Teaching Financial Wellness During Hormonal Transitions: The Overlooked Gaps in Women’s Wealth
by Dr. Kimberly Derezil, MD
Double Board-Certified Physician • Menopause Society Certified Practitioner • Certified Wealth Manager
Founder, Meno & Money™
Most financial plans prepare for things like job loss, market downturns, and divorce. But they rarely address the menopausal transition – and that’s a major oversight. Perimenopause usually begins between ages 45 and 55, right when many women are earning the most and carrying the greatest financial responsibility at work and at home.
A 2023 study published in Mayo Clinic Proceedings looked at 4,400 working women. It found that 13.4% had at least one negative work impact from menopause symptoms. Just from lost workdays, researchers estimated the U.S. economy loses about $1.8 billion each year to menopause-related absenteeism. This number only counts days missed, not the less productive women, those who were turned down for promotions or who stepped back from leadership roles.
In 2025, the same Mayo Clinic researchers found that over 80% of middle-aged women with menopause symptoms did not seek medical help. Many said they simply did not know about effective treatment options.
Because hormonal transitions are often left out, there is a gap in the materials financial educators use with clients. This means clients may not know how to support themselves during this important time. If you recognize this gap, you can help your clients understand your perspective and encourage empathy and motivation to address it.
The Menopause Tax™
I see this often in my practice. Many successful, educated women in their late 40s and early 50s experience symptoms like brain fog, poor sleep, mood swings, lower self-confidence, and trouble focusing. They often think these are just symptoms of stress, burnout, or aging. To cope, they may cut back their work hours, turn down demanding opportunities, or even leave their jobs.
These changes add up in three main areas, which I call the “Menopause Tax”™:
- Care Costs: These are the out-of-pocket expenses for services such as specialist visits, lab tests, and hormone therapy. Insurance often does not cover these costs. Hormone replacement therapy alone can cost $1,200 to $3,600 a year, depending on the type and insurance. Many women end up paying with credit cards or dipping into retirement savings.
- Career Costs: These include missed promotions, reduced hours, or leaving a job during the toughest years of symptoms. Looking back, these choices often seem like financial decisions; but at the time, they are often just about getting through each day.
- Compound Costs: These are the long-term effects on wealth, social security, and retirement timing. For example, if a woman goes part-time for two years at age 50, she loses not just income, but also her employer’s 401(k) match and two years of investment growth – right when her earning and saving potential is highest.
What Financial Advisors Can Do To Help
Most financial planning models focus on “Save More – Spend Less.” But for women facing hormonal changes, this is not enough. Adding three new ideas to financial education can help close this gap.
1. Create Health Gap Funds
Standard financial planning guides recommend creating an emergency fund to prepare for job loss. However, women transitioning into perimenopause require an additional cushion for out-of-pocket healthcare costs that exceed typical health insurance coverage limits, which can be substantial. Introducing this concept helps your clients feel more comfortable and supported in providing resources to women facing these financial challenges.
2. Conduct Career Longevity Audits
Traditional financial education asks the question, “When can I retire?” A much better question is,
“Can my current work environment support me throughout the most challenging symptomatic years?” This may involve negotiating flexible arrangements before they become essential, developing skill sets that provide more portable income streams, or documenting accommodations requested under applicable laws (e.g., the ADA/PWFA).
3. Rebrand Self-Capital Investments
A menopause-trained provider, a dietitian specializing in menopausal nutrition, a fitness coach helping women through the physical aspects of menopause – each of these types of professionals is categorized as ‘personal expense’ items in virtually every household budget. They really belong in the ‘professional’ category. If investing $5,000 to $8,000 a year in symptom relief and physical health can extend a woman’s working years by only 5 years, the future value of those additional working years far exceeds the cost of the investment. Unfortunately, this kind of analysis is rare in traditional financial wellness programming. It should be essential.
Why This Should Be Included in Financial Education
For the women I support, navigating perimenopause is often a forced realization of what they have tolerated, what they have undervalued, and what they have put off until later. This transition demands a higher level of precision in financial planning, as it involves significant physiological, physical, and mental shifts.
Perimenopause is a financial event. It arrives during peak earning years and quietly alters how a woman evaluates risk, pursues career opportunities, allocates healthcare dollars, and makes investment decisions. Financial literacy that does not account for what is happening in her body during this window is missing the single largest variable in her financial picture. And the women living this right now are already sitting in your workshops.
