Why Europe can no longer afford under-treatment of menopause

At an event hosted by MEP Dan-Ştefan Motreanu (EPP, Romania) at the European Parliament in Brussels, The Parliament and Besins Healthcare Germany brought together policymakers, clinicians and workplace voices to confront a topic that still too often sits in the private sphere: menopause, and the very public costs of leaving it undertreated. 
 
Prior to the opening, Lesley Salem, Founder and CEO of Over The Bloody Moon introduced attendees to the MenoVest, a jacket designed to simulate two of the many symptoms of menopause: hot flushes across different parts of the upper body, and tightening pressure on the chest. The aim was to make people feel how much these two symptoms can affect their lives and to show with a practical example to what extent it can negatively impact women’s work and personal life. 

Salem explained that the vest emerged from a recurring challenge: when workplaces run awareness sessions, “it was only the people in menopause that were showing up”, while the managers and colleagues who shape the working culture were missing. For many women, she added, symptoms can be relentless, with hot flushes coming “up to ten” times an hour, accompanied by sleep disruption and cognitive strain. “We can’t change work culture unless people truly empathise,” she said, arguing that a lack of understanding often translates into silence, and silence often translates into people stepping back from work. 
 
Ludwig Kiesel, Professor of Gynaecology and Obstetrics at the University Hospital of Münster and General Secretary of the European Menopause and Andropause Society (EMAS), set out why timing matters, as menopausal transition is not a “single moment but a phase that can begin years before the final period”, with symptoms and health risks building through perimenopause. He underlined that while experiences vary, severe symptoms affect roughly a third of women after 50, with another third reporting moderate problems. Women’s longer life expectancy means they spend a substantial share of their lives in post-menopause, making this a structural issue for health systems and labour markets. 

We can’t change work culture unless people truly empathise 

Kiesel described how lower oestrogen can affect sleep, mood, joints and bone health, and why support should be framed as prevention, as it “is much more useful and effective than starting to repair things afterwards,” he said, warning that waiting until symptoms become unmanageable can mean higher medical and economical costs, and recalled that women often arrive at consultations after long periods of uncertainty. 
 
Menopause remains under-recognised in training and under-served in reimbursement structures, which affects what clinicians learn and what they can realistically deliver. “Money drives teaching,” he said, pointing to areas like breast cancer, where targeted investment created specialist training, centres of excellence and better care pathways over time. Menopause, despite the scale of the population affected and the growing urgency of labour shortage, has not benefited from the same sustained focus as women with breast cancer from newly established certified multi-disciplinary Breast Cancer Centers in Europe. 

Kai Agnes, Equality Attaché at the Permanent Representation of Germany to the EU, pressed on how policymakers should think about the longer-term impacts of treatment. If some interventions can relieve symptoms quickly, she asked, “how can health systems build the evidence, so that care focuses on prevention instead of emergencies?” While Kiesel agreed that the long-term picture requires careful research and better data, he warned against using uncertainty as a reason for inaction on what already improves quality of life and helps women remain active.  
 
Doris Manu, Delegate to Resilience and Preparedness at the Permanent Representation of Romania to the EU, pushed the room toward implementation. “How”, she asked, “can policymakers be persuaded to direct funding toward measures that change outcomes?” Kiesel suggested, that although major system reforms take time, one bridge measure can start sooner: clinician education, to make earlier recognition more likely. “It is not my favourite option, but it’s a good start”, he said.  

Prevention is much more useful than starting repairing things

Véronique Willems, Secretary General of SMEunited, who spoke both for small and medium-sized enterprises and from personal experience, described years of consultations that treated her symptoms as something else, leading toward antidepressants and referrals that did not address the underlying issue. When she finally accessed the right support, she said, “I started turning into a normal person again.” She also stated that misdiagnosis drives avoidable spending and workplace disruption. “I wouldn’t have had to step out last year if I would have gotten the right treatment in the right moment,” she added, arguing that earlier recognition could reduce both personal and systemic costs for smaller employers that cannot easily absorb sudden absences. 
 
Salem returned to the question of what scalable action looks like, drawing on work across 19 countries. She argued that awareness campaigns are not enough if care remains hard to access or too expensive. Training, she said, must reach clinicians, managers and workplace decision-makers, and support must be designed with different realities in mind, including marginalised women, neurodivergent people and those living with pre-existing conditions. The common thread, she argued, is that silence tends to push people out of work first, and only later into healthcare systems, when symptoms and consequences have worsened. 
 

The evening closed with a political message delivered by an assistant of MEP Dan-Ştefan Motreanu, as he was held up due to longer than expected negotiations in Committee. He framed menopause as a public policy issue with direct consequences for women’s health, labour market participation and Europe’s economic performance. With negotiations on the next multiannual budget, he argued that menopause needs visibility across health, employment and social policy, supported by better data, stronger training and workplace measures developed with social partners. 
 
If one idea ran through every intervention, it was that silence shifts costs into the future, onto health systems, employers and women themselves. The speakers argued for coordinated action that makes earlier diagnosis more likely and treats menopause care as prevention. In a Europe preoccupied by workforce shortages and ageing, the message was straightforward: ignoring menopause does not save money, it simply delays the bill. 

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