From “Nice-to-Have” to Business Imperative: Why Menopause Belongs in Your Benefits Strategy

Menopause affects retention, productivity, and healthcare costs. Learn why employers are making menopause support a core benefits strategy.

6 Min read
January 19, 2026

Susan Thomas

RN, MBA, Chief Commercial Officer, LucyRx

Best Practices

Twenty years ago, most conversations about women’s health in benefits meetings began and ended with maternity.

That frame is breaking. Employers are starting to talk about fertility, postpartum support, caregiving and women’s mental health. Yet there is still a quiet gap for women who are not starting families. They are leading teams, running P&Ls and navigating perimenopause and menopause at the same time.

From where I sit, at the intersection of healthcare delivery and employer benefits, we are underestimating what that gap costs us in both human and business terms. As a nurse, I also see how often women are left wondering, “Is this just aging, or is there something I can actually do?”

The scale of the midlife gap

Global work from the World Economic Forum and the McKinsey Health Institute shows that women spend about 25% more of their lives in poor health than men, and that closing the women’s health gap could add 1 trillion dollars a year to global GDP by 2040.¹

One of the most important “moments” in that gap is midlife. In the United States, about 1.3 million women enter menopause each year, and roughly one in five workers is in some phase of the menopause transition.²

A Mayo Clinic study linked menopause symptoms to $1.8 billion in lost work time and 26.6 billion dollars in total annual costs in the U.S.³ Other large analyses show that about one in ten women has left a job due to menopause symptoms, as unmanaged symptoms collide with peak career responsibilities.⁴

At the same time, AARP and NORC’s review of national health expenditure data found that only about 5% of women ages 45 to 64 receive menopause treatment in a given year.⁵

This is not a niche issue. It is a leadership, equity and retention issue.

Behind the numbers: a familiar story

Behind the data is a pattern many of us recognize.

A woman in her late 40s cannot sleep. She feels foggy in meetings. She starts to question her performance and wonders if she is “just burning out.” Her primary care doctor adjusts an antidepressant. Her gynecologist is rushed. No one pulls all the threads together in a way that feels comprehensive, affordable and sustainable.

She keeps going. But she is not operating at her full potential, and she knows it. So do the people who depend on her.

Women are asking. The system is not ready.

One myth I still hear is, “Women are not asking for this,” or “Menopause is too personal to address in a benefits plan.”

The data says otherwise.

A Yale claims review cited by AARP found that about 60% of women with significant menopause symptoms seek medical attention, but roughly three-quarters leave untreated.⁶ Years later, an AARP/NORC analysis of national expenditure data shows that only about 5% of women ages 45–64 receive menopause treatment in a given year, even though many more report symptoms.⁵ The pattern has been stubbornly consistent: women ask for help, and the system rarely meets them with treatment.

A national survey of residents published in Mayo Clinic Proceedings found that only a minority of OB/GYN programs offer formal menopause training, and that most residents feel “barely comfortable” managing menopause.⁷

On the employer side, Bank of America and the National Menopause Foundation report that more than half of women do not feel comfortable discussing menopause at work, and only 14% believe their employer recognizes the need for menopause benefits.²

The Society for Women’s Health Research EMPACT study found that most employees report no menopause-specific policies or resources, and the majority of women feel uncomfortable asking for accommodations.⁹ Carrot Fertility’s Menopause in the Workplace report reinforces this: many women describe menopause as a workplace challenge, while only a small fraction feel they receive meaningful employer support.¹⁰

Women are raising their hands. The healthcare and benefits infrastructure is simply not consistently prepared to answer.

A pharmacy benefit that finally treats menopause like a business issue

When we talk about menopause benefits, a lot of initial energy goes to:

Virtual clinics and telehealth
Coaching and digital apps
HR policy and manager training

All of that is needed. But as a prescription care partner and independent PBM, we see a practical lever that often gets overlooked: pharmacy benefit design.

If your pharmacy strategy:

Excludes many hormone therapies or treats them as “cosmetic”
Places key drugs on high tiers with restrictive prior authorization
Treats midlife women as a generic risk group in analytics

…you will leave a lot of value, and a lot of women, on the table.

Pharmacy is the place where:

Evidence-based therapies either become accessible or remain theoretical
Women either move from repeated symptom prescriptions to appropriate treatment, or continue to cycle through sleep and mood medications
Data can reveal who is struggling and whether your investments are changing outcomes

For us, this is prescription care in action. Closing the gap between what women need and what benefits actually deliver. That is why we built the LucyRx Women’s Health Benefit as a defined option inside the pharmacy benefit itself.

What we are doing at LucyRx

The Women’s Health Benefit is something a CHRO or CFO can point to in the plan and ask, “Is this turned on?” It is a named benefit inside the pharmacy plan, not a bolt-on point solution. It combines three capabilities.

1) Expanded coverage for menopause and hormonal therapies

We add and appropriately tier hormone replacement therapies and related options that are often excluded. We also include newer non-hormonal and localized treatments where clinically appropriate. We streamline review processes so indicated treatment does not stall in prior authorization or appeals.

2) One-to-one support from menopause-trained Care Guides

Our Care Guides are licensed nurses, pharmacists and certified pharmacy technicians with additional training in menopausal and midlife health. They help women understand their options, navigate cost, coordinate with prescribers and stay on track with treatment.

3) LucyIQ analytics connected to the Outcomes Accord

LucyIQ helps identify women who may be navigating menopause alongside cardiometabolic risk. It routes them into proactive outreach and shows employers how the benefit is affecting utilization, adherence, symptom medications and total cost over time. Those insights are aligned with the performance metrics in our Outcomes Accord.

Most PBMs barely mention menopause. Employers are left stitching together niche vendors on top of a pharmacy strategy that still treats menopause therapies as optional. We built the Women’s Health Benefit so coverage, human support and data live in one place.

What I would ask CHROs and CFOs to consider

If you are a CHRO:

Do you know how many women in your workforce are in the 45 to 60 age band, and what their experience of work and health looks like?
Do your managers know how to respond if a woman raises menopause as a concern, or do they change the subject?
Are you asking your prescription care partner how pharmacy strategy supports midlife women, not only maternity?

If you are a CFO:

Are you looking at cardiometabolic trend, disability and absence for midlife women as a discrete risk area?
Do you know whether your current benefit design makes it easier or harder for women to access evidence-based therapies?
Do you have reporting that links women’s health investments to outcomes and total cost of care, or are you guessing?

I do not believe every employer needs the same configuration. I do believe every employer needs an intentional answer that is better than “nothing” or “we have an EAP.”

LucyRx exists to close the gap between what people need and what benefits deliver. Menopause is one of the clearest gaps. We measure success by whether more midlife women get, afford and stay on the therapies that help them keep living and leading.

The women who built your business deserve better than that. If you would like to see what the Women’s Health Benefit could look like for your workforce, my team and I would be glad to walk through it with you.

See how menopause shows up inside your pharmacy plan

LucyRx helps you understand where coverage, access, and cost support or limit care for your midlife workforce.

Request a plan review

From “Nice-to-Have” to Business Imperative: Why Menopause Belongs in Your Benefits Strategy

6 Min read

Susan Thomas

The scale of the midlife gap

Behind the numbers: a familiar story

Women are asking. The system is not ready.

A pharmacy benefit that finally treats menopause like a business issue

What we are doing at LucyRx

1) Expanded coverage for menopause and hormonal therapies

2) One-to-one support from menopause-trained Care Guides

3) LucyIQ analytics connected to the Outcomes Accord

What I would ask CHROs and CFOs to consider

See how menopause shows up inside your pharmacy plan

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