Zora Health / Employer guide / United States
Support your experienced employees through menopause, and help them stay at their best.
Poor sleep, fatigue and brain fog can hit your most experienced employees at the height of their careers, yet many work through symptoms without telling their manager. Zora Health helps you build practical menopause support, from workplace policies and manager training to confidential care navigation and access to 128+ partner clinics in 16 countries, around your workforce and budget. Companies including Hilton, LinkedIn, Sanofi, HSBC, Mastercard, Carousell and Singapore Management University work with us.
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Five things US HR leaders should know
- The average age of menopause in the US is 52. Women aged 45 to 54 had a labour force participation rate of 77.3% in 2025, so most of the women going through it are at work.
- In a Mayo Clinic study of 4,440 working women aged 45 to 60, 13.4% reported at least one adverse work outcome due to menopause symptoms, and missed workdays cost an estimated US$1.8 billion a year.
- In a 2022 survey of 1,010 working women aged 50 to 65, 17% had quit or considered quitting because of symptoms.
- No federal law names menopause. The ADA and FMLA can apply where symptoms meet their tests, and Rhode Island became the first state to require menopause accommodations in 2025.
- In November 2025 the FDA began removing the boxed warnings on menopausal hormone therapy for heart disease, breast cancer and dementia.
Why menopause is a business problem for employers
Menopause rarely announces itself at work. It looks like a senior manager who slept four hours, a wave of heat in the middle of a client call, a word that will not come in a board presentation. Symptoms come and go for years, and many women do not link them to menopause or raise them with their manager.
So the cost stays out of your reports. It shows up instead as:
- Resignations. In a survey of 1,010 US women aged 50 to 65 working full or part time, 17% had quit or considered quitting because of menopause symptoms (Biote, June 2022). The survey was commissioned by a company, not peer-reviewed.
- Lower performance. In the same survey, 4 in 10 said symptoms affected their work performance at least weekly, and 1 in 4 said symptoms had hurt their career development.
- Lost workdays. In a Mayo Clinic study of 4,440 working women aged 45 to 60, 10.8% had missed work in the past year because of symptoms, a median of 3 days. Women with the most severe symptoms had 15.6 times the odds of an adverse work outcome (Faubion et al., Mayo Clinic Proceedings, 2023).
- Unequal access. Cover for consultations and hormone therapy depends on each employee’s plan design and formulary. Out-of-pocket costs for some branded hormone therapies exceed US$100 a prescription (GoodRx, October 2024).
What employers gain
Keep the people who know how your business runs
Replacing an employee costs one-half to two times their annual salary, according to Gallup. Women aged 45 to 54 had a labour force participation rate of 77.3% in 2025, and women aged 55 to 64 61.4% (Bureau of Labor Statistics). A written policy, trained managers and quick access to the right doctor can help address barriers that contribute to employee attrition.
Stand out to experienced women
In the Biote survey, 1 in 4 women said menopause symptoms had hurt their career development. A clear menopause offer, with practical adjustments and access to clinicians who know menopause care, signals that experienced women can build their careers with you.
Make menopause support financially predictable
US employer health costs are projected to rise 9.5% again in 2027, after reaching US$14,432 per employee in 2026 (Aon, via AJMC). Much of what helps menopause costs very little: a flexible start time, a desk fan, a manager who knows what to say.
Zora helps employers set an annual allowance or outpatient top-up around what your plan already covers, so HR can run the programme within an agreed budget. The benefit works alongside your existing insurance.
Want to see what this would look like for your US workforce?
What menopause care costs, and what the state pays
Most menopause care in the US is outpatient: a primary care or gynaecology visit and, where suitable, hormone therapy. What employees pay depends on their health plan, deductible and formulary.
| Item | Public support | What the employee still carries |
|---|---|---|
| Primary care or gynaecology visit | Covered under most employer health plans, subject to deductibles and copays; we found no federal law requiring specific menopause cover | Costs vary widely by plan design and network |
| Menopause hormone therapy | Cover depends on the plan formulary | Average out-of-pocket cost of US$14.33 per 30-day prescription; some brands cost over US$100 |
| Specialist menopause care | Depends on the plan network | Clinicians certified in menopause care are not available in every network |
| Time off for appointments | No federal menopause leave; FMLA gives up to 12 weeks of unpaid, job-protected leave for a serious health condition, for eligible employees | Paid sick leave depends on state law and employer policy |
Prescription costs from GoodRx Research (October 2024), a commercial source. FMLA rules from the Department of Labor. These are published examples, not guaranteed current prices: actual costs depend on cover, clinic, doctor and treatment, so confirm fees with the provider before budgeting.
The clinical picture changed in late 2025. The FDA began removing boxed warnings for heart disease, breast cancer and probable dementia from menopausal hormone therapy labels, and recommends starting systemic therapy within 10 years of menopause or before 60.
Source: HHS, 10 November 2025. For employers, the practical opportunity is to help employees recognise their symptoms, understand their options and reach a clinician who knows menopause care sooner.
Menopause support that fits your workforce and budget
You do not need to overhaul your existing health insurance to support employees through menopause. Start with awareness and manager education, add confidential one-to-one support, or introduce a fuller programme across your offices. There is no minimum company size.
Where included in the employer programme, eligible employees can use talks and care navigation without paying Zora a separate fee. Care navigation allowances are set in each proposal. Treatment and other third-party costs are paid separately, either by employees or through the allowance their employer provides.
Companies starting the conversation
Essentials
Expert-led talks for employees and managers, menopause policy templates, manager guides and full access to the Zora app. Up to 2 talks a year.
Employees supported one to one
Navigation
Everything in Essentials, plus confidential one-to-one care navigation and access to our partner clinic network.
Large teams across countries
Complete
Everything in Navigation, plus quarterly anonymised reporting, a dedicated account manager and scheduled review meetings with HR.
Optional add-ons can be added to any programme, subject to availability: hormone diagnostics and telehealth with specialists. Pricing is tailored to your headcount, your countries and the services you choose. Most companies start with a single talk.
Request a proposal See how Zora works for employers
Comparing menopause benefit providers? Use our RFP question bank
Our question bank has 40 questions for multi-country benefits teams, with why each one matters, what a good answer looks like and a scoring sheet for three providers. Six of the questions for menopause support in the US:
- Is menopause support included as standard, or only fertility?
- What access do employees get to menopause specialists and hormone testing, and how quickly?
- How does the programme support accommodation requests under the ADA and state law, such as Rhode Island’s menopause provisions?
- Do you provide fertility and menopause policy templates for our markets?
- How can an employee get help confidentially without telling their manager?
- What individual-level data does HR see?
Your download link appears as soon as you submit. Zora Health may contact you about employee benefits; see our privacy policy.
Plan your menopause benefit budget
Menopause care allowance planner
Model the annual claims budget for a menopause care allowance. Change any number.
This is a claims budget, not a Zora quotation. Zora’s programme fees, implementation and optional services are separate.
It estimates the annual budget for a menopause care allowance from your eligible workforce, expected utilisation and allowance per employee, and assumes each user claims the full allowance. Eligible employees defaults to 15% as a stand-in for women aged 45 and over; use your own headcount data. The default allowance of US$1,000 is an illustrative figure for specialist visits and prescription costs not covered by your plan. Utilisation is an editable assumption, not observed Zora data. For a proposal covering both programme costs and employee benefits, request an employer proposal.
Estimate the potential workforce impact of menopause symptoms
A rough planning scenario. It applies a published estimate to your headcount, so it is not a prediction for your workforce, a measured loss or a forecast of savings from any programme.
Range: US$35,698 to US$108,058 a year, depending on replacement cost.
Assumptions: 13.4% of working women aged 45 to 60 reported at least one adverse work outcome due to menopause symptoms, and those who missed work lost a median of 3 days a year (Faubion et al., Mayo Clinic Proceedings, 2023). This was a sample of Mayo Clinic primary care patients, so it may not reflect your workforce. The default salary is close to US median full-time earnings (about US$1,232 a week in Q3 2026); use your own. Replacing an employee costs one-half to two times their annual salary (Gallup, 2019); the headline uses the low end. Absence is valued at salary divided by 250 working days. Exit rate is your own assumption.
Already have corporate health insurance? Here is where Zora fits
Your medical plan may cover some consultations and treatment. Employees still need to recognise their symptoms, understand their options and find a doctor who knows menopause care, and many never get that far.
Zora works alongside your existing insurance and benefits. We help employees get reliable information, navigate their care options and reach suitable specialists, and we give HR manager training, policy templates and, on the Complete programme, anonymised reporting. You strengthen menopause support without replacing your medical plan.
How Zora works
For your employees
Employees join the Zora app with a company code, or single sign-on for larger teams. They can learn about perimenopause and menopause, understand what your benefit covers, book a confidential care navigation call and find partner doctors and specialists.
For HR
- Kick-off, week 1. Agree goals, countries and which employees are eligible.
- Policy and benefit design, weeks 2 to 4. Draft or update your menopause policy and flexible work guidance using our templates.
- Launch, typically weeks 4 to 6. A launch talk for employees and managers, plus a communications pack for HR to send.
- Live support. Employees book care navigation calls and use the Zora app.
- Reporting, every 3 months, on the Complete programme. Anonymised usage, common themes and our recommendations, reviewed with your account manager.
Privacy
On the Complete programme, HR receives anonymised, aggregated reports only: how many employees used the programme, which services they used and the common themes. On every programme, HR never sees an individual employee’s health information, bookings or test results, and employees can get help without telling their manager. Employee data is stored on Amazon Web Services in Singapore and handled in line with Singapore’s Personal Data Protection Act.
Clinics and doctors in the United States
Zora’s clinic and doctor directory does not list providers in the United States yet. It lists 421 clinics and 1,185 doctors across 25 countries, mostly in Asia Pacific and the Middle East (browse clinics or browse doctors). Employees in the United States can still use Zora’s education and the Zora app. Ask us how your team in the United States would use Zora before you launch. See Zora’s employer guides for every country.
Rules and eligibility in the US
Americans with Disabilities Act
Title I covers employers with 15 or more employees. A disability is an impairment that substantially limits one or more major life activities (ADA.gov). Menopause is not a disability in itself, but severe symptoms may meet the test, in which case reasonable accommodation applies.
Family and Medical Leave Act
Eligible employees can take up to 12 weeks of unpaid, job-protected leave in 12 months, with group health benefits kept. They need 12 months’ service and 1,250 hours, at a site with 50 employees within 75 miles (Department of Labor). Menopause symptoms qualify only where they meet the definition of a serious health condition.
Pregnant Workers Fairness Act
The PWFA covers employers with 15 or more employees. The EEOC’s guidance does not list menopause among related conditions (EEOC), and the rule is under review, so do not assume it covers menopause.
Rhode Island
Rhode Island added menopause and related conditions to its Fair Employment Practices Act, requiring reasonable accommodations such as modified schedules, cooler workspaces and flexible breaks unless they cause undue hardship (Rhode Island General Assembly). Bills have been proposed in other states.
Federal menopause care bill
S. 4503, the Advancing Menopause Care and Mid-Life Women’s Health Act, was introduced in May 2026 (GovInfo). It is a health bill, not an employment mandate.
Why employers choose Zora
Companies including Hilton, LinkedIn, Sanofi, HSBC, Mastercard, Carousell and Singapore Management University work with Zora Health. We work alongside your existing insurance, helping employees use the cover they already have and find suitable doctors and specialists based on their needs.
Zora Health helped me to reclaim my confidence to thrive at work!
Questions HR teams ask us
Do US employers have to give menopause leave?
No. There is no federal menopause leave. Eligible employees can use FMLA leave where symptoms meet the definition of a serious health condition, alongside paid sick leave under state law or company policy.
Is menopause a disability under the ADA?
Not in itself. Severe symptoms may meet the ADA test of an impairment that substantially limits a major life activity, in which case employers with 15 or more employees should consider reasonable accommodation.
Does the Pregnant Workers Fairness Act cover menopause?
It is not settled. The EEOC guidance does not list menopause, and the rule is under review, so treat menopause requests through your ADA and company processes.
Which states have menopause laws?
Rhode Island became the first state to require menopause accommodations in June 2025. Bills have been proposed elsewhere, so check the states where you employ people.
What has changed for hormone therapy?
In November 2025 the FDA began removing boxed warnings for heart disease, breast cancer and probable dementia from menopausal hormone therapy labels, which may increase demand for consultations.
Does Zora replace our health insurance?
No. Zora works alongside your insurance. We help employees understand their options, find suitable specialists and use the cover they already have.
How much does menopause support cost an employer?
It depends on the programme, any allowance and expected uptake. Use the budget planner on this page for a first estimate, then ask us for a tailored proposal based on your headcount and countries.
How quickly can we launch?
Typically 4 to 6 weeks from contract to launch, depending on scope and countries. Most companies start with a single talk.
Related guides for US employers
Build a menopause support programme for your team
Whether you are introducing menopause benefits for the first time or improving an existing programme, tell us your headcount, countries and priorities. We will come back within two working days with suitable services, an indicative budget and a practical rollout plan for your US team. No obligation.
Sources
- National Institute on Aging, What is menopause?
- Faubion et al., Impact of menopause symptoms on women in the workplace, Mayo Clinic Proceedings, 2023 (4,440 working women aged 45 to 60, Mayo Clinic primary care patients)
- Biote, National Women in the Workplace Survey, via Business Wire, 6 June 2022 (1,010 women aged 50 to 65)
- Bureau of Labor Statistics, Employment status by sex and age, 2025 annual averages
- Bureau of Labor Statistics, Usual weekly earnings, Q3 2026
- GoodRx Research, Menopause medication prices climbing, October 2024
- HHS, FDA removes misleading warnings on hormone replacement therapy, 10 November 2025
- AJMC, US employer health care costs projected to rise 9.5% in 2027, August 2026
- ADA.gov, Introduction to the Americans with Disabilities Act
- US Department of Labor, Family and Medical Leave Act
- EEOC, What you should know about the Pregnant Workers Fairness Act
- Rhode Island General Assembly, menopause workplace accommodations law, June 2025
- S. 4503, Advancing Menopause Care and Mid-Life Women’s Health Act, May 2026
- Gallup, This fixable problem costs US businesses $1 trillion, 2019