause as well as menopause-related legislation has become uncertain under the Trump administration, and it remains to be seen whether the progress of recent years will be built upon or stalled. Research, in particular, may be interrupted by federal funding freezes and additional political scrutiny or de-prioritization of research on gender and women by the National Science Foundation.

Health Care for Menopause Symptoms

There is no universal public health system in the United States. Instead, people in the U.S. rely on private insurance, employer-sponsored plans, and limited public programs such as Medicare, a federally funded health insurance program for those with certain disabilities and those ages 65 or older, and Medicaid, a joint federal and state program that provides health coverage for some people with limited income and resources. As a result of this patchwork system, coverage for menopause-related treatments varies widely, depending on federal and state-level regulations and insurance providers. Many plans, including public plans, do not cover basic menopause management treatments such as hormone therapy. Currently, only two states—Illinois and Louisiana—mandate that both public and private insurance providers cover medically necessary menopause treatment—both hormonal and non-hormonal. Even in these states, health plans may continue to limit or delay coverage through utilization management practices such as step-therapy and prior authorization requirements.

Insufficient training and awareness among health care professionals also hinders women from receiving appropriate menopause care. Denise Pines, a filmmaker behind The M Factor, president of the Osteopathic Medical Board of California, and past president of the Medical Board of California, noted in an interview with FP Analytics that some medical practitioners lack the training and expertise to treat the full spectrum of menopause-related challenges women face. Supporting this, a 2017 survey published in Mayo Clinic Proceedings found that only about 7 percent of medical residents felt adequately prepared to manage menopause. Meanwhile, more than one in five medical residents reported receiving no lectures on menopause during residency, and nearly one-third said they would not offer hormone therapy to a symptomatic, newly menopausal woman without warnings. This hesitancy among providers is partly linked to the FDA’s black box warning on estrogen and progestin therapies, which highlights potential risks, such as an increased likelihood of blood clots, stroke, and certain cancers. While more recent research suggests that hormone therapy (MHT) is safe and effective for many women when used appropriately, the lingering effects of the early 2000s Women’s Health Initiative (WHI) study, combined with a lack of provider knowledge, have contributed to the low uptake of MHT. Beyond hormone treatments, access to non-hormonal treatment options also remains limited, given the lack of prioritization of menopause, care provider training on menopause, and limited insurance coverage.

FIGURE 2

Menopause Policy and Implementation Overview

To address gaps in training and awareness, organizations such as the Menopause Society provide resources, including an online database of certified menopause practitioners, to assist women in accessing high-quality care. In California, legislators introduced AB 360, a 2025 bill requiring the state’s medical boards to survey physicians about their menopause training as part of the license-renewal process to assess provider knowledge of menopause. Legislators in other states, in tandem with advocacy groups, could take a similar approach to improve menopause treatment by encouraging health care workers to upskill and enhance their knowledge of menopause symptoms, treatments, and co-morbidities.

Menopause in the Workplace

Perimenopausal, menopausal, and postmenopausal women make up an increasing proportion of the U.S. workforce yet receive little support to manage their symptoms in the workplace. Federal law does not explicitly require employers to accommodate menopausal symptoms, and legislation regarding workplace discrimination does not appear to consider menopause as a protected characteristic or condition. Although the Americans with Disabilities Act requires employers to provide “reasonable accommodations” for workers with disabilities, U.S. courts have consistently held that menopause is not a disability, even when its symptoms seriously affect a person’s ability to do their job. Similarly, the Equal Employment Opportunity Commission (EEOC) guidance for implementing the Pregnant Workers Fairness Act (PWFA) does not reference menopause, despite the law’s ambiguity around “related conditions” and discussions of menopause during the regulation’s comment period.

In practice, the availability of care, rights, and protections for menopausal women heavily depends on employers’ policies and accommodations, but employer support for menopause in the U.S. is limited. According to a 2022 survey by global fertility and health platform Carrot Fertility, only 21 percent of women reported that their employer offered support during the transition, while 59 percent reported no menopause support at all. This same survey found that one in five women considered changing jobs for better menopause support, with women of color being nearly twice as likely to consider switching jobs, compared to their white counterparts. This finding may connect to other research that shows vasomotor symptoms among Black and Hispanic women tend to be more frequent and intense than those reported by white women. Moving forward, existing research on how race and economic status intersect with women’s experiences of menopause, and their health and economic implications, needs to be more systematically leveraged to inform care.

FIGURE 3

Economic Impact of Menopause on the Workforce

Menopausal women in the United States face significant economic challenges, with lost workdays, early retirement, and reduced income affecting productivity.

Sources: U.S. Bureau of Labor Statistics, SHRM, Mayo Clinic Proceedings

As an additional challenge, the timing of the menopause transition often overlaps with key career growth years for many professional women, as they may pursue management or senior leadership positions. In the U.S., women are under-represented in workplace leadership positions: In 2023, only 11.8 percent of approximately 15,000 C-suite roles at publicly traded U.S. firms were held by women. The challenges of menopause—often overlooked in workplace culture—can add an additional, invisible barrier to advancement during this pivotal stage in a woman’s career, and a time in which women may be at their most economically productive. Employer support for menopause, thus, may be key to achieving greater equity as well as improving the economy’s overall productivity.

Looking Ahead

In the United States, systemic gaps in health care access, clinical training, workplace support, and state and federal policy leave many women without the resources they need to manage menopause effectively. As the postmenopausal population grows, there is an urgent need for coordinated, evidence-based strategies that center menopause in health, labor, and gender equity frameworks. Without targeted action, the U.S. risks sidelining a vital segment of its workforce during their peak years of vocational experience and economic contributions. Addressing these gaps will be vital to ensuring that menopausal women in the U.S. can continue thriving in society and the workforce. Steps to improve menopause care and support in the U.S. include:

• Catalyzing Employer Action: Employers can lead by establishing workplace policies supporting menopausal employees. Supports can include flexible work arrangements, such as working from home or adjusting hours to accommodate symptoms, and providing access to menopause-related health resources. Women in positions of authority and leadership within companies can lead by example by implementing and publicizing adequate menopause accommodations, and by speaking frankly about their own experiences of menopause, to overcome lingering taboos.
• Improving Provider Knowledge: States can standardize and improve care for women undergoing menopause by including menopause-specific training in medical licensure renewals or certification programs. States require that doctors take continuing medical education (CME) of between 12 and 50 hours, depending on the state, to remain licensed. Requiring a menopause CME would ensure that all OB-GYNs, general practitioners, and other relevant health care professionals are adequately trained in menopause management, and women can access high-quality menopause care regardless of geographic location or the quality of their insurance coverage.
• Expanding Coverage for Menopause Treatment: As of 2025, only Illinois and Louisiana mandate that both public and private insurance providers cover medically necessary menopause treatment. Mandating coverage and curbing health plans’ ability to limit access through utilization management practices would ensure access to evidence-based care, help reduce disparities, improve health outcomes, and support women’s continued participation and productivity in the workforce.