The Hidden Stress of ‘Menopause Masking’: Three in Five Women Consider Leaving Job Due to Lack of Workplace Support

• Three-quarters (75%) of women experience menopause symptoms
• Nearly half (47%) who have taken a day off work due to symptoms said they wouldn’t tell their employer the real reason
• Tapping into the vagus nerve can lead to 35% reduction in anxiety, 48% reduction in fatigue and 32% increase in memory recall.

From sitting in meetings battling brain fog to smiling through hot flushes, millions of women make efforts not to let their menopause symptoms show in daily life. Experts warn that menopause masking may be taking a significant toll on the nervous system, driving women out of the workplace, and holding them back.

Menopause has long been treated as a liability, yet as new research emerges to suggest that better support during this stage can actually unlock greater clarity and emotional resilience, the question has become, why are these valuable traits going unrecognised?

Analysis conducted by neuromodulation company Nurosym found that for three-quarters (75%) of women who experience symptoms, menopause arrives with unexpected changes to cognition and emotion. The NHS currently recognises thirty-four possible symptoms of perimenopause and menopause, spanning brain fog, memory lapses, irritability, anxiety, hot flushes, night sweats and general sleep disruption.

However, three-quarters (75%) of women feel they are not well-informed about menopause, highlighting that women may still feel unable to discuss their symptoms or let them show openly.

In recent years, the term ‘menopause masking’ has been used to describe the gap between how women present themselves externally and the internal effort women undertake to keep appearing as functioning normally.

According to Dr Elisabetta Burchi, Head of Research at Nurosym, supporting women at this moment of their life could be really impactful, she states “Menopause represents a profound physiological and psychological change in a woman’s life. However, the perimenopausal transition can also become a critical window to engage women in comprehensive preventive strategies addressing cardiovascular, metabolic, bone and cognitive health.”

Despite the potential professional advantages, we could see if menopausal women received better support, workplaces are still not designed with menopause in mind. In the UK, around four million women aged 45–55 are currently in the workforce, lining up with the most common window for menopause.

In the workplace, where expectations to perform remain high, there is a lack of acknowledgement, as four in five women aged 45 to 55 years say their workplace does not offer basic support for menopause. It is this added pressure that can lead to symptom masking.

According to the British Menopause Society, over two in five (45%) of women say menopause symptoms have had a negative impact on their work, and almost half (47%) who have taken a day off work due to menopause symptoms said they wouldn’t tell their employer the real reason.

“Menopause remains culturally stigmatised, and this stigma shapes how women themselves respond to it. Many mask their experience, appearing composed while suppressing symptoms and concealing physical and emotional distress. Left unaddressed and misunderstood, this silent burden can erode emotional resilience and cognitive function, ultimately holding women back from their full potential,” warns Dr Burchi.

The effect of masking is that one in 10 (10%) of women aged 40–55 have left a job due to their menopause symptoms, while for those unable to step away completely, they are forced to make adjustments to their careers in order to cope, such as stepping back from opportunities or leadership roles. The research shows 14% reduce their hours or demote to part-time work, while 8% avoid going for promotions.

Even among those who have no choice but to remain in work, the issue is front of mind, with three in five (60%) of women aged 45–60 saying they have considered leaving their job due to a lack of menopause support.

How can tapping into the vagus nerve help?

Despite affecting half the population, menopause remains under-researched, leaving many women to navigate this complex transition phase without adequate support.

Experts at Nurosym warn that constant internal management of menopause symptoms, without additional support, can cause significant cognitive strain and disrupt nervous system regulation, only exacerbating existing menopause symptoms.

According to Dr Burchi, “Menopause symptoms aren’t just something to be pushed through, they’re signals that the body’s homeostatic system is under pressure. When women are constantly masking how they feel, they’re effectively overriding those signals, which can lead to prolonged stress, fatigue, and cognitive strain. Supporting the autonomic nervous system directly, particularly through the vagus nerve, can help restore wellbeing through improvement in body resilience.”

With the menopause market projected to reach more than £18 billion by 2030, there is no one-size-fits-all solution for menopause management. However, one emerging area of interest is vagus nerve stimulation.

Despite three million women in the UK taking HRT to support the symptoms of menopause, new research from the University of Cambridge, analysing 125,000 women in the UK Biobank, found HRT does not help in preventing broader neurological and psychological changes during menopause, leading us to look elsewhere.

The vagus nerve is the body’s longest running nerve and acts as the key regulator of our calming system. It plays a critical role in managing stress, mood, cognitive function and inflammation. When vagal tone is low, resilience drops. When it’s supported, the body is better able to return to a state of balance.

Vagus nerve stimulation (VNS) is an emerging, science-backed approach to restoring nervous system health. Backed by more than 50 clinical studies, Nurosym is the most studied auricular vagus nerve stimulation device available, with no serious adverse effects reported to date and clinical findings show up to 35% reduction in anxiety, 48% reduction in fatigue, 32% increase in memory recall, and a 61% increase in vagus nerve activity.