Is 'menopause masking' silently sabotaging women's health and careers? That's the question I couldn't shake after my own experience with brain fog unexpectedly ignited a national conversation. I was stunned by the outpouring of support – nearly 400 LinkedIn comments, countless private messages, and hundreds more responses to my BBC News article. The resounding theme? People called me "brave" for speaking out and thanked me for "normalizing" brain fog.
Honestly, I didn't feel brave or normal at the time. But it hammered home just how much shame and stigma still cling to perimenopause and menopause symptoms, even though they affect roughly half the population at some point.
We've seen Hollywood icons like Oprah Winfrey and Halle Berry, and TV personalities like Davina McCall and Lorraine Kelly, bravely share their menopause journeys. Gwyneth Paltrow even called for a menopause "rebrand" way back in 2018.
And progress is happening! Menopause screening will soon be a standard part of NHS health checks in England for women over 40. Plus, the Employment Relations Bill will require UK companies with 250+ employees to implement "menopause action plans" by April 2027 (with voluntary adoption encouraged from this April).
But here's where it gets controversial... A University College London survey (self-selecting, with around 1,600 participants) revealed that over 75% of women feel inadequately informed about menopause. This suggests a significant gap between awareness campaigns and actual understanding. Are current efforts truly reaching the women who need them most?
The core issue? Many women still feel immense stigma and believe they can't openly discuss menopause.
One academic in her 60s, specializing in social policy, told me she'd started jokingly referring to her "menopausal moments" with female colleagues. Yet, she admitted it was still "embarrassing," especially when she momentarily forgets specific policy terms within her expertise. It highlights the pressure women feel to maintain a facade of competence, even when dealing with genuine cognitive challenges.
But concealing these symptoms – what I call "menopause masking" – takes a serious toll.
Fionnuala Barton, a GP and certified menopause specialist with the British Menopause Society, explains: "The energy expended in masking or making up for the challenges women face will often further deplete reserves and reduce thresholds for overwhelm." In other words, trying to hide your symptoms actually worsens them.
This chronic strain, Barton argues, can dramatically increase burnout risk. And this is the part most people miss... Could the act of concealing menopause symptoms itself negatively impact women's lives, even beyond the symptoms themselves? It's a crucial question to consider.
The NHS lists a staggering 34 possible menopause symptoms, some far more common and debilitating than others.
One woman contacted me after seeing my LinkedIn post, explaining that declining estrogen levels caused severe vaginal dryness, making even walking painful. Imagine the impact on your daily life if a simple activity like walking became a source of constant discomfort.
A friend confided that she developed bladder weakness "almost overnight," now struggling to reach the toilet in time. "It's more annoying than anything else," she said, but admitted it made her avoid returning to an office, preferring to work from home. This illustrates how menopause symptoms can directly limit career choices and social interactions.
Another woman shared her reluctance to socialize due to debilitating brain fog, making it impossible to follow conversations.
Countless others described their coping mechanisms: desk fans for hot flashes, copious notes to combat brain fog during meetings, and elaborate planning to minimize potential embarrassments.
On the one hand, this speaks volumes about the creativity and resilience of women who manage debilitating symptoms while navigating their lives.
Fiona Clark, journalist and author of Menowars, notes that women often experience a distinct journey when symptoms appear: "In the beginning there's confusion and denial, then there's grief and then there's acceptance. But if you're hiding it or masking it you're not going out and getting the help that you need."
Menopause masking poses a particular challenge in the workplace. A 2024 government report estimates that approximately four million women aged 45-55 are employed in the UK – the prime window for menopause.
Jo Brewis, professor of people and organizations at The Open University Business School, argues that masking symptoms at work creates significant "intensive margin costs."
"In other words, the effort involved creates an extra burden for those affected." This burden can manifest in various ways.
An estimated one in ten women aged 40-55 have left a job due to menopause symptoms, according to a 2022 Fawcett Society report based on a Savanta ComRes survey of around 4,000 UK women. This represents a massive loss of talent and experience.
"This burden can take the form of making themselves less visible – such as not applying for promotions or even moving into a lower status, usually lower paid role, to be able to cope," Brewis explains. "People can also invest extra effort to avoid any perception that they are slacking off or their performance is dipping. For example, they might work longer hours to ensure they have double-checked their work if they are experiencing common symptoms like loss of focus or fatigue."
But here's a crucial counterpoint... While the Western perspective often focuses on the negative aspects of menopause, other cultures view it very differently.
For instance, the Japanese term "konenki" translates to "renewal and energy," sometimes described as a "second spring" – a positive transition into a new life phase.
Dr. Megan Arnot, honorary research fellow in evolutionary anthropology at University College London, notes that while many countries share the UK's stigma around menopause, attitudes are shifting here. She points out that in some indigenous communities, such as Native American and Mayan cultures, menopause is seen as a transition into wisdom and leadership, granting women greater respect and influence. Similarly, among Indigenous Australian communities, postmenopausal women often become vital cultural educators and spiritual guides.
Melissa Melby, a professor of anthropology at the University of Delaware, agrees that in the West, "there is this perception that menopause is going to be horrendous, it's going to be hard to navigate, and it's all downhill from there."
"Generally, we give women symptom checklists of negative symptoms. Problems. We never ask them, did anything change during this time that was positive for you? If you only ask questions about negative things, you're going to have very negative perceptions."
Melby spent a decade in Japan, and her conversations with women there left her with "a sense of potential and hope for the next phase of [her] life."
Admittedly, I don't currently share this entirely, and if my husband suggested it right now, his safety wouldn't be guaranteed! But perhaps there's value in shifting our focus from the symptom rollercoaster to the bigger picture.
Menopause has become big business, with dietary supplements, symptom trackers, therapeutic headbands, and specialized life coaches. My social media feeds are flooded with ads for midlife natural remedies.
The menopause market was valued at over $17 billion in 2024 and is projected to exceed $24 billion by 2030. But often, these solutions alone aren't enough.
Regarding the workplace, Brewis emphasizes the need for employers to provide targeted support. Line managers require specific training to facilitate sensitive conversations and implement reasonable adjustments. It's also crucial to explicitly recognize menopause as a legitimate reason for absence.
"Some people will never want to disclose their menopausal status at work, no matter how compassionate or supportive their organization is, and that is absolutely their prerogative," she adds. "But effective menopause initiatives can and should make disclosure easier and reduce this stigma."
Ultimately, attitude plays a critical role.
More than 70 years ago, Margaret Mead, a pioneering anthropologist, coined the term "post-menopausal zest."
Back in the 1950s, she declared: "There is no greater power in the world than the zest of a postmenopausal woman."
So, for now, positive thinking is what many of us must embrace.
As for me, I'll cling to that for as long as I can, channel "konenki," and continue HRT.
But the overwhelming support and conversations sparked by my brain fog moment have revealed an even more comforting truth: I am definitely not alone.
What are your thoughts? Have you experienced 'menopause masking' yourself? Do you think our society adequately supports women navigating this transition? Share your experiences and opinions in the comments below.
