Should I Take the Leave?

You’re exhausted. You’re barely sleeping, you can’t concentrate, and your confidence is shot. Things you’ve done easily for years now take twice the effort. Maybe it’s perimenopause, maybe it’s burnout, maybe it’s both. Your doctor suggests taking time away from work.

For some, the first thought might be “thank goodness.” But, for most, it’s “what is this going to do to my career?”

That was my first thought, and I didn’t take the leave because of it. As we get more open about peri/menopause, mental health and burnout at work, we tell people to use the support available to them. Take the leave. Ask for the accommodation. Tell your manager what you need. All of that is reasonable advice. But most of us in the corporate workplace make wonder whether they’ll still be seen the same way when they come back.

Just this month I learned of two women, mid-40’s who took the leave – one was let go while on leave, the other let go a week after she returned from leave. I don’t know all the details of each, and no one can say for sure whether the leave caused it. But I know what stories like that do. Women hear them, and they remember them. So, when they’re deciding whether to ask for help, they’re weighing more than the health benefit of stepping away. They’re weighing the career risk. Will people think I can’t handle pressure? Will my manager stop giving me the hardest assignments? Will I still be considered for promotion? Will it come up at performance review time, or in the next reorganization?

Those fears sit inside a workplace culture that has long rewarded the “ideal worker,” the person who always seems available, productive and unaffected by whatever is happening outside of work. A 2025 paper in Gender, Work & Organization looks at how those ideal worker expectations contribute to the silencing of menopause at work.

That makes “just take the leave” a lot more complicated than it sounds.

Sometimes leave is exactly what someone needs. When that happens, the organization has to answer another question: what happens when she comes back? Return to work should mean deliberately bringing her back in. Giving her meaningful work. Putting her back in the important conversations. Talking about what’s next and ask what she wants. Keep developing her. Keep investing.

I worry that we’ll build better leave and accommodation policies without changing the assumptions underneath them, and we’ll end up with workplaces that are technically supportive where women still don’t feel safe using the support.

I want women to be able to make decisions about their health based on what they need, not on fear of what asking for help might say about their ambition. And I want managers to understand that a season of recovery tells you very little about what she can do over the next five or ten years.

A season isn’t a ceiling. Maybe that’s the principle our leave policies have been missing.

If you’re debating a leave, let’s talk. If you’re worried about the upcoming performance review cycle, stay tuned for a free workshop I’ll be offering on how to keep yourself in the room.

The Most Expensive Menopause Benefit May Be the One You Don’t Offer

When companies talk about menopause at work, they usually start with accommodations: flexible schedules, temperature control, remote work, time for medical appointments. Those things matter. I just think we’re starting the business conversation in the wrong place.

Rather than thinking through the lens of, “what will it cost us to support her?” let’s start with, “what will it cost us if we lose her?”

Think about who we’re actually talking about. Menopause happens at a mean age of about 52. These aren’t people at the end of their careers. They’re executives, team leaders, technical experts, operators, managers and mentors, with 20 or 30 years of experience behind them and often another decade or more of meaningful contribution ahead. These should be some of the most valuable years they have.

The cost is real. Mayo Clinic researchers estimated that menopause symptoms account for about $1.8 billion a year in lost work time in the U.S., and $26.6 billion once medical costs are added.

Those are big numbers, but how do you put a number on the executive who quietly decides not to go for the next role? Or the woman who stops raising her hand because her confidence took a hit, or the leader who leaves because she’s convinced she can’t do the job anymore? Or the employee whose manager sees a temporary dip and quietly decides she’s no longer “high potential”?

The Washington governor’s office, citing Society for Women’s Health Research data, points out that two in five women surveyed had considered leaving or had left a job because of menopause symptoms, and one in four had considered not pursuing or had not pursued a leadership opportunity. That isn’t just a wellness issue. It’s a talent issue, and probably a very expensive one.

Take a 48-year-old executive with 25 years of experience. She knows the business and the customers. She knows which ideas were tried ten years ago and why they failed, and she knows how decisions actually get made. She has relationships across the company that don’t show up on any org chart. She’s hired people, developed people, gotten through reorganizations, launched products and handled crises, and she has the kind of judgment you can’t get from a training program.

Then she has a hard 18 months. She isn’t sleeping, the brain fog makes work harder, her confidence drops, and she isn’t showing up quite the way she did at 44. The organization decides she’s not the same anymore.

In some ways she may not be. But the question is whether you’re looking at a permanent change in what she can do or a temporary change in how it’s showing up. Those are very different things, and getting it wrong is expensive. Companies put enormous amounts of money into recruiting senior talent, developing leaders, building succession plans and trying to hold onto institutional knowledge, and almost never connect any of that to menopause. I think they should.

Supporting a high performer through a hard stretch isn’t charity. It’s retention. And it takes more than a menopause policy on the intranet. Managers need to know what to do when someone suddenly seems different: how to separate what they’re seeing from what they’re assuming, and how to ask a useful question without diagnosing anyone. Organizations also need to make sure that getting support doesn’t quietly take someone out of the running for what’s next.

That’s where I think this conversation needs to go. Asking the question, “how do we keep experienced women contributing, advancing and leading through a stage of life we can predict?”

That’s a very different business question, and how a company answers it may decide whether it keeps some of its most experienced leaders or spends years trying to replace what walked out the door.

“Problematic to Hire.” This Is Exactly the Problem.

Last week, a Pennsylvania lawmaker said women were problematic to hire and it’s certainly made some waves.

The House Labor & Industry Committee was discussing House Bill 2135, which would require employers to provide reasonable accommodations for pregnancy- and menopause-related conditions. Representative Scott Barger said he used to evaluate employees “based on how problematic they are to hire,” and that with legislation like this hanging over employers, “they’re gonna find a reason not to hire the woman.”

Back home in Washington, Governor Bob Ferguson signed an executive order in June directing the state Women’s Commission to work with agencies to strengthen menopause and perimenopause accommodations, and to develop guidance and training for employers.

On the surface, that looks like two states disagreeing about accommodations. In reality, I’m not sure it’s about accommodations at all.

We’ve spent the past few years telling women it’s okay to ask for support, but in my experience, we haven’t made it professionally safe to do it.

Picture a woman who’s 47. She has spent 25 years building her career and she leads a team. Then she stops sleeping. She loses her train of thought in meetings, her anxiety spikes, and she starts doubting herself in ways she never has before. Eventually she figures out it’s perimenopause, so she does what we keep telling women to do and asks for help. Maybe it’s some flexibility in her schedule, or the occasional day at home after a night with almost no sleep, or time for medical appointments.

What does her employer tell themselves once she asks? “She needs some flexibility right now” can turn into “she can’t handle this role anymore.” “She’s going through a hard time” can turn into “maybe she’s not ready for the next level.” And if you take Representative Barger at his word, “she needs an accommodation” turns into “women her age are a problem to hire.” And, increasingly in the current employment environment, a problem to keep.

We need accommodations. We need better healthcare, and women need to understand what’s happening in their own bodies. But none of that fixes the workplace problem by itself, because the real damage happens in the space between what someone observes and what they decide it means.

A woman gets quieter. That’s an observation. “She’s lost her ambition” is an interpretation. A woman asks for flexibility, and that’s an observation. “She can’t handle a demanding leadership role” is a story we’ve added. Those aren’t the same thing, and it’s very easy to slide from one to the other without noticing.

Women know this, which is why so few of them say anything. New research from the Society for Women’s Health Research and The Fuchsia Tent found that nearly half of symptomatic women said they’d be comfortable talking to HR about menopause. Only 6% actually had. Women in the study’s roundtables described worrying that speaking up would cost them career progression.

So, women aren’t only deciding whether to share a health issue. They’re deciding whether they can afford to be seen differently afterward.

That’s why the workplace conversation has to go past “what accommodations should we offer?” We also have to ask what happens to her once she uses them. Does she still get the stretch assignment? Does her manager still talk about her as high potential? Is she still on the succession plan? Does anyone still picture her running the place five years from now?

Support without continued investment isn’t really support. It’s a politer way of writing someone off.

One idea I come back to constantly at Spark is that change is information, not a conclusion. See what’s happening. Pause before you build the story. Ask instead of assuming. Respond with the right support. And keep investing.

As I’ve shared before, the goal is to make sure nobody mistakes a season of change for the end of a woman’s potential. It’s not just about helping women get through menopause at work and feeling safe to do so.

I’ll be launching a workshop soon that goes into detail on this topic – for women and for managers. Add yourself to the interest list on my workshops page.

What Perimenopause Can Look Like at Work — Before You Know It's Perimenopause

When perimenopause hit me in my mid-40’s I had no idea why suddenly my joints hurt, why I couldn’t remember action items from my last team meeting, and why I just didn’t feel like myself. If you’re feeling that, here’s the info I wish someone had shared with me when I was 40.

I know I wouldn't have checked every box, but a few years later, when things actually started changing, I might have reached for a different explanation. I simply figured I was burned out and ready to be doing something else.

We talk about menopause like it's a 50s thing — hot flashes, cycle changes, done. But perimenopause can start years earlier, and at work it rarely announces itself with a hot flash. More often, it just looks like a career problem.

Late 30s. You're building — bigger teams, kids, aging parents, the next promotion — and you're not thinking about hormones at all. Then sleep gets weird. Your cycle shifts. Stress hits differently than it used to. You think you need a vacation, or to exercise more, or to get better at managing everything. Maybe you do. But this is the age to start noticing your baseline, so you can actually recognize it later when something changes.

Early 40s. The job you've done well for years suddenly takes more out of you. You reread the same paragraph twice. You're mid-sentence in a meeting and the word you need just isn't there. You know the answer — you just can't retrieve it fast enough, so you start writing more things down. Nobody's told you cognitive changes can come with perimenopause, so instead of “my body is changing,” you think: what's happening to me? This is often where the career impact actually starts — because your confidence in your capability changed, even though your capability hasn’t changed at all.

Mid-40s. Now other people start noticing too. You're quieter in meetings because you're afraid of losing your train of thought. You stop raising your hand for the stretch assignment. Feedback that used to roll off you suddenly doesn't. Your manager reads it as less engaged, less confident, maybe thinking you don't want the next job. You might be reading it the same way, and neither of you knows what's actually going on. This is the pattern that helped me create Spark and what I focus on breaking for others: behavior gets interpreted, interpretation becomes a story, and that story starts making career decisions for you.

Late 40s. “Maybe I should step back.” This is the red flag. By now you've likely spent a few years compensating — working harder to produce what used to come easy, hiding the fog, apologizing for being emotional. Eventually you stop raising your hand. Decide you've lost your ambition. I call this career withdrawal — rarely one big decision, usually a hundred small ones. Deloitte's 2025 global survey backs this up: women reporting menopause symptoms said it had undermined their confidence at work, cost them opportunities, or had them considering leaving altogether.

50s. You may finally understand what was actually happening — which brings relief, and a harder question. What decisions did I make when I didn't know? Did I step back when I didn't need to? But menopause isn't the end of ambition, and your 50s aren't the epilogue. For a lot of women, they're the start of something else entirely.

If you're 35, 38, 40, and reading this thinking that's years away — good. You're exactly who I want reading it. Know your baseline. Pay attention when it shifts. Talk to your doctor. And don't let a change in how you feel quietly become a verdict on who you are.

If you're already living it: give yourself the same grace. See what's changing. Pause before deciding what it means. Ask better questions. Respond with real support. Keep yourself in the room. S.P.A.R.K.

The real goal is bigger than getting women through menopause. It’s keeping their confidence, their ambition, and their careers intact along the way.

What If We’re Misdiagnosing Women?

This article is for the managers. Especially the ones who genuinely care about their people.

Have you ever thought:

• "Something feels off with [fill in the name]."

• "She doesn't seem as engaged as she used to be."

• "She's not operating at the same level."

• "Maybe she's burned out."

• "Maybe she's peaked."

Now ask yourself a different question: What if your observation was accurate, but your conclusion was wrong?

One of the most important insights I've learned on this journey is that perimenopause often begins in the brain long before women connect the dots themselves.

The symptoms can look remarkably similar to the things managers are trained to watch for:

• Lower energy

• Reduced confidence

• Difficulty concentrating

• Forgetfulness

• Emotional reactions

• Withdrawal

• Loss of engagement

From a leadership perspective, those symptoms often trigger concern. From a biological perspective, they may signal something entirely different.

The challenge is that managers can't see hormones. They can only see behavior. And when behavior changes, we naturally create explanations:

• She's losing interest.

• She's overwhelmed.

• She's no longer ambitious.

• She's not ready for the next role.

But what if she's working twice as hard just to maintain the same level of performance? What if she's lying awake every night? What if she's struggling with anxiety she can't explain? What if she's terrified someone will notice? What if she hasn't lost her spark at all?

This isn't an argument for lowering standards. It's an argument for improving understanding.

The women most likely to experience perimenopause are often the same women organizations can least afford to lose. They are directors. Vice presidents. Founders. Subject matter experts. Mentors. The people carrying decades of institutional knowledge.

Are we accurately interpreting what we're seeing? Because if we're not, we may be quietly pushing talented women out of the workforce during the exact years when they have the most to contribute. And that's a leadership issue.

It’s why I created The Spark Framework. A practical guide for organizations and managers to have a compassionate conversation about midlife at work. It’s the ultimate “how-to” communications guide for what companies should be thinking about now and how to approach conversations that may once have been off-limits, difficult or uncomfortable. And similarly, a guide for women to understand how to start these conversations with managers without fear of being dismissed.

Every working woman will go through this midlife transition while simultaneously over-achieving, trying to deliver, and trying to prove herself. Let’s support her.

Five Things I Learned from my First Interviews on Perimenopause for Working Women

When I started talking openly about perimenopause, something unexpected happened. Women started talking back. Not cautiously. Not awkwardly. Immediately. One conversation became five. Five became ten. Ten became twenty. And before long I realized I wasn't collecting stories. I was uncovering patterns.

Here are the five biggest things I've learned so far.

1.      Everyone thought it was something else.

• Burnout

• Stress

• Depression

• Aging

• Lack of motivation

• Too much work

• Not enough vacation

Nobody I spoke with immediately thought: "Maybe this is perimenopause." Instead, women were treating individual symptoms while missing the larger picture.

2.      Brain fog is terrifying.

Interestingly, there isn’t any one system associated with perimenopause, but the one that came up most often was cognitive change.

Women described forgetting words. Losing thoughts mid-sentence. Walking into meetings feeling unprepared even when they knew the material cold.

For high performers whose careers have been built on sharp thinking, that experience can be deeply unsettling.

And it’s the one most often misdiagnosed as disengaged. Because when the women I talked to described how they felt when they forgot words, felt embarrassed in meetings when they lost their train of thought, they also retreated. They lost their confidence and spoke up less.

3.      Many women are suffering silently at work.

Not because they want to. Because they're afraid.

Afraid of looking weak. Afraid of being passed over. Afraid of reinforcing stereotypes. Afraid someone will conclude they've lost their edge.

So they do what women have always done. They push through.

4.      Nobody knows where to go for help.

Many women don't know where to start. Many doctors aren't trained in menopause care, let alone perimenopause care. Many employers don't talk about it. Many managers don't recognize it.

Everyone seems to agree this is happening but few seem prepared to address it.

5.      Something powerful happens on the other side.

This one surprised me.

Many women who had found the right support didn't simply return to normal. They emerged with a completely different perspective.

Some wanted bigger careers. Some wanted entirely different careers. Some left jobs that no longer fit. Others stepped into leadership roles they had previously avoided.

What looked from the outside like a breakdown often became a reassessment. And in many cases, a breakthrough.

The more conversations I have, the more convinced I become that this isn't just a health story. It's a leadership story. It's a workplace story.

And it's a story millions of women are navigating largely on their own.

Welcome to Spark

Earlier this year, I left Amazon after 15 years.

I told myself I'd finally rest. Sleep past 7. Go on vacation. Read the books that had been sitting on my nightstand for two years. Do absolutely nothing for a while. And for a few weeks, I actually did that. I rarely saw a number before 10 a.m. on my bedside clock.

But something kept nagging at me: a curiosity that wouldn’t go away. For months before I left, I'd been in the thick of perimenopause and had no idea. I'd be mid-sentence in a meeting, completely sure of my point, and just lose it. Not distracted — gone. My patience was shorter than I recognized as mine. Some days my brain and my body seemed to be on two different calls entirely.

If you've spent your whole career being the person who's sharp and fast and unbothered, that kind of change doesn't stay contained to how you feel physically. It starts to mess with how you see yourself, period.

So I went looking for answers, mostly by talking to other women. Almost everyone had some version of the same story — they thought they were burned out, chalked it up to aging, and despite their self-doubt, just powered through.

Which got me stuck on one question: how many women are quietly questioning themselves — or getting quietly questioned by everyone around them — at exactly the moment they have the most to offer?

I didn't love the answer. So I built something instead.

Fifteen years at Amazon taught me more than I can fit into a post (maybe that’ll be a book someday), but the short version is: how to build something from nothing, how to push a project forward when no one's telling you how, and how to make something actually scale. I'm using every bit of that now, just pointed somewhere a lot more personal.

Spark is what I'm calling this next thing — it sits at the overlap of perimenopause, career and leadership. The goal is simple to say and harder to do: help women stay confident and visible through this transition instead of quietly shrinking, and help the people managing them recognize what's actually going on instead of mistaking it for something else.

Right now that looks like workshops, 1:1 coaching, and consulting for companies who want to get ahead of this instead of getting caught off guard by it.

If any of this sounds familiar — you're in it, you're managing someone who might be, or you've just been wondering why we don't talk about this at work — I'd love for you to follow along.

We're not losing our spark. We're living through something nobody explained to us, at exactly the moment we needed it explained. I'm trying to fix that.