By Sarah McIntyre, CEO | Culture CFO
I had a conversation recently that stopped me in my tracks.
A woman I deeply respect told me something I needed to hear: programs like Rhythm & Results are important, but there’s a reason they didn’t take off in the UK until legislation was in place to protect women first. Without that legal foundation, asking employees to self-identify their cycle-related challenges doesn’t just feel vulnerable. It can be.
She was right. And I think about it differently now.
In the UK, the Equality Act 2010 already covers menopause symptoms under three protected characteristics: age, sex, and disability. That means if a woman is treated unfairly at work because of perimenopause or menopause, she has real legal recourse. It’s not perfect and menopause is still not a standalone protected category, but the framework exists.
The Employment Rights Act 2025 went further. Starting in 2027, every UK employer with 250 or more employees will be legally required to publish a formal Menopause Action Plan as part of their broader equality obligations. Voluntary compliance is already being encouraged now. The message from the UK government is clear: this is not optional, and a policy document sitting in a drawer is not enough.
That legal backdrop changes everything about how programs like this work. When a woman knows her employer is legally required to support her and legally prohibited from penalizing her for disclosing symptoms, she can actually use the tools available to her. When that protection doesn’t exist, even the best-designed program becomes something women have to calculate the risk of engaging with.
Here in the US, there is no federal legislation specifically protecting women from discrimination based on menstruation, perimenopause, or menopause. The Americans with Disabilities Act and Title VII offer some potential coverage, but only on a case-by-case basis, only when symptoms are severe enough to qualify under the ADA’s definition, and only with medical documentation. It’s a high bar that most women never clear, and most never try.
The state-level picture is moving faster. Rhode Island became the first state to mandate workplace accommodations for menopausal women. Virginia passed legislation prohibiting discrimination under its Human Rights Act for symptoms related to menopause. New York, New Jersey, Illinois, and California all have active bills in progress, ranging from anti-discrimination protections to paid leave provisions to insurance coverage mandates. Philadelphia, which is meaningful to me personally as someone based in this region, became the first major US city to pass a local ordinance requiring accommodations for menstruation, perimenopause, and menopause symptoms, effective January 1, 2027.
At the federal level, the Advancing Menopause Care and Mid-Life Women’s Health Act, introduced by a bipartisan group of senators in 2024, proposes $275 million in funding for research, provider training, and public education. It has not yet passed. But the bipartisan nature of it matters. This issue has repeatedly crossed party lines at the state level too. In the California Assembly, a related bill passed 70 to 1.
The momentum is real. The legislation is not yet here.
This is the part that sat with me after that conversation.
When we ask employees to self-identify cycle-related challenges without a legal framework protecting them from the consequences, we are putting the burden and the risk entirely on them. A woman disclosing that perimenopause is affecting her focus or energy is making a calculated bet that her employer will respond with support rather than quiet scrutiny. Some will win that bet. Many will not. And the women least able to take that risk are often the ones who need support most: women in performance-managed roles, women in male-dominated environments, women who’ve watched other colleagues get managed out.
Studies show that a significant percentage of women are reluctant to disclose menopause symptoms at work even when they are struggling significantly. That’s not weakness. That’s a rational response to a real risk.
This is exactly the tension that any well-designed workplace program has to grapple with. The organizational-level work, the culture audits, the manager training, the HR policy design, needs to happen at the systems level. It should create the conditions where disclosure becomes safer over time, rather than demanding disclosure before safety exists.
Waiting for federal law is not a strategy. Some of the most important work organizations can do right now doesn’t require legislative cover.
Start with manager education. Managers who understand the science of hormonal variation, who know how to respond without bias, and who are trained not to interpret normal biological variation as a performance problem are the single highest-leverage intervention an organization can make. This doesn’t require any employee to disclose anything. It changes the environment.
Build flexibility into the structure, not just on request. Organizations that bake flexibility into how work is scheduled and evaluated remove the need for employees to ask for accommodation in the first place. Flexible meeting structures, outcome-based performance evaluation, and asynchronous work options benefit everyone and protect the specific people who most need them.
Review your absence and performance policies. Many companies are inadvertently penalizing hormonal health through rigid attendance policies, trigger-based absence systems, and performance review frameworks that don’t account for episodic variation. A policy audit often surfaces problems that can be fixed quietly, without fanfare, in ways that reduce legal exposure and improve retention.
Create visible leadership commitment without requiring employee disclosure. When senior leaders talk openly about the organization’s commitment to supporting all stages of hormonal health, they signal safety without requiring anyone to step forward. That signal matters more than most leaders realize.
Document everything you do. The UK’s legal framework makes this explicit: a document on a shelf is not compliance. In the US, organizations that build documented, systematic support for women’s hormonal health are already ahead of where legislation is heading, and they’re in a far stronger position if legal requirements do arrive or if an employee ever files a claim.
Research from the Mayo Clinic estimates that menopause-related symptoms cost US employers $1.8 billion annually in lost work time. One in ten women who have worked during menopause has left a job specifically because of their symptoms. These are not numbers that improve on their own.
The UK experience is instructive here too. Organizations that moved on menopause support before it became legally required didn’t just avoid compliance risk. They saw measurable improvements in retention, engagement, and employer reputation. Candidates are now actively asking prospective employers what their menopause and hormonal health support looks like before accepting offers. That’s already happening in the US too, particularly in competitive talent markets.
The organizations that act now, before the law requires it, will have a genuine head start. The ones that wait will be scrambling to comply while their competitors are already reaping the benefits of having built something real.
I’m in the early research phase of building Rhythm & Results, a cycle-aware workplace program through Culture CFO, and conversations like the one that sparked this post are exactly what I need more of.
If you’re a woman who has navigated hormonal health challenges at work, whether tied to your cycle, perimenopause, or menopause, I want to hear your experience. Not to sell you anything. To understand what’s actually happening inside organizations so that whatever gets built is genuinely useful and doesn’t recreate the kind of risk the UK took years to legislate away.
I recently launched a short research survey as part of this effort. If you’re willing to share your experience, it takes about five minutes and directly shapes what this program becomes. You can find it here: www.surveymonkey.com/r/Rhythm_and_Results
And if you’re an HR or People leader who wants to talk through what your organization is already doing, or where you feel stuck, I’d welcome that conversation too. Reach me at Hello@CultureCFO.com.
Sarah McIntyre is the CEO of Culture CFO, a consulting firm that bridges the gap between financial strategy and organizational culture. She holds an MBA and Advanced Certification in Strategic Financial Management from Drexel University, and has held leadership roles across nonprofit, government, higher education, and private sectors. She is also a certified meditation and yoga instructor.
References
Equality Act 2010 (UK): https://www.legislation.gov.uk/ukpga/2010/15/contents
Employment Rights Act 2025 (UK) - Menopause Action Plans overview: https://www.get-carrot.com/en-gb/blog/menopause-and-employment-rights-bill-obligations
ACAS: Menopause and Discrimination at Work: https://www.acas.org.uk/menopause-at-work/menopause-and-the-law
Bloomberg Law: States Look to Protect Menopausal Workers as Federal Policy Lags: https://news.bloomberglaw.com/daily-labor-report/states-look-to-protect-menopausal-workers-as-federal-policy-lags
WorkCare: States Move to Protect Employees with Disabling Menstrual and Menopause Symptoms: https://workcare.com/resources/blog/states-move-to-protect-employees-with-disabling-menstrual-and-menopause-symptoms/
Harvard Petrie-Flom Center: Out of the Shadows: Menopause and the Law: https://petrieflom.law.harvard.edu/2024/10/16/out-of-the-shadows-menopause-and-the-law/
Penn LDI: Workplace Protections for Those Experiencing Menopause: https://ldi.upenn.edu/our-work/research-updates/employment-protections-for-individuals-experiencing-menstruation-perimenopause-or-menopause/
Lozen Advisory: Menopause Legislation Tracker: https://www.lozenadvisory.com/menopause-legislation-tracker/
Ms. Magazine: What's Next for Menopause Legislation in Your State?: https://msmagazine.com/2026/01/07/menopause-legislation-law-policy-state/
Faubion et al., Mayo Clinic Proceedings (2023): Impact of Menopause Symptoms on Women in the Workplace: https://doi.org/10.1016/j.mayocp.2023.02.025