You're presenting the Q3 budget to senior management and your mind goes completely blank. Not just forgetting a word, blank. Like someone's wiped your brain clean. The slide deck's right there but you can't remember what you were saying. Everyone's staring. Sweat's trickling down your back, soaking through your blouse. Hot flush or pure panic? You honestly can't tell anymore.
Last week you missed a critical deadline. The week before, you forgot an important client meeting entirely. Your colleague (the one who started six months after you) had to cover. Again. Your manager keeps asking if everything's "okay" in that tone suggesting she's already decided it's not.
We see you. And we know you're terrified your job's slipping through your fingers.
What's happening to your brain at work
Up to a third of women experience menopause symptoms severe enough to wreck quality of life. At work, that becomes impossible to hide.
Your brain's struggling because oestrogen (which helps regulate memory and concentration) is all over the place or dropping off. Memory or concentration problems are listed by the NHS as common mental health symptoms of menopause. Brain fog isn't in your head. Well, it is. But it's real, measurable changes in how your brain functions.
Research shows just over 60% of women report cognitive difficulties during their menopause transition. Women describe struggling to remember people's names, finding the right word mid-conversation, concentrating on tasks, making decisions. Actual tests show difficulties with verbal memory, verbal fluency, attention in perimenopausal women.
It's not just your imagination. Your brain genuinely can't function the way it used to right now.
And it's not just your brain. Hot flushes in an open-plan office mean everyone notices when you suddenly turn scarlet and start frantically fanning yourself with a folder. Night sweats mean you're barely sleeping, so you're exhausted all day. You're snapping at colleagues you normally like. Crying in the toilets over something that wouldn't usually register.
The most commonly reported work difficulties? Poor concentration, tiredness, poor memory, feeling low or depressed, lowered confidence.
Sound familiar?
Why work makes everything worse
The cruel bit: work stress makes menopause symptoms worse. Menopause symptoms make work more stressful. You're stuck in a vicious loop.
Research shows psychosocial factors at work (job insecurity, worrying about work, job dissatisfaction, feeling poorly appreciated) are linked to increased difficulty coping with menopausal symptoms. It's not the physical demands of your job causing most problems. It's how you feel about your work and whether you feel supported.
Already anxious about your performance? The brain fog feels more terrifying. Worried about being judged? Every hot flush becomes a nightmare. Concerned about job security? Asking for help feels impossible.
Around 67% of working women aged 40-60 with menopausal symptoms say they've had a mostly negative impact at work. But many women don't tell their employers the real reason when they need time off or support.
Why? Worried managers will link symptoms to their performance. Embarrassed. Fear being seen as "difficult" or "past it."
You might think you're the only one struggling. You're not. But the silence around menopause at work makes it feel like you are.
Your legal rights (they're stronger than you think)
What you're actually entitled to, then.
Menopause isn't a protected characteristic under the Equality Act 2010. But (and this matters) if you're put at a disadvantage or treated less favourably because of menopause symptoms, that's likely discrimination related to:
Sex (menopause affects women and people who menstruate)
Age (menopause typically happens between 45-55)
Disability (if your symptoms substantially affect your ability to carry out normal day-to-day activities long-term)
Your employer also has duties under health and safety law. They must ensure your health, safety, and welfare at work. That includes making sure workplace factors don't worsen your menopausal symptoms.
If your symptoms count as a disability (and for some women, they do), your employer must make reasonable adjustments. Not "should consider." Must. It's law.
What reasonable adjustments actually look like
Reasonable adjustments aren't nice-to-have. They're things your employer should do to help you keep working effectively.
Temperature control: A desk fan. Moving your desk away from radiators or windows. Access to a cooler space. Adjusting uniform requirements if you wear one.
Flexible working: Changing start/finish times to avoid rush hour when you're exhausted. Working from home on difficult days. Taking more frequent short breaks. Reducing hours temporarily if symptoms are severe.
Practical support: Easy access to toilets and cold drinking water. A quiet space when you're struggling with concentration. Allowing you to take medication when needed. Using tech to help (reminders on your phone, taking more notes for brain fog).
Work adjustments: Temporarily changing duties if current tasks are particularly difficult. Recording menopause-related absence separately from other sickness. Being more flexible about deadlines during bad periods.
You can request these. You don't have to suffer in silence.
If you have access to occupational health at work, speak to them. If your employer has a menopause policy, read it. If they don't, you can still request adjustments under health and safety law and flexible working rights.
How to ask for help without falling apart
This is where it gets scary. Actually saying the words "I'm struggling with menopause" to your manager.
You don't have to disclose anything you're not comfortable with. But if symptoms are affecting your work, being honest usually leads to better support.
Before the conversation, document what's happening. Not formal complaint style. Just notes for yourself: which symptoms are affecting your work most, how they're impacting your performance, what adjustments might help, what you're already doing to manage things.
Check if your employer has a menopause policy. Check your company's flexible working and health and wellbeing policies too.
Book a proper meeting with your manager. Not a corridor chat. A scheduled conversation in private. This signals it's important and gives you both time to prepare.
Be specific. "I'm finding it difficult to concentrate for long periods because of perimenopause brain fog. Could I work from home two days a week where it's quieter?" is more actionable than "I'm struggling with menopause."
If your manager doesn't know much about menopause, be prepared to educate a bit. Frustrating that you have to, but it helps. You could send them ACAS guidance or NHS information beforehand.
Manager unhelpful or dismissive? Escalate to HR or occupational health. You have legal protections. Don't be fobbed off.
What actually improves symptoms (so you can function)
Managing symptoms isn't just about work adjustments. It's about getting medical support that actually works.
Your next step: book with a menopause specialist, not just your GP. Menopause specialists have specific training in hormone health that many GPs don't. They understand how symptoms wreck work and daily life. They're more likely to prescribe effective treatment quickly.
Hormone replacement therapy is the most effective treatment for menopause symptoms. It replaces the oestrogen your body's not making enough of anymore. For many women, it transforms brain fog, mood, sleep, energy levels within weeks.
If you have a womb, you'll also take progesterone to protect your womb lining. If HRT improves your other symptoms but low sex drive persists, you might be offered testosterone too.
HRT isn't suitable for everyone. But for most women, it's safe and effective. A menopause specialist will discuss your individual situation, any risks, whether it's right for you.
Can't take HRT or don't want to? Other options exist. Certain antidepressants help with hot flushes and mood. Cognitive behavioural therapy developed specifically for menopause can help manage hot flushes, sleep problems, low mood. There's evidence from research that CBT improves work outcomes for women with menopausal symptoms.
Lifestyle stuff helps too (though it won't fix everything): regular exercise, eating well, good sleep habits (easier said than done with night sweats, we know), cutting back on caffeine and alcohol.
Don't try to white-knuckle through this alone. Medical treatment exists. Use it.
When it feels like your career's over
You're lying awake at 3am worrying you're going to lose your job because you can't think straight anymore.
This won't last forever. The brain fog and memory problems typically get better once you're through menopause. As hormone levels stabilize, cognitive symptoms improve.
But right now, in the middle of it, when you're forgetting important details in meetings and struggling to write a simple email, it feels catastrophic. Especially if you've built a career over decades and suddenly feel like you're failing at everything.
Some women leave jobs they love because they can't cope with symptoms and don't feel supported. That's heartbreaking. Often unnecessary.
If you're at that point, please:
Talk to a menopause specialist urgently. Effective treatment can change everything within weeks.
Speak to occupational health at work if available. They can assess what support you need and recommend adjustments.
Contact ACAS (0300 123 1100) if you need advice about your rights or if your employer isn't being supportive.
Consider whether you might be covered by disability discrimination protections. If your symptoms substantially affect your daily activities long-term, you likely are. That entitles you to reasonable adjustments and protection from unfair treatment.
Don't make big career decisions while you're in the thick of difficult symptoms. Get treatment first. See if adjustments help. Give yourself time.
What good workplace support looks like
Some workplaces are getting this right. They have menopause policies. They train managers. They create environments where women feel safe asking for help.
Good workplace support looks like:
Open conversations where menopause isn't whispered about or treated as embarrassing. Managers who understand symptoms and know how to offer support. Clear policies explaining what adjustments are available. Temperature control and ventilation in offices. Flexible working options. Occupational health access. Not tolerating age-based or sex-based discrimination or jokes about menopause.
If your workplace doesn't have this, you could:
Suggest developing a menopause policy (the British Menopause Society has resources). Ask HR to provide menopause awareness training. Connect with other women experiencing similar issues (strength in numbers). Point your employer to government guidance on menopause in the workplace.
You shouldn't have to be the one pushing for this. But sometimes that's reality. Pushing for better support helps you and every woman who comes after you.
You're not failing
The fact you're reading this probably means you're desperate. Trying to hold it together at work while your brain's foggy and your body's betraying you. Worried about your job, your career, your future.
We want you to know this: struggling at work during menopause doesn't mean you're not good at your job anymore. It means you're going through a significant physiological change while trying to maintain your professional life in a system that mostly pretends menopause doesn't exist.
You've spent years, maybe decades, building your career and expertise. That hasn't disappeared. Your brain fog is temporary. Your skills and experience are still there.
Get medical help. Ask for workplace adjustments. Know your legal rights. Remember that millions of women are going through exactly what you're going through right now.
You're not alone. You don't have to choose between managing menopause and keeping your career.
¹- NHS. Menopause - Symptoms. https://www.nhs.uk/conditions/menopause/symptoms/
²- Women's Health Concern. Menopause in the Workplace. https://www.womens-health-concern.org/help-and-advice/menopause-in-the-workplace/
³- ACAS. Menopause at work. https://www.acas.org.uk/menopause-at-work
⁴- Equality and Human Rights Commission. Menopause in the workplace: Guidance for employers. https://www.equalityhumanrights.com/guidance/menopause-workplace-guidance-employers
⁵- The Conversation. Brain fog during menopause is real – it can disrupt women's work and spark dementia fears. https://theconversation.com/brain-fog-during-menopause-is-real-it-can-disrupt-womens-work-and-spark-dementia-fears-173150
⁶- Rodrigo CH, et al. (2023). Effectiveness of workplace-based interventions to promote wellbeing among menopausal women: A systematic review. Post Reproductive Health. https://doi.org/10.1177/20533691231177414
⁷- NHS. Menopause - Treatment. https://www.nhs.uk/conditions/menopause/treatment/
⁸- NHS Inform. Menopause and the workplace. https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/menopause-and-the-workplace/
⁹- Gov.UK. Menopause and the Workplace: How to enable fulfilling working lives. https://www.gov.uk/government/publications/menopause-and-the-workplace-how-to-enable-fulfilling-working-lives-government-response
¹⁰- British Menopause Society. https://thebms.org.uk/
