There I was, sitting on stage in front of hundreds of people, answering questions about leadership, diversity, and women in the financial services industry. Confident. Poised. Professional. And also managing an internal countdown, tracking exactly how much longer I had before needing to make a discreet exit.
We don't talk about it in professional settings, but any woman who menstruates knows this mental math all too well. The strategic planning around bathroom access. The backup wardrobe options. The pain management calculations. The hyper-awareness of your body while trying to focus on delivering that presentation or leading that meeting. These are the invisible calculations running in the background of our professional lives that men simply don't experience.
The Burden We Silently Carry
At 40 years old, I'm still forced to wrap what happens to my body every 24 days—yes, 24, not the textbook 28—into a neat little bow to make others comfortable. For years, I've endured ridiculous, debilitating periods that have stolen days of my life each month. Days of presence with my family. Days of simply being able to exist without pain.
This isn't a complaint. I've carried this burden with silence and strength, like millions of women do. This is a callout to the systems and inequities that perpetuate women's health disparities or, frankly, erode them altogether.
The Professional Tightrope
Try explaining to a board of directors why you need to reschedule a critical presentation. "I'm bleeding through super-plus tampons every hour" isn't exactly boardroom talk, is it? So instead, we say "health issues" or "a minor procedure" and watch eyes glaze over with discomfort.
The professional burden extends far beyond the boardroom. Imagine:
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Planning business travel around your cycle, because heaven forbid you're stuck on a six-hour flight during your heaviest day
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Scheduling speaking engagements with a buffer of "safe days" before and after or having to turn them down altogether
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The anxiety of negotiating back-to-back meetings with no bathroom breaks
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Packing twice the professional attire needed for a conference “just in case”
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Maintaining executive presence while experiencing hormonal migraines or debilitating cramps
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The constant awareness of bathroom locations wherever you go, like a mental map most of your colleagues never need to create
The truth we don't talk about: women carry this additional mental load while still delivering results that match or exceed expectations. We're demonstrating extraordinary capacity by performing at high levels despite these invisible challenges. We've become masters of contingency planning, risk management, and operational logistics simply to navigate routine bodily functions.
The Real Cost of Women's Healthcare
Last week, I underwent an endometrial ablation. The hospital's estimate was $2,970—not including doctor's fees. When I called earlier, they quoted $1,700. "Sorry, we misspoke on the phone," they said with indifference that comes from knowing women will pay whatever it costs to stop suffering.
We're fortunate to have the funds and good health insurance. Many Americans aren't so lucky. Research shows that working women in the US pay approximately $15 billion more each year on healthcare costs than working men—an average of $266 more per woman annually, even excluding pregnancy-related expenses. This gender-divided financial burden exacerbates the impacts of the already significant gender pay gap.
But the financial cost is just the beginning.
What the Innovation Economy Loses
"Take a week off work to recover," they said. Maybe two. The reality? Full healing takes 4-6 weeks. But who has that kind of time? So we innovate. We create workarounds. We develop systems and strategies that allow us to contribute despite physical limitations that would sideline many of our male colleagues.
What's lost isn't just individual women's contributions when health forces absence. What's lost is the full measure of what women could create, build, and lead if these biological realities were accommodated rather than ignored. The question shouldn't be "How much work do women miss because of menstrual issues?" but rather "How much more could society gain if we supported women's health properly?"
Studies indicate that addressing conditions like endometriosis could unlock significant economic potential. In some countries, women employed by textile factories miss an average of six days of work monthly due to menstrual issues—days they often aren't paid for, deepening economic disparities.
The World Bank estimates that 500 million women globally lack access to adequate menstrual hygiene facilities. In a 2019 study in the United States, 64% of menstruators reported struggling to afford menstrual products within the previous year. Yet despite these barriers, women continue to advance in every field, demonstrating extraordinary resilience and capability.
And when it comes time to actually address these health issues? That's when we discover yet another gap in the system.
The Advocate Conversation
Here's a sobering thought experiment: Do you ever stop to consider that our partners, often people who know minimal amounts about the inner workings of our bodies, are the people designated to advocate for us if something happens and we can't speak for ourselves?
Many of us have supportive and well-meaning partners, but do they truly know what questions to ask if or when we’re unable to advocate for ourselves? My recent procedure crystallized this absurdity and I sat down with my husband before the procedure and walked through everything: the name, the recovery process, potential complications, and even gave him a list of knowledgeable women to call if questions arose that he couldn't answer. While I love my husband and trust him as my healthcare power of attorney, I recognize that trust needs to be paired with education and preparation.
The Economic Impact We're Ignoring
The McKinsey Global Institute estimates that addressing the women's health gap could add $1 trillion annually to the global economy by 2040. Their research shows that closing this gap could reduce the time women spend in poor health by almost two-thirds and add up to seven healthy days for every woman each year, or more than 500 days over a woman's lifetime.
The largest economic impact, approximately $400 billion, would come from women experiencing fewer health conditions, enabling them to avoid 24 million life years lost to disability and boosting economic productivity significantly. For every $1 invested in women's health, about $3 is projected in economic growth, generating the equivalent impact of 137 million women accessing full-time positions.
Women's health issues, from menstrual disorders to menopause, significantly impact workplace productivity, with roughly 80% of women reporting that menopause interferes with their lives and work.
In terms of menopausal symptoms alone, studies show these can lead to premature departure from the workforce, not because women can't handle challenging work, but because workplaces fail to adapt to biological realities. This creates a cascade of consequences, not just for women's lifetime earning potential and economic security, but for organizations that lose experienced talent and diverse leadership precisely when women have accumulated decades of valuable expertise.
What True Equity Would Unleash
Imagine a world where:
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Women's health issues receive equal research funding and attention, unlocking innovations that benefit everyone
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Workplaces create flexible policies that accommodate biological realities, retaining top talent at all career stages
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Healthcare costs don't disproportionately burden women, freeing resources for education, entrepreneurship, and wealth building
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Recovery time is respected as an investment in long-term productivity, not penalized as a liability
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The economic value of women's unpaid care work (estimated at 10-60% of GDP according to the IMF) is recognized and redistributed
This is not an asking for special treatment. This is an identification of systemic barriers that prevent organizations and economies from benefiting from women's full potential. The issue isn't that women can't perform, it's that we're performing at extraordinary levels despite these barriers. Imagine what we could accomplish if they were removed.
Yet even as we quantify these economic costs, a new threat compounds the existing challenges women face.
The Political Assault on Reproductive Healthcare
As if the natural burdens of our biology weren't enough, we're now facing unprecedented political attacks on reproductive healthcare access. The dismantling of abortion rights across numerous states creates yet another layer of uncertainty, fear, and potential medical danger.
This isn't just about pregnancy termination. Doctors are now hesitating to provide standard care because treatments for miscarriage management are identical to those used in abortions. Women with ectopic pregnancies, which are never viable and always life-threatening, have reported delays in receiving life-saving care.
Even more insidious is how these laws interfere with the doctor-patient relationship. Medical decisions that should be made based on clinical judgment and individual circumstances are now subject to political frameworks designed by legislators who likely couldn't pass a basic anatomy quiz about female reproductive systems.
Let's be clear: restricting reproductive healthcare access means women will die from preventable causes. It means more suffering, more missed workdays, more career opportunities lost, and more economic inequity.
These challenges require both personal strategies and collective action. With that in mind, here are practical steps to navigate today's reality while working toward a better tomorrow.
Takeaways for Women
If you're navigating these challenges:
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Document your symptoms meticulously: Track patterns, severity, and duration to advocate effectively with healthcare providers.
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Research before appointments: Come armed with specific questions and treatment options to discuss.
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Prioritize financial planning for healthcare: Build a dedicated health fund if possible; medical costs for women are systematically higher.
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Seek second opinions: Many women's health conditions are dismissed or misdiagnosed; persevere until you find a provider who listens.
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Create a detailed healthcare directive: Ensure your healthcare proxy understands your specific conditions and preferences.
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Connect with others: Find communities of women with similar conditions for support and resource-sharing.
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Advocate for workplace policies: Push for flexible scheduling, remote work options, and adequate sick leave.
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Know your rights: Research your insurance coverage details and workplace protections before you need them.
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Practice boundary-setting: It's okay to cancel plans, take sick days, and prioritize recovery without guilt.
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Share your story: Breaking the silence helps others and contributes to changing the system.
Moving Forward
This conversation isn't just about acknowledging problems. It's about recognizing untapped potential. By addressing these invisible burdens, we unlock possibilities not just for women, but for innovation, economic growth, and societal advancement.
For all of us standing in front of conference rooms wondering how long we have until our menstrual cup overflows, for everyone who's ever had to decide between adequate recovery and keeping their position, for all the women carrying invisible health battles while putting on a brave face—I see you.
This isn't just a women's issue. It's an economic issue. It's a workplace issue. It's a societal issue that affects half the population directly and everyone else indirectly.
And frankly, it's bullshit that we're still having this conversation in 2025.
But having it we are. So let's make it count.
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