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Picture four women in your organisation right now.
One is 26, doubled over with period pain she hasn't told her manager about, because the culture doesn't make it feel safe to. One is 34, three months into fertility treatment, taking "dentist appointments" every other week and telling nobody why. One is 38, back from maternity leave, exhausted, wondering if she's cut out for the promotion she was on track for before she left. One is 49, your most senior woman in the room, lying awake at 3am, struggling to concentrate by 10am, starting to wonder if she's losing her edge.
The chances are none of them will raise it at work. Most will just quietly manage, or quietly leave.
There have been some great strides in recent years - especially with menopause. Menopause is usually the only one of these four that gets a policy and a webinar. The other three often don’t get much support from workplaces, even though menstrual health, fertility, pregnancy, postnatal recovery and long-term conditions like endometriosis and PMOS shape how women perform and progress for the entirety of their careers, often years before menopause is even on the table.
What inaction & lack of support is costing you
Menopause-related absenteeism and presenteeism alone cost UK businesses a whopping £10.5bn a year. A quarter of mums quit within 12 months of maternity leave, costing UK businesses a further £650m. 83% of these blame poor employer support. Replacing a senior leader costs 200-400% of their salary, and that's before you count the succession planning, mentorship and institutional knowledge that walks out with her. One in four working women have considered quitting because of menopause or menstrual symptoms. One in seven are actively planning to leave.
This is a cost affecting most businesses, yet most aren’t doing much about it yet!
A leaking pipeline
The drop-off clusters around age 45-55: the fastest-growing demographic in the UK workforce, and the exact stage where menopause typically begins, cardiovascular risk climbs, and women reach their most senior roles. Only 93 women are promoted to manager for every 100 men, and that gap compounds at every level above it. Women make up 49% of the entry-level workforce but just 29% of the C-suite. Every one of those numbers is a woman who could have been retained.
Stigma is doing the real damage
Go back to the woman with endometriosis. She isn't managing it. She's white-knuckling through it, taking unplanned sick days rather than the flexibility a proper conversation could give her. The woman in fertility treatment isn't struggling with the medical side alone, she's also managing the anxiety of hiding it from colleagues. The woman in perimenopause who can't name what's happening to her doesn't think "I need support." She thinks "I'm not as sharp as I used to be," and quietly stops putting herself forward.
92% of women say health symptoms affect their work, yet most managers aren't equipped to respond. 42% don't feel comfortable raising a health issue with their manager at all. 60% believe their issues weren't taken seriously. None of this looks dramatic in the moment. It shows up months later as an exit interview that never mentions the real reason.
Four blind spots to check for
- Treating menopause as shorthand for women's health. It's one chapter in a 40-year story.
- Measuring participation instead of outcomes. Webinar attendance tells you nothing. Retention, absence trends and manager confidence do.
- Framing it as a women's issue. Exclude male managers from the conversation and support stays siloed.
- Assuming policy equals culture change. Without leadership backing and trained managers, a policy on the intranet rarely changes what happens in a 1:1.
The case for acting now
Menopause-related tribunal claims have tripled in two years, and the Employment Rights Act is tightening requirements further. On the other side of the ledger, employers investing in proactive support see presenteeism drop 35% and attrition fall 20%. This is one of the highest-return investments still sitting unmade on most people strategies.
Why PMI and an EAP aren't enough
Most benefits packages already include private medical insurance and an EAP which is great, but neither is built for specialist women’s health support. PMI kicks in once something's already gone wrong. An EAP offers a helpline, not a specialist who understands fertility, menopause or postnatal recovery, and rarely on-demand.
These women want to speak to a real person who knows what they're dealing with, confidentially, without a waiting list or a referral.
That's the gap specialist providers like Peppy exist to close: direct, on-demand access to clinicians across the full women's health lifecycle, alongside manager training so the people setting the day-to-day tone know how to respond.
This isn't just an HR responsibility. It's a leadership one, a line-manager one, a whole-business one. Every one of those four women is someone else's colleague, direct report, or future leader.
Want the full data set, the four pillars of high-impact support, and a 90-day action plan to take this from audit to embedded practice? Peppy's guide, Unstoppable: Why women's health is your biggest untapped retention and leadership lever, is built for HR and benefits leaders ready to act.