Washington’s Menopause Workplace Order Highlights a Real Workforce Issue

A public starting point for better workplace support without burdening employers

On June 1, Washington Gov. Bob Ferguson signed Executive Order 26-01, a new order focused on supporting women in the workplace who are experiencing perimenopause and menopause symptoms.

Sarai Childs, President of Business Health Trust, spoke as a small business owner, an employer, a business representative and a woman in her 40s. She also spoke from the day-to-day reality of helping employers understand benefits, health needs and workplace resources.

“I come here today not just as an employer and a business representative, but as a woman in my 40s,” Sarai said.

Her support for the order centered on a point employers should hear clearly: this is not about adding another burden. It is about making a common phase of life easier to talk about, easier to support and less likely to push experienced women out of the workforce.

Sarai described how awareness made a difference in her own life: “When I started noticing things and was getting three hours of sleep and not functioning the next day, I knew where to turn,” she said. “I knew I had options.”

Perimenopause and menopause are not side topics. They affect 600,000 women professionals. They affect women during key leadership and earning years. Sarai put it plainly: “It’s not just a women’s health issue. This is also a workforce issue and an economic opportunity.”

Gov. Ferguson made a similar point at the signing, saying Washington is losing people with “tremendous knowledge, tremendous experience” because workplaces are not prepared for a natural stage of life that affects half the population.

“Menopause has been invisible in workplace policy for too long” explained Brittany Gregory, executive director of the Washington State Women’s Commission.

Cherika Carter of the Washington State Labor Council, AFL-CIO, called the issue one of “dignity, retention, and worker power.”

The order directs the Washington State Women’s Commission to work with state agencies to review policies, identify best practices and develop training and guidance. Reporting on the order has noted that practical supports may include telework, flexible dress codes, access to cold water, temperature control, clearer manager training and better guidance for public and private employers.

For small and mid-sized employers, Sarai’s comments are especially important. She pointed out that instead of another mandate on small businesses,  rather, “It is the state leading by example.” Sarai said the state’s example can create resources employers can use, including case studies, provider training, policies and best practices that can be adapted to their own workplaces.

Business Health Trust alignment

BHT works to be a resource to employers. We help employers get more from their benefits through expert guidance, useful tools, competitive benefit options and support that makes employee benefits easier to manage in one place.

When symptoms such as hot flashes, night sweats, poor sleep, brain fog, anxiety, migraines, heavy bleeding or heart palpitations are misunderstood or ignored, the cost is not only personal. It can show up in missed work, turnover, missed promotions and lost leadership.

“I’m also really proud that the health plans that we represent, that we offer our employers, we have coverage for perimenopause and menopause and the treatment,” she said. The major health insurance carriers BHT partners with do cover all of the common menopause treatments. Additionally, Nice Healthcare makes medications available for free (no copay) along with free virtual pelvic floor therapy with a physical therapist.

Nice Healthcare can help turn awareness into care.

For employers offering Nice Healthcare through BHT, one practical value is access. Employees can start with a Nice clinician who can listen, evaluate symptoms and talk through care options. In the Puget Sound and Spokane areas, most workers on BHT benefits can also have Nice come to their home or office to draw blood for labs.

When a Nice clinician prescribes a medication on the Nice no-cost medication list, members can pick it up at their usual pharmacy for $0.

$0 Medications with Nice, including Estradiol & Paxil

• Hormone therapy options to help with symptoms such as hot flashes, night sweats and sleep disruption, including estradiol and progesterone. Familiar names may include Estrace and Prometrium.
• Progestin options, including medroxyprogesterone acetate (Provera). This may be used as part of certain hormone therapy plans or for cycle-related concerns.
• Symptom management related to the menstrual cycle depending on the person: estrogen/progestin combinations and 91-day cycle options. Familiar names may include Yaz, Yasmin, Aviane, Seasonale and others.
• Some non-hormonal options that could help with hot flashes or night sweats like Paxil (aka paroxetine). Additionally, others also like venlafaxine (Effexor), escitalopram (Lexapro), and clonidine.

This isn’t medical advice. You’ll need to discuss this with your doctor (or a Nice Healthcare clinician!) Every person’s symptoms and health history are different. That is why access to a clinician matters. Nice gives employees a place to ask questions, review symptoms and understand care options before the issue becomes harder to manage.

Washington’s executive order will not solve menopause in the workplace by itself. But it does create a public starting point. Sarai Childs showed why that matters for employers: good support is not always complicated. It starts with awareness, practical resources, benefits that work and a care path employees can actually use.

At BHT, that fits our mission. We want to help employers offer benefits that support real life, reduce administrative friction and give employees more places to turn when care cannot wait.

For employers, the opportunity is simple: do not wait until a valued employee is burned out, missing work or quietly stepping back from leadership. Start the conversation now. Review your policies. Know your benefits. Point employees to care. Make perimenopause and menopause part of the normal benefits conversation.

That is good for women. It is good for employers. And it is one more way BHT helps smaller teams get more.