In a recent meeting at Astellas Pharma Canada, an employee stood up and said something that might catch most boardrooms off guard: “I’m having a hot flash. Do you mind if I move closer to the A/C?” She moved, no one blinked, and the meeting continued.

For Sandra Heller, general manager of Astellas Canada–a global health company specializing in innovative pharmaceuticals–that simple moment signalled a real cultural shift. A year after committing to becoming a menopause-inclusive workplace, openness and candour have replaced the awkward discomfort that once surrounded the topic. Employees now speak about symptoms like fatigue or brain fog without fear of judgment. 

That quiet normalization—making menopause management part of everyday work life—was exactly what Heller hoped for when she launched the initiative. Through friends and colleagues, she already knew how symptoms like hot flashes and night sweats could make working life difficult–even pushing some women to leave their jobs. But that changed with a piece of illuminating research.

In 2024, Astellas conducted its Menopause Experience and Attitudes Study, surveying nearly 14,000 men and women worldwide to explore the impact of menopause-related stigma and barriers to care. In Canada, one in three respondents said menopause had affected their work life, citing reduced productivity, anxiety about disclosure, and in some cases, missed promotions or lost hours. 

Equally striking was the stigma the study uncovered. Almost three-quarters of women said they didn’t feel comfortable discussing menopause symptoms with a supervisor, and a third reported that it negatively affected their performance. Heller recalls a telling example: a colleague experiencing a hot flash during a presentation was told by her male supervisor that she appeared “unprepared” because she was blushing. She chose not to correct him, later telling Heller she would rather be seen as unprepared than explain it was a hot flash—a decision she says reflects how stigma prevents people from speaking openly about their symptoms.

These personal experiences point to a broader challenge for employers. The Menopause Foundation of Canada estimates that unmanaged menopause symptoms cost the national economy roughly $3.5 billion annually. A 2025 Angus Reid poll commissioned by Astellas found that 85 per cent of Canadian women over 45 see menopause as a health condition employers should take seriously, and nearly three-quarters said workplaces should offer accommodations like fans, cooling stations, or flexible hours. Yet 78 per cent still consider menopause taboo, and almost a quarter had witnessed or experienced discrimination related to symptoms. 

At Astellas Canada, those findings were hard to ignore: two-thirds of the workforce are women, most over 45. Many are at the peak of their careers—years when leadership experience, institutional knowledge, and mentorship are most valuable. While the company had been consulting external experts and advocates on menopause since 2021, the research prompted leadership to act, concluding that supporting employees was both a moral responsibility and a sound business choice. Astellas’ menopause pledge was first piloted in the U.K. in 2022 before expanding globally. 

The company’s focus on women’s health provided a natural foundation for change.  With recent product launches in oncology and women’s health, the leadership team wanted its internal culture to reflect the values it championed publicly. “We talk about unmet medical needs all the time,” Heller says. “This was an unmet workplace need.” 

The effort began with education. For the past five years, webinars led by menopause medical experts, advocates, and partners like Over the Bloody Moon—an organization specializing in workplace hormonal health—have been held globally. In Canada, Astellas also hosted an all-staff learning session with the Menopause Foundation of Canada featuring an employee sharing her personal menopause journey. Rather than creating new resources, Astellas partnered with these organizations to share materials, making them accessible via centralized SharePoint sites, email communications, and local affiliate channels.

Smaller workshops led by HR, communications, and patient access team members from over 15 countries allowed employees to co-create the program and exchange feedback. These workshops focused on four themes: the need for support and resources, leadership buy-in, cultural sensitivity, and creating safe spaces for sharing lived experiences. Participants spoke frankly about sleeplessness, concentration lapses, and the strain of concealing symptoms that affected their performance. 

Attention then turned to equipping managers. In 2025, line managers received training on navigating these conversations with empathy and discretion, delivered collaboratively with Over the Bloody Moon, the Menopause Foundation of Canada, and Astellas’ internal HR team. A digital toolkit—part medical primer, part resource guide—gave managers the basics: what menopause is, what accommodations help most, and where employees could find support. The goal was to replace uneasy hesitation with informed, confident responses, regardless of managers’ personal experience with menopause. 

Employee support now covers a wide range of needs. Those dealing with disrupted sleep can adjust their hours, while paid leave and medication coverage are included in benefits. Counselling and coaching are available through the employee-assistance program, and preventive-care coverage extends to surgical or treatment-related menopause. Importantly, these policies apply equally to field staff and office workers, reflecting the fact that menopause affects employees across every role.

To strengthen peer support, Astellas also launched a global Menopause Ambassador Program—volunteer employees trained as informal points of contact. Training begins in November and ambassadors receive toolkits to support local implementation. They also have a dedicated Microsoft Teams channel for collaboration, and local ambassadors determine how often to hold discussions based on employees’ needs. They host peer circles—acknowledging that talking with a colleague can be easier than approaching a manager—share practical advice, and relay recurring concerns to leadership. As Heller notes, “Sometimes the best insight comes from a peer who’s living it.”

Meanwhile, empathy training took an inventive in-office turn. The company introduced wearable “hot-flash vests” from an external provider, stimulating the sudden heat surges many women experience during menopause. Colleagues, including many men, tried them on during workshops. Heller says that while the experience “sounds funny, it changes your perspective instantly. Imagine trying to give a presentation to 200 people while feeling that.”

Heller attributes part of the rollout’s success to its gradual pace: awareness first, then management training, followed by peer-to-peer initiatives. She believes that that pacing allowed the changes to take root naturally, avoiding the feeling of a stale corporate campaign. Recent engagement surveys show steady improvement in how supported and heard employees feel. Heller has also seen small but meaningful cultural shifts, such as managers openly acknowledging their own menopause symptoms, or employees comfortably pausing meetings to manage brain fog and respond more clearly.

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The most striking impact has been the cultural shift–Heller says that the topic has simply lost its stigma. “Ultimately, this is a workplace equity issue,” she says. “A company looking to make similar changes might consider gathering some data to see where support and resources are needed most. But just creating that awareness piece, talking to people about it, and making it normal is a high-impact change on its own.” 

At 51, with three daughters, Heller hopes the next generation won’t need formal initiatives to normalize menopause. “I don’t want them working in a world where menopause is something to hide,” she says. “Menopause is a part of life. Workplaces should treat it that way.”