Of America's 500 largest companies, only 42 have female CEOs. And if you look at other countries, the data is similar, and in some cases, worse. And, of course, there are a number of factors contributing to global gender inequity in the workplace. But I believe that there is one factor often underecognized, and that's menopause.
So what do I mean? Many women will rise into senior positions of leadership in their 40s or their 50s. The average age of a CEO is mid-50s. Perimenopause, or the transition into menopause, generally occurs also between 45 and 55. And this is where the symptoms really start, and it can last up to 10 years. So just as a woman is stepping up, taking the reins, earning at her highest potential, her body can feel like it's betraying her.
Now, for anyone who doesn't know, which turns out to be many of us -- for me, I had my first conversation with my own mother about menopause in the last few years -- it's a big deal. And it's not just a big deal for women over 45. Nonbinary, transmasculine and younger women may all cope with menopausal symptoms. So what are these symptoms? They can be physical, so that's hot flushes, joint pain, urinary incontinence, heavy periods. They can also be mental: anxiety, depression, bouts of low confidence, difficulty sleeping. Imagine that -- 10 years of difficulty sleeping. The list is long and symptoms can change, so it means you never really know what to expect. But make no mistake: they are significant.
So significant, that in a study by Vodafone across five countries, it found that 60 percent of women dealing with menopausal symptoms said it impacted their work. In another study in the UK, 30 percent of women said they missed work due to their symptoms. And at the extremes, women are making serious choices about their careers. As many as 11 percent forewent a promotion opportunity, and as many as eight percent resigned from their positions because of menopausal symptoms.
My fascination with female leadership and the obvious gap began as a strategy consultant working in boardrooms around the world. In over 10 years, I can count on one hand the number of senior women over 50 in executive positions that I saw, whether it was Seattle or Dubai, Lagos or upstate New York, women were scarce at the top. I started to look around and question the system I was in, wonder what opportunities really existed. The women at the top were exceptional. The bar seemed almost too high to reach. And so I started speaking to my friends and colleagues in their 40s and 50s. They talked about things I knew: balancing a serious job, teenagers and caring for elderly parents. But in a few instances, close friends opened up. They talked about how their bodies and their minds were changing and the impact of menopause on many aspects of their lives, including work. It was at that point that I realized if I wanted to make a difference to women in the workplace so we can all work as long as we want to, it was to improve menopause care.
I believe the workplace can play a major role in improving the experience for women coping with menopausal symptoms. And it might sound cliché, but it does start with awareness. And then it means changing the physical setup of our offices, resetting expectations around work culture and updating health care policies.
So, first: awareness. Since we learn virtually nothing about menopause in school, in the news, in pop culture, it's impossible to expect that even the most well-intentioned manager would have a clue how to be supportive. So many societies place so much pressure on women to appear young and happy and vibrant all of the time. All that effort put towards pretending that you're not going through a natural process of aging is a complete waste of time. Meanwhile, a day in the life of a peri- or postmenopausal woman could be running to the bathroom to wait out a hot flush, looking for paper towels for perspiration that came out of nowhere when everyone else was freezing, skipping a meeting or sending someone else, because a wave of anxiety made you feel like you couldn't cope or skipping a business trip altogether, because heavy periods made leaving home virtually impossible. One way to raise awareness is to bring the discussion right into the workplace. Many companies already offer training programs on things like diversity and inclusion, anti-harassment, conversations on mental health or parental leave. Let's normalize conversation on menopause, inviting people of all genders and all ages to understand what's happening in this natural process of aging, so people can learn how to be supportive.
Next is the physical setup and expectations around work culture. For example, open-plan offices are a disaster for so many reasons, not being able to control the temperature, having no doors to close when you're having a hot flush or need a moment to regroup. And, of course, you can't change an entire floor plan overnight. But there probably are some things you can do, whether that's desk fans, availability of period products, letting someone move their desk from closest to the radiator or having a few rooms with a few doors that you can close if you need a moment to regroup are all good ideas. In situations where women wear uniforms at work, updating the cut to a thinner fabric, making it more breathable or even sweat-wicking can make a huge difference to a woman's comfort, as well as having a few extra around, if a quick change is required during the day.
For employees who can work remotely, you can make it easier by giving examples of things to say to a manager when symptoms are out of control. For example, "I'm having a really tough day due to my symptoms, and it's making it difficult for me to perform at my best in the office." In cases where that's not possible, being able to say things like, "I need to take a few more frequent breaks today rather than one long break," or "Hold on a second -- I'm having a hot flush." I truly believe that more openness about this topic, as well as leniency from an office around scheduling or more frequent breaks will make a huge difference to retaining women and getting them over that next promotion hurdle.
And then there's health care, which is perhaps the most important. In many cases, a workplace will provide in-part or in-full health care to its employees. So there's an opportunity to include menopause directly. It can benefit a woman to have access to real information about what treatment options are available and what doctors or specialists she may want to see, whether that's gynecologists, endocrinologists, pelvic floor physios or talk therapists. Menopause is a highly complex and individualized situation, and having access to high-quality health care providers that can talk you through your treatment options and help you figure out what you want to do is critical. In many cases, insurance does cover this, or national health systems do have this available, but it can be hard to navigate, and all of the symptoms make finding the right doctor time-consuming and energy-draining. Just as we have health care resources for what to expect when you're having a child and how to be a great parent, we need better health care resources for what to expect in perimenopause and support through the entire transition.
Every workplace is different, and not all companies will have the same approach to becoming menopause friendly. But at the very least, increasing awareness and demonstrating some real empathy can be low-cost. Just this year, we've heard several corporations make announcements about boosting female leadership at the top -- and that's great. And it will take a lot of coordinated efforts to get there. But what's the first step? Getting serious about menopause.
Thank you.