At home, women also have more time and space to compose themselves after experiencing something emotionally triggering. Mood-related issues — which affect about 40 percent of women in perimenopause — can pose problems at work. “I’ll have patients tell me, ‘It’s really impacting not only my personal relationships, but my professional career, too, because I am responding in a way that I would not have before, and it’s not appropriate,’” said Dr. Monica Christmas, the director of the Center for Women’s Integrated Health at UChicago Medicine.

Menopause can also affect women’s sleep, and the ensuing exhaustion can lead to mood swings, too. Symptoms such as hot flashes and night sweats can drastically reduce how much sleep women get at night, with sleep loss affecting an estimated 40 to 60 percent of menopausal women. “Patients are just totally fatigued,” Dr. Shen said, “by not having gotten a full night of sleep for months, if not years.”

Jeannine Ouellette, 53, a writer from Minneapolis who is in perimenopause, is grateful that she gets to work from home most of the time because she often sleeps poorly at night and benefits from short cat naps during the day. “If I just close my eyes for 10 minutes, I can come back to that task and get it done three times faster than trying to struggle through it on a sleepless brain,” she said.

Another major problem is that menstrual cycles change in perimenopause, so women don’t always know when they will start bleeding, Ms. Ouellette said. “To have that, combined with potentially very heavy bleeding, is very stressful in a professional environment,” she said. “That feeling that every woman knows — that gush — you’re like, oh my God, how am I even going to get out of this room?”

Nicola Green, a consultant in Britain who advises employers on how to support workers going through menopause, recommends that workplaces provide free menstrual products in their bathrooms and access to cold drinking water. If workers are required to wear uniforms, employers should have extra uniforms available so that people can change if necessary. She also advises workplaces to allow employees to work from home, or have flexible hours, when they are experiencing menopause symptoms.

People who “are completely sleep deprived, or may be suffering from the most horrendous periods that make them really struggle to leave the house, they can manage that so much better by working at home,” she said. When workers aren’t given these accommodations, she added, they may instead call in sick.

Fran Poodry, 51, who works in customer service at an educational technology company in Portland, Ore., recalled a time several years ago when she woke up and couldn’t stop crying. “I explained to my supervisor that it was perimenopause since I was not sad or upset,” she said. “I just was helpless to turn off the tears and snot due to hormones,.”

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