Managing menopause-related sickness absence: What employers need to know

Menopause symptoms can sometimes become severe enough that an employee is not fit to work. Employers should normally manage time off work due to menopause through their usual sickness absence procedure, while considering the employee's individual circumstances, any relevant Equality Act 2010 (“Equality Act”) duties and what may support a safe return.

Menopause is a natural phase of life, but its effect on working lives varies. For many employees, menopausal symptoms do not require sick leave. Other menopausal people experience hot flushes, sleep disruption, low mood, mood swings, poor concentration, joint pain or other symptoms that substantially affect their ability to carry out work. Perimenopause symptoms can also affect attendance before menopause itself.

This guide focuses on the point at which an employee is already absent or may need time off for perimenopause or menopause related symptoms. For an employee who is still working but finding symptoms difficult to manage, see our blog on struggling at work due to menopause. For the broader legal framework, read our guide to menopause at work and employers' responsibilities.

Can you be signed off work with menopause?

Yes. If menopausal symptoms mean an employee is not fit for work, they can take sickness absence in the same way as they would for another health condition. There is no separate statutory category of 'menopause leave'.

Menopausal symptoms can have a negative impact on work performance and health. Employees experiencing menopause symptoms may find that common symptoms such as hot flushes, poor sleep and concentration difficulties make work temporarily unmanageable, particularly where working conditions make symptoms worse.

The employer's role is to manage the absence fairly and consider what could support the employee's return. An employee experiencing menopausal symptoms may need only a short period away from work, while another may need a more structured return with case-specific support.

What are employers' legal obligations when managing menopause-related absence?

Employers' legal obligations can arise under the Equality Act, health and safety law and ordinary employment rights. Menopause is not itself a protected characteristic, but menopausal symptoms can amount to a disability where they have a substantial impact on normal day-to-day activities and that effect is long term. In that situation, the duty to make reasonable adjustments may apply.

Employers should also consider whether an apparently neutral absence rule could indirectly discriminate, for example if it places people at a particular disadvantage and cannot be objectively justified.

How should menopause-related sickness absence be recorded?

Employers should record the reason, length and frequency of sickness absence accurately while protecting confidential health information.

Acas recommends recording menopause-related absence separately from other sickness absence. Counting it automatically as part of an employee's overall attendance record could, depending on the circumstances, be unfair or discriminatory, and independent advice should be obtained

Separate recording does not mean ignoring the absence. Employers can still review attendance and discuss support. The purpose of having two discussions is to make sure an automated process does not overlook absence due to menopause symptoms, disability-related absence or other protected characteristics. For employees experiencing perimenopausal or menopausal symptoms, separate recording can also help the employer identify whether repeated short absences point to a need for further support.

A menopause policy or sickness absence policy should also make clear how sensitive information is handled and who can access it.

How much contact should employers have during the absence?

Agree a reasonable level and method of contact rather than allowing communication to become excessive or disappear altogether.

Contact can cover the likely return date, new medical evidence and possible reasonable adjustments. When workers feel able to discuss what they need without pressure, employers are better placed to plan a sustainable return. Employers should not pressure an employee to return before they are fit. If the employee is uncomfortable discussing menopause with their usual line manager, consider whether HR or another suitable contact should manage communication.

When should employers seek occupational health advice?

Specialist workplace health input may be useful where absence is repeated or prolonged, the likely return date is unclear, or the employer needs advice about reasonable adjustments.

An occupational health referral can help assess how menopause affects the employee's ability to work, whether a phased return may help, whether hours or duties should change and whether there are any legal issues that may be relevant. The government's 2026 guidance on support for employees experiencing menopause says tailored workplace health advice can reduce barriers at work. The employer still makes the final employment decision, but specialist advice can help it identify the right support for someone affected by menopause.

What reasonable adjustments could support a return to work?

Where menopause symptoms amount to a disability under the Equality Act, employers may have a duty to make reasonable adjustments. This can include adjusting both the job and the absence-management process.

Possible reasonable adjustments can include:

• A phased return
• Temporarily reduced or altered hours
• Different working patterns or flexible working
• Home working where practical
• Additional or regular breaks
• Temporary changes to duties
• Changes to the working environment, including temperature control, a quiet space or access to cold drinking water

Making reasonable adjustments should focus on the employee's actual disadvantage rather than assumptions about menopausal employees generally. For menopausal people returning after sickness absence, the right support may be a temporary change rather than a permanent alteration to the role. For broader workplace support, see our guide to how employers can support menopause at work.

How should employers plan the return to work?

A return-to-work discussion should establish whether the employee is ready to return and what will help them remain at work. It should also help workers feel able to explain any remaining health or wellbeing concerns without having to repeat unnecessary medical details. For example, an employer could consider options including (but not limited to) fit note advice, current symptoms, a phased return, flexible working, temporary changes to work tasks and whether risk assessments need review.

A phased return can reduce hours temporarily or involve lighter duties; the duration should be agreed in advance and reviewed regularly. Many employees find that needs change over time, so review support rather than assuming the first arrangement will remain suitable throughout their working lives.

How should employers deal with absence trigger points?

Trigger points can help employers review attendance, but they should not automatically lead to disciplinary or capability action.

Acas advises employers to consider individual circumstances, including whether an absence is disability-related and whether reasonable adjustments to a trigger system are needed.

Possible reasonable adjustments can include increasing a trigger threshold or excluding some disability-related absence. Even where disability is not established, employers should consider Acas's specific recommendation to record menopause-related absence separately.

A rigid approach can increase the risk of claims. Employers should review the reason for the absence before deciding what action is appropriate.

What about menopause-related medical appointments?

There is no general statutory right to paid time off specifically for menopause-related medical appointments. Contractual rights or workplace policies may provide paid or unpaid leave.

Nevertheless, allowing time for menopause-related appointments is good practice. Where symptoms amount to a disability, flexibility around appointments may also need to be considered as part of the employer's reasonable adjustment obligations.

What if menopause-related sickness absence becomes long term?

Long-term absence may eventually require a capability process, but employers should first obtain current medical evidence, understand the likely prognosis and explore whether further support could enable a return. Employees affected by menopause may face similar challenges, but the effect on attendance and the likely duration of absence can differ significantly between individuals.

This may include workplace reasonable adjustments, flexible working, a phased return or another suitable role. Employers should consult with the employee and keep options under review.

Menopause is not itself a protected characteristic. However, symptoms can amount to a disability under the Equality Act, while age, sex and gender reassignment may also be relevant protected characteristics. Employers should keep these obligations in mind throughout the process, since overlooking them at any stage can expose the organisation to a discrimination claim. 

Independent legal advice should be obtained to assist with managing this process and /or any considerations around a potential dismissal.

Key steps for managing menopause-related sickness absence

Employers should:

• Follow the sickness-reporting procedure while considering the employee's individual circumstances.
• Record menopause-related absence accurately and consider keeping it separate from other absence.
• Use self-certification and fit notes correctly.
• Agree proportionate contact while the employee is away.
• Seek specialist workplace health input where useful, particularly for repeated or long-term absence.
• Consider the Equality Act and whether symptoms may amount to a disability.
• Consider making reasonable adjustments to the role, workplace or absence process.
• Review flexible working and working patterns that could support a return.
• Review relevant risk assessments if working conditions may worsen symptoms.
• Plan the return carefully, including any phased return or temporary changes.
• Review absence triggers before formal action.
• Use a fair capability process if absence becomes long term, supported by current evidence and meaningful consultation.

A consistent process helps employers manage attendance while recognising that menopause and perimenopause symptoms affect employees in different ways.