The Perimenopause “Broken Rung” Hypothesis: Bridging Health and Career Gaps for Women in Corporate America
By Dr. Manna Semby, ND, MSCP, IFMCP
Introduction
As a former corporate woman who navigated the demanding and competitive environments of Wall Street, I know firsthand what it takes to climb the corporate ladder. Having worked my way up to Vice President at Goldman Sachs, I witnessed many women struggle, and some leave their careers, as they approached senior leadership roles. Over time, I came to believe that the phenomenon of perimenopause is an under-acknowledged contributor to the attrition of women in senior management.
This article presents my perspective on how addressing perimenopause could be key to supporting more women to succeed in senior roles, helping to bridge the gap that leaves so many women behind at critical career junctures. By offering the support women need during perimenopause, we might significantly reduce the number of women who leave their careers just when they are on the cusp of senior leadership.
The “Broken Rung”: A Barrier to Women’s Advancement
The term “broken rung,” coined by McKinsey, describes a critical barrier to women’s advancement in corporate America: the difficulty women face in moving from entry-level to first-level management. As a result, women’s representation dwindles at higher levels of leadership. Despite increased awareness, McKinsey’s 2023 Women in the Workplace report shows little progress on this front, with women still holding only about 20% of C-suite positions.
But what if we are overlooking a crucial factor contributing to this gap? Having experienced the physical and mental challenges of perimenopause myself, I believe it plays a significant yet invisible role in exacerbating the “broken rung” effect. Many women in their 40s and 50s, just as they are positioned to step into more senior roles, begin experiencing perimenopause symptoms that can severely impact their work performance and quality of life.
The Perimenopause “Broken Rung” Hypothesis
Perimenopause, the transitional phase leading to menopause, often begins in a woman’s early to mid-40s. This period is marked by hormonal fluctuations that bring significant physical, cognitive, and emotional changes. Unfortunately, the corporate world has largely overlooked how these changes affect women’s performance and ambitions just as they approach the peak of their careers.
In my years in corporate America, I saw many ambitious women either scale back their career goals or leave the workforce altogether as they approached senior roles. Perimenopause symptoms such as brain fog, memory issues, fatigue, and emotional changes undoubtedly play a part in this. Without proper support and treatment, these symptoms can drive high-achieving women to downshift or quit—resulting in the broken rung effect that continues to hinder women’s progress.
The Impact of Perimenopause on Women’s Health and Career Advancement
The physical and mental challenges of perimenopause are well-documented. The SWAN (Study of Women’s Health Across the Nation) findings underscore the magnitude of these challenges, highlighting increased risks of mood disturbances, sleep problems, cognitive decline, and physical exhaustion. Each of these symptoms has the potential to disrupt a woman’s ability to perform at the high levels of focus and energy required for senior management roles.But in the corporate world, these challenges often go unspoken. Women may not connect their symptoms to perimenopause or feel comfortable discussing them at work due to the stigma surrounding menopause. This silence perpetuates the problem, leaving women to struggle alone, often leading them to reduce their workload, step back from promotions, or leave their jobs altogether. The broken rung is not just about the lack of opportunities for promotion—it’s also about the lack of support for women’s health at a critical time in their careers.
Why Employers Must Recognize Perimenopause
The corporate world has made strides in supporting women with maternity leave and family care benefits, but perimenopause remains a blind spot. It’s time we recognize perimenopause as a key factor influencing women’s career trajectories. If employers provided health benefits and workplace support for women in their 40s and 50s, including access to hormone therapy, nutritional guidance, and cognitive health support, we might see a significant shift in the number of women staying the course toward senior leadership roles.A study conducted by the Bank of America in 2023 highlights this gap in communication between HR managers and employees regarding menopause-related issues. While 76% of HR managers claim to discuss menopause-related benefits, only 3% of women report such conversations. This disconnect is troubling and underscores the need for a more open dialogue and proactive solutions.
Bridging the Gap: A Call to Action for Corporate America
Imagine what we could achieve if we gave women the health support they need during perimenopause. Women who receive treatment for their perimenopausal symptoms—whether through hormone therapy, cognitive support, or mental health resources—can maintain their resilience and ambition, allowing them to continue climbing the corporate ladder.It’s not just about offering perks; it’s about creating an environment where women feel empowered to address their health needs without fear of stigma or career repercussions. With appropriate support, women can preserve their cognitive sharpness, emotional balance, and physical vitality through perimenopause and beyond. By fostering this resilience, we can help women sustain their upward trajectory in the corporate world, breaking through not just glass ceilings but the invisible barriers that arise with age and hormonal changes.
Conclusion
The broken rung hypothesis and its impact on women’s career advancement cannot be fully understood without acknowledging the role of perimenopause. Women who have worked hard to reach senior roles deserve the support that will allow them to thrive during this critical life stage. Addressing perimenopause-related health challenges is a crucial step toward achieving gender parity in corporate leadership.As someone who has walked this path, I’m committed to helping other women navigate the complexities of perimenopause while maintaining their professional aspirations. The stakes are too high for us to ignore this any longer. It’s time for corporate America to step up and provide the necessary resources to help women succeed in both their health and careers.
About the author:
Dr. Manna Semby, ND, MSCP, IFMCP, is a Naturopathic Doctor and a former Vice President at Goldman Sachs. She is the founder of Aruna Personalized Medicine and the Center for Cognitive Resilience. Dr. Semby is passionate about helping women navigate perimenopause and menopause while retaining their mental clarity, emotional resilience, and physical strength, and she is committed to advancing the conversation around women’s health in the workplace.
