March 7, 2025 • 43 mins
Despite impacting nearly half the workforce, menopause remains one of the workplace’s most overlooked conversations. It’s not just a women’s health issue—it’s a leadership and business issue.
In this episode of Courageous Conversations, host Paul Tripp sits down with former C-suite executive Susan Mealy to shed light on the realities of perimenopause in the workplace. Susan shares her personal journey—how symptoms disrupted her career, why so many women struggle in silence, and what companies can do to better support their employees.
From tracking symptoms to advocating for policy changes, Susan offers practical advice for women navigating this transition and compelling reasons why leaders—men included—need to engage. Whether you’re an executive, a manager, or simply someone who cares about creating a more inclusive workplace, this episode challenges us to rethink how we support women at every stage of their careers.
This episode is brought to you by AceUp and produced and edited by Buttered Toast.
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Episode Transcript
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(00:03):
How do you lead when your body'sbetraying you?
How do you perform at your peakwhen brain fog makes you forget
your own passwords?
And why, when nearly half theworkforce goes through
menopause, are companies stilltreating it like a private
inconvenience instead of aleadership crisis?
Well today we're ripping off thelid of one of the biggest
workplace blind spots.
(00:24):
One that's silently pushingpowerhouse women out of
leadership and forcing them tochoose between their careers and
their health.
Our guest, Susan Mealy.
She was at the top of her game,a C suite executive, leading HR
for a cutting edge financialtechnology company, until
perimenopause brought her to herknees.
She did what countless womenhave done before her.
(00:47):
She walked away.
But unlike most, she's notstaying silent about why.
Now she's on a mission to exposethe system that let her and
millions of women down.
She's here to talk about why menin leadership need to care about
menopause, the radical policyshift that could change the game
overnight, and this boldest movea CEO could make by finally
(01:08):
bringing menopause out of theshadows.
This is the conversation HRdepartments don't want to have,
but we're having it anyway.
This is CourageousConversations.
This is the conversation everywoman needs to hear and share.
According to my watch, it's timefor a Courageous Conversation.
(01:30):
Susan, welcome to CourageousConversations.
Thank you for having me.
Yeah, you bet.
So I want to start off with, youdidn't just leave a job, you
left behind a really highpowered job because of
perimenopause.
And I'm wondering, in a worldthat glorifies pushing through,
do you see your decision as aresignation or an act of
rebellion against a system thatstill isn't recognizing the
(01:53):
biological realities of women?
Gosh, I wish I could say it wasa rebellion, but it really was a
resignation.
It was a desperate decision forme, Paul, to save really my
sanity, my career, in that I wasstarting to lose myself and not
understanding what was going onwith my symptoms.
(02:15):
So I had severe rapid onsetperimenopause and I was I had
been the chief people officer ata financial technology company.
We had navigated 9 11 withpeople on the ground, people in
the planes, just two yearsearlier.
So stress was not new to me.
I also was a hardworking kidfrom the time I was 14.
(02:35):
So it wasn't like All of asudden I woke up one day and
this job was too stressful, butslowly, but surely I was, my
mental state was unraveling andall input was, it had to be the
pressure of the job andlifestyle.
My daughter was five at thetime.
She's now almost 26.
So my symptoms were severe, andthey were mostly psychological.
(02:59):
I had very few physicalsymptoms.
And because I was so young, evenif I had the physical symptoms,
they may still have beendismissed as stress related or
burnout or anxiety.
So I got a lot of offers forantidepressants or anti anxiety
medication, which I did try, butthe lifestyle at the time in the
early 2000s working in financialservices, I made the wise
(03:22):
decision facetiously to selfmedicate with alcohol, which
just further deteriorated myphysical mental health and then
was wreaking havoc on mymarriage because we, my husband
was working in a big corporaterole at that time.
So I was piling up poordecisions.
And I realized that if I didn'ttake control and do something
(03:43):
about it, then something bad wasgoing to happen.
My husband was going to leave.
I was going to get fired.
I was going to do somethingoutrageous.
And the irony that I was a chiefpupil officer is not lost on me.
So I ended up resigning.
After a particularly upsettingpresentation where I lost my
train of thought and I couldn'tget it back and then I started
(04:04):
crying to the bathroom and nevercame back.
So, unfortunately, it wasresignation, not rebellion, and
if I had known what was goingon, I might have been able to
get the help that I needed in ashort time.
medical leave of absence andbeen back to work in six weeks,
but I didn't know what was goingon and it was almost impossible
(04:25):
to get the help that I needed.
And the gaslighting, bothpersonally and in the medical
community, is something thatpeople are still dealing with
today.
And so, 20 years later, that'swhy I find myself so involved
and engaged in this advocacywork around normalizing the
menopause conversation at work.
Because when I finally took abreak from corporate, Just 2023,
(04:48):
I left my last chief peopleofficer role and I started
talking to people, I realized ithasn't changed.
The workplace conversation hasnot changed.
So, menopause is a very timelyconversation right now.
It's still not being talkedabout at work.
Yeah, I'm curious.
You said you were 42, and youstarted noticing symptoms, and I
know there are women out therelistening that are noticing
(05:11):
symptoms, right?
That are noticing, I'm tired, orI'm foggy, or I'm whatever.
And 42 sounds young to me.
Now, what do I know?
But 42 sounds young.
What would you say are some ofthe symptoms that Women need to
pay attention to here.
I'm going to start just back upfor a second and say one of the
biggest myths that stillpersists around menopause is
(05:32):
that it's an older person'scondition.
And older was previously definedas over 50.
So anyone in their late 30s orearly 40s ends up treating the
symptoms individually, hence whyyou end up on an antidepressant
medication, or you end up beingtold just relax and have a glass
(05:55):
of wine, or do meditation, or dothings that relieve the stress.
So I think that The, thepersistent myth that menopause
doesn't happen until you're over50 is one of the things I'm
trying to help create awarenessaround, as are many other people
right now.
And again, with my focus beingon the workforce, it's a little
bit more targeted than thegeneral population, social
(06:17):
media, influencing, books, etcetera.
So what I've been telling womenis, first of all, there's three
stages of menopause.
That's the other myth.
There's perimenopause.
which happens up to that daybefore you have your last
period.
And that can last from 4 to 10years and can start as early as
your mid 30s.
(06:38):
And the average age of menopauseis 51, so it can start as early
as your mid 30s.
You could go through menopausein your mid 40s.
Paralysis is when your hormonesfluctuate wildly, your estrogen
and progesterone.
In fairness to the medicalprofessionals, they're also very
hard for the medicalprofessionals to pinpoint.
So tracking your symptoms isreally important.
Tracking your moods, trackingyour irritability, tracking your
(07:02):
periods, tracking your sleepcycles, like tracking all the
things that would, if you addthem up, say, oh, this could be
perimenopause, as opposed totreating your symptoms one off.
Like, heart palpitations isanother one.
People go see a cardiologist.
The mental stuff, people go seea psychologist.
The urea, genital stuff, peoplego see their OBGYN.
(07:25):
And then, these people aren'tspeaking to each other.
So there's no like aha moment.
So that's the advocacy part andthe tracking part.
And one of the relatively simplethings I advise women to do,
which is track your symptoms.
So paramenopause is pre,menopause is simply one day on
the calendar, which is the daythat's 12 months after you've
had your last period.
(07:45):
Now, most people know exactlywhen that is.
But so it's a roughapproximation.
And then everything after thatone day is postmenopause.
And postmenopause, your symptomscan become more severe because
your hormones continue todecline and that's when your
risks of the long term healthissues like osteoporosis and
(08:07):
heart disease that come fromdeclining estrogen really
increase.
So it's pretty complicated,right?
But your question was women intheir late 30s and early 40s who
could be, God forbid, they couldbe postpartum.
And perimenopausal, so theycould be just full of not
understanding what's going on.
(08:28):
And then they're super busy,right?
So it's like, I can handle this.
I got a little kid.
I got to get to daycare.
I got a presentation I have togive tomorrow.
I have aging parents that I haveto worry about.
Women are largely trained tosort of suck it up and take care
of others and often leavethemselves as the last person
that they take care of.
(08:48):
So I think that's the what'sgreat about all the Publicity
that menopause is getting rightnow is people are like, wait,
what?
42?
I had someone just write to methe other day who's 46 and she
was like, I had no idea.
So before I get to where canwomen go or what should they do,
what actions should they take?
(09:09):
I really want to talk aboutCorporate America and their role
in this, you know, becauseCorporate America spent billions
on DE& I and we know right nowthat's being kind of pushed
back.
However, menopause affects 100percent of women.
Right.
And it's absent from theconversation, as you just said.
And so I'm wondering what's thefundamental flaw in how
companies are approaching thisissue and what's the fastest way
(09:32):
to fix it.
So I think the fundamental flawis also lack of awareness and
the impact on the workforce.
So I think there is a true lackof understanding.
When I resigned from my job 20years ago, my boss was like, I
think you're taking an extremereaction.
Like you're fine.
You'll be fine.
Like that breakdown was nothing.
(09:52):
And I was like, I'm not fine.
That wasn't fine.
And I'd rather just go beforeyou have to get rid of me, any
professional credibility that Ihave last shred of.
Credibility or sanity that Ihave left is gone.
So I'm going to go before that,but I think the lack of
awareness and the lack ofbringing it into the light and
(10:14):
talking about it is thefundamental flaw in corporate
America, which is compounded bythe fact that ageism and sexism.
in the workplace is a real issuefor women.
So you're already dealing withageism and sexism.
The last thing you want to addon top of that is, oh, by the
way, I'm forgetful some days, orI'm really uncomfortable and I
(10:37):
have to use the ladies room.
More often than not.
Yeah.
Nobody wants to have thatconversation when it's not part
of a regular inclusive dialogue.
I have often related to mentalhealth and when I first started
in HR, which was almost 40 yearsago, we didn't talk about mental
health, right?
Right.
If you had a therapist, that wasunusual in the 80s, and if you
(10:59):
did, it was like, oh boy, you'reone step away from the
institution.
But over the last 10 15 years,mental health has certainly
become much less stigmatized,much more normalized in the
workplace.
Similarly, if we're stickingwith the topic of women's
reproductive life, so hasfertility.
Many companies offer fertilitybenefits, uh, these days.
(11:23):
Many companies offer paternityleaves.
That was not a thing.
Even 25 years ago, paternityleave wasn't a thing.
I think my husband probably, ifhe got two weeks off, I'm
surprised.
I don't remember.
And I also think that by talkingabout it generally, And talking
about it to men who work in theworkplace, they still might not
want to talk about it in theworkplace, but if they start
(11:44):
talking about it at home, justlike mental health, you start
talking about it more with yourfriends, with your spouse, then
it starts to just become morenormal.
So then bringing thatconversation into the workplace
feels less strange, lesstargeted.
less uncomfortable for the womenthat might be experiencing these
symptoms.
(12:04):
I think that's where corporateAmerica has an opportunity or,
and we all have as, asparticipants in these
conversations at home and atwork.
So let me ask you, where does itsit?
As you were talking, I wasthinking, does this sit under
the mental health bucket?
I don't know.
I'm ignorant.
You're the pro here.
So tell me, where does it sit?
(12:25):
I've been talking to some, somefolks in this space in the last
few years.
Few weeks about this topic andwe've been debating around like
who is gonna who are we gonnaapproach target market to around
bringing this into the workplacein a sustainable way so my
worry.
Is if we go with the DNI routeand forget everything that's
(12:48):
going on in the world with DNI,but employee resource groups are
a really good Avenue to bringthis message in women's employee
resources group in particular,sometimes bigger companies have
mental health employee resourcegroups, but from an inclusion,
but that's a great Avenue.
The challenge with that is itfeels like it's.
Has a huge potential to be oneand done and not really have the
(13:12):
ability to make a long termimpact.
Now, by having at least oneconversation, it could lead to
more and it could have a trickleeffect.
That's, that's one avenue.
Wellness programs is another.
But so the benefits department,the folks who do the wellness
programming, and these aregenerally larger companies that
have both of these avenues, butI think Beyond that is also
(13:37):
employee engagement andorganizational development that
could bring the conversation tolearning and development doing
menopause 101 training,supervisory training around how
to talk to your employees aboutmenopause, which is challenging
because I know from experiencethat having it across different
(13:59):
places is going to make itharder to have the sticking
power to actually create amenopause friendly workplace
where it has become anintegrated part of wellness.
benefits, inclusion, learningand development.
I feel like that's, that's alittle ways away because we're
going to have to get in howeverwe can and then we're going to
(14:19):
spread out.
And I think that before the DE&I efforts became like pedal to
the metal in 2020, when I wasworking at Foundation Medicine,
we were building like from theground up, which is a lot of how
we did a lot of the work ofFoundation Medicine so that it
would.
Slowly take hold.
And we had the privilege ofbeing owned by the Roche group
and having the resources and theleadership support.
(14:43):
And so I feel like that's alwaysthe best way to build programs,
right?
It's the way I built a coachingprogram.
That was award winning beforecoaching was something that
leaders were really into.
It's like start small, getpeople to really like it, get
the leadership buy in top down,bottom up.
And then that's how it sticks.
So I think we still have a hugeopportunity for the stickiness,
(15:06):
even if we're having theconversations.
How it's going to stick is goingto be all avenues coming
together to make it happen.
So do you think a policy is thefirst kind of framework that
companies need to think aboutimplementing in terms of
breathing life into it?
I understand the approach, butas a policy, the starting point.
So therefore it's, uh, this ishow we're going to address it.
(15:29):
No, I think a policy is the laststop and I think the policies
are easy because the policy, thepolicies exist today.
Paternity leaves exist,fertility benefits exist, leave
work accommodations forillnesses exist.
Just amending them to addmenopause into the policies is
(15:52):
easy.
It's the converse that are hard.
It's the, oh, okay, this policysays I could take a leave for
menopause, but now I have to sayI have menopause symptoms that
are causing me to lose days inthe office, that are impacting
my productivity, that areimpacting my self esteem to the
point where I'm consideringeither leaving or not putting
(16:15):
myself up for that promotion.
So it's the dialogue, it's thenormalizing the narrative.
We, we talked about what's theradical thing that companies can
do.
The radical thing to do is nameit, put a face to it, then
build.
Up under it, those threepillars, right?
The communication, the learningand development, the policies,
(16:36):
or as a former HR person, Ithink the policy piece is easy.
Now there are some benefits thatI think would be a little harder
depending on the demographic ofthe company to ensure that
you're covering hormone therapy,to ensure that you're covering
menopause specialists, butagain, that is, those are not
insurmountable.
(16:56):
Barriers.
Those are a fairly low bar.
And if you're a self insuredcompany, if you're a large
enough company that you'repaying claims directly, you have
a lot of control over what youcover.
So I think it's the naming andthe putting the face to it and
having the conversation.
That's the most radical thingfor companies.
(17:17):
I, and this is true in othertopic areas where C level women
say, I want to be known as agreat CEO, not because I was a
woman.
But because I'm a great CEO, sotherefore I don't want to be
associated with that woman'sprogram.
And I'm like, that sucks,frankly, because you are a
woman, you are a CEO, and youhave an opportunity to lead this
(17:39):
conversation and I get it, I seeboth sides of it, but it's going
to take a few brave leaders, afew brave men, who's maybe.
personal experience with theirmoms or their wives or their
daughters is like, Oh, wow, thisis really, really something I
should be talking about.
And a few brave women, but Ifound a lot of receptive in the
(18:02):
audiences that I've talked with.
I found a lot of curiosity amongthe men in the audiences as
well, because they're concerned.
They're concerned about theirwives.
I mean, if you could have myhusband on next, he will tell
you how gravely concerned he was20 years ago.
He was like, I do not knowwhat's happening.
As you were talking, I waswondering about men because I
(18:23):
was thinking, why should mencare about this issue?
Not in a sexist way, but youknow, it doesn't hit them in
their daily lives.
And yet their moms, their wives,their daughters, whomever,
that's when they start to payattention.
And so I'm wondering how can weget men to move beyond lip
service around this issue andgenerally invest in menopause
(18:44):
friendly workplace policies?
So I, I think the mom angle is areally good one because my mom
passed away nine years ago, andif she were still alive, she'd
be like roughly 90.
But the quality of her life thelast 10 or 15 years was not
great.
That post menopausal phase thatI was talking to you about a few
minutes ago, your hormonesdecline and they don't come back
(19:07):
unless you get it synthetically.
You can't make it.
So your bone health startsdeclining and your
cardiovascular health startsdeclining and you're prone to
excessive UTIs that could killyou.
And so if your mom is sufferingfrom all those things, you're
(19:27):
like, wait, what?
And you start to become awareand.
My mom died of osteoporosisrelated complications that if
she had been on estrogen, shemight not have suffered the
severe osteoporotic fracturesthat she lived with for probably
10 years before she died.
So, I think moms is a greatangle to get men to pay
(19:49):
attention if they don't havewives, right?
And then if you have wives, thelargest demographic in the
workforce is a menopausal age.
45 to 60, that's the target ofmenopause.
So, I think if you know a woman,you love a woman, you work with
a woman, like a close colleague,and you're, like, I haven't
(20:09):
talked to many of the men Iworked with during that time
lately, but, well, they wouldhave wanted to help me if they
could have.
They were watching me literallydeteriorate in front of their
eyes.
I was a highly, highly competentperson that in a period of six
months couldn't hold a sentencetogether.
So I know they would have wantedto help if they had the tools
(20:31):
and the language to do so.
Just like back in the day, mydad wouldn't have ever talked to
me about My period or gottentampons for me, but like we'll
come a long way with that.
My husband does that for mydaughter.
That's a big deal for him.
So I feel like it's all theselittle ways that we'll get men.
And I feel like the more we getmen in their personal lives, the
(20:53):
more they'll.
Be aware of what's happening inthe workplace.
The more comfortable they aretalking outside of work, the
more they can make it, Oh, well,I know someone that is
experiencing that my sister, itmight be my, it might be your
sister.
I've watched my sister.
She just, I don't have anybrothers, but again, if I had a
brother, I would like to thinkthat after they, they would
(21:15):
have, he would have been like,shit, I'm watching this woman at
work, go through this thing, I'mgoing to pull her aside and say,
Hey, are you okay?
Yeah.
Like, just like a human, like weteach, like we coach people to
be human, just human.
It, you don't have to beparticularly nosy, but you could
be like, I've noticed you seemreally forgetful or really
(21:36):
tired.
Are you feeling okay?
Just opening up the conversationfeels like not that hard.
And we've been teaching peoplefor years, right?
To have more inclusiveconversations.
So it, it's, it's on the samepath.
So again, I'm like big into thesurround sound sort of approach
to this.
Come at it from all thedifferent angles and it will
make it seem less scary.
(21:58):
And just as a quick aside, Imentioned that I have an almost
26 year old daughter.
She's been having some hormonalissues monthly, and she wasn't
feeling good at work yesterday.
Also happens to be in humanresources.
Coincidentally, following mom'spath.
Yeah.
So I said, you should talk toyour boss because it's been a
monthly kind of thing for thelast few months.
So something's going on.
She has a female boss.
She's like, I cannot have thatconversation with my boss.
(22:20):
And I was like, she's young.
She's 26.
And I was like, wait, what?
She's like, yeah, no, I feel tooweird.
I go, okay, then you should notbe talking to me because I am
trying to get people to talkabout menopause in the
workplace.
So if you can't even tell yourboss.
That you're having some issues,like I got a lot of work to do,
there's a lot of opportunityhere.
So let me play with that justfor a minute.
(22:42):
I really like what you just saidis, let's say there are women
out there that are havingissues, right?
Cycle issues or hormonal issues.
How would you frame up aconversation for them to go to
someone, male or female, to talkabout?
What would be your approach?
Yeah, so I just was talking withanother coaching friend of mine
about this and some of the womenthat she's coaching and I think
(23:03):
again, it first starts withhelping the woman to understand
a they're not ill, right?
This isn't an illness.
It's a decline in hormones.
It's a condition but it's not anillness.
So I think that's the otherthing that we do.
We get worried and we get in ourheads about it.
We're like, we start forgettingthings.
(23:24):
So we think, oh my god, we haveearly Alzheimer's, right?
So we gaslight ourselves and weget nervous.
So I think starting with.
Being very honest, I have abunch of symptoms.
I'm not really sure what's goingon.
I have an appointment in acouple weeks, but I'm not
sleeping that well, which isleading me to be a little bit
foggy.
So I'd just love if I could havea little extra time on this
(23:47):
project.
Like, just gently easing intothe conversation without a lot
of detail.
Enough detail to share, hey,this is like big picture what's
going on, and here's how it'simpacting me.
And I'm working on getting theright going forward, but could I
have a little grace just likeany other illness that someone
(24:09):
might have any otheraccommodation.
And again, I said, it's not anillness and it's not, but the
symptoms show up in ways thatare debilitating for some
people.
But when you're suffering fromdebilitating symptoms to not
even have the conversation,think about how much energy that
takes.
Right?
Think about how much energy ittakes to try to hide your
(24:29):
symptoms in your day and whatthat does to your mood, your
productivity, your socialability to interact, right?
It's taking all your energy justto sit up straight, you know,
and like hope that your periodisn't bleeding through your
pants when you're in aconference room.
You know, so it is like suckingpeople's energy so that they
(24:52):
can't put it towards their jobs.
And then they're get into thatself fulfilled prophecy.
Well, maybe I just can't do thisjob.
Right.
I spent seven years after I leftthat job thinking I couldn't do
that job anymore.
Yeah.
Yeah.
You know what I appreciate aboutwhat you said?
It's about recontracting.
It's about going in and saying,Hey, this is where I am.
I might need some extra time onthis project or process.
(25:14):
I want you to be aware.
I'm on it on my end, but I justneed you to know that's what's
happening on my end to createsome space.
Yeah, and a lot of the examplesthat are coming right to mind
are people who have had newbabies or people who have had
terrible pregnancies wherethey've been throwing up in the
bucket all day.
Now, of course, we've moved alot more towards hybrid work
(25:35):
than 20 years ago, but men andwomen have.
You know, over the last 12 yearsof my CPO career, I've been
like, Hey, you know, I'm havinga really hard time.
I'm not getting enough sleep.
My kid's cranky.
That's a pretty normalconversation in the workplace
right now.
It's like, I hope you don'tmind, but I'm gonna put the baby
(25:55):
down and work from 5 to 9 p.
m.
And I'll get done what I need toget done, but I'm not gonna be
available.
Because between one and three inthe afternoon is really
difficult.
And I know I worked for someprogressive companies and was
fortunate about that.
And I was a very human bossmyself, at least in the last
decade.
I'm not sure about the firsttwo.
(26:16):
So I feel like normalizing itagain, back to that word that
I'm overusing a bit, butrecontracting, normalizing it,
and thinking about it like anyother issue.
My wife's sick.
I have to take care of her.
I, I'm going to need someaccommodations to my schedule.
Yeah.
And so let me ask you this.
So you have the conversation,someone has the conversation,
(26:37):
and then where do they go?
Because you'd mentionedcardiologists, primary care,
antidepressants.
Where do women go to get helparound this issue?
Because you can't go to a singlereferral, right, specialist,
because they're going to look atit from their specialty lens.
Yes, so menopause specialists,and they're, they're few and far
between, but they exist, and ifyou go to menopause.
(27:01):
org, which is the medicalassociation that certifies
menopause MDs or nursepractitioners.
So that's the first place Irecommend people look for a
specialist.
And that could be a primary caredoctor, that could be an OB GYN,
it could be an endocrinologist,it could be any doctor who's
decided that this is importantto their practice, and they went
(27:24):
and became a menopausespecialist as a result.
So they could be acrossdisciplines in the medical
space.
So menopause specialists, GYNs,and then if no help is
available, there are telehealthresources that I was just going
to ask that.
Yeah.
I think there are betterreasonable alternatives.
MidiHealth, AlloyHealth, Maven.
(27:46):
A handful of really seeminglyvery well reputable telehealth
organizations that have poppedup over the last few years.
Now many of them popped upstarting with fertility.
And now along with a lot ofother benefits are extending
beyond the reproductive healthchain to include.
(28:07):
Menopause.
So at least talking to somebody,that was my problem.
I was so isolated.
I didn't know who to talk to.
And then I tried talking to mydoctors and that didn't go very
well.
And none of my friends wereexperiencing it because they
were all young.
And I had a five year old and itcouldn't have been part of them
because she was five.
(28:27):
I just didn't know who to talkto.
And then everybody I did talk towas like, oh god, yeah, you have
a very stressful life.
Your job is really stressful.
My, I like love my job.
And I, Was really good at it upuntil like last week, so I'm not
sure that's it.
So, uh, talking to people Ithink is critical so you don't
feel alone and isolated.
That, women spend at least threeyears in perimenopause
(28:49):
undiagnosed.
Is there a book out there thatwomen can read to say, Oh, gee,
this is perimenopause?
Yes, there's lots of books now.
You have a favorite?
I have two favorites.
One is, uh, the menopausemanifesto by a woman whose name
is Dr.
Jen Gunter, G U N T E R, and theother is called Estrogen
(29:12):
Matters, and that's just been rereleased, Paul, and really talks
about the disservice that thatstudy in the 1990s did.
to women's hormonal health andwhy so many people spent so long
being scared of hormone therapy.
A lot of the others are fallinginto that like social influencer
(29:35):
cat category of practitionersand profiting from the work that
they're doing in the menopausespace.
So they're selling supplements,they're selling programming,
they're reading their book.
And so That doesn't mean they'renot good resources.
It's just harder to walk theline and harder to understand
are they telling me this becausethey want me to buy their thing
(29:58):
or do they really believe this?
They're doing a lot of work ingetting the message out which
has been incredibly helpful butthese two books are are much
more factually based.
Manipause.
org has a whole series for smallcompanies, like big companies.
Can do all sorts of things, butfor small companies that's
(30:18):
demographic might have a lot ofwomen in their 40s.
There's a whole set of freeresources like worksheets and
benefits and policies and thingsaround menopause in the
workplace on the menopause dotdot.
That's great.
I'd like to talk about hormonereplacement therapy.
Some people and men say it's alifeline.
Other people say it's alightning rod.
And I know that in talking toyou before the interview, you've
(30:41):
experienced the dangers ofhormone replacement therapy
firsthand.
So talk to me about why womenshould or shouldn't consider
hormone replacement therapy ifthey're experiencing
perimenopause.
So I think First of all, that'swhere the menopause specialist
is really important, to makesure that you have someone that
understands your uniquesituation.
(31:03):
But the biggest misconceptionaround hormone replacement
therapy, in general, is thatit's dangerous for all women.
And that's just factually nottrue.
It is not dan It is dangerous insome very limited circumstances,
like estrogen positive breastcancers.
It's very difficult.
(31:23):
for women who have an estrogenpositive to take estrogen
because they're trying toeliminate the estrogen.
But otherwise, all of the mythsaround the danger of hormone
therapy have largely beendebunked in the last decade.
So depending on where you are,how old you are, et cetera, when
you start How severe yourmenopause and how severe your
(31:45):
symptoms are really determineslike your path for treatment
when it comes to hormonereplacement therapy.
So I'm going to tell you twostories.
One is my own and one is afriend.
So I was, obviously I was young.
It took me seven years.
to get on hormone therapybecause of the timing.
So I had, I was right in thattiming where it was not being
(32:07):
prescribed because it had justlargely been taken off the
market because of some flaweddata and some hyperbole around
reporting causal relationshipbetween hormone therapy and
cancer, which was inaccurate.
I was to put on At age 50,roughly lifesaver for me when it
came to long term health issues,because both my grandmother and
(32:30):
my mom died from osteoporosisrelated complications.
My mom's are very indirect.
My grandma was a typical falland broke her head.
My mother lost five inches inheight and she was.
like a small person with one ofthose kyphosis in her back by
the time she passed away.
So for me, the estrogen andprogesterone were life saving.
Testosterone is the one that'scontroversial, and it's actually
(32:52):
controversial for men and women.
But for me, I started ontestosterone not at the same
time.
And when I moved to Maine, I hadtrouble accessing hormone
therapy.
So I went to a conciergepractice and was super over
medicated because it's, it wasinserted via pallet, which is
(33:13):
hard to know how much you'regetting dosed and their general
practice was they.
The more testosterone, thebetter.
And in some cases, that works.
And lucky for me, I didn't haveany really long term side
effects from it, because I'vebeen on this journey for quite
some time.
So I knew enough to know, uh oh,this is not good.
And this is going to lead toplaces that may be irreversible
(33:36):
in terms of hair loss and skinchange and other things.
So I didn't have any reallysevere long term side effects
from it, but it took months toget it normalized.
So now I'm on a physiologicaldose, which is much, much
healthier and, you know,questionable as to whether all
women need testosterone and, orwill benefit from it.
(33:57):
And I don't know enough aboutit.
When it comes to men to talkabout it, other than it just
declines at a much slower rate,and has also, once you go on it,
you can't go off of it if youstop making it once you're on it
as a man.
So there's some challengesrelated to that.
Now, I have a friend who neverwent on it.
She didn't have debilitatingsymptoms of menopause, but she
(34:20):
has osteoporosis.
and heart disease and severedental issues.
So her estrogen decline was shewasn't experiencing the radical
up and down that leads to a lotof the symptoms in perimenopause
and she had a relatively symptomfree menopause and she was quite
a bit older than the average ageof menopause so she thought life
(34:42):
sailed through menopause but nowshe has a degenerative.
disease, osteoporosis, heartdisease, and has had like three
or four implants, so her teethare not so, not in great health.
So I think even symptomlessmenopause requires you to
understand what's going on inyour body in relation to your
hormones and whether you will orwill not.
(35:03):
benefit from hormone replacementtherapy.
So I think that's the othermisconception that if you don't
have symptoms, you don't needit.
But even if you don't havesymptoms, your estrogen is
declining and estrogen is inevery part of your body.
So.
The most direct causal effect oflow estrogen, lacking estrogen,
(35:24):
is osteoporosis and heartdisease.
There are others that are beingstudied now.
What is the relation to brainhealth?
Because there's so many estrogenreceptors in your brain, over
time we'll see that.
I want to go back to, how do youunderstand this to be a business
issue?
Why should businesses care?
This is one of my favoritequestions.
So, 100 percent of women willexperience menopause.
(35:45):
The largest age demographicgrowing.
segment of the workforce orwomen over 50.
Women who are living longer,working longer, staying engaged
much longer, women will live onethird to one half of their life
in menopause or post menopause.
So one in five women eitherleave the workforce or consider
(36:07):
leaving the workforce or take astep back due to menopausal
symptoms.
1.
8 billion dollars was lost inwages due to productivity
related to menopausal symptoms,and that was in 2023.
The 20 hasn't come out yet.
We will never, I'm not even surewhere gender equality is in the
(36:27):
workplace on the scale of thingsthat are important these days,
but if we don't normalize themenopause narrative, At work,
we'll never have a chance ofhaving the women to choose from
to be our next level CEOs and bein the C suite because they'll
either leave or they'll bepassed over because they aren't
(36:50):
viewed as competent.
So, we know how retaining peopleis, what, 5 percent of the cost
of losing somebody and having toreplace them?
And so having a pipeline offuture female leaders to
eventually create some sort ofgender equality in the
workplace, it's like a criticalbusiness issue.
And that's not even, those coststhat I mentioned aren't even
(37:13):
including the long term healththings that we talked about.
So you stay in the workforcelonger, you can't afford to
retire because who can afford toretire these days, or you don't
want to because women, we're allliving longer and we want to
stay engaged.
We love our work.
We want to continue to do it.
Then you start piling on diseaseand osteoporosis.
(37:33):
And those are all costs to acompany that if they had been
offering menopausal benefitsmuch earlier, they may have
prevented those long termmedical costs as well.
So it feels like a relativelysimple business.
Equation to me as a former chiefpeople officer, I think it's
just, we have to get out thereand I thank you for having me to
(37:55):
talk about this because that's abig step and when we talk about
where people will hopefully payattention.
So I'd like to end with thequestion around, you've said the
boldest move a CEO can make isto openly acknowledge menopause
as a leadership issue.
And if you had five minutes witha fortune 500 CEO, what's the
one radical action you'dchallenge them to take
(38:16):
immediately?
I would challenge them to be theface of menopause.
Okay, so let's say I did arecent webinar with a women's
employer resource group.
I had a C level woman who wasmoderating.
What if that was a CEO who was aman that was moderating?
That doesn't actually seem thathard, but we both know that it
is.
What if the CEO of that companywas the person that was
(38:39):
moderating that one hourconversation around Why don't we
talk about that at work insteadof delegating it to the woman
who was the C level woman whowas willing to be the face.
So it seems simple in theory,much more difficult in practice,
but I think that's a bigopportunity for us.
To get the men out there engagedin the dialogue when most of the
(39:03):
people I know doing work in thisspace are women.
In fact, all of the people Iknow doing work in this space
are women.
But some senior level men,particularly at the executive
level, CEO if possible, I thinkwould change it immediately,
right?
Cause in your work and all thework I've done in my career.
It starts at the top.
All of it starts at the top.
(39:23):
How people behave in theworkplace, how people treat
other people in the workplace,business practices, everybody
looks up to the leader.
And I think that leaders forgetthat sometimes.
And I'm sure your work every dayis reminding people that people
are looking to them.
You get a CEO moderating an allfemale panel to talk about a
(39:44):
male CEO.
to talk about menopause in theworkplace and share maybe a
personal story about his mom orhis wife or sister.
I think that will change thatconversation in that company
immediately.
You know, it's interesting asyou've been talking and I'm
hearing the business impact andobviously the impact to the
workforce and I even think ofMedicare costs, how it could
(40:05):
save our government money andit's a health issue.
I think what you're describingis a human issue.
It's not a DEI issue, but it's ahuman issue.
I know my own mom struggles.
What would you say to that?
When I speak outside ofcompanies, I talk about it as a
societal issue.
Cause all the things we justtalked about as it relates to
the workforce.
relates to how people are ableto live their life, right?
(40:28):
And when I think about theworkforce, I've worked in pretty
privileged places inMassachusetts, and that's not
the world.
Think about female firefighters.
They must have to stop working.
Like, I don't know what they do.
I'd love to find some to talkto, but.
I consider 40 a month forhormone replacement therapy
affordable.
(40:48):
That isn't affordable for somepeople.
You have to choose to spend that40 on that versus perhaps on
your child's formula orsomething.
So eventually birth controlbecame free.
In, in England, hormonereplacement therapy is covered
by the government.
But in this conversation, I'mtalking about this limited world
that I grew up and worked in,which was.
(41:09):
In the greater Boston area,highly educated affluent in
terms of the companies, butthere is a whole world out there
that doesn't have that sameprivilege that.
Is really suffering withoutaccess, without information.
So getting this out even broaderbeyond the large companies that
we perhaps have an opportunityto influence, but to the smaller
(41:32):
places that don't have the sameaccess, I think is next.
So if a company wants to bringyou in and have you talk about,
lead a discussion, how do theyget in touch with you?
Oh, I have a website.
It's SusanMeely.
com.
Um, my LinkedIn is pretty, uh,up to date.
I've been doing a lot of postingtoo, just for people to get
(41:54):
familiar.
Like I've posted on the myths ofmenopause.
Why don't we talk about it atwork?
Cause I've been trying to get aregular LinkedIn conversation
going about menopause, but mywebsite is also pretty
comprehensive.
So.
And just for the listeningaudience, Susan's last name is
spelled M I E L E.
That's Mike India Echo Lima Echofor all of you who enjoy the
(42:16):
phonetic alphabet.
So Miele, right?
Okay.
Susan, thank you so much foryour passion and for your
insight and for being brave andstepping into this for all of
us.
I really appreciate it.
I appreciate you wanting to havethe conversation.
I'm excited.
I'm excited to get it out in theworld.
Me too.
Me too.
Thank you.
Thank you.
Bye paul I hope what you heardin today's episode is that this
(42:43):
is not just a women's issue It'sa leadership issue.
It's a business issue.
It is a human issue.
And yet for decades, workplaceshave ignored it, forcing
powerhouse women like Susan tochoose between their careers and
their well being.
So if you're a leader, step up.
Start the conversation.
Demand policies that recognizemenopause as the workplace
(43:07):
reality it is.
And if you're a woman strugglingin silence, you're not alone.
Track your symptoms.
Find a menopause specialist.
If you don't have access to aspecialist, go to menopause.
org and find a telehealth optionthat's right for you.
And most importantly, speak up.
Change starts with onecourageous conversation, but it
(43:27):
doesn't end here.
Share this episode.
Tag your CEO.
Bring menopause out of theshadows and into the boardroom.
Because the cost of silence istoo high for all of us.
Until next time, stay bold, stayvocal, and keep having the
conversations that matter.
This is CourageousConversations, and this is just
(43:48):
the beginning.
How do you lead when your body'sbetraying you?
How do you perform at your peakwhen brain fog makes you forget
your own passwords?
And why, when nearly half theworkforce goes through
menopause, are companies stilltreating it like a private
inconvenience instead of aleadership crisis?
Well today we're ripping off thelid of one of the biggest
workplace blind spots.
(00:24):
One that's silently pushingpowerhouse women out of
leadership and forcing them tochoose between their careers and
their health.
Our guest, Susan Mealy.
She was at the top of her game,a C suite executive, leading HR
for a cutting edge financialtechnology company, until
perimenopause brought her to herknees.
She did what countless womenhave done before her.
(00:47):
She walked away.
But unlike most, she's notstaying silent about why.
Now she's on a mission to exposethe system that let her and
millions of women down.
She's here to talk about why menin leadership need to care about
menopause, the radical policyshift that could change the game
overnight, and this boldest movea CEO could make by finally
(01:08):
bringing menopause out of theshadows.
This is the conversation HRdepartments don't want to have,
but we're having it anyway.
This is CourageousConversations.
This is the conversation everywoman needs to hear and share.
According to my watch, it's timefor a Courageous Conversation.
(01:30):
Susan, welcome to CourageousConversations.
Thank you for having me.
Yeah, you bet.
So I want to start off with, youdidn't just leave a job, you
left behind a really highpowered job because of
perimenopause.
And I'm wondering, in a worldthat glorifies pushing through,
do you see your decision as aresignation or an act of
rebellion against a system thatstill isn't recognizing the
(01:53):
biological realities of women?
Gosh, I wish I could say it wasa rebellion, but it really was a
resignation.
It was a desperate decision forme, Paul, to save really my
sanity, my career, in that I wasstarting to lose myself and not
understanding what was going onwith my symptoms.
(02:15):
So I had severe rapid onsetperimenopause and I was I had
been the chief people officer ata financial technology company.
We had navigated 9 11 withpeople on the ground, people in
the planes, just two yearsearlier.
So stress was not new to me.
I also was a hardworking kidfrom the time I was 14.
(02:35):
So it wasn't like All of asudden I woke up one day and
this job was too stressful, butslowly, but surely I was, my
mental state was unraveling andall input was, it had to be the
pressure of the job andlifestyle.
My daughter was five at thetime.
She's now almost 26.
So my symptoms were severe, andthey were mostly psychological.
(02:59):
I had very few physicalsymptoms.
And because I was so young, evenif I had the physical symptoms,
they may still have beendismissed as stress related or
burnout or anxiety.
So I got a lot of offers forantidepressants or anti anxiety
medication, which I did try, butthe lifestyle at the time in the
early 2000s working in financialservices, I made the wise
(03:22):
decision facetiously to selfmedicate with alcohol, which
just further deteriorated myphysical mental health and then
was wreaking havoc on mymarriage because we, my husband
was working in a big corporaterole at that time.
So I was piling up poordecisions.
And I realized that if I didn'ttake control and do something
(03:43):
about it, then something bad wasgoing to happen.
My husband was going to leave.
I was going to get fired.
I was going to do somethingoutrageous.
And the irony that I was a chiefpupil officer is not lost on me.
So I ended up resigning.
After a particularly upsettingpresentation where I lost my
train of thought and I couldn'tget it back and then I started
(04:04):
crying to the bathroom and nevercame back.
So, unfortunately, it wasresignation, not rebellion, and
if I had known what was goingon, I might have been able to
get the help that I needed in ashort time.
medical leave of absence andbeen back to work in six weeks,
but I didn't know what was goingon and it was almost impossible
(04:25):
to get the help that I needed.
And the gaslighting, bothpersonally and in the medical
community, is something thatpeople are still dealing with
today.
And so, 20 years later, that'swhy I find myself so involved
and engaged in this advocacywork around normalizing the
menopause conversation at work.
Because when I finally took abreak from corporate, Just 2023,
(04:48):
I left my last chief peopleofficer role and I started
talking to people, I realized ithasn't changed.
The workplace conversation hasnot changed.
So, menopause is a very timelyconversation right now.
It's still not being talkedabout at work.
Yeah, I'm curious.
You said you were 42, and youstarted noticing symptoms, and I
know there are women out therelistening that are noticing
(05:11):
symptoms, right?
That are noticing, I'm tired, orI'm foggy, or I'm whatever.
And 42 sounds young to me.
Now, what do I know?
But 42 sounds young.
What would you say are some ofthe symptoms that Women need to
pay attention to here.
I'm going to start just back upfor a second and say one of the
biggest myths that stillpersists around menopause is
(05:32):
that it's an older person'scondition.
And older was previously definedas over 50.
So anyone in their late 30s orearly 40s ends up treating the
symptoms individually, hence whyyou end up on an antidepressant
medication, or you end up beingtold just relax and have a glass
(05:55):
of wine, or do meditation, or dothings that relieve the stress.
So I think that The, thepersistent myth that menopause
doesn't happen until you're over50 is one of the things I'm
trying to help create awarenessaround, as are many other people
right now.
And again, with my focus beingon the workforce, it's a little
bit more targeted than thegeneral population, social
(06:17):
media, influencing, books, etcetera.
So what I've been telling womenis, first of all, there's three
stages of menopause.
That's the other myth.
There's perimenopause.
which happens up to that daybefore you have your last
period.
And that can last from 4 to 10years and can start as early as
your mid 30s.
(06:38):
And the average age of menopauseis 51, so it can start as early
as your mid 30s.
You could go through menopausein your mid 40s.
Paralysis is when your hormonesfluctuate wildly, your estrogen
and progesterone.
In fairness to the medicalprofessionals, they're also very
hard for the medicalprofessionals to pinpoint.
So tracking your symptoms isreally important.
Tracking your moods, trackingyour irritability, tracking your
(07:02):
periods, tracking your sleepcycles, like tracking all the
things that would, if you addthem up, say, oh, this could be
perimenopause, as opposed totreating your symptoms one off.
Like, heart palpitations isanother one.
People go see a cardiologist.
The mental stuff, people go seea psychologist.
The urea, genital stuff, peoplego see their OBGYN.
(07:25):
And then, these people aren'tspeaking to each other.
So there's no like aha moment.
So that's the advocacy part andthe tracking part.
And one of the relatively simplethings I advise women to do,
which is track your symptoms.
So paramenopause is pre,menopause is simply one day on
the calendar, which is the daythat's 12 months after you've
had your last period.
(07:45):
Now, most people know exactlywhen that is.
But so it's a roughapproximation.
And then everything after thatone day is postmenopause.
And postmenopause, your symptomscan become more severe because
your hormones continue todecline and that's when your
risks of the long term healthissues like osteoporosis and
(08:07):
heart disease that come fromdeclining estrogen really
increase.
So it's pretty complicated,right?
But your question was women intheir late 30s and early 40s who
could be, God forbid, they couldbe postpartum.
And perimenopausal, so theycould be just full of not
understanding what's going on.
(08:28):
And then they're super busy,right?
So it's like, I can handle this.
I got a little kid.
I got to get to daycare.
I got a presentation I have togive tomorrow.
I have aging parents that I haveto worry about.
Women are largely trained tosort of suck it up and take care
of others and often leavethemselves as the last person
that they take care of.
(08:48):
So I think that's the what'sgreat about all the Publicity
that menopause is getting rightnow is people are like, wait,
what?
42?
I had someone just write to methe other day who's 46 and she
was like, I had no idea.
So before I get to where canwomen go or what should they do,
what actions should they take?
(09:09):
I really want to talk aboutCorporate America and their role
in this, you know, becauseCorporate America spent billions
on DE& I and we know right nowthat's being kind of pushed
back.
However, menopause affects 100percent of women.
Right.
And it's absent from theconversation, as you just said.
And so I'm wondering what's thefundamental flaw in how
companies are approaching thisissue and what's the fastest way
(09:32):
to fix it.
So I think the fundamental flawis also lack of awareness and
the impact on the workforce.
So I think there is a true lackof understanding.
When I resigned from my job 20years ago, my boss was like, I
think you're taking an extremereaction.
Like you're fine.
You'll be fine.
Like that breakdown was nothing.
(09:52):
And I was like, I'm not fine.
That wasn't fine.
And I'd rather just go beforeyou have to get rid of me, any
professional credibility that Ihave last shred of.
Credibility or sanity that Ihave left is gone.
So I'm going to go before that,but I think the lack of
awareness and the lack ofbringing it into the light and
(10:14):
talking about it is thefundamental flaw in corporate
America, which is compounded bythe fact that ageism and sexism.
in the workplace is a real issuefor women.
So you're already dealing withageism and sexism.
The last thing you want to addon top of that is, oh, by the
way, I'm forgetful some days, orI'm really uncomfortable and I
(10:37):
have to use the ladies room.
More often than not.
Yeah.
Nobody wants to have thatconversation when it's not part
of a regular inclusive dialogue.
I have often related to mentalhealth and when I first started
in HR, which was almost 40 yearsago, we didn't talk about mental
health, right?
Right.
If you had a therapist, that wasunusual in the 80s, and if you
(10:59):
did, it was like, oh boy, you'reone step away from the
institution.
But over the last 10 15 years,mental health has certainly
become much less stigmatized,much more normalized in the
workplace.
Similarly, if we're stickingwith the topic of women's
reproductive life, so hasfertility.
Many companies offer fertilitybenefits, uh, these days.
(11:23):
Many companies offer paternityleaves.
That was not a thing.
Even 25 years ago, paternityleave wasn't a thing.
I think my husband probably, ifhe got two weeks off, I'm
surprised.
I don't remember.
And I also think that by talkingabout it generally, And talking
about it to men who work in theworkplace, they still might not
want to talk about it in theworkplace, but if they start
(11:44):
talking about it at home, justlike mental health, you start
talking about it more with yourfriends, with your spouse, then
it starts to just become morenormal.
So then bringing thatconversation into the workplace
feels less strange, lesstargeted.
less uncomfortable for the womenthat might be experiencing these
symptoms.
(12:04):
I think that's where corporateAmerica has an opportunity or,
and we all have as, asparticipants in these
conversations at home and atwork.
So let me ask you, where does itsit?
As you were talking, I wasthinking, does this sit under
the mental health bucket?
I don't know.
I'm ignorant.
You're the pro here.
So tell me, where does it sit?
(12:25):
I've been talking to some, somefolks in this space in the last
few years.
Few weeks about this topic andwe've been debating around like
who is gonna who are we gonnaapproach target market to around
bringing this into the workplacein a sustainable way so my
worry.
Is if we go with the DNI routeand forget everything that's
(12:48):
going on in the world with DNI,but employee resource groups are
a really good Avenue to bringthis message in women's employee
resources group in particular,sometimes bigger companies have
mental health employee resourcegroups, but from an inclusion,
but that's a great Avenue.
The challenge with that is itfeels like it's.
Has a huge potential to be oneand done and not really have the
(13:12):
ability to make a long termimpact.
Now, by having at least oneconversation, it could lead to
more and it could have a trickleeffect.
That's, that's one avenue.
Wellness programs is another.
But so the benefits department,the folks who do the wellness
programming, and these aregenerally larger companies that
have both of these avenues, butI think Beyond that is also
(13:37):
employee engagement andorganizational development that
could bring the conversation tolearning and development doing
menopause 101 training,supervisory training around how
to talk to your employees aboutmenopause, which is challenging
because I know from experiencethat having it across different
(13:59):
places is going to make itharder to have the sticking
power to actually create amenopause friendly workplace
where it has become anintegrated part of wellness.
benefits, inclusion, learningand development.
I feel like that's, that's alittle ways away because we're
going to have to get in howeverwe can and then we're going to
(14:19):
spread out.
And I think that before the DE&I efforts became like pedal to
the metal in 2020, when I wasworking at Foundation Medicine,
we were building like from theground up, which is a lot of how
we did a lot of the work ofFoundation Medicine so that it
would.
Slowly take hold.
And we had the privilege ofbeing owned by the Roche group
and having the resources and theleadership support.
(14:43):
And so I feel like that's alwaysthe best way to build programs,
right?
It's the way I built a coachingprogram.
That was award winning beforecoaching was something that
leaders were really into.
It's like start small, getpeople to really like it, get
the leadership buy in top down,bottom up.
And then that's how it sticks.
So I think we still have a hugeopportunity for the stickiness,
(15:06):
even if we're having theconversations.
How it's going to stick is goingto be all avenues coming
together to make it happen.
So do you think a policy is thefirst kind of framework that
companies need to think aboutimplementing in terms of
breathing life into it?
I understand the approach, butas a policy, the starting point.
So therefore it's, uh, this ishow we're going to address it.
(15:29):
No, I think a policy is the laststop and I think the policies
are easy because the policy, thepolicies exist today.
Paternity leaves exist,fertility benefits exist, leave
work accommodations forillnesses exist.
Just amending them to addmenopause into the policies is
(15:52):
easy.
It's the converse that are hard.
It's the, oh, okay, this policysays I could take a leave for
menopause, but now I have to sayI have menopause symptoms that
are causing me to lose days inthe office, that are impacting
my productivity, that areimpacting my self esteem to the
point where I'm consideringeither leaving or not putting
(16:15):
myself up for that promotion.
So it's the dialogue, it's thenormalizing the narrative.
We, we talked about what's theradical thing that companies can
do.
The radical thing to do is nameit, put a face to it, then
build.
Up under it, those threepillars, right?
The communication, the learningand development, the policies,
(16:36):
or as a former HR person, Ithink the policy piece is easy.
Now there are some benefits thatI think would be a little harder
depending on the demographic ofthe company to ensure that
you're covering hormone therapy,to ensure that you're covering
menopause specialists, butagain, that is, those are not
insurmountable.
(16:56):
Barriers.
Those are a fairly low bar.
And if you're a self insuredcompany, if you're a large
enough company that you'repaying claims directly, you have
a lot of control over what youcover.
So I think it's the naming andthe putting the face to it and
having the conversation.
That's the most radical thingfor companies.
(17:17):
I, and this is true in othertopic areas where C level women
say, I want to be known as agreat CEO, not because I was a
woman.
But because I'm a great CEO, sotherefore I don't want to be
associated with that woman'sprogram.
And I'm like, that sucks,frankly, because you are a
woman, you are a CEO, and youhave an opportunity to lead this
(17:39):
conversation and I get it, I seeboth sides of it, but it's going
to take a few brave leaders, afew brave men, who's maybe.
personal experience with theirmoms or their wives or their
daughters is like, Oh, wow, thisis really, really something I
should be talking about.
And a few brave women, but Ifound a lot of receptive in the
(18:02):
audiences that I've talked with.
I found a lot of curiosity amongthe men in the audiences as
well, because they're concerned.
They're concerned about theirwives.
I mean, if you could have myhusband on next, he will tell
you how gravely concerned he was20 years ago.
He was like, I do not knowwhat's happening.
As you were talking, I waswondering about men because I
(18:23):
was thinking, why should mencare about this issue?
Not in a sexist way, but youknow, it doesn't hit them in
their daily lives.
And yet their moms, their wives,their daughters, whomever,
that's when they start to payattention.
And so I'm wondering how can weget men to move beyond lip
service around this issue andgenerally invest in menopause
(18:44):
friendly workplace policies?
So I, I think the mom angle is areally good one because my mom
passed away nine years ago, andif she were still alive, she'd
be like roughly 90.
But the quality of her life thelast 10 or 15 years was not
great.
That post menopausal phase thatI was talking to you about a few
minutes ago, your hormonesdecline and they don't come back
(19:07):
unless you get it synthetically.
You can't make it.
So your bone health startsdeclining and your
cardiovascular health startsdeclining and you're prone to
excessive UTIs that could killyou.
And so if your mom is sufferingfrom all those things, you're
(19:27):
like, wait, what?
And you start to become awareand.
My mom died of osteoporosisrelated complications that if
she had been on estrogen, shemight not have suffered the
severe osteoporotic fracturesthat she lived with for probably
10 years before she died.
So, I think moms is a greatangle to get men to pay
(19:49):
attention if they don't havewives, right?
And then if you have wives, thelargest demographic in the
workforce is a menopausal age.
45 to 60, that's the target ofmenopause.
So, I think if you know a woman,you love a woman, you work with
a woman, like a close colleague,and you're, like, I haven't
(20:09):
talked to many of the men Iworked with during that time
lately, but, well, they wouldhave wanted to help me if they
could have.
They were watching me literallydeteriorate in front of their
eyes.
I was a highly, highly competentperson that in a period of six
months couldn't hold a sentencetogether.
So I know they would have wantedto help if they had the tools
(20:31):
and the language to do so.
Just like back in the day, mydad wouldn't have ever talked to
me about My period or gottentampons for me, but like we'll
come a long way with that.
My husband does that for mydaughter.
That's a big deal for him.
So I feel like it's all theselittle ways that we'll get men.
And I feel like the more we getmen in their personal lives, the
(20:53):
more they'll.
Be aware of what's happening inthe workplace.
The more comfortable they aretalking outside of work, the
more they can make it, Oh, well,I know someone that is
experiencing that my sister, itmight be my, it might be your
sister.
I've watched my sister.
She just, I don't have anybrothers, but again, if I had a
brother, I would like to thinkthat after they, they would
(21:15):
have, he would have been like,shit, I'm watching this woman at
work, go through this thing, I'mgoing to pull her aside and say,
Hey, are you okay?
Yeah.
Like, just like a human, like weteach, like we coach people to
be human, just human.
It, you don't have to beparticularly nosy, but you could
be like, I've noticed you seemreally forgetful or really
(21:36):
tired.
Are you feeling okay?
Just opening up the conversationfeels like not that hard.
And we've been teaching peoplefor years, right?
To have more inclusiveconversations.
So it, it's, it's on the samepath.
So again, I'm like big into thesurround sound sort of approach
to this.
Come at it from all thedifferent angles and it will
make it seem less scary.
(21:58):
And just as a quick aside, Imentioned that I have an almost
26 year old daughter.
She's been having some hormonalissues monthly, and she wasn't
feeling good at work yesterday.
Also happens to be in humanresources.
Coincidentally, following mom'spath.
Yeah.
So I said, you should talk toyour boss because it's been a
monthly kind of thing for thelast few months.
So something's going on.
She has a female boss.
She's like, I cannot have thatconversation with my boss.
(22:20):
And I was like, she's young.
She's 26.
And I was like, wait, what?
She's like, yeah, no, I feel tooweird.
I go, okay, then you should notbe talking to me because I am
trying to get people to talkabout menopause in the
workplace.
So if you can't even tell yourboss.
That you're having some issues,like I got a lot of work to do,
there's a lot of opportunityhere.
So let me play with that justfor a minute.
(22:42):
I really like what you just saidis, let's say there are women
out there that are havingissues, right?
Cycle issues or hormonal issues.
How would you frame up aconversation for them to go to
someone, male or female, to talkabout?
What would be your approach?
Yeah, so I just was talking withanother coaching friend of mine
about this and some of the womenthat she's coaching and I think
(23:03):
again, it first starts withhelping the woman to understand
a they're not ill, right?
This isn't an illness.
It's a decline in hormones.
It's a condition but it's not anillness.
So I think that's the otherthing that we do.
We get worried and we get in ourheads about it.
We're like, we start forgettingthings.
(23:24):
So we think, oh my god, we haveearly Alzheimer's, right?
So we gaslight ourselves and weget nervous.
So I think starting with.
Being very honest, I have abunch of symptoms.
I'm not really sure what's goingon.
I have an appointment in acouple weeks, but I'm not
sleeping that well, which isleading me to be a little bit
foggy.
So I'd just love if I could havea little extra time on this
(23:47):
project.
Like, just gently easing intothe conversation without a lot
of detail.
Enough detail to share, hey,this is like big picture what's
going on, and here's how it'simpacting me.
And I'm working on getting theright going forward, but could I
have a little grace just likeany other illness that someone
(24:09):
might have any otheraccommodation.
And again, I said, it's not anillness and it's not, but the
symptoms show up in ways thatare debilitating for some
people.
But when you're suffering fromdebilitating symptoms to not
even have the conversation,think about how much energy that
takes.
Right?
Think about how much energy ittakes to try to hide your
(24:29):
symptoms in your day and whatthat does to your mood, your
productivity, your socialability to interact, right?
It's taking all your energy justto sit up straight, you know,
and like hope that your periodisn't bleeding through your
pants when you're in aconference room.
You know, so it is like suckingpeople's energy so that they
(24:52):
can't put it towards their jobs.
And then they're get into thatself fulfilled prophecy.
Well, maybe I just can't do thisjob.
Right.
I spent seven years after I leftthat job thinking I couldn't do
that job anymore.
Yeah.
Yeah.
You know what I appreciate aboutwhat you said?
It's about recontracting.
It's about going in and saying,Hey, this is where I am.
I might need some extra time onthis project or process.
(25:14):
I want you to be aware.
I'm on it on my end, but I justneed you to know that's what's
happening on my end to createsome space.
Yeah, and a lot of the examplesthat are coming right to mind
are people who have had newbabies or people who have had
terrible pregnancies wherethey've been throwing up in the
bucket all day.
Now, of course, we've moved alot more towards hybrid work
(25:35):
than 20 years ago, but men andwomen have.
You know, over the last 12 yearsof my CPO career, I've been
like, Hey, you know, I'm havinga really hard time.
I'm not getting enough sleep.
My kid's cranky.
That's a pretty normalconversation in the workplace
right now.
It's like, I hope you don'tmind, but I'm gonna put the baby
(25:55):
down and work from 5 to 9 p.
m.
And I'll get done what I need toget done, but I'm not gonna be
available.
Because between one and three inthe afternoon is really
difficult.
And I know I worked for someprogressive companies and was
fortunate about that.
And I was a very human bossmyself, at least in the last
decade.
I'm not sure about the firsttwo.
(26:16):
So I feel like normalizing itagain, back to that word that
I'm overusing a bit, butrecontracting, normalizing it,
and thinking about it like anyother issue.
My wife's sick.
I have to take care of her.
I, I'm going to need someaccommodations to my schedule.
Yeah.
And so let me ask you this.
So you have the conversation,someone has the conversation,
(26:37):
and then where do they go?
Because you'd mentionedcardiologists, primary care,
antidepressants.
Where do women go to get helparound this issue?
Because you can't go to a singlereferral, right, specialist,
because they're going to look atit from their specialty lens.
Yes, so menopause specialists,and they're, they're few and far
between, but they exist, and ifyou go to menopause.
(27:01):
org, which is the medicalassociation that certifies
menopause MDs or nursepractitioners.
So that's the first place Irecommend people look for a
specialist.
And that could be a primary caredoctor, that could be an OB GYN,
it could be an endocrinologist,it could be any doctor who's
decided that this is importantto their practice, and they went
(27:24):
and became a menopausespecialist as a result.
So they could be acrossdisciplines in the medical
space.
So menopause specialists, GYNs,and then if no help is
available, there are telehealthresources that I was just going
to ask that.
Yeah.
I think there are betterreasonable alternatives.
MidiHealth, AlloyHealth, Maven.
(27:46):
A handful of really seeminglyvery well reputable telehealth
organizations that have poppedup over the last few years.
Now many of them popped upstarting with fertility.
And now along with a lot ofother benefits are extending
beyond the reproductive healthchain to include.
(28:07):
Menopause.
So at least talking to somebody,that was my problem.
I was so isolated.
I didn't know who to talk to.
And then I tried talking to mydoctors and that didn't go very
well.
And none of my friends wereexperiencing it because they
were all young.
And I had a five year old and itcouldn't have been part of them
because she was five.
(28:27):
I just didn't know who to talkto.
And then everybody I did talk towas like, oh god, yeah, you have
a very stressful life.
Your job is really stressful.
My, I like love my job.
And I, Was really good at it upuntil like last week, so I'm not
sure that's it.
So, uh, talking to people Ithink is critical so you don't
feel alone and isolated.
That, women spend at least threeyears in perimenopause
(28:49):
undiagnosed.
Is there a book out there thatwomen can read to say, Oh, gee,
this is perimenopause?
Yes, there's lots of books now.
You have a favorite?
I have two favorites.
One is, uh, the menopausemanifesto by a woman whose name
is Dr.
Jen Gunter, G U N T E R, and theother is called Estrogen
(29:12):
Matters, and that's just been rereleased, Paul, and really talks
about the disservice that thatstudy in the 1990s did.
to women's hormonal health andwhy so many people spent so long
being scared of hormone therapy.
A lot of the others are fallinginto that like social influencer
(29:35):
cat category of practitionersand profiting from the work that
they're doing in the menopausespace.
So they're selling supplements,they're selling programming,
they're reading their book.
And so That doesn't mean they'renot good resources.
It's just harder to walk theline and harder to understand
are they telling me this becausethey want me to buy their thing
(29:58):
or do they really believe this?
They're doing a lot of work ingetting the message out which
has been incredibly helpful butthese two books are are much
more factually based.
Manipause.
org has a whole series for smallcompanies, like big companies.
Can do all sorts of things, butfor small companies that's
(30:18):
demographic might have a lot ofwomen in their 40s.
There's a whole set of freeresources like worksheets and
benefits and policies and thingsaround menopause in the
workplace on the menopause dotdot.
That's great.
I'd like to talk about hormonereplacement therapy.
Some people and men say it's alifeline.
Other people say it's alightning rod.
And I know that in talking toyou before the interview, you've
(30:41):
experienced the dangers ofhormone replacement therapy
firsthand.
So talk to me about why womenshould or shouldn't consider
hormone replacement therapy ifthey're experiencing
perimenopause.
So I think First of all, that'swhere the menopause specialist
is really important, to makesure that you have someone that
understands your uniquesituation.
(31:03):
But the biggest misconceptionaround hormone replacement
therapy, in general, is thatit's dangerous for all women.
And that's just factually nottrue.
It is not dan It is dangerous insome very limited circumstances,
like estrogen positive breastcancers.
It's very difficult.
(31:23):
for women who have an estrogenpositive to take estrogen
because they're trying toeliminate the estrogen.
But otherwise, all of the mythsaround the danger of hormone
therapy have largely beendebunked in the last decade.
So depending on where you are,how old you are, et cetera, when
you start How severe yourmenopause and how severe your
(31:45):
symptoms are really determineslike your path for treatment
when it comes to hormonereplacement therapy.
So I'm going to tell you twostories.
One is my own and one is afriend.
So I was, obviously I was young.
It took me seven years.
to get on hormone therapybecause of the timing.
So I had, I was right in thattiming where it was not being
(32:07):
prescribed because it had justlargely been taken off the
market because of some flaweddata and some hyperbole around
reporting causal relationshipbetween hormone therapy and
cancer, which was inaccurate.
I was to put on At age 50,roughly lifesaver for me when it
came to long term health issues,because both my grandmother and
(32:30):
my mom died from osteoporosisrelated complications.
My mom's are very indirect.
My grandma was a typical falland broke her head.
My mother lost five inches inheight and she was.
like a small person with one ofthose kyphosis in her back by
the time she passed away.
So for me, the estrogen andprogesterone were life saving.
Testosterone is the one that'scontroversial, and it's actually
(32:52):
controversial for men and women.
But for me, I started ontestosterone not at the same
time.
And when I moved to Maine, I hadtrouble accessing hormone
therapy.
So I went to a conciergepractice and was super over
medicated because it's, it wasinserted via pallet, which is
(33:13):
hard to know how much you'regetting dosed and their general
practice was they.
The more testosterone, thebetter.
And in some cases, that works.
And lucky for me, I didn't haveany really long term side
effects from it, because I'vebeen on this journey for quite
some time.
So I knew enough to know, uh oh,this is not good.
And this is going to lead toplaces that may be irreversible
(33:36):
in terms of hair loss and skinchange and other things.
So I didn't have any reallysevere long term side effects
from it, but it took months toget it normalized.
So now I'm on a physiologicaldose, which is much, much
healthier and, you know,questionable as to whether all
women need testosterone and, orwill benefit from it.
(33:57):
And I don't know enough aboutit.
When it comes to men to talkabout it, other than it just
declines at a much slower rate,and has also, once you go on it,
you can't go off of it if youstop making it once you're on it
as a man.
So there's some challengesrelated to that.
Now, I have a friend who neverwent on it.
She didn't have debilitatingsymptoms of menopause, but she
(34:20):
has osteoporosis.
and heart disease and severedental issues.
So her estrogen decline was shewasn't experiencing the radical
up and down that leads to a lotof the symptoms in perimenopause
and she had a relatively symptomfree menopause and she was quite
a bit older than the average ageof menopause so she thought life
(34:42):
sailed through menopause but nowshe has a degenerative.
disease, osteoporosis, heartdisease, and has had like three
or four implants, so her teethare not so, not in great health.
So I think even symptomlessmenopause requires you to
understand what's going on inyour body in relation to your
hormones and whether you will orwill not.
(35:03):
benefit from hormone replacementtherapy.
So I think that's the othermisconception that if you don't
have symptoms, you don't needit.
But even if you don't havesymptoms, your estrogen is
declining and estrogen is inevery part of your body.
So.
The most direct causal effect oflow estrogen, lacking estrogen,
(35:24):
is osteoporosis and heartdisease.
There are others that are beingstudied now.
What is the relation to brainhealth?
Because there's so many estrogenreceptors in your brain, over
time we'll see that.
I want to go back to, how do youunderstand this to be a business
issue?
Why should businesses care?
This is one of my favoritequestions.
So, 100 percent of women willexperience menopause.
(35:45):
The largest age demographicgrowing.
segment of the workforce orwomen over 50.
Women who are living longer,working longer, staying engaged
much longer, women will live onethird to one half of their life
in menopause or post menopause.
So one in five women eitherleave the workforce or consider
(36:07):
leaving the workforce or take astep back due to menopausal
symptoms.
1.
8 billion dollars was lost inwages due to productivity
related to menopausal symptoms,and that was in 2023.
The 20 hasn't come out yet.
We will never, I'm not even surewhere gender equality is in the
(36:27):
workplace on the scale of thingsthat are important these days,
but if we don't normalize themenopause narrative, At work,
we'll never have a chance ofhaving the women to choose from
to be our next level CEOs and bein the C suite because they'll
either leave or they'll bepassed over because they aren't
(36:50):
viewed as competent.
So, we know how retaining peopleis, what, 5 percent of the cost
of losing somebody and having toreplace them?
And so having a pipeline offuture female leaders to
eventually create some sort ofgender equality in the
workplace, it's like a criticalbusiness issue.
And that's not even, those coststhat I mentioned aren't even
(37:13):
including the long term healththings that we talked about.
So you stay in the workforcelonger, you can't afford to
retire because who can afford toretire these days, or you don't
want to because women, we're allliving longer and we want to
stay engaged.
We love our work.
We want to continue to do it.
Then you start piling on diseaseand osteoporosis.
(37:33):
And those are all costs to acompany that if they had been
offering menopausal benefitsmuch earlier, they may have
prevented those long termmedical costs as well.
So it feels like a relativelysimple business.
Equation to me as a former chiefpeople officer, I think it's
just, we have to get out thereand I thank you for having me to
(37:55):
talk about this because that's abig step and when we talk about
where people will hopefully payattention.
So I'd like to end with thequestion around, you've said the
boldest move a CEO can make isto openly acknowledge menopause
as a leadership issue.
And if you had five minutes witha fortune 500 CEO, what's the
one radical action you'dchallenge them to take
(38:16):
immediately?
I would challenge them to be theface of menopause.
Okay, so let's say I did arecent webinar with a women's
employer resource group.
I had a C level woman who wasmoderating.
What if that was a CEO who was aman that was moderating?
That doesn't actually seem thathard, but we both know that it
is.
What if the CEO of that companywas the person that was
(38:39):
moderating that one hourconversation around Why don't we
talk about that at work insteadof delegating it to the woman
who was the C level woman whowas willing to be the face.
So it seems simple in theory,much more difficult in practice,
but I think that's a bigopportunity for us.
To get the men out there engagedin the dialogue when most of the
(39:03):
people I know doing work in thisspace are women.
In fact, all of the people Iknow doing work in this space
are women.
But some senior level men,particularly at the executive
level, CEO if possible, I thinkwould change it immediately,
right?
Cause in your work and all thework I've done in my career.
It starts at the top.
All of it starts at the top.
(39:23):
How people behave in theworkplace, how people treat
other people in the workplace,business practices, everybody
looks up to the leader.
And I think that leaders forgetthat sometimes.
And I'm sure your work every dayis reminding people that people
are looking to them.
You get a CEO moderating an allfemale panel to talk about a
(39:44):
male CEO.
to talk about menopause in theworkplace and share maybe a
personal story about his mom orhis wife or sister.
I think that will change thatconversation in that company
immediately.
You know, it's interesting asyou've been talking and I'm
hearing the business impact andobviously the impact to the
workforce and I even think ofMedicare costs, how it could
(40:05):
save our government money andit's a health issue.
I think what you're describingis a human issue.
It's not a DEI issue, but it's ahuman issue.
I know my own mom struggles.
What would you say to that?
When I speak outside ofcompanies, I talk about it as a
societal issue.
Cause all the things we justtalked about as it relates to
the workforce.
relates to how people are ableto live their life, right?
(40:28):
And when I think about theworkforce, I've worked in pretty
privileged places inMassachusetts, and that's not
the world.
Think about female firefighters.
They must have to stop working.
Like, I don't know what they do.
I'd love to find some to talkto, but.
I consider 40 a month forhormone replacement therapy
affordable.
(40:48):
That isn't affordable for somepeople.
You have to choose to spend that40 on that versus perhaps on
your child's formula orsomething.
So eventually birth controlbecame free.
In, in England, hormonereplacement therapy is covered
by the government.
But in this conversation, I'mtalking about this limited world
that I grew up and worked in,which was.
(41:09):
In the greater Boston area,highly educated affluent in
terms of the companies, butthere is a whole world out there
that doesn't have that sameprivilege that.
Is really suffering withoutaccess, without information.
So getting this out even broaderbeyond the large companies that
we perhaps have an opportunityto influence, but to the smaller
(41:32):
places that don't have the sameaccess, I think is next.
So if a company wants to bringyou in and have you talk about,
lead a discussion, how do theyget in touch with you?
Oh, I have a website.
It's SusanMeely.
com.
Um, my LinkedIn is pretty, uh,up to date.
I've been doing a lot of postingtoo, just for people to get
(41:54):
familiar.
Like I've posted on the myths ofmenopause.
Why don't we talk about it atwork?
Cause I've been trying to get aregular LinkedIn conversation
going about menopause, but mywebsite is also pretty
comprehensive.
So.
And just for the listeningaudience, Susan's last name is
spelled M I E L E.
That's Mike India Echo Lima Echofor all of you who enjoy the
(42:16):
phonetic alphabet.
So Miele, right?
Okay.
Susan, thank you so much foryour passion and for your
insight and for being brave andstepping into this for all of
us.
I really appreciate it.
I appreciate you wanting to havethe conversation.
I'm excited.
I'm excited to get it out in theworld.
Me too.
Me too.
Thank you.
Thank you.
Bye paul I hope what you heardin today's episode is that this
(42:43):
is not just a women's issue It'sa leadership issue.
It's a business issue.
It is a human issue.
And yet for decades, workplaceshave ignored it, forcing
powerhouse women like Susan tochoose between their careers and
their well being.
So if you're a leader, step up.
Start the conversation.
Demand policies that recognizemenopause as the workplace
(43:07):
reality it is.
And if you're a woman strugglingin silence, you're not alone.
Track your symptoms.
Find a menopause specialist.
If you don't have access to aspecialist, go to menopause.
org and find a telehealth optionthat's right for you.
And most importantly, speak up.
Change starts with onecourageous conversation, but it
(43:27):
doesn't end here.
Share this episode.
Tag your CEO.
Bring menopause out of theshadows and into the boardroom.
Because the cost of silence istoo high for all of us.
Until next time, stay bold, stayvocal, and keep having the
conversations that matter.
This is CourageousConversations, and this is just
(43:48):
the beginning.
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