Is it Perimenopause or is your Company Culture to Blame?

It’s not exactly a secret that leadership is a complex landscape for women to navigate. For many, the journey to the top has been far steeper and more arduous than it is for their male counterparts. After finally earning that coveted key to the top-floor office, it can feel like the hard work should be over. Yet, just as you settle into your new role, you might find yourself facing unexpected challenges: memory lapses, difficulty concentrating in meetings, mood swings, and the only thing that seems to be excelling is rising tide of your anxiety.

While studies differ on the exact numbers, research suggests that anywhere from 10% to 25% of women have considered leaving the workforce due to what they believe are symptoms of menopause. There’s no question that hormonal fluctuations during this time can significantly impact some women, and it’s encouraging to see the emergence of workplace policies aimed at offering support. However, these initiatives often overlook a critical question: Could our work culture and environment be exacerbating—or even causing—these symptoms?

The idea that the pressures and demands of leadership might intensify the physical and emotional challenges of menopause is one that deserves serious consideration. The stress, long hours, and often unrealistic expectations placed on women in leadership roles may not only amplify these symptoms but also make them harder to manage. Instead of just addressing the symptoms, perhaps it’s time to rethink the structures and cultures that make these symptoms so overwhelming in the first place.

When I first began researching the structural changes that occur in the brain during perimenopause, I was struck by the consistent findings: a noticeable shrinking of the amygdala, the hippocampus, and the prefrontal cortex. These areas are crucial for emotional regulation, memory, and decision-making. What truly startled me, though, was the realization that these are the same brain regions that shrink in response to prolonged chronic stress.

This discovery prompted me to delve deeper into the scientific literature, particularly to explore what unique stressors women might face on a daily basis that men typically don’t. The findings were both enlightening and troubling. High on the list of stressors was the mental load associated with running a household—responsibilities that disproportionately fall on women, especially those who are married or living with a male partner.

However, the home environment is just one part of the story. The burden of emotional and mental labor extends far beyond the domestic sphere. In the workplace, women often carry an additional, invisible load, managing not just their own work but also the emotions and well-being of those around them. This dual burden—at home and at work—can create a perfect storm of stress that exacerbates the very brain changes associated with perimenopause, further complicating an already challenging time in a woman's life.

Even in our modern corporate culture, much of the work that women do is not found in job descriptions or performance reviews. This invisible work, known as emotional labor, a term first coined by sociologist Arlie Hochschild, consists of managing and regulating one’s own emotions and the emotions of others to maintain harmony, provide support, and ensure a positive environment. It is deeply rooted in gender stereotypes that assign women the roles of caregivers and nurturers. This form of labor goes far beyond the tasks typically associated with a job title. It involves everything from soothing an upset colleague to organizing team celebrations, mentoring less experienced employees, or simply being the person everyone turns to when they need emotional support. All of these responsibilities require energy and mental bandwidth, but they often go unrecognized and unrewarded. And while these tasks may seem small, they add up, contributing to a significant cognitive and emotional burden that can detract from her primary responsibilities and professional growth.

To fully understand why emotional labor is so draining, it’s worth taking a moment to explore the neuroscience behind it. Every action and decision your brain makes, no matter how small, requires resources. It needs energy, which primarily comes from glucose, neurotransmitters, and essential ions like sodium, calcium, and magnesium. But these resources aren’t limitless.

Imagine your brain’s energy like money in a bank account. You’ve likely had the experience of checking your bank statement and being surprised at how quickly your balance dwindled. Small purchases—a coffee here, a magazine there, an impulse buy at the movies—add up faster than you realize. Each transaction seems insignificant on its own, but together they consume a substantial portion of your funds, leaving you with little to show for it. You may not even notice these expenses in the moment, and they certainly don’t provide the lasting satisfaction or reward that a bigger, more meaningful purchase might, like a trip or an investment in something you’ve long desired.

The same principle applies to emotional and mental labor. Each time you invest your focus and attention, you’re making a small withdrawal from your brain’s energy reserves. These acts of emotional labor may not seem like much on their own, but they accumulate quickly, depleting your mental resources. And unlike completing a major project or receiving recognition for your work, emotional labor doesn’t provide the dopamine boost—the brain’s reward signal—that comes from achieving a goal or earning praise. You end up exhausted, but without the sense of accomplishment that typically follows hard work.

The disproportionate burden of emotional labor on women is deeply entrenched in societal norms and expectations. From a young age, girls are often socialized to be empathetic, nurturing, and accommodating, whereas boys are encouraged to be assertive and independent. This conditioning follows women into the workplace. Women who do not conform to these expectations—who don’t take on the additional emotional labor or who prioritize their own needs—are often judged more harshly than men. They may be labeled as “cold” or “uncooperative,” further reinforcing the pressure to conform to these gendered expectations.

Which brings me to the next point, the double bind. The double bind in leadership is a situation where women are expected to embody two contradictory traits: assertiveness and nurturing. On one hand, leadership roles demand decisiveness, confidence, and authority—traits typically associated with strong, effective leaders. On the other hand, we have those societal norms expecting women to be caring, supportive, and emotionally intuitive. This dichotomy creates a challenging environment where meeting one set of expectations may lead to criticism or undermining from those who hold the opposing view.

For instance, a woman in a leadership position might be praised for her assertiveness in making tough decisions but criticized for being too aggressive. Conversely, if she adopts a more nurturing approach, she might be seen as lacking the necessary strength or ambition for a leadership role. This balancing act can place immense psychological strain on women, who may feel they are perpetually navigating a minefield of conflicting expectations.

The constant pressure to meet both assertive and nurturing expectations can lead to elevated levels of stress and anxiety. This chronic stress can be debilitating, impacting both mental and physical health.

Burnout is often the inevitable outcome when women are caught in this vicious cycle. Emotional labor, combined with the double bind, creates a perfect storm of chronic stress. The constant need to manage others' emotions, maintain harmony, and simultaneously prove oneself as a competent, assertive leader, while also being nurturing and supportive, is an exhausting and often thankless endeavor. Over time, this leads to emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment—all hallmarks of burnout.

The insidious nature of burnout lies in how it gradually erodes a woman's capacity to function both professionally and personally. Initially, it might manifest as irritability, fatigue, or trouble concentrating—symptoms that are often dismissed as typical menopausal changes. However, as the stress continues unchecked, these symptoms can escalate into more severe cognitive impairments, such as memory lapses and difficulty with decision-making. These are precisely the kinds of changes observed in the hippocampus and prefrontal cortex under chronic stress conditions, as well as during perimenopause. However, while the impact perimenopause has on the brain is temporary, the damage caused by chronic stress can be far more enduring. 

As the onset of perimenopause often coincides with the time when women advance to more senior leadership roles, it is easy to dismiss the early warning signs of burnout as simply down to fluctuations in hormone levels. Unfortunately, this misdiagnosis can have disastrous, career ending consequences for many. Afterall, even hormone replacement therapy is powerless against this relentless mental onslaught. 

So what can employers do to help lead the change? 

One of the most impactful interventions is implementing implicit bias training across the organization. This training helps all employees, particularly those in leadership, recognize and address unconscious biases that may influence their expectations and judgments about women in the workplace. By bringing these biases to light, organizations can begin to dismantle the gender stereotypes that contribute to the disproportionate burden of emotional labor on women.

Implicit bias training can also help to shift perceptions around the double bind. When leaders understand how societal expectations influence their judgments, they may be less likely to criticize women for being either "too assertive" or "too nurturing." Instead, they can begin to appreciate a wider range of leadership styles, recognizing that effective leadership is not confined to traditionally masculine traits.

Considering how important emotional labor is for the health of a work environment, it should be part of any job description. It should be outlined in detail and delegated fairly and in advance. And it should be reviewed and rewarded in the same manner as any other skills required to succeed in a given role. 

One of the most effective tools for women facing the challenges of emotional labor and the double bind in the workplace is coaching focused on setting stronger boundaries and developing assertiveness skills. 

For many women, the expectation to take on additional emotional labor in the workplace often comes with the unspoken pressure to say "yes" to everything. Setting stronger boundaries is about recognizing the limits of what one can reasonably handle without compromising personal well-being or job performance. Coaching can help women assess their boundaries objectively and identify areas where they might be overextending themselves and teach them how to prioritize tasks that align with their primary job responsibilities and career goals.

Assertiveness is another critical skill for women who are navigating the double bind. Women are often socialized to be accommodating and to avoid conflict, which can make it difficult for them to assert their needs or push back against unreasonable demands. Assertiveness training helps women develop the ability to express their thoughts, feelings, and needs clearly and confidently, without being aggressive or dismissive.

As cultural norms are unlikely to shift dramatically in a short period of time, it is also vital to acquire robust stress management skills and implement tools that foster emotional resilience. Companies should invest in evidence based training for both just as they invest in any other form of leadership training, or at least compensate women for any expenses incurred if they seek out support in gaining the much needed skills themselves.

Of course there are many more things companies can do to support women, such as flexible work schedules, but I wanted to purely focus on the ways that company culture directly impacts women's mental health and most importantly, dismantle the stereotype of the ‘mentally unstable  menopausal woman’. By recognising the unique challenges women face, and working towards solutions, organizations can retain the experience and expertise of some of their most senior employees. This proactive approach is far more cost-effective than the expensive and time-consuming process of hiring and training replacements. Ultimately, fostering an environment where women can thrive ensures that businesses don’t just maintain, but enhance their leadership and performance.

Hormonal changes, significant as they may be, are just a drop in the bucket compared to the myriad challenges women face throughout their lives. From the moment a young girl is handed her first doll to the time when memories fade and only fragments of the past remain, the pressures and expectations placed on women shape every aspect of their existence. These lifelong burdens, rooted in societal norms and reinforced at every stage, far outweigh the biological shifts that come with age.

Sybille Hazward

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