Addressing the hidden costs of menopause: How physicians can provide support
Key Takeaways
A new study found that menopause-related symptoms contribute to lost time and money in the workplace.
Keeping patients physically and financially healthy requires taking the time to listen to their symptoms—and referring them to specialists when needed.
Menopause is costing people time and money in the workplace.
According to a new estimate by the Mayo Clinic, menopause-related symptoms garner $1.8 billion in lost work time in the United States each year without accounting for medical costs—the annual toll spikes to $26.6 billion when medical expenses are added.[]
Sameena Rahman, MD, a board-certified gynecologist and menopause specialist at the Center for Gynecology and Cosmetics (CGC), says that one of the reasons that menopause can be so taxing in the workplace is that symptoms are not always recognized or diagnosed. This can make it harder for people to find proper treatment or present barriers to taking paid time off.
“Patients think they have to suffer through them and ‘Suck it up, buttercup,’” says Rahman. “The key is that these are untreated symptoms, and this is something that we can help mitigate.”
Menopause can strike at the pinnacle of someone’s career
Menopause can strike at any age, but people most commonly undergo the transition between ages 45 and 55.[]
“These are midlife women, at the pinnacle of their career, or trying to get to the pinnacle of their career or taking care of kids or elderly patients,” says Rahman. “Whatever the case may be—they have a lot weighing on them, financially, economically, and socially.”
Some symptoms that can be particularly hard to deal with in the workplace include brain fog, hot sweats, bladder changes, or irritability.
“If you have brain fog and you're in the middle of a presentation and all of a sudden you can't remember the next statement you were gonna make, it's embarrassing; it makes you look like you don't know what you're talking about,” she adds. “These are people that have worked really hard to get where they are.”
Bladder and vaginal changes caused by menopause can likewise significantly impact people’s productivity, resulting in discomfort—and more unscheduled office bathroom breaks in the office—says Alexandra Dubinskaya, MD, an OBGYN who specializes in urogynecology and pelvic reconstructive surgery at Cedars-Sinai Medical Center.
“Urination can become uncomfortable and more urgent,” says Dubinskaya. “Some women experience urinary leakage for the first time, which comes with [the] additional inconvenience of wearing pads and planning your life around bathrooms.”
She adds that the vagina can also lose natural lubrication and decrease in caliber, making people vulnerable to urinary tract infections and causing “persistent discomfort that can make it difficult to sit for prolonged periods of times.”
Menopause treatments can be expensive, too
Untreated menopause symptoms can reduce a person’s productivity levels, but when treated, they can drain a person's bank account. Treating symptoms like urinary tract infections, which are common in menopause, can lead to a bill of several hundred dollars a month, says Dubinskaya.
“In order to treat a single urinary tract infection, women are required to take time off work to visit a healthcare professional, get their urine checked, and fill in a prescription for antibiotics,” she explains.
This is in addition to over-the-counter supplements they may buy to help mitigate symptoms, adds Dubinskaya. “Managing menopause is not cheap.”
How can doctors help alleviate the financial burdens of menopause?
Alleviating menopause’s financial burdens starts with treating symptoms. And treating symptoms starts with diagnosing them, which begins with listening to patients.
Not all doctors take the time to listen to patients, often due to time constraints in the workplace and sometimes due to implicit biases that need to be challenged, says Rahman. Furthermore, not all primary care doctors are trained in menopause diagnostics and treatment, which makes this task easier said than done. Rahman received most of her training in menopause after she completed her residency, which she says is “shameful.”
For doctors who don’t know what to do, she adds that it’s better to refer a patient to someone who does than to offer a vague or “best guess” answer.
“You have to be comfortable with what your area of expertise is and what you don't have as much knowledge on,” she says. “You may not be able to help that patient, but we shouldn't lie to patients.”
She adds that even primary care doctors who are adequately trained to handle menopause cases may not have enough wiggle room in their schedules to give each case the time it deserves. This can be an issue for doctors who are underpaid and/or overbooked with patients, she says. In these cases, she recommends homing in on one symptom at a time, writing referrals, or scheduling follow-ups to dive deeper into the issues at a later date.
“Physician burnout is real, too,” says Rahman. “You have situations where you're on a hamster wheel seeing patients, and you may want to help [someone work through menopause symptoms], but your job depends on you seeing more patients.”