States Look to Protect Menopausal Workers as Federal Policy Lags

The effects of menopause in the workplace have grabbed state lawmakers’ attention in the absence of clear federal policy, spurring proposals across the country to strengthen job protections and treatment access.

A pair of Virginia bills would expand the state’s anti-discrimination and reasonable job accommodations laws to specifically account for workers experiencing perimenopause or menopause, as well as require state-regulated health plans (S790) to cover related medical treatments. The legislation awaits Gov. Abigail Spanberger’s (D) signature.

Similar proposals are pending from New York to California, as a broader push for menopause-friendly work policies grows in the US and abroad. The movement got a publicity boost in 2024, when actress Halle Berry spoke about her own experience and endorsed a bill in Congress. Despite the momentum, mostly Democratic-majority states are leading the charge while federal proposals lie dormant.

Rhode Island last year became the first state to specifically add menopause protections (S361) to its workplace accommodations requirements.

“It’s kind of the start of a cultural shift for women in the workplace,” said state Sen. Lori Urso (D), who sponsored the Rhode Island legislation. Women in many cases struggle to navigate symptoms at work that can include brain fog, sleep deprivation, and severe hot flashes, she said, which sometimes results in them leaving their jobs or losing promotions just when they’ve reached a level of experience to qualify for senior leadership roles.

Helping employees with menopause stay on the job could combat skilled workforce shortages and inequality for women, both during and after their working years, she added.

“Women are less prepared for retirement because they’re leaving before reaching those higher positions,” Urso said. “It’s really about supporting women through what’s really a temporary period.”

The Rhode Island bill’s passage helped spark a surge of proposals in 2026 legislative sessions. A Bloomberg Government analysis found at least 16 menopause-related bills introduced since Jan. 1, up from only three in 2025.

Clarifying Job Protections

The move to specifically protect workers against menopause-related bias stands to clarify existing law that arguably might already protect them in many cases, said Francesco A. DeLuca, an attorney at Ogletree Deakins Nash Smoak & Stewart P.C. in Providence, R.I.

Discriminating against a worker based on menopausal symptoms could be deemed sex-based bias under Title VII of the 1964 Civil Rights Act, he said. Likewise failing to provide reasonable accommodations could run afoul of the Americans with Disabilities Act, he added.

“The definition of disability is purposely broad and it’s a relatively low standard to satisfy,” DeLuca said. The Rhode Island law “clarifies and just makes it abundantly clear that menopause qualifies for protections separate and apart of whether it fits into Title VII or the ADA.”

Biden-era federal regulations implementing the Pregnant Workers Fairness Act aimed to apply that law’s protections broadly to conditions related to reproductive health, potentially including menopause.

But Andrea Lucas, chair of the Equal Employment Opportunity Commission under the current Trump administration, has signaled she intends to roll back those regulations and focus them more closely on being pregnant itself, as opposed to “related” medical conditions tied to the ability to become pregnant.

Analysis in the Biden PWFA regulations notes federal case law has been mixed on whether menstruation, peri-menopausal symptoms, and breastfeeding are protected by anti-discrimination laws including Title VII. A 2024 issue brief from the US Labor Department Women’s Bureau acknowledged federal workplace laws don’t explicitly cover menopause itself as a disability, but its symptoms may meet the ADA’s definition.

The case-by-case approach under federal law also applies to the Family and Medical Leave Act, which the brief said could be triggered when a worker experiences “severe symptoms.”

The Virginia legislation passed largely along party lines. GOP senators raised concerns in committee about the difficulty in determining what’s a reasonable accommodation and the risk of endlessly expanding the protected categories in the state’s civil rights law.

“What’s to stop us from adding every disease that’s undetectable by the human eye?” Sen. Bryce Reeves (R) said during a January hearing.

“Civil rights enforcement is increasingly uncertain at the federal level,” said Kaili Moss, policy counsel at the ACLU of Virginia, testifying in favor of the bill at the same committee hearing. “Menopause discrimination sits at the intersection of age, sex, and disability, yet it falls into a gap in existing legal frameworks.”

In addition to the state efforts, Philadelphia amended its local workplace bias ordinance in December to cover menstruation, menopause, and perimenopause.

Varying Approaches

Legislative proposals differ across states, with some focused on requiring coverage by state-regulated health plans and others zeroed in on workplace accommodations.

An Illinois bill (HB 5284) covers all of those, plus it mandates doctors who treat menopausal symptoms to include menopause-related training in their annual continuing education requirements.

New York state is “going one step further and taking the best of everything that’s been presented,” said Maria Trapenasso, national practice leader for human capital solutions at benefits consulting firm NFP, a unit of insurance company Aon plc.

One bill pending there would ban job bias and require accommodations (A5436) for conditions related to menstruation, menopause, and perimenopause. Another would mandate five days per year of paid time off for menopause symptoms (S9244).

The measures don’t necessarily have a clear path to enactment in all blue states. When California lawmakers passed insurance coverage bills in 2024 and 2025, Gov. Gavin Newsom (D) vetoed them and called for a narrower proposal to better balance cost concerns with access to care.

“We’re just looking for awareness, recognition, no discriminating against women,” Urso said.