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She's been with your company for 15 years. Mid-40s. High performer. Reliable. Recently promoted to senior leadership. Then something shifts. More sick days. Stepping back from projects. Declining opportunities she would have taken without hesitation six months ago.
You assume burnout. Or personal issues she doesn't want to discuss. The real reason: she's navigating perimenopause symptoms. Brain fog that makes her doubt every decision. Insomnia that leaves her exhausted by 2pm. Anxiety she's never experienced before. She hasn't disclosed it because she doesn't think anyone would understand, and she's worried it will damage how people see her capability.
This scenario is playing out across organisations right now. Quietly. Expensively. Women's health at work is not an HR nice-to-have. It's a retention issue. A leadership issue. A performance issue.
What is the business cost of poor women's health support at work?
Understanding what inaction is already costing you matters before any investment case can be made.
One in four women have considered leaving their job due to lack of menopause support. Eight in 10 say their employer hasn't shared information, trained staff, or put in place a menopause absence policy. The annual cost to UK businesses from menopause-related absenteeism and presenteeism sits at £10.5 billion.
Menstrual health tells a similar story. Two in three women say it negatively affects their performance at work. Long-term sickness rates for women have reached nearly 35%, overtaking men for the first time. 1.5 million women are currently off work due to ill-health in the UK.
Women are 62% more likely to feel unsupported at work for health issues than men. 40% report that health issues related to gender have negatively impacted their career prospects. 60% believe work has worsened their health.
Replacing a top talent executive costs anywhere from 200% to 400% of their annual salary.
Menstrual health, fertility treatment, pregnancy, postnatal recovery and long-term conditions like endometriosis or polycystic ovary syndrome (PCOS) all create invisible friction in women's working lives. The impact shows up in absence data, disengagement scores and stalled careers. Rarely labelled, almost never addressed proactively.
At what career stages do women disengage and leave?
The drop-off isn't random. It clusters around specific health-related life stages, and they often coincide with the years when women should be reaching their most senior, most valuable levels.
Menstrual health (typically from the mid-teens onwards)
Around one in 10 women has endometriosis. Conditions like PCOS, fibroids and severe menstrual pain affect productivity, attendance and self-confidence. Most workplaces have no specific support in place and the stigma around period health keeps women silent. They take the days, but they don't disclose why.
Fertility and pregnancy (can affect women at any stage of their career)
Fertility journeys are often emotionally and physically demanding, whether on a path to natural conception or undergoing fertility treatment. Many people navigate this experience privately, balancing medical appointments, difficult decisions, physical side effects, uncertainty and anxiety alongside full-time work and everyday responsibilities. Pregnancy loss affects around one in four pregnancies and is often not openly acknowledged. Without visible, compassionate support, those in this stage can feel isolated, overlooked and unseen.
Postnatal and return to work (can affect women at any stage of their career)
Return to work after maternity leave is a known attrition pinch point. A quarter of mothers are quitting work within a year of maternity leave, costing UK businesses £650 million annually. When returning women don't feel supported through flexible working, breastfeeding space, mental health check-ins or postnatal care, many leave within 12 months. The investment in their development walks out with them.
Perimenopause and menopause (typically 40s–55+, but often earlier than expected)
Symptoms begin earlier than most employers realise, often in the early 40s. Brain fog, fatigue, anxiety, poor sleep and joint pain affect concentration, confidence and performance. Women in this stage are often at the most senior levels of an organisation. Losing them is costly. Keeping them requires more than a policy. Almost one in four working women have considered quitting due to the impact of menopause or menstrual symptoms at work, and one in seven are actively planning to leave.
Heart health, metabolic health and long-term conditions (relevant across all life stages, risk increases with age)
Women are significantly underdiagnosed for cardiovascular disease, with symptoms presenting differently to men. Post-menopause, the risk rises sharply, yet most workplace health benefits don't address it. Conditions like type 2 diabetes, thyroid dysfunction and autoimmune diseases disproportionately affect women, often going unmanaged until they significantly impair daily function.
"Women live longer than men, but a significant proportion of those extra years are spent in ill health. Preventive support that begins early changes that trajectory entirely." – Laura Carter-Penman, Director of Clinical Services, Peppy
How does women's health affect the leadership pipeline?
The most significant talent risk is not at entry level. It's at the top.
The fastest-growing workforce demographic is women aged 45–55. This is the exact age range where menopause begins, where cardiovascular risk starts to rise, and where women should be entering their most senior leadership roles. This is also the stage where, without support, many step back, step sideways or leave entirely.
Women make up 49% of the entry-level workforce, but just 29% of the C-suite. Only 93 women are promoted to manager for every 100 men. That's the broken rung, and the gap it creates compounds at every level above it.
Mid-career is where the biggest drop-off happens, the same window where health challenges peak. For every £1 invested in employee health and wellbeing, employers get back an average of £4.70 in productivity gains. Women's health is the most underinvested category.
Every time a senior woman leaves because of an unsupported health need, you lose not just her experience. You lose the succession planning, the mentorship, the institutional knowledge. The cost of replacing her far exceeds the cost of keeping her.
Why does stigma around women's health at work make the problem worse?
Silence does not protect the business. It escalates the problem.
A woman managing endometriosis pain in silence takes more unplanned absence than one who feels able to have an open conversation and adjust her schedule. A woman going through fertility treatment who can't disclose it manages her distress alone, with predictable impact on her focus and resilience. A woman in perimenopause who doesn't recognise her symptoms may attribute brain fog and low confidence to her own failure, and quietly stop putting herself forward.
60% of women believed their health issues were not taken seriously in the workplace. 42% do not feel comfortable discussing health issues with their manager. Women are two thirds more likely to feel unsupported with health issues at work than men. 92% report health symptoms affect their work, yet most managers aren't equipped to respond.
Reducing stigma starts with making support visible, normalising the conversation and training managers to respond with confidence.
What should HR leaders do next?
The data is sobering. But this is entirely addressable.
Organisations that retain women and protect their leadership pipelines are doing something different. They're not just writing policies or running awareness campaigns. They're giving women access to preventative, expert, personalised health support across all life stages.
Download the Peppy Women's Health Guide
Unsupported women's health shows up in attrition data long before it shows up in policy. The Peppy UNSTOPPABLE guide gives HR and Benefits leaders a practical framework for building best-in-class women's health support, including a 90-day action plan, key statistics to use in leadership conversations, and guidance on closing the gaps in your current benefits provision.
Download the women's health guide
Frequently asked questions
What is the business cost of poor women's health support in the workplace?
The annual cost to UK businesses from menopause-related absenteeism and presenteeism alone is £10.5 billion. Beyond menopause, a quarter of mothers quit work within a year of returning from maternity leave, costing UK businesses £650 million annually. When you factor in the cost of replacing a senior female employee, which can reach 200% to 400% of their annual salary, the financial case for proactive support becomes clear.
Which life stages put women most at risk of leaving the workforce?
Attrition clusters around five key health-related life stages: menstrual health issues from the mid-teens onwards, fertility and pregnancy challenges, postnatal return to work, perimenopause and menopause (which can begin as early as the early 40s), and long-term conditions such as cardiovascular disease and thyroid dysfunction. Each stage creates specific pressures on performance, attendance and career progression.
Why don't women disclose health issues at work?
42% of women do not feel comfortable discussing health issues with their manager, and 60% believe their health issues are not taken seriously in the workplace. Stigma keeps women silent across all health stages, from period health to perimenopause. When support isn't visible, disclosure feels risky, and problems escalate rather than getting resolved.
Does women's health support affect leadership diversity?
Women make up 49% of the entry-level workforce but just 29% of the C-suite. The biggest drop-off in women's careers happens mid-career, the same window where health challenges peak. Without support, women at the most senior levels are the most likely to step back or leave entirely, directly weakening the leadership pipeline.
What does effective women's health support at work look like?
Effective support goes beyond policy documents and awareness days. It includes visible, accessible clinical support from specialists, trained managers who can hold sensitive conversations with confidence, preventive and lifestyle-led care, and genuinely inclusive provision that recognises the different experiences of Black and Asian women, neurodivergent women, and trans and non-binary employees.