Menopause costs the Canadian economy billions every year. Here’s why

Deepti Neto, 63, was trying to run her Toronto-based real estate business running on three to four hours of sleep every night.

She had always been a great sleeper, but in 2013 she started experiencing insomnia and her cognitive and communication abilities were declining as a result.

Neto tried to buy a new mattress to help, but it wasn’t until she noticed her period became more sporadic that she realized she may be experiencing perimenopausal symptoms.

“So I did what everyone does: I drank herbal teas, went to acupuncture, I did everything I could do, but nothing was helping. My sleep was getting worse,” she said, adding that it was affecting her business.

“I am a real estate agent so my communication and cognitive skills are my best skills, it’s my job.  I was getting worried.”

She then went to her doctor, who informed her that he could not provide treatment until she had gone a full year without a period, as that is “when they consider you to be in menopause,” she said. Instead, she was given antidepressants.

But Neto was still having sporadic periods. She was experiencing insomnia, hot flashes and anxiety, all of which are characteristic of perimenopause, the stage leading up to menopause. And she said the antidepressants were causing her more fatigue.

She stopped taking the antidepressants and switched doctors. She was then prescribed menopause hormone therapy and “immediately started feeling better.”

“The sleep symptoms were eradicated within a week or two,” she said, adding that if she hadn’t advocated for her health, she may have never found the solution.

Menopause, exacerbated by stigma, lack of workplace support and the burden of debilitating symptoms, carries a substantial cost for the Canadian economy, amounting to an estimated $3.5 billion per year, according to a new report.

The Menopause Foundation of Canada released the report Monday, finding that unmanaged symptoms of menopause cost employers an estimated $237 million annually in lost productivity. And women experience a substantial financial burden, with $3.3 billion in lost income because of reduced hours, diminished pay, or leaving the workforce altogether.

The report also found that 540,000 lost days of work can be attributed to menopause symptom management per year.

“Many women are blindsided by menopause, which is really just being unprepared for this stage of life,” explained Janet Ko, president and co-founder, of the Menopause Foundation of Canada.

“What that leads to is some women stepping back from the workforce, leaving altogether, taking a lesser job, reducing their hours, going part-time or not taking that promotion. We believe menopause is the missing link to explain why more women are breaking through the glass ceiling,” she added.

In Canada, there are more than two million working women aged 45-55, which is the average age at which most women experience menopause, according to the report.

There is also a period before menopause, called perimenopause, which can last two to 20 years, Ko said. And then there’s post-menopause, which can last for the rest of a woman’s life.

“So women will actually spend up to half of their lives in a stage of menopause,” she said.

While menopause is a universal life stage for most women, a survey in the report found that 46 per per cent of respondents said they are not prepared for this transition.

Ko referred to this as the “menopause knowledge gap,” signifying a lack of understanding among women regarding the changes in their bodies and the symptoms triggered by hormonal fluctuations.

As a result, many women do not get the help they need.

“That not only impacts their health, their quality of life, but it also impacts their ability to work as productively as they would like,” she said, adding that menopause usually happens during the peak of women’s careers.

The survey also found that more than one-third of working women said menopause symptoms negatively impacted their work performance. And around one-quarter said they hid their symptoms at work.

Sixty-seven per cent said they would not feel comfortable talking to their supervisor about their symptoms, and almost half said they would be too embarrassed to ask for help at work.

And an estimated one in 10 women will leave the workforce due to unmanaged symptoms of menopause.

During menopause, the ovaries stop the process of ovulation and estrogen production, and as a consequence, women stop menstruating, explained Teresa Isabel Dias, a pharmacist and a certified menopause practitioner based in Toronto.

Perimenopause is the transition period, lasting six to eight years, leading up to menopause when a woman’s menstrual cycles could become irregular as the hormone levels fluctuate.

“Women may start experiencing things like this at the age of 35. And nobody is aware of that such big change can take place so early in life. So a lot of women struggle for many years when they have early perimenopause because our health care is not trained on this,” she said.

In Canada, the average age of menopause is 51.5 years. But most women are in perimenopause between the ages of 40 and 50, according to the Menopause Foundation of Canada.

And women can continue experiencing symptoms into their 60s and 70s.

There are also over 30 symptoms of menopause, including hot flashes, insomnia, brain fog, anxiety and joint pains.

Not every woman goes through a rough time, Dias said, adding that “20 per cent do not experience any bothersome symptoms.”

But one of the biggest risks of menopause that she hopes women will be aware of is the loss of estrogen.

“Estrogen is protective for the bones. It helps to not lose bone density as fast. It also helps with the heart,” she said.

“Estrogen is a girl’s best friend. And when we don’t have it, we have to do other things to reduce our risk for disease,” she said.

The number one piece of advice Dias gave for women is to lead a healthy lifestyle, such as eating healthy nutritious foods, drinking enough water, getting regular exercise and sleeping at least eight hours every night.

“We have to have compassion towards ourselves, have a lot of patience to go through this and believe that we’ll get to the other side,” she said.

Treatments for menopause, like hormone replacement therapy and pelvic floor physiotherapy, are available options. However, Ko pointed out that due to the significant stigma surrounding this topic, many women do not know where to seek help and often are hesitant to talk about it.

The report found that 87 per cent of working women felt their employer does not provide, or do not know if they provide, support related to menopause. The most common supports identified as desirable are medical coverage, flexible workplace policies and environmental adjustments, along with general awareness and education, the report found.

“It’s a really important topic that doesn’t get a lot of attention,” Ko said. “Menopause is overwhelmingly viewed as negative in our society.

“The image of the menopausal woman is very unflattering, which is why I think many women don’t want to be associated with that negative portrayal of a woman. So menopause comes wrapped up in secrecy and mystery.”

But the workplace could be a great place to start breaking down the stigma, she said.

This could entail holding information sessions with employees, putting information up on the company website, creating an employee resource group and improving benefit plans (to cover hormone therapy), Ko said.

“We believe that most employers have just never considered this and that when they understand the number of women in the workforce that are going through this they’ll start to look at it,” she said.

“We have the skills, experience and leadership that employers need, and they can’t afford to lose.”

— with files from Global News’ Saba Aziz