PMS, PMDD and menopause can affect work in recurring patterns. Managers do not need to diagnose, but they do need to respond with curiosity, consistency and care.

Client voice - Metropolitan Police Service: “We now have a network of over 200 trained Champions who can help and support women, managers and colleagues with menopause. This is not to be underestimated.”

Managers are often trained to respond to incidents: a missed deadline, a difficult conversation, a day of absence, a behaviour change, a performance concern.

But hormone health often does not show up as one isolated incident. It shows up as a pattern.

That is why managers need a different kind of literacy. In the 15 April 2026 survey sample, over 60% had contemplated leaving, or had left, their job because of symptoms. These findings come from a self-selecting survey sample and should be read as directional evidence, not population estimates.

Newson Health explains that PMS can include physical and emotional symptoms, PMDD is a more severe form, and hormonal fluctuations during perimenopause can worsen PMS or PMDD symptoms.

At work, this matters because patterns can easily be misread. Someone may be energetic and confident for part of the month, then anxious, exhausted or withdrawn at another point. Someone may have recurring absences. Someone may experience cyclical pain, mood changes, brain fog or fatigue. During perimenopause, symptoms may become less predictable or more intense.

Without understanding, a manager may see inconsistency. With a better understanding, they may see a need for support.

This does not mean managers should start diagnosing employees. They absolutely should not. But they can learn to notice patterns and open a work-focused conversation.

A good question might be: “I’ve noticed there seems to be a recurring pattern where work feels harder at certain times. Is there anything we can do to support you at work?”

That is very different from: “Is this PMS?”

The first is respectful and practical. The second is intrusive and likely to shut the conversation down.

Pattern literacy is a useful 2026 concept for employers because it helps move hormone health away from stigma and towards better management. It encourages managers to pause before labelling someone as unreliable, emotional or difficult. It supports earlier conversations. It can help employees feel less judged and more able to ask for practical adjustments.

It also protects the business. If recurring symptoms are ignored, the likely outcomes are familiar: increased absence, strained team relationships, reduced performance, loss of confidence, formal processes, disengagement or resignation. If patterns are recognised early, employers have a better chance of supporting the person before the situation escalates.

Managers need to understand the boundary between support and medical advice. Their role is to discuss work impact, explore adjustments and signpost. They should not ask intrusive questions about cycles, bleeding, treatment or diagnosis. They should not make jokes. They should not minimise symptoms. And they should not assume every woman has the same experience.

They should also know when to escalate. If an employee describes severe distress, immediate risk or a medical emergency, managers must follow safeguarding procedures and call 999 where required.

At Balance@Work, we believe manager confidence is central to workplace hormone health support. Patterns should lead to better conversations, not faster judgement.

A workplace that understands patterns is not excusing poor performance. It is creating the conditions for fairer, earlier and more effective support.

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