How do you lead when your body's betraying you? How do you perform at your peak when brain fog makes you forget your own passwords? And why, when nearly half the workforce goes through menopause, are companies still treating it like a private inconvenience instead of a leadership crisis? Well today we're ripping off the lid of one of the biggest workplace blind spots. One that's silently pushing powerhouse women out of leadership and forcing them to choose 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 financial technology company, until perimenopause brought her to her knees. She did what countless women have done before her. She walked away. But unlike most, she's not staying silent about why. Now she's on a mission to expose the system that let her and millions of women down. She's here to talk about why men in leadership need to care about menopause, the radical policy shift that could change the game overnight, and this boldest move a CEO could make by finally bringing menopause out of the shadows. This is the conversation HR departments don't want to have, but we're having it anyway. This is Courageous Conversations. This is the conversation every woman needs to hear and share. According to my watch, it's time for a Courageous Conversation. Susan, welcome to Courageous Conversations. Thank you for having me. Yeah, you bet. So I want to start off with, you didn't just leave a job, you left behind a really high powered job because of perimenopause. And I'm wondering, in a world that glorifies pushing through, do you see your decision as a resignation or an act of rebellion against a system that still isn't recognizing the biological realities of women? Gosh, I wish I could say it was a rebellion, but it really was a resignation. It was a desperate decision for me, Paul, to save really my sanity, my career, in that I was starting to lose myself and not understanding what was going on with my symptoms. So I had severe rapid onset perimenopause and I was I had been the chief people officer at a financial technology company. We had navigated 9 11 with people on the ground, people in the planes, just two years earlier. So stress was not new to me. I also was a hardworking kid from the time I was 14. So it wasn't like All of a sudden I woke up one day and this job was too stressful, but slowly, but surely I was, my mental state was unraveling and all input was, it had to be the pressure of the job and lifestyle. My daughter was five at the time. She's now almost 26. So my symptoms were severe, and they were mostly psychological. I had very few physical symptoms. And because I was so young, even if I had the physical symptoms, they may still have been dismissed as stress related or burnout or anxiety. So I got a lot of offers for antidepressants or anti anxiety medication, which I did try, but the lifestyle at the time in the early 2000s working in financial services, I made the wise decision facetiously to self medicate with alcohol, which just further deteriorated my physical mental health and then was wreaking havoc on my marriage because we, my husband was working in a big corporate role at that time. So I was piling up poor decisions. And I realized that if I didn't take control and do something about it, then something bad was going to happen. My husband was going to leave. I was going to get fired. I was going to do something outrageous. And the irony that I was a chief pupil officer is not lost on me. So I ended up resigning. After a particularly upsetting presentation where I lost my train of thought and I couldn't get it back and then I started crying to the bathroom and never came back. So, unfortunately, it was resignation, not rebellion, and if I had known what was going on, I might have been able to get the help that I needed in a short time. medical leave of absence and been back to work in six weeks, but I didn't know what was going on and it was almost impossible to get the help that I needed. And the gaslighting, both personally and in the medical community, is something that people are still dealing with today. And so, 20 years later, that's why I find myself so involved and engaged in this advocacy work around normalizing the menopause conversation at work. Because when I finally took a break from corporate, Just 2023, I left my last chief people officer role and I started talking to people, I realized it hasn't changed. The workplace conversation has not changed. So, menopause is a very timely conversation right now. It's still not being talked about at work. Yeah, I'm curious. You said you were 42, and you started noticing symptoms, and I know there are women out there listening that are noticing symptoms, right? That are noticing, I'm tired, or I'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 of the symptoms that Women need to pay attention to here. I'm going to start just back up for a second and say one of the biggest myths that still persists around menopause is that it's an older person's condition. And older was previously defined as over 50. So anyone in their late 30s or early 40s ends up treating the symptoms individually, hence why you end up on an antidepressant medication, or you end up being told just relax and have a glass of wine, or do meditation, or do things that relieve the stress. So I think that The, the persistent myth that menopause doesn't happen until you're over 50 is one of the things I'm trying to help create awareness around, as are many other people right now. And again, with my focus being on the workforce, it's a little bit more targeted than the general population, social media, influencing, books, et cetera. So what I've been telling women is, first of all, there's three stages of menopause. That's the other myth. There's perimenopause. which happens up to that day before you have your last period. And that can last from 4 to 10 years and can start as early as your mid 30s. And the average age of menopause is 51, so it can start as early as your mid 30s. You could go through menopause in your mid 40s. Paralysis is when your hormones fluctuate wildly, your estrogen and progesterone. In fairness to the medical professionals, they're also very hard for the medical professionals to pinpoint. So tracking your symptoms is really important. Tracking your moods, tracking your irritability, tracking your periods, tracking your sleep cycles, like tracking all the things that would, if you add them up, say, oh, this could be perimenopause, as opposed to treating your symptoms one off. Like, heart palpitations is another one. People go see a cardiologist. The mental stuff, people go see a psychologist. The urea, genital stuff, people go see their OBGYN. And then, these people aren't speaking to each other. So there's no like aha moment. So that's the advocacy part and the tracking part. And one of the relatively simple things 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 day that's 12 months after you've had your last period. Now, most people know exactly when that is. But so it's a rough approximation. And then everything after that one day is postmenopause. And postmenopause, your symptoms can become more severe because your hormones continue to decline and that's when your risks of the long term health issues like osteoporosis and heart disease that come from declining estrogen really increase. So it's pretty complicated, right? But your question was women in their late 30s and early 40s who could be, God forbid, they could be postpartum. And perimenopausal, so they could be just full of not understanding what's going on. 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 to give tomorrow. I have aging parents that I have to worry about. Women are largely trained to sort of suck it up and take care of others and often leave themselves as the last person that they take care of. So I think that's the what's great about all the Publicity that menopause is getting right now is people are like, wait, what? 42? I had someone just write to me the other day who's 46 and she was like, I had no idea. So before I get to where can women go or what should they do, what actions should they take? I really want to talk about Corporate America and their role in this, you know, because Corporate America spent billions on DE& I and we know right now that's being kind of pushed back. However, menopause affects 100 percent of women. Right. And it's absent from the conversation, as you just said. And so I'm wondering what's the fundamental flaw in how companies are approaching this issue and what's the fastest way to fix it. So I think the fundamental flaw is also lack of awareness and the impact on the workforce. So I think there is a true lack of understanding. When I resigned from my job 20 years ago, my boss was like, I think you're taking an extreme reaction. Like you're fine. You'll be fine. Like that breakdown was nothing. And I was like, I'm not fine. That wasn't fine. And I'd rather just go before you have to get rid of me, any professional credibility that I have last shred of. Credibility or sanity that I have left is gone. So I'm going to go before that, but I think the lack of awareness and the lack of bringing it into the light and talking about it is the fundamental flaw in corporate America, which is compounded by the fact that ageism and sexism. in the workplace is a real issue for women. So you're already dealing with ageism and sexism. The last thing you want to add on top of that is, oh, by the way, I'm forgetful some days, or I'm really uncomfortable and I have to use the ladies room. More often than not. Yeah. Nobody wants to have that conversation when it's not part of a regular inclusive dialogue. I have often related to mental health and when I first started in HR, which was almost 40 years ago, we didn't talk about mental health, right? Right. If you had a therapist, that was unusual in the 80s, and if you did, it was like, oh boy, you're one 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 sticking with the topic of women's reproductive life, so has fertility. Many companies offer fertility benefits, uh, these days. Many companies offer paternity leaves. That was not a thing. Even 25 years ago, paternity leave wasn't a thing. I think my husband probably, if he got two weeks off, I'm surprised. I don't remember. And I also think that by talking about it generally, And talking about it to men who work in the workplace, they still might not want to talk about it in the workplace, but if they start talking about it at home, just like mental health, you start talking about it more with your friends, with your spouse, then it starts to just become more normal. So then bringing that conversation into the workplace feels less strange, less targeted. less uncomfortable for the women that might be experiencing these symptoms. I think that's where corporate America has an opportunity or, and we all have as, as participants in these conversations at home and at work. So let me ask you, where does it sit? As you were talking, I was thinking, 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? I've been talking to some, some folks in this space in the last few years. Few weeks about this topic and we've been debating around like who is gonna who are we gonna approach target market to around bringing this into the workplace in a sustainable way so my worry. Is if we go with the DNI route and forget everything that's going on in the world with DNI, but employee resource groups are a really good Avenue to bring this message in women's employee resources group in particular, sometimes bigger companies have mental health employee resource groups, but from an inclusion, but that's a great Avenue. The challenge with that is it feels like it's. Has a huge potential to be one and done and not really have the ability to make a long term impact. Now, by having at least one conversation, it could lead to more and it could have a trickle effect. That's, that's one avenue. Wellness programs is another. But so the benefits department, the folks who do the wellness programming, and these are generally larger companies that have both of these avenues, but I think Beyond that is also employee engagement and organizational development that could bring the conversation to learning and development doing menopause 101 training, supervisory training around how to talk to your employees about menopause, which is challenging because I know from experience that having it across different places is going to make it harder to have the sticking power to actually create a menopause friendly workplace where it has become an integrated part of wellness. benefits, inclusion, learning and development. I feel like that's, that's a little ways away because we're going to have to get in however we can and then we're going to spread out. And I think that before the DE& I efforts became like pedal to the metal in 2020, when I was working at Foundation Medicine, we were building like from the ground up, which is a lot of how we did a lot of the work of Foundation Medicine so that it would. Slowly take hold. And we had the privilege of being owned by the Roche group and having the resources and the leadership support. And so I feel like that's always the best way to build programs, right? It's the way I built a coaching program. That was award winning before coaching was something that leaders were really into. It's like start small, get people 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 huge opportunity for the stickiness, even if we're having the conversations. How it's going to stick is going to be all avenues coming together to make it happen. So do you think a policy is the first kind of framework that companies need to think about implementing in terms of breathing life into it? I understand the approach, but as a policy, the starting point. So therefore it's, uh, this is how we're going to address it. No, I think a policy is the last stop and I think the policies are easy because the policy, the policies exist today. Paternity leaves exist, fertility benefits exist, leave work accommodations for illnesses exist. Just amending them to add menopause into the policies is easy. It's the converse that are hard. It's the, oh, okay, this policy says I could take a leave for menopause, but now I have to say I have menopause symptoms that are causing me to lose days in the office, that are impacting my productivity, that are impacting my self esteem to the point where I'm considering either leaving or not putting myself up for that promotion. So it's the dialogue, it's the normalizing the narrative. We, we talked about what's the radical thing that companies can do. The radical thing to do is name it, put a face to it, then build. Up under it, those three pillars, right? The communication, the learning and development, the policies, or as a former HR person, I think the policy piece is easy. Now there are some benefits that I think would be a little harder depending on the demographic of the company to ensure that you're covering hormone therapy, to ensure that you're covering menopause specialists, but again, that is, those are not insurmountable. Barriers. Those are a fairly low bar. And if you're a self insured company, if you're a large enough company that you're paying claims directly, you have a lot of control over what you cover. So I think it's the naming and the putting the face to it and having the conversation. That's the most radical thing for companies. I, and this is true in other topic areas where C level women say, I want to be known as a great CEO, not because I was a woman. But because I'm a great CEO, so therefore I don't want to be associated with that woman's program. And I'm like, that sucks, frankly, because you are a woman, you are a CEO, and you have an opportunity to lead this conversation and I get it, I see both sides of it, but it's going to take a few brave leaders, a few brave men, who's maybe. personal experience with their moms or their wives or their daughters is like, Oh, wow, this is really, really something I should be talking about. And a few brave women, but I found a lot of receptive in the audiences that I've talked with. I found a lot of curiosity among the men in the audiences as well, because they're concerned. They're concerned about their wives. I mean, if you could have my husband on next, he will tell you how gravely concerned he was 20 years ago. He was like, I do not know what's happening. As you were talking, I was wondering about men because I was thinking, why should men care about this issue? Not in a sexist way, but you know, it doesn't hit them in their daily lives. And yet their moms, their wives, their daughters, whomever, that's when they start to pay attention. And so I'm wondering how can we get men to move beyond lip service around this issue and generally invest in menopause friendly workplace policies? So I, I think the mom angle is a really good one because my mom passed away nine years ago, and if she were still alive, she'd be like roughly 90. But the quality of her life the last 10 or 15 years was not great. That post menopausal phase that I was talking to you about a few minutes ago, your hormones decline and they don't come back unless you get it synthetically. You can't make it. So your bone health starts declining and your cardiovascular health starts declining and you're prone to excessive UTIs that could kill you. And so if your mom is suffering from all those things, you're like, wait, what? And you start to become aware and. My mom died of osteoporosis related complications that if she had been on estrogen, she might not have suffered the severe osteoporotic fractures that she lived with for probably 10 years before she died. So, I think moms is a great angle to get men to pay attention if they don't have wives, right? And then if you have wives, the largest demographic in the workforce is a menopausal age. 45 to 60, that's the target of menopause. 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 talked to many of the men I worked with during that time lately, but, well, they would have wanted to help me if they could have. They were watching me literally deteriorate in front of their eyes. I was a highly, highly competent person that in a period of six months couldn't hold a sentence together. So I know they would have wanted to help if they had the tools and the language to do so. Just like back in the day, my dad wouldn't have ever talked to me about My period or gotten tampons for me, but like we'll come a long way with that. My husband does that for my daughter. That's a big deal for him. So I feel like it's all these little ways that we'll get men. And I feel like the more we get men in their personal lives, the more they'll. Be aware of what's happening in the workplace. The more comfortable they are talking outside of work, the more they can make it, Oh, well, I know someone that is experiencing that my sister, it might be my, it might be your sister. I've watched my sister. She just, I don't have any brothers, but again, if I had a brother, I would like to think that after they, they would have, he would have been like, shit, I'm watching this woman at work, go through this thing, I'm going to pull her aside and say, Hey, are you okay? Yeah. Like, just like a human, like we teach, like we coach people to be human, just human. It, you don't have to be particularly nosy, but you could be like, I've noticed you seem really forgetful or really tired. Are you feeling okay? Just opening up the conversation feels like not that hard. And we've been teaching people for years, right? To have more inclusive conversations. So it, it's, it's on the same path. So again, I'm like big into the surround sound sort of approach to this. Come at it from all the different angles and it will make it seem less scary. And just as a quick aside, I mentioned that I have an almost 26 year old daughter. She's been having some hormonal issues monthly, and she wasn't feeling good at work yesterday. Also happens to be in human resources. Coincidentally, following mom's path. Yeah. So I said, you should talk to your boss because it's been a monthly kind of thing for the last few months. So something's going on. She has a female boss. She's like, I cannot have that conversation with my boss. And I was like, she's young. She's 26. And I was like, wait, what? She's like, yeah, no, I feel too weird. I go, okay, then you should not be talking to me because I am trying to get people to talk about menopause in the workplace. So if you can't even tell your boss. That you're having some issues, like I got a lot of work to do, there's a lot of opportunity here. So let me play with that just for a minute. I really like what you just said is, let's say there are women out there that are having issues, right? Cycle issues or hormonal issues. How would you frame up a conversation for them to go to someone, male or female, to talk about? What would be your approach? Yeah, so I just was talking with another coaching friend of mine about this and some of the women that she's coaching and I think again, it first starts with helping 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 an illness. So I think that's the other thing that we do. We get worried and we get in our heads about it. We're like, we start forgetting things. So we think, oh my god, we have early Alzheimer's, right? So we gaslight ourselves and we get nervous. So I think starting with. Being very honest, I have a bunch of symptoms. I'm not really sure what's going on. I have an appointment in a couple weeks, but I'm not sleeping that well, which is leading me to be a little bit foggy. So I'd just love if I could have a little extra time on this project. Like, just gently easing into the 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's impacting me. And I'm working on getting the right going forward, but could I have a little grace just like any other illness that someone might have any other accommodation. And again, I said, it's not an illness and it's not, but the symptoms show up in ways that are debilitating for some people. But when you're suffering from debilitating symptoms to not even have the conversation, think about how much energy that takes. Right? Think about how much energy it takes to try to hide your symptoms in your day and what that does to your mood, your productivity, your social ability to interact, right? It's taking all your energy just to sit up straight, you know, and like hope that your period isn't bleeding through your pants when you're in a conference room. You know, so it is like sucking people's energy so that they can't put it towards their jobs. And then they're get into that self fulfilled prophecy. Well, maybe I just can't do this job. Right. I spent seven years after I left that job thinking I couldn't do that job anymore. Yeah. Yeah. You know what I appreciate about what 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 on this project or process. I want you to be aware. I'm on it on my end, but I just need you to know that's what's happening on my end to create some space. Yeah, and a lot of the examples that are coming right to mind are people who have had new babies or people who have had terrible pregnancies where they've been throwing up in the bucket all day. Now, of course, we've moved a lot more towards hybrid work than 20 years ago, but men and women have. You know, over the last 12 years of my CPO career, I've been like, Hey, you know, I'm having a really hard time. I'm not getting enough sleep. My kid's cranky. That's a pretty normal conversation in the workplace right now. It's like, I hope you don't mind, but I'm gonna put the baby down and work from 5 to 9 p. m. And I'll get done what I need to get done, but I'm not gonna be available. Because between one and three in the afternoon is really difficult. And I know I worked for some progressive companies and was fortunate about that. And I was a very human boss myself, at least in the last decade. I'm not sure about the first two. So I feel like normalizing it again, back to that word that I'm overusing a bit, but recontracting, normalizing it, and thinking about it like any other issue. My wife's sick. I have to take care of her. I, I'm going to need some accommodations to my schedule. Yeah. And so let me ask you this. So you have the conversation, someone has the conversation, and then where do they go? Because you'd mentioned cardiologists, primary care, antidepressants. Where do women go to get help around this issue? Because you can't go to a single referral, right, specialist, because they're going to look at it from their specialty lens. Yes, so menopause specialists, and they're, they're few and far between, but they exist, and if you go to menopause. org, which is the medical association that certifies menopause MDs or nurse practitioners. So that's the first place I recommend people look for a specialist. And that could be a primary care doctor, that could be an OB GYN, it could be an endocrinologist, it could be any doctor who's decided that this is important to their practice, and they went and became a menopause specialist as a result. So they could be across disciplines in the medical space. So menopause specialists, GYNs, and then if no help is available, there are telehealth resources that I was just going to ask that. Yeah. I think there are better reasonable alternatives. MidiHealth, AlloyHealth, Maven. A handful of really seemingly very well reputable telehealth organizations that have popped up over the last few years. Now many of them popped up starting with fertility. And now along with a lot of other benefits are extending beyond the reproductive health chain to include. 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 my doctors and that didn't go very well. And none of my friends were experiencing it because they were all young. And I had a five year old and it couldn't have been part of them because she was five. I just didn't know who to talk to. And then everybody I did talk to was 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 up until like last week, so I'm not sure that's it. So, uh, talking to people I think is critical so you don't feel alone and isolated. That, women spend at least three years in perimenopause undiagnosed. Is there a book out there that women 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 menopause manifesto by a woman whose name is Dr. Jen Gunter, G U N T E R, and the other is called Estrogen Matters, and that's just been re released, Paul, and really talks about the disservice that that study in the 1990s did. to women's hormonal health and why so many people spent so long being scared of hormone therapy. A lot of the others are falling into that like social influencer cat category of practitioners and profiting from the work that they're doing in the menopause space. So they're selling supplements, they're selling programming, they're reading their book. And so That doesn't mean they're not good resources. It's just harder to walk the line and harder to understand are they telling me this because they want me to buy their thing or do they really believe this? They're doing a lot of work in getting the message out which has been incredibly helpful but these two books are are much more factually based. Manipause. org has a whole series for small companies, like big companies. Can do all sorts of things, but for small companies that's demographic might have a lot of women in their 40s. There's a whole set of free resources like worksheets and benefits and policies and things around menopause in the workplace on the menopause dot dot. That's great. I'd like to talk about hormone replacement therapy. Some people and men say it's a lifeline. Other people say it's a lightning rod. And I know that in talking to you before the interview, you've experienced the dangers of hormone replacement therapy firsthand. So talk to me about why women should or shouldn't consider hormone replacement therapy if they're experiencing perimenopause. So I think First of all, that's where the menopause specialist is really important, to make sure that you have someone that understands your unique situation. But the biggest misconception around hormone replacement therapy, in general, is that it's dangerous for all women. And that's just factually not true. It is not dan It is dangerous in some very limited circumstances, like estrogen positive breast cancers. It's very difficult. for women who have an estrogen positive to take estrogen because they're trying to eliminate the estrogen. But otherwise, all of the myths around the danger of hormone therapy have largely been debunked in the last decade. So depending on where you are, how old you are, et cetera, when you start How severe your menopause and how severe your symptoms are really determines like your path for treatment when it comes to hormone replacement therapy. So I'm going to tell you two stories. One is my own and one is a friend. So I was, obviously I was young. It took me seven years. to get on hormone therapy because of the timing. So I had, I was right in that timing where it was not being prescribed because it had just largely been taken off the market because of some flawed data and some hyperbole around reporting causal relationship between 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 my mom died from osteoporosis related complications. My mom's are very indirect. My grandma was a typical fall and broke her head. My mother lost five inches in height and she was. like a small person with one of those kyphosis in her back by the time she passed away. So for me, the estrogen and progesterone were life saving. Testosterone is the one that's controversial, and it's actually controversial for men and women. But for me, I started on testosterone not at the same time. And when I moved to Maine, I had trouble accessing hormone therapy. So I went to a concierge practice and was super over medicated because it's, it was inserted via pallet, which is hard to know how much you're getting dosed and their general practice was they. The more testosterone, the better. And in some cases, that works. And lucky for me, I didn't have any really long term side effects from it, because I've been 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 to places that may be irreversible in terms of hair loss and skin change and other things. So I didn't have any really severe long term side effects from it, but it took months to get it normalized. So now I'm on a physiological dose, which is much, much healthier and, you know, questionable as to whether all women need testosterone and, or will benefit from it. And I don't know enough about it. When it comes to men to talk about 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 you stop making it once you're on it as a man. So there's some challenges related to that. Now, I have a friend who never went on it. She didn't have debilitating symptoms of menopause, but she has osteoporosis. and heart disease and severe dental issues. So her estrogen decline was she wasn't experiencing the radical up and down that leads to a lot of the symptoms in perimenopause and she had a relatively symptom free menopause and she was quite a bit older than the average age of menopause so she thought life sailed through menopause but now she has a degenerative. disease, osteoporosis, heart disease, and has had like three or four implants, so her teeth are not so, not in great health. So I think even symptomless menopause requires you to understand what's going on in your body in relation to your hormones and whether you will or will not. benefit from hormone replacement therapy. So I think that's the other misconception that if you don't have symptoms, you don't need it. But even if you don't have symptoms, your estrogen is declining and estrogen is in every part of your body. So. The most direct causal effect of low estrogen, lacking estrogen, is osteoporosis and heart disease. There are others that are being studied now. What is the relation to brain health? Because there's so many estrogen receptors in your brain, over time we'll see that. I want to go back to, how do you understand this to be a business issue? Why should businesses care? This is one of my favorite questions. So, 100 percent of women will experience menopause. The largest age demographic growing. segment of the workforce or women over 50. Women who are living longer, working longer, staying engaged much longer, women will live one third to one half of their life in menopause or post menopause. So one in five women either leave the workforce or consider leaving the workforce or take a step back due to menopausal symptoms. 1. 8 billion dollars was lost in wages 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 sure where gender equality is in the workplace on the scale of things that are important these days, but if we don't normalize the menopause narrative, At work, we'll never have a chance of having the women to choose from to be our next level CEOs and be in the C suite because they'll either leave or they'll be passed over because they aren't viewed as competent. So, we know how retaining people is, what, 5 percent of the cost of losing somebody and having to replace them? And so having a pipeline of future female leaders to eventually create some sort of gender equality in the workplace, it's like a critical business issue. And that's not even, those costs that I mentioned aren't even including the long term health things that we talked about. So you stay in the workforce longer, you can't afford to retire because who can afford to retire these days, or you don't want to because women, we're all living longer and we want to stay engaged. We love our work. We want to continue to do it. Then you start piling on disease and osteoporosis. And those are all costs to a company that if they had been offering menopausal benefits much earlier, they may have prevented those long term medical costs as well. So it feels like a relatively simple business. Equation to me as a former chief people officer, I think it's just, we have to get out there and I thank you for having me to talk about this because that's a big step and when we talk about where people will hopefully pay attention. So I'd like to end with the question around, you've said the boldest move a CEO can make is to openly acknowledge menopause as a leadership issue. And if you had five minutes with a fortune 500 CEO, what's the one radical action you'd challenge them to take immediately? I would challenge them to be the face of menopause. Okay, so let's say I did a recent webinar with a women's employer resource group. I had a C level woman who was moderating. What if that was a CEO who was a man that was moderating? That doesn't actually seem that hard, but we both know that it is. What if the CEO of that company was the person that was moderating that one hour conversation around Why don't we talk about that at work instead of delegating it to the woman who was the C level woman who was willing to be the face. So it seems simple in theory, much more difficult in practice, but I think that's a big opportunity for us. To get the men out there engaged in the dialogue when most of the people I know doing work in this space are women. In fact, all of the people I know doing work in this space are women. But some senior level men, particularly at the executive level, CEO if possible, I think would change it immediately, right? Cause in your work and all the work I've done in my career. It starts at the top. All of it starts at the top. How people behave in the workplace, how people treat other people in the workplace, business practices, everybody looks up to the leader. And I think that leaders forget that sometimes. And I'm sure your work every day is reminding people that people are looking to them. You get a CEO moderating an all female panel to talk about a male CEO. to talk about menopause in the workplace and share maybe a personal story about his mom or his wife or sister. I think that will change that conversation in that company immediately. You know, it's interesting as you've been talking and I'm hearing the business impact and obviously the impact to the workforce and I even think of Medicare costs, how it could save our government money and it's a health issue. I think what you're describing is a human issue. It's not a DEI issue, but it's a human issue. I know my own mom struggles. What would you say to that? When I speak outside of companies, I talk about it as a societal issue. Cause all the things we just talked about as it relates to the workforce. relates to how people are able to live their life, right? And when I think about the workforce, I've worked in pretty privileged places in Massachusetts, 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 talk to, but. I consider 40 a month for hormone replacement therapy affordable. That isn't affordable for some people. You have to choose to spend that 40 on that versus perhaps on your child's formula or something. So eventually birth control became free. In, in England, hormone replacement therapy is covered by the government. But in this conversation, I'm talking about this limited world that I grew up and worked in, which was. In the greater Boston area, highly educated affluent in terms of the companies, but there is a whole world out there that doesn't have that same privilege that. Is really suffering without access, without information. So getting this out even broader beyond the large companies that we perhaps have an opportunity to influence, but to the smaller places that don't have the same access, I think is next. So if a company wants to bring you in and have you talk about, lead a discussion, how do they get 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 posting too, just for people to get familiar. Like I've posted on the myths of menopause. Why don't we talk about it at work? Cause I've been trying to get a regular LinkedIn conversation going about menopause, but my website is also pretty comprehensive. So. And just for the listening audience, Susan's last name is spelled M I E L E. That's Mike India Echo Lima Echo for all of you who enjoy the phonetic alphabet. So Miele, right? Okay. Susan, thank you so much for your passion and for your insight and for being brave and stepping into this for all of us. I really appreciate it. I appreciate you wanting to have the conversation. I'm excited. I'm excited to get it out in the world. Me too. Me too. Thank you. Thank you. Bye paul I hope what you heard in today's episode is that this is not just a women's issue It's a leadership issue. It's a business issue. It is a human issue. And yet for decades, workplaces have ignored it, forcing powerhouse women like Susan to choose between their careers and their well being. So if you're a leader, step up. Start the conversation. Demand policies that recognize menopause as the workplace reality it is. And if you're a woman struggling in silence, you're not alone. Track your symptoms. Find a menopause specialist. If you don't have access to a specialist, go to menopause. org and find a telehealth option that's right for you. And most importantly, speak up. Change starts with one courageous conversation, but it doesn't end here. Share this episode. Tag your CEO. Bring menopause out of the shadows and into the boardroom. Because the cost of silence is too high for all of us. Until next time, stay bold, stay vocal, and keep having the conversations that matter. This is Courageous Conversations, and this is just the beginning.