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Menopause in the EU: Health, employment and equality policy
Menopause in the EU: Health, employment and equality policy
Marie Lecerf, Members' Research Service
Summary
Menopause — the permanent cessation of menstruation, typically between the ages of 45 and 55 — affects approximately half of the EU population. Around 85 % of women experience at least one symptom; for 25 to 30 %, symptoms are moderate to severe, disrupting health, quality of life and capacity to work. Despite these figures, menopause remains institutionally under-addressed: medical training and access to evidence-based treatment varies widely both across and within Member States, and no EU instrument explicitly names menopause as a policy priority or prohibits menopause discrimination specifically.
The EU has a robust basis for action enshrined in Articles 8, 153, 157 and 168 of the Treaty on the Functioning of the European Union (TFEU) and in the Charter of Fundamental Rights, although health system organisation remains a Member State competence under Article 168(7) TFEU. Directives 2006/54/EC and 2000/78/EC can cover menopause-related workplace discrimination through sex, disability and age grounds, as confirmed by the Commission's answer to Parliamentary Question E-000279/2022, but EU law lacks an explicit mechanism for intersectional claims combining all three grounds simultaneously, leaving a significant enforcement gap. However, the Commission's new gender equality strategy 2026-2030 marks a new step, explicitly mentioning menopause and committing to a relevant macro-economic impact study, WHO collaboration on women's health, and best-practice exchanges on menopause poverty. Ireland, France, Germany, Belgium and Spain offer promising initiatives, but these are not yet replicated across the EU, and Member State practices remain uneven.
Stakeholders broadly converge on the need for a dedicated EU menopause framework, increased research funding and explicit anti-discrimination guidance, while diverging on legislative versus voluntary instruments. The European Parliament has progressively raised the issue — from the 2021 resolution on sexual and reproductive rights (SRHR), to the 2025 Committee of Women's Rights and Gender Equality (FEMM) white paper, to the joint FEMM and Committee on Public Health (SANT) public hearing of 24 March 2026 — framing menopause as an integral part of the gender health gap, the gender pension gap (estimated at 25 % across the EU) and the healthy ageing agenda.
Menopause in the EU
Approximately half of the EU population will experience menopause, marking the permanent end of ovarian follicular activity and natural fertility. Clinically, menopause is confirmed retrospectively, after 12 consecutive months without menstruation (amenorrhea). This follows a perimenopausal transition — often lasting several years — characterised by hormonal fluctuations, menstrual irregularity and a wide spectrum of physical and psychological symptoms. In western populations, the average age of onset is 51 and the menopausal transition commonly begins in the mid-to-late 40s. Premature ovarian insufficiency (POI) (often known as premature menopause) affects approximately 1 % of women before the age of 40, carrying distinct clinical consequences, including substantially elevated risks of accelerated bone mineral density loss (osteoporosis) and cardiovascular issues that require prompt hormonal intervention, regardless of symptom presentation. Cancer and several oncological treatments — including chemotherapy, pelvic radiotherapy and surgical oophorectomy — are recognised causes of treatment‑induced premature menopause, also with well‑documented implications for long‑term bone and cardiovascular health.
Symptom burden is both wide and prolonged. Clinical studies document vasomotor disturbances — hot flushes and night sweats — in up to 80-85 % of women, alongside sleep disruption, mood changes (including a higher risk of depression), cognitive difficulties, joint and musculoskeletal pain and genitourinary symptoms, collectively described as genitourinary syndrome of menopause (GSM). Menopause can also be accompanied by ocular symptoms, particularly dry eye disease. This is largely related to reduced estrogen levels, which contribute to tear-film stability and ocular surface protection. Around 25-30 % of women experience moderate to severe symptoms, noticeably disrupting daily activities, with effects persisting for 7-14 years on average. In addition, recent longitudinal evidence underscores the role of menopausal symptoms in future health and longevity. Long-term health consequences of unmanaged menopause include osteoporosis, increased cardiovascular risks from oestrogen withdrawal, and amplified urogenital morbidity. A study across six European countries (Denmark, France, Germany, Italy, the Netherlands and the United Kingdom) found that 30 % of women aged between 55 and 75 reported urogenital ageing symptoms significant enough to require management. A separate analysis found that only around 60 % of women with urogenital symptoms had used Menopause Hormone Therapy (MHT) for relief, demonstrating that many symptomatic women still do not receive appropriate treatment. More broadly, although 60 % of women seek medical care for menopause-related issues, only around 25 % receive treatment and fewer than 5 % of midlife women across Europe currently use MHT.
No EU-wide standardised data exists on menopause prevalence, symptom severity or health service utilisation. However, national studies and European reviews converge on the scale and significance of the issue for working women. A narrative literature review identifies menopause as a significant occupational health issue that remains largely unaddressed in organisational contexts across the EU. Institutional taboo is cited as a primary barrier to both workplace disclosure and employer action, and research on the topic remains scarce, despite its clear impact on work ability. The European Menopause and Andropause Society (EMAS) reports that menopausal symptoms contribute to absenteeism, reduced working hours and early exit from employment, particularly in inflexible or physically demanding sectors. A 2024 study using linked health and administrative data from Sweden and Norway identified a significant 'menopause penalty' in earnings and employment, with disability insurance claims rising sharply as women exit the workforce during this transition.These findings are echoed in emerging national data on working menopausal women. A recent Belgian study from Maturitas of 760 employed menopausal women shows that 53.3 % of those surveyed who were currently experiencing menopause symptoms reported difficulties in performing their work. Meanwhile, 41.2 % had a high need for recovery after work, an established predictor of burnout. In the survey, 61.1 % of women reported additional work-related problems due to menopause. A high need for recovery was associated with poor work-life balance, higher physical workload, discomfort from cognitive demands, low organisational justice and limited social support. This led the authors to underline the importance of workplace cultures in which menopause can be discussed openly and appropriate adjustments be made. Research estimates that untreated menopausal symptoms cost Germany around €9.5 billion annually, through 40 million work-absence days, strengthening the economic case for workplace support. No comparable EU-wide figure currently exists — a gap that is itself a reflection of the broader failure to collect standardised data on the economic and societal costs of menopause at a European level.
Vulnerable groups bear disproportionate burdens. Low-income women often face barriers to accessing specialist consultations and evidence-based treatments such as MHT. Women in manual or shift work report symptom exacerbation from heat exposure, stress and inadequate rest facilities. This gap is particularly acute among socially deprived women, where MHT uptake remains significantly lower; owing to cultural barriers, healthcare professional awareness gaps and systemic inequities.
This structural gap is further compounded by limitations within the healthcare system itself. Despite the scale, duration and the clinical consequences of menopause outlined above, practitioner preparedness remains uneven, with evidence highlighting significant shortcomings in training. A 2025 survey by the British Menopause Society found that 72 % of healthcare professionals believe newly qualified practitioners lack sufficient menopause education, while 55 % report insufficient evidence-based training, even among qualified professionals. This deficit contributes to delayed diagnoses, insufficient treatment and inconsistent care outcomes.
A deeper structural cause underlies these gaps. Until the 1990s, women were systemically excluded from clinical trials as their hormonal cycles were deemed 'troublesome variables'. The consequences are still apparent in menopause care today. Drug dosages, treatment protocols and diagnostic thresholds across cardiology, psychiatry, rheumatology and neurology were developed on demographics that do not reflect menopausal women's physiology. Perimenopausal women continue to be routinely excluded from clinical trials owing to hormonal variability — meaning the timeframe where there is the highest symptom burden and the greatest window for preventive intervention remains the least studied. The European Society of Endocrinology published its first Clinical Practice Guideline for Menopause and Perimenopause only in October 2025, 130 years after menopause was formally described in medical literature. This research deficit weakens the evidence base available to EU policymakers and national health systems alike.
EU policies
Public health organisations, employment conditions and social policy remain primarily Member State competences under the EU treaties. Nevertheless, the EU supports action on menopause-related issues through its competences in gender equality, non-discrimination, occupational safety and public health; hence providing legal, policy and financial instruments to complement and reinforce national efforts.
Legal basis
Primary law
The Treaty on the Functioning of the European Union (TFEU) establishes a multi-dimensional foundation for EU action on menopause:
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Article 8 imposes a positive obligation on the Union to eliminate inequalities and promote equality between women and men in all its activities (gender mainstreaming);
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Article 19 empowers the Court of Justice of the European Union to take action to combat discrimination based on sex and other grounds;
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Article 153 provides for the competence to support and complement Member States' actions in the fields of working conditions, equal opportunities and equal treatment in employment;
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Article 157 addresses equal pay and authorises positive action measures to remove de facto inequalities for women;
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Article 168 obliges the EU to ensure a high level of human health protection in the definition and implementation of all its policies. The Union must complement national policies through coordination, incentive measures and responding to cross-border health threats while explicitly preserving Member States' responsibilities over the organisation of their health systems under Article 168(7).
The Charter of Fundamental Rights reinforces these obligations through Article 21 (non-discrimination), Article 23 (equality between women and men), Article 31 (fair and just working conditions) and Article 35 (access to healthcare).
Secondary law
EU Member States have not established menopause as a distinct, protected characteristic and EU anti-discrimination law currently addresses grounds individually rather than providing explicit mechanisms for intersectional claims involving sex, age and disability simultaneously — the precise combination most attributable to menopause-related discrimination.
The UK Equality Act 2010
The UK Equality Act 2010 serves as a leading model by enabling menopause-related workplace claims through its consolidated framework of nine protected characteristics, including age, sex and disability. The Equality and Human Rights Commission (EHRC) guidance clarifies that severe, long-term menopausal symptoms can qualify as a disability, triggering employers' duty to provide reasonable adjustments such as flexible hours, temperature control and rest facilities, while also recognising indirect discrimination where policies disproportionately affect menopausal women. Cases such as Davies v Scottish Courts and Tribunals Service (2018) demonstrates how this act allows flexible interpretation without requiring new legislation. The UK framework is frequently cited in academic and policy literature as the most advanced model in Europe, illustrating what explicit statutory recognition can achieve.
In parallel, Framework Directive 89/391/EEC imposes a general duty on employers to ensure workers' safety, health and welfare 'in every aspect related to work', including psychosocial risks and adaptation to workers' personal characteristics such as gender and age-specific physiological factors. This encompasses menopause as a workplace health issue.
Pioneering policy initiatives
European Agency for Safety and Health at Work (EU-OSHA)
EU-OSHA's 'Safer and healthier work at any age' project (2013-2015) first addressed the challenges of an ageing workforce, and its employer guidance includes practical measures relevant to menopause, such as manager awareness, flexible working, access to information and occupational health support, and workplace adjustments including temperature management and rest facilities. EU-OSHA's subsequent research synthesis, 'Women and the ageing workforce' (2022), explicitly identifies menopause among the key occupational health challenges for midlife women workers.
European Pillar of Social Rights
Principle 16 of the European Pillar of Social Rights commits the EU to timely access to affordable, preventive, curative, quality healthcare throughout life, directly applicable to access to menopause care. The 2021 action plan sets out a target for a female employment rate of 78 %, implicitly requiring consideration of midlife retention barriers, including menopause. Principle 3 (equal treatment) and Principle 4 (active employment support) reinforce the Pillar's relevance for menopause-affected workers.
The gender equality strategy 2026-2030
Published in March 2026, the Union's gender equality strategy 2026-2030 marks a key step forward in addressing menopause within the EU's gender equality framework, committing to:
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combating menstrual and menopause poverty through best-practice exchanges;
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commissioning a 2028 study on the economic and societal benefits of closing the women's health gap related to menopause;
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launching a 2026 World Health Organisation collaboration on women's health;
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supporting relevant health mapping.
Building on the EU gender equality strategy 2020-2025, which adopts a life-course and intersectional approach to gender equality in health, the 2026 EuroHealthNet report calls for menopause to be integrated into EU policy. The report recommends using sex-disaggregated data, supporting EU-funded research, including Horizon Europe, and mapping the availability, accessibility, and quality of menopause-related services across Member States.
EU funding programmes
The EU supports research relevant to menopause through several components of Horizon Europe, the EU's research and innovation framework programme for 2021-2027. These include the Marie Skłodowska-Curie Actions (MSCA) and the European Research Council (ERC), which form part of Horizon Europe's Excellent Science pillar, as well as Cluster 1: Health within the Global Challenges and European Industrial Competitiveness Pillar.
Three current EU-funded projects specifically address menopause or the menopausal transition:
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CARAMEL (2024-2029), funded under Horizon Europe, is developing AI-enabled tools for personalised cardiovascular-risk assessments and prevention for women aged 40-60.
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MenoBrain (2025-2029) is a Horizon Europe MSCA Doctoral Network that investigates menopause-related brain health, including hormonal influences on cognition and brain ageing.
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MappingPerimenopause (2025-2030) is an ERC-funded Horizon Europe project examining brain changes during perimenopause through longitudinal and multimodal data.
More broadly, the European Commission reports that the EU has invested over €2 billion in more than 1 000 women's-health projects across Horizon 2020 and Horizon Europe. Menopause-related research forms part of this wider women's health research portfolio.
Member States' initiatives
Across the EU, a growing number of Member States are addressing menopause through targeted healthcare as well as workplace and public-awareness initiatives. These measures commonly seek to improve access to appropriate care, foster menopause-friendly working environments, increase public awareness, and support research and innovation.
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Belgium: In December 2024, Belgium's Health Ministers established an inter-federal task force to coordinate menopause policy across regions, marking an early political commitment. Several major hospitals have dedicated menopause services.
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Finland: Finland has incorporated menopause recognition into government policy and current occupational care guidelines, acknowledging the need to strengthen work ability and labour market participation for menopausal women. Its prevailing approach integrates menopause into broader occupational healthcare frameworks, with the role of occupational health services varying substantially according to national policy priorities and available resources.
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France: The Mon bilan prévention programme, introduced in 2024, offers women aged 45-50 a health consultation that can address menopause-related symptoms and health needs. Menopause is also being integrated into later-stage training for general practitioners and there are university-led awareness initiatives that contribute to improving knowledge and reducing stigma around the menopausal transition.
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Germany: University clinics in Berlin and Munich offer dedicated menopause outpatient services, while the Bavarian State Ministry of Health provides resources to employers on menopause's productivity impacts.
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Ireland: The Health Service Executive operates Complex Menopause Clinics at six locations nationwide, providing referral-based multidisciplinary care for complex cases, including premature menopause, supported by the Women's Health Fund.
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The Netherlands: Amsterdam's University Medical Centre hosts a menopause research unit focusing on the impact of menopause on women's health and employment.
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Spain: Catalonia's Pla Integral d'Equitat Menstrual i Climateri (2023-2025) is an ongoing a pioneering regional initiative focused on improving healthcare access, increasing social visibility and promoting equity during the climacteric transition. The plan includes public awareness campaigns, training for healthcare professionals and integration of menopause support into primary care, in addition to workplace and occupational health measures.
Across all Member States, most documented interventions focus narrowly on menopause rather than the broader continuum of reproductive health across working life, so evidence demonstrating the effectiveness of workplace measures remains insufficient.
Stakeholders' positions
Medical and scientific organisations
The European Menopause and Andropause Society (EMAS) calls for the systemic integration of menopause care into national women's health strategies, mandatory general practitioners and primary care training and substantially increased research funding for long-term menopause health outcomes. A 2022 EMAS position statement sets out an essential menopause curriculum for healthcare professionals, identifying core competencies across clinical diagnosis, treatment options, long-term health implications and patient communication, while noting that current training coverage falls far below what is clinically necessary. EMAS also advocates for occupational health frameworks that explicitly address menopausal health through workplace risk assessments, an open organisational culture and clinical referral pathways.
National societies, including the Belgian Menopause Society (BMS), the French Menopause Society (GEMVI) and the German Society for Gynaecology and Obstetrics (DGGG), echo these calls, emphasising the need for specialised clinical centres and updated guidelines aligned with 2025 European Society of Endocrinology standards. The International Menopause Society's (IMS') white paper (Climacteric, 2024) articulates the goal that all women across the world should have easy and equitable access to evidence-based knowledge and healthcare during the menopause transition.
Employer organisations and trade unions
Trade unions, including the European Trade Union Confederation (ETUC), increasingly frame menopause as a workplace and equality issue. They develop guidance and training resources for representatives and workers. ETUC has published an online resource entitled 'Understanding the menopause in the workplace', providing a training tool for trade union representatives. At a national level, the Irish Congress of Trade Unions (ICTU) has issued 'Promoting Equality in Employment for Women Affected by Menopause – Guidance for Employers, Trade Union Reps and Employees', while at an international level, the UNI Global Union has produced 'Menstruation, Maternity and Menopause are Workplace Issues: Practical Guide for Trade Unionists'. All three of these documents describe menopause explicitly as a workplace issue and set out practical ways for trade unionists to address it in workplace policies, collective bargaining and support measures.
Civil society and professional organisations
Women's rights organisations, led by the European Women's Lobby, frame menopause within a broader sexual and reproductive health and rights life‑course approach, calling for systematic EU‑wide data collection, integration into the EU gender equality strategy and explicit recognition in EU health information frameworks, including the European Health Data Space. Menopause‑specific advocacy groups promote workplace charters, destigmatisation campaigns and patient-centred policy drawing on lived experience, following a similar pattern to menstrual poverty initiatives. Clinical societies such as EMAS and civil society actors, including the European Institute of Women's Health (EIWH), present menopause — beginning in perimenopause and extending well into post‑menopause — as a structural issue for health systems and labour markets that requires comprehensive and sustained policy responses, rather than ad hoc measures.
European Parliament's position
The European Parliament increasingly considers menopause as a cross-cutting policy matter, encompassing gender equality, women's health, employment and ageing. In its 2021 resolution on sexual and reproductive health and rights (SRHR), Parliament identified menopause, alongside infertility and reproductive cancers, as an issue that impacts women's entitlement to accessible, high-quality healthcare throughout their lives. The resolution called for appropriate rehabilitation and support services and for the Commission to report on EU programmes supporting sexual and reproductive health.
This sentiment has been maintained during the current legislature. Written Question E-003429/2025 invited the Commission to clarify what measures it does and could take to improve awareness of menopause, address persisting data gaps and consider the case for an EU strategy on menopause. A further written question draws attention to period and menopause poverty.
This work has been reinforced through committee activity. The Committee on Public Health (SANT) conducted a public consultation on women's health to gather the views and experiences of citizens and stakeholders. On 24 March 2026, the Committee on Women's Rights and Gender Equality (FEMM) and the (SANT) committee held a joint public hearing on menopause care in the EU. The hearing examined potential EU-level approaches to tackling stigma and misinformation, strengthening care and research, and promoting cooperation among Member States.
These developments are complemented by the own-initiative procedure entitled 'Menopause beyond a health issue: turning menopause into an economic, working and social priority' (2026/2055(INI)). Together, they indicate a growing recognition within Parliament that menopause has implications extending beyond clinical care, including for employment, social inclusion, health literacy, research and gender equality, while respecting Member States' primary responsibility for organising and delivering health services.
Main references
- Davaki, K., Gender inequalities in medical research, drug development and access to care, Policy Department for Citizens, Equality and Culture, European Parliament, November 2025.
Classification
Policy areas: Gender Issues, Equality and Diversity
Regions: European Union
Committees: Women's Rights and Gender Equality (FEMM)
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