Menopause at Work Just Became a Global Standard

ISO 45010 is the first international standard on menstruation and menopause at work. It is voluntary, it is free, and it changes what “reasonable” looks like.

On 7 September 2026, the International Organization for Standardization published ISO 45010:2026 — Occupational health and safety management — Menstruation and menopause in the workplace — Guidance. It is the first international standard of its kind, and for employers who have spent the last two years watching menopause move from a private matter to a policy question, it is the clearest signal yet about where this is heading.

ISO 45010 does not create a legal obligation. That distinction matters and we will come back to it. But the arrival of an internationally agreed reference point changes the conversation in a way no single jurisdiction’s law can, because it gives every organization — in any country, in any sector, of any size — a common answer to the question “what does good look like?”

What ISO 45010 Actually Says

The standard runs to 58 pages and was developed by ISO/TC 283, the technical committee responsible for occupational health and safety management — the same committee behind the ISO 45001 family that many organizations already work within. Development was led by the British Standards Institution and the Swedish Institute for Standards, building on the British standard on menstruation and menopause published in 2023.

That lineage matters. ISO 45010 is not a standalone curiosity bolted onto an unrelated subject; it sits inside the occupational health and safety management system vocabulary that risk, EHS and HR teams already use. An organization certified to ISO 45001 will recognize the structure immediately, and the guidance is written to be dropped into an existing management system rather than run alongside one.

Its scope is deliberately practical. ISO 45010 gives leaders, managers, HR professionals and occupational health practitioners a framework for identifying the workplace factors that affect employees experiencing menstruation or menopause, and for choosing actions that address them. It assumes no clinical expertise on the employer’s part and asks for none.

The framing throughout is that the workplace itself is a variable. Symptoms interact with rigid schedules, inadequate facilities, uniform requirements, temperature, shift patterns and organizational understanding. Change those, and the same symptoms produce a different outcome. That is a meaningfully different premise from the one most organizations have operated on, which treats symptoms as something the employee manages privately and brings to work already resolved.

What ISO 45010 Is Not

Three limits are worth stating plainly, because the standard will be misdescribed in both directions over the coming months.

It is not a law. ISO 45010 is voluntary guidance. No regulator enforces it, no penalty attaches to ignoring it, and nothing in it overrides local employment law.

It is not certifiable. Unlike ISO 45001, ISO 45010 is a guidance document rather than a requirements document. There is no audit, no certificate and no badge. Any vendor offering “ISO 45010 certification” is selling something the standard does not support.

It is not medical guidance. The standard says nothing about treatment, hormone therapy or clinical management. Its subject is workplace policy, practice, support and adjustment — the employer’s domain, not the clinician’s.

ISO is making the full text available at no cost, in read-only form, to maximize adoption. The practical effect is that the usual objection to engaging with a standard — the licence fee — does not apply here.

The Gap the Standard Was Built to Close

Research published alongside the launch puts the problem in numbers. BSI surveyed 6,494 women across seven countries and found that 68 percent believe employers should support employees with menstruation and menopause-related health issues, and 70 percent want their employer to have a clear process and approach in place.

60 percent reported that their employer had never proactively raised the subject.

That is the gap ISO 45010 exists to close: not a gap in willingness, and not really a gap in awareness either, but a gap between awareness and action. As BSI’s Anne Hayes put it at the launch, conversations about menstruation and menopause are becoming more common in workplaces, yet three years on from the foundational British standard there is still a significant distance between talking about it and doing something about it.

This is the same pattern we have written about before — employees now understand menopause better than the organizations they work for, and the burden of coping falls entirely on the individual as a result.

The Areas ISO 45010 Addresses

The standard organizes its guidance around the places where workplace design and employee health actually meet:

• Workplace policies and practices — having something written down, findable and usable rather than handled case by case at a manager’s discretion.
• Practical, cost-effective adjustments — the standard is explicit that most useful changes are inexpensive. Temperature control, break timing, uniform flexibility, task rotation and schedule adjustment carry almost no cost and considerable benefit.
• Workplace design and facilities — ventilation, access to water, rest space, and toilet and washing facilities that work for the people using them.
• Manager awareness and support — because the first conversation an employee has determines whether she ever has a second one.
• Recruitment and worker well-being — ensuring hiring practices and role design do not quietly screen out or push out midlife women.
• Reducing stigma and avoidable barriers — the cultural work, which the standard treats as a management responsibility rather than an attitude problem.
• Employee engagement and retention — measuring whether any of it is working.

Notably, none of these require a clinical program. They are operational questions, which is precisely why they belong in an occupational health and safety standard rather than a benefits brochure.

Where the Standard Bites Hardest

ISO 45010 applies to organizations of every size and sector, but it is not neutral about where the stakes are highest. The standard specifically contemplates workplaces with demanding physical or psychological conditions — and those are exactly the environments where the usual accommodations are hardest to improvise.

A desk-based employer can often solve a great deal with flexible hours and a quiet room. A hospital, a manufacturing line, a transport operator, a school or an emergency service cannot. Fixed shift patterns, mandated uniforms and PPE, limited toilet access, safety-critical attention demands and rigid break structures all interact with symptoms in ways that a generic wellbeing policy never reaches.

That is where ISO 45010 earns its place in an occupational health and safety framework rather than a benefits one. The adjustments it describes — ventilation and temperature control, uniform and PPE flexibility, predictable access to water and facilities, rest provision, task rotation — are the vocabulary of workplace risk assessment, not of employee perks. An organization that already runs a competent risk assessment process has most of the machinery it needs; it has simply never pointed that machinery at this factor.

How ISO 45010 Lands in the U.S. Picture

American employers are reading ISO 45010 against a domestic backdrop that has shifted considerably in eighteen months. Rhode Island became the first state to mandate menopause accommodations, Philadelphia and Illinois have since acted, and in July a federal bill — the Menopausal Workers’ Fairness Act, H.R. 9671 — was introduced in Congress.

ISO 45010 is not part of that legal chain. But it arrives in the middle of it, and the two reinforce each other in a specific way. Legislation tends to establish a floor: what an employer must not do, and what it must provide on request. A standard describes practice: how an organization actually goes about identifying issues, designing adjustments and checking whether they worked.

An employer building toward the first will find that ISO 45010 answers most of the operational questions the statute leaves open. Where H.R. 9671 would require a documented, good-faith interactive process, ISO 45010 describes what a competent one looks like. Where Rhode Island requires reasonable accommodation, the standard supplies the menu.

For multinational employers the case is stronger still. Until now, an organization operating across several countries had to reconcile a patchwork: a British standard here, a state mandate there, nothing at all somewhere else. ISO 45010 offers a single internal benchmark that satisfies the spirit of all of them and can be applied consistently across a global workforce — which is usually the difference between a policy that exists and a policy that gets implemented.

Why Voluntary Guidance Still Changes Your Position

It is tempting to file a voluntary standard under “monitor, no action required.” That underestimates what published standards do over time.

Standards shift the definition of reasonable practice. Once an internationally agreed document exists describing what a competent employer does about a known workplace factor, “we had not considered it” becomes a weaker position than it was the week before publication — in an accommodation dispute, in an occupational health review, in a procurement questionnaire, and in front of employees who can now read the standard themselves for free.

The same logic already applies elsewhere in your risk register. Untreated menopause symptoms are a workplace safety variable and they surface in workers’ compensation data whether or not anyone has named the cause. ISO 45010 gives that exposure a recognized reference point.

A Readiness Check

Five questions worth putting to your leadership team this quarter:

• Does a written policy exist that names menopause, or is it inferred from a general accommodation policy?
• If an employee raised a symptom-related concern tomorrow, does her manager know what to do, and is there a documented process behind it?
• Have the low-cost environmental adjustments — temperature, ventilation, water, rest space, uniform flexibility, break timing — been reviewed at all?
• Can employees reach a clinician with menopause training through the benefits you already pay for?
• Are you measuring anything — retention in the 45-plus cohort, absence patterns, engagement — that would tell you whether support is working?

Most organizations can answer two of these. ISO 45010 is a usable map for the rest, and employers do not need to wait for legislation to start: educate employees, train managers and HR, review the policy, offer the adjustments, and improve access to specialized care.

The international guidance has arrived. The question is whether your workplace is ready for it.

Sources: ISO 45010:2026 and the ISO launch announcement, 7 September 2026; BSI research (6,494 respondents across seven countries). This post is expanded from a LinkedIn reflection by Katy Khalili, Co-Founder of TeltraCare.