Why employees underuse menopause support at work

Most large employers that offer menopause support services see low uptake for four reasons. People don't feel safe saying they need it. They don't know what's available. Their line manager isn't ready for the conversation. And the policy on the intranet doesn't connect to clinical support that matches their symptoms.

None of these are signs that employees don't need help. Symptoms such as poor sleep, hot flushes, brain fog and anxiety still arrive at work. When the support goes unused, the need shows up somewhere more expensive: sickness absence, people working at half capacity, and experienced staff reducing their hours or leaving.

This guide sets out why menopause support services stay underused, and what HR and benefits teams can change to build trust, awareness, manager readiness and policy uptake.

1. Menopause stigma makes people hide symptoms

The biggest barrier to uptake is the risk people see in being identified. Many employees worry that mentioning menopause will mark them as less capable, put them in line for fewer opportunities, or count against them in a performance or redundancy conversation. Some don't link their symptoms to menopause at all, so they never look for menopause support in the first place.

That worry has a practical basis. If a sick day for menopause symptoms lands on the same attendance record as any other absence, people learn quickly to call it something else. Acas advises recording menopause-related absence separately, because counting it towards overall attendance could be unfair or discriminatory.

The signal HR sends here matters more than the benefit itself. If using support feels like a disclosure to the organisation, most people won't use it. If it feels private and routine, more will.

2. People don't know the support exists, or what it covers

In a large organisation, a new benefit gets announced once, sits on a benefits portal next to dozens of others, and is forgotten by the time someone needs it. Menopause support has an extra problem. People reach for it at a specific moment, often after a bad night or a difficult meeting, and if they can't find it in a minute they move on.

Vague descriptions make this worse. "Menopause support" can mean a policy document, a peer network, an Employee Assistance Programme (EAP) helpline or access to a specialist clinician. Employees can't tell which one they're getting, so they assume it's the least useful option.

Awareness also misses people who aren't in the obvious age bracket. Perimenopause can start earlier than many expect, and menopause can be brought on by surgery or medical treatment. Partners and colleagues need to know the support is there too, because they're often the ones who suggest it.

3. Line managers aren't ready for the conversation

For most employees, the line manager is the route to support. If that manager looks awkward, changes the subject or reaches straight for a formal process, the employee stops talking. Many managers want to help and don't know what to say, what the organisation offers, or what they're allowed to ask.

The CIPD's guidance for people managers sets out the basics that make the difference:

• Ask open, general questions such as "How are you doing at the moment?" and let the employee decide what to share.
• Offer the option of speaking to another manager or to HR if that feels easier.
• Treat anything disclosed as confidential, and agree who else is told and by whom.
• Explore health causes before starting any formal process for underperformance.

Training that only covers symptoms leaves managers with nothing to offer at the end of the conversation. They also need to know exactly what support the organisation provides and how to refer someone to it in one step.

4. The policy exists, but the support behind it doesn't fit the need

A workplace menopause policy sets out entitlements and adjustments. On its own, it won't get anyone in front of a clinician. Many policies list reasonable adjustments and point to the Employee Assistance Programme, then stop. That leaves a gap between the document and a person struggling with symptoms on a Tuesday afternoon.

Existing benefits rarely close that gap on their own. An EAP is built for counselling and short-term emotional support, which helps with some psychological symptoms but can't advise on hormone replacement therapy (HRT) or other treatment. Private medical insurance (PMI) policies vary in whether they cover menopause care, and many start with a GP referral. GP appointments are short, and people often come away without a clear plan. When employees try these routes and get nowhere, they conclude the organisation's menopause support doesn't work and stop asking.

Policy also goes stale. Acas recommends reviewing related policies on absence, sickness reporting, flexible working and health and safety so they don't contradict the menopause policy. Under the Employment Rights Act 2025, publishing an action plan that includes support for employees experiencing menopause becomes mandatory in 2027 for employers with 250 or more workers. A plan that sits on paper won't hold up well once it's published.

Learn more about Peppy's menopause support

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How to increase uptake of menopause support services

Build trust by making access private

• Give employees a route to clinical support that doesn't go through their manager or HR. Uptake rises when people can get help without telling anyone at work.
• State plainly, in the benefit description and the policy, what the employer can and can't see. Aggregate usage figures, yes. Individual names and conditions, no.
• Record menopause-related absence separately from general sickness absence, and tell people you do.
• Have senior leaders talk about menopause in internal channels. It signals that raising it won't count against anyone's career.

Raise awareness at the moments people need it

• Describe the support in concrete terms: who they'll speak to, how fast, and what that person can help with.
• Put it where people look when symptoms bite: the absence reporting process, return-to-work conversations, occupational health referrals and manager toolkits.
• Repeat the message through the year, with peaks around World Menopause Day in October and benefits enrolment.
• Make it clear the support covers perimenopause, early and medically induced menopause, and partners or colleagues who want advice.

Make managers ready, then get out of their way

• Train every people manager, including supervisors and team leaders, as Acas recommends.
• Give them a one-page guide with three things: how to open the conversation, what adjustments they can agree on the spot, and the link to clinical support.
• Set up menopause champions or a peer network so people have someone to talk to who isn't their manager.

Turn the policy into something people use

• Link every section of your HR menopause guidelines to an action: a named contact, a form, an app, a phone number.
• Review absence, flexible working and performance policies so they point the same way.
• Use your menopause action plan to commit to measurable changes in access, and report on them.

Measure what's happening

Track uptake of the service against the size of the population likely to need it, and look at trends rather than a single figure. Compare menopause-related absence before and after launch, and add a menopause question to engagement surveys and exit interviews. If uptake stays low, ask employees why before changing the provider.

Where Peppy fits alongside your EAP and PMI

Peppy fills the clinical gap between a menopause policy and the benefits most large employers already have. Employees get unlimited, confidential access to specialist menopause clinicians through an app, without a GP referral and without going through their manager. Your EAP keeps doing what it does well, and your PMI stays in place for the conditions it covers.

The same app gives access to specialists in fertility, men's health, women's health, pregnancy and parenthood, and neurodiversity, so one benefit covers six areas of health. Peppy supports 250+ employers in 20+ countries and over 3 million people.

Frequently asked questions

Why are menopause support services underused in large companies?

Four reasons come up most often: fear that disclosure will harm someone's career, low awareness of what the support includes, line managers who aren't prepared for the conversation, and policies that don't connect to clinical help that matches symptoms.

Why do employers struggle to provide menopause support for staff?

Most employers rely on benefits designed for other needs. EAPs focus on emotional support, PMI cover for menopause varies, and GP access can be slow. Without specialist clinical access, a policy has little to send people to.

What should HR menopause guidelines include?

What menopause is and how it affects people differently, the adjustments available, how absence is recorded, the training managers receive, a named point of contact, and exactly how employees reach clinical support.

How can HR measure whether menopause support is working?

Track service uptake over time, menopause-related absence recorded separately, engagement survey responses and exit interview reasons. Ask employees directly if uptake stays low.