The $30.2 Billion Number: What the 2025 RAND and Mayo Studies Tell Employers

Two landmark 2025 studies finally put a number on what unsupported menopause costs American employers — and on the care gap that keeps producing it.

For years the case for menopause workplace support rested on anecdote. That ended in 2025. The RAND Corporation published the first comprehensive, state-by-state analysis of the economic cost of menopause among working women in the United States, and the Mayo Clinic published a survey of nearly 5,000 midlife women documenting how few of them get any care at all. Read together, the two studies describe a $30.2 billion problem that is almost entirely untreated — which is another way of saying it is almost entirely addressable.

To put $30.2 billion in context: the CDC estimates that chronic diseases and modifiable health behaviors — diabetes, hypertension, smoking, obesity and physical inactivity combined — account for roughly $40.2 billion in annual U.S. productivity losses. Menopause is not a disease. It is a universal life stage. And it sits in the same order of magnitude.

A Growing Share of Your Workforce

The 2025 RAND study found that approximately 30% of all women in the U.S. labor force are between ages 45 and 60 — the age range corresponding to the menopausal transition. That share varies from 22.6% in Washington, D.C. to 32.5% in Vermont, and runs higher in specific industries: 31% of female healthcare workers and 35% of female education workers fall in that band.

The trend is not flattening. Labor force participation among women aged 55–64 rose from 56.6% in 2003 to 59.6% in 2023, and by 2050 the percentage of working-age women in the menopausal transition is projected to grow in nearly every state, with the sharpest increases in the Mountain states and the Northeast. Whatever this costs an employer today, it costs more each year by default.

The Care Gap Underneath the Cost

The 2025 Mayo Clinic study, published in Mayo Clinic Proceedings, surveyed nearly 5,000 women ages 45–60 across four primary care locations. Its findings explain why the economic number is as large as it is:

• More than 75% of respondents experienced menopause symptoms.
• 34% reported moderate to very severe symptoms.
• Over 80% of symptomatic women did not seek medical care for them.
• Only about 1 in 4 women were receiving any treatment at the time of the survey.
• Sleep disturbance and weight gain were each reported by more than half of participants.

The reasons women gave for not seeking care are the most actionable part of the study: many preferred to manage symptoms on their own, others were simply too busy, and some did not know effective treatments existed. That is not a failure of individual judgment. It is a failure of awareness, access and workplace culture — three things an employer can directly change.

As Mayo Clinic’s Dr. Ekta Kapoor noted, the symptoms are common and disruptive, and yet few women are receiving care that could help them.

Where the $5.4 Billion Comes From

RAND’s productivity estimate rests on what women reported actually doing. Among women ages 45–60 in the workforce:

• 10.8% missed at least one day of work due to menopause symptoms in the prior 12 months, with a mean of three days missed.
• 5.6% reported cutting back on hours, with a median of five days of reduced hours.
• 0.3% reported being laid off because of menopause symptoms.
• Women with severe symptoms are up to three times more likely to report diminished work capacity.

The researchers are explicit that $5.4 billion is a conservative lower bound. It does not capture early retirement, missed promotions, moves to lower-paying jobs, presenteeism, or the unpaid caregiving labor many midlife women are carrying at the same time. Every one of those is a real cost to an employer; none of them are in the number.

Where the $24.8 Billion Comes From

The larger share of the burden is medical, not productivity: roughly $24.8 billion annually in excess direct medical expenditures for women ages 45 to 60, derived from national population data and inflation-adjusted per-woman cost estimates.

The mechanism is straightforward. When women lack education and access to appropriate menopause care, symptoms go unmanaged and drive higher use of emergency services, specialist visits, diagnostic testing and prescriptions. An untreated symptom does not stay quiet; it becomes a cascade of encounters, most of which could have been avoided with earlier, evidence-based management.

Which Industries and States Absorb It

Healthcare and education carry the highest menopause-related productivity cost, driven by large female workforces and high concentrations of women in the transition age range — both sectors already under acute staffing and retention pressure.

By state, California and Texas face the largest absolute annual losses at $688 million and $433 million, followed by New York ($385M), Florida ($336M) and Pennsylvania ($216M) — a function of both workforce size and average salary.

The ROI Case for Acting

Retention of high-value talent

Menopause arrives at an inflection point in women’s careers — often when they are at the height of their professional influence, serving as mentors, leaders and holders of institutional knowledge. RAND notes that approximately one-third of women have considered leaving or have left the workforce because of menopause symptoms, with disproportionate impact on women in senior roles.

Replacing a senior employee costs 100–200% of their annual salary. When an experienced woman exits over unsupported symptoms, the employer loses the individual and the accumulated human capital, mentorship capacity and leadership pipeline she represented. Menopause support is, in budget terms, a retention line.

Reduced absenteeism and presenteeism

With 10.8% of women in the transition missing workdays and 5.6% cutting hours, employers are already absorbing this cost — whether or not it is visible in any report. Preliminary evidence from the United Kingdom suggests that investments in menopause workplace support are already reducing absenteeism and helping women feel more supported. The business case is not theoretical.

Lower healthcare spend

The $24.8 billion in excess medical expenditure is the largest single savings opportunity in the data. Employer-sponsored education and navigation programs redirect women toward evidence-based, cost-effective treatment earlier — before the downstream utilization accumulates.

Competitive advantage and employer brand

More than 20 states have introduced menopause care and workplace legislation since 2023, and nine or more measures are now law. Rhode Island remains the only state with a binding workplace accommodation and anti-discrimination statute, in force since June 2025. Philadelphia’s ordinance takes effect January 1, 2027. Illinois passed a comprehensive workplace and insurance bill through both chambers on May 28, 2026 and awaits the Governor’s signature. Virginia’s Governor vetoed the accommodation mandate in May 2026 while the anti-discrimination provision survived, and Washington’s Governor signed Executive Order 26-01 in June 2026 directing workplace accommodation guidance. New York, New Jersey and California all have active proposals. Employers who act now get ahead of compliance and get the recruiting benefit of having done it first.

What Both Studies Tell Employers to Do

Mayo and RAND converge on the same conclusion: targeted workplace policies and interventions are urgently needed. Mayo’s researchers call for strategies that destigmatize menopause care and make it visible and accessible. RAND recommends accommodations modeled on existing protections for pregnancy and breastfeeding. Specifically, the studies advise employers to:

• Implement education and awareness programs for employees and management.
• Provide accommodations such as remote or hybrid options, ergonomic adjustments and flexible scheduling.
• Expand healthcare coverage for menopause treatments and specialist consultations.
• Offer digital tools and symptom-tracking resources.
• Create support groups and peer networks that normalize the conversation.
• Adopt menopause-inclusive policies that protect against discrimination.
• Measure and track menopause-related workforce metrics.
• Invest in clinician training to close the provider knowledge gap.
• Proactively identify and address symptoms in the employee population.

That is a long list, and building it from scratch is exactly why most organizations never start. It is also, item for item, what TeltraCare was built to deliver: organization-wide education rather than programming aimed only at symptomatic women; a workplace assessment that examines claims data, productivity pulse surveys, HRIS absenteeism patterns, physical space, dress code and schedule flexibility; telehealth that connects employees directly to menopause-trained clinicians with integrated medication management; and a dedicated community that makes the topic ordinary instead of unspeakable.

The Evidence Is In

The 2025 RAND and Mayo Clinic studies removed the ambiguity. Menopause is a $30.2 billion workforce challenge, it is growing with the demographics, and more than 80% of symptomatic women are not seeking care for it. Employers who continue to treat it as a private matter will keep absorbing the cost in lost productivity, preventable healthcare spending and departing talent — without ever seeing it named on a report.

The employers who act will be the ones who measured it first.

Sources: Heissel, J.A., Donofry, S.D., Bonheur, A., Shinnick, D., Rollison, J., & Troxel, W.M. (2025). The Economic Impacts of Menopause in the United States. RAND Corporation, RR-A4292-1. Kapoor, E., et al. (2025), Mayo Clinic Proceedings, published October 29, 2025. Faubion, S.S., et al. (2023). Impact of Menopause Symptoms on Women in the Workplace. Mayo Clinic Proceedings, 98(6), 833–845. O’Neill, M.T., et al. (2023). Impact of menopausal symptoms on work and careers. Occupational Medicine, 73(6), 332–338. Asay, G.R., et al. (2016). Preventing Chronic Disease, 13, E141. Adapted from the TeltraCare white paper The Business Case for Menopause Workplace Support (2026).