What should employers do when an employee is struggling at work due to menopause?

Menopause affects people very differently, and for some employees it will have little effect on their work at all. For others, symptoms can begin to affect how they manage at work, and when this happens, the priority is to provide understanding and agree what may help. Employers should respond promptly, privately and on an individual basis rather than assuming that a standard measure will solve the problem.

The immediate focus should be practical for example but not limited too: how are the symptoms affecting the individuals work, are they communicating if anything in the workplace is making it harder for them to manage, and what could help the individual continue working effectively? Depending on the circumstances, this may involve temporary changes, flexible working, reasonable adjustments or further specialist input.

This guide focuses on the point at which an employee is already struggling at work due to menopause. For the wider legal framework, read our guide to menopause at work and an employer's responsibilities.

Start with a private and supportive conversation

The first step should normally be a private informal conversation. Line managers should give the employee enough time to explain what they are finding difficult and avoid jumping immediately to solutions.

Acas advises employers to let the worker lead the discussion. Managers should not suggest what symptoms the employee might be experiencing or make assumptions based on age, appearance or behaviour.

Useful questions can focus on work rather than medical detail for example:-

• Which parts of work are currently most difficult?
• Are there particular tasks, times or aspects of the workplace environment that make symptoms worse?
• Is there anything that would make work more manageable now?
• Would the employee find it helpful for HR or occupational health to be involved?

The employee should not be expected to disclose more health information than is reasonably needed to understand the workplace issue. Managers should also explain how information will be handled and agree what, if anything, can be shared with colleagues.

Support should not depend on one manager's personal knowledge. Line managers need to know and understanding their obligations and a clear route for escalating concerns and accessing further advice.

Focus on how the symptoms are affecting work

Managers are not expected to diagnose menopause or establish which stage of the menopause transition an employee is experiencing. Their role is to understand the functional effect on work.

Common symptoms can include hot flushes, night sweats, poor sleep, fatigue, anxiety, low mood, mood changes and poor concentration. Some people also experience brain fog or other mental health and wellbeing effects. Symptoms can change and/or fluctuate over time.

The useful question is therefore not simply: "What symptoms do you have?" It is, "What is happening at work, and what could reduce the difficulty?"

Agree immediate changes that could help

Once the employer understands the problem, it should consider whether a short-term reasonable adjustment could help the employee remain at work and carry out their role effectively.

Depending on the employee's specific needs, this might include:

• Greater flexibility over start and finish times
• Regular breaks when symptoms are difficult to manage
• A temporary change to particular duties or how work is organised
• Home working where practical
• Access to a private area to rest

The aim is to address the actual workplace difficulty the employee has described, not apply a fixed checklist. This means agreeing workplace changes in writing and allowing reasonable time for them to take effect and then review can be undertaken.

More detailed practical advice on proactive menopause support is covered in How to create a menopause action plan: A step-by-step guide for employers

Consider whether reasonable adjustments may be required

If menopausal symptoms amount to a disability under the Equality Act 2010 (“Equality Act”), the employer may have a legal duty to make reasonable adjustments.

An employee does not need to use the phrase "reasonable adjustments" before the employer considers the issue. If disability may be relevant, managers should focus on the difficulty the employee is experiencing and involve HR where there is uncertainty about the legal position.

Any reasonable adjustments should be considered on there own facts and reviewed for effectiveness. 

Our guide to employers' legal responsibilities for menopause explains the Equality Act position in more detail.

Consider flexible working where a longer-term change may help

An informal change may be enough where symptoms fluctuate. In other cases, a longer-term flexible working arrangement may help.

This could involve a change to hours, working patterns or location. An employee who believes a longer-term change would help with menopause symptoms can make a flexible working request.

Employers should distinguish between temporary flexibility, a formal flexible working request and a reasonable adjustment. The right route will depend on the circumstances of the specific case..

When should an employer involve occupational health?

Specialist workplace health advice may help where the effect of  perimenopause or menopause symptoms are unclear, several changes are being considered or existing support is not resolving the difficulty.

A referral can provide impartial workplace health advice about functional limitations and possible support. The government's 2026 guidance on occupational health and menopause explains that tailored advice can help reduce health-related barriers at work.

The employer still makes the final decision, taking the advice alongside the employee's views, the role and its legal duties.

Where anxiety, low mood or other mental health difficulties are also relevant, an Employee Assistance Programme may provide additional support if the organisation offers one.

What if the employee does not want to speak to their line manager?

Many employees may not feel comfortable discussing menopause with their direct manager. Employers should provide another appropriate route for raising concerns.

Depending on the organisation, this could be HR, another trained manager, a menopause or wellbeing champion, a trade union representative or an Employee Assistance Programme.

Whoever handles the issue should understand confidentiality and know how to access further support. A menopause policy can make these routes clear.

Record what has been agreed

Once changes or next steps have been agreed, confirm them in writing. Record the workplace issue, support agreed, whether it is temporary or ongoing, who needs to know, confidentiality arrangements and the review date.

Review the support rather than treating the first conversation as the end

Menopausal symptoms can change during the menopause transition, so support that works initially may need adapting. At review, the manager should ask whether the difficulty is improving, whether the changes are working and whether further HR or specialist input is needed.

Regular reviews are particularly useful where someone is coping with menopause at work while symptoms fluctuate.

What if menopause symptoms are affecting performance?

If the employee says they are experiencing perimenopause or menopause symptoms that are affecting their work performance, the employer should understand that connection before moving directly into formal performance management.

It should identify which concerns may be connected with perimenopause or menopause symptoms, consider whether support or reasonable adjustments could address them, allow agreed measures a reasonable opportunity to work and review performance afterwards.

Employers can still manage genuine performance concerns, but should consider any Equality Act obligations before formal action.

What if the employee needs time off work?

Menopause symptoms can sometimes make an employee unfit for work. Where that happens, follow the organisation's absence process while taking account of the employee's circumstances and any relevant legal duties. For issues such as fit notes, contact during absence, return-to-work discussions and capability, see [Internal link when live: Managing Menopause-Related Sickness Absence: What Employers Need to Know].

What should managers avoid doing?

When dealing with menopause in the workplace, managers should not:

• Assume an employee is menopausal because of their age or behaviour.
• Tell the employee what symptoms they must be experiencing.
• Dismiss menopause as simply a natural part of life that they should manage alone.
• Give medical advice or recommend treatment.
• Share health information without permission unless there is a clear lawful reason.
• Assume all menopausal women need the same support.
• Move directly to performance management without understanding whether symptoms are relevant.
• Assume time away from work is the only option where workplace changes may help.
• Treat an agreed change as permanent without reviewing it.

A manager does not need to be a menopause specialist. They do need to listen, understand the organisation's support options and know when further expertise is required.

Key steps when an employee is struggling at work due to menopause

Employers should keep the individual response focused and practical:

• Speak privately. Give the employee an appropriate setting to explain what is happening.
• Listen before proposing solutions. Understand the effect of the symptoms on their working life.
• Identify the workplace problem. Focus on particular tasks, arrangements or environmental factors creating difficulty.
• Agree immediate support. Consider proportionate temporary changes that could help now.
• Consider legal duties. Assess whether reasonable adjustments or other Equality Act protections may be relevant.
• Consider flexible working. Decide whether a longer-term change to working arrangements may help.
• Seek further input where useful. Involve HR or specialist workplace health support where necessary.
• Protect confidentiality. Agree what information can be shared and with whom.
• Record and review. Confirm the arrangement and check whether it remains effective.
• Move into another process only when needed. If absence or ongoing performance issues develop, address them through the appropriate process with the employee's circumstances in mind.

This individual response sits alongside the organisation's wider menopause support. Employers with trained line managers, clear support routes and suitable workplace policies are better placed to respond consistently.