You May Already Have a Right to Workplace Accommodations for Perimenopause
Only 7% of working women know that workplace accommodations for perimenopause and menopause symptoms exist — and that figure is lower than it was a year ago. Meanwhile, 48% say symptoms have hurt their income, 23% say they’ve lost at least $10,000 because of it, and 27% hide their symptoms at work out of fear of how they’ll be seen, rising to 30% among women in their forties. A right almost nobody has heard of doesn’t function much like a right. And this one isn’t hypothetical — in at least one US state, it’s already been law for over a year.
It Started in Rhode Island, Not Philadelphia
On June 24, 2025, Rhode Island Governor Daniel McKee signed House Bill 6161, amending the state’s Fair Employment Practices Act to make Rhode Island the first state in the country to expressly require employers to accommodate menopause and related conditions — effective immediately. The law requires employers to engage in a “timely, good-faith, interactive process” to identify a reasonable accommodation once a worker’s symptoms affect her ability to do her job, and it’s specific about what counts: the amended definition names “the need to manage the effects of vasomotor symptoms” — hot flashes and night sweats, in plainer language — directly. Employers also have to post notice of the right and provide it to every employee at hire.
That’s not a proposal, or a bill working its way through committee. It’s been the law in Rhode Island since the summer of 2025, and the Bonafide awareness figure above — 7%, falling — was measured well after it took effect.
Philadelphia Follows, on a Longer Runway
Philadelphia is next, and it’s the one that’s made headlines, probably because it’s a city rather than a state and because its effective date is still ahead of us. On November 20, 2025, City Council amended the Philadelphia Fair Practices Ordinance to add menstruation, perimenopause and menopause as protected categories; Mayor Cherelle Parker signed the bill (No. 250849) on December 3, 2025. Starting January 1, 2027, employers in the city will have to prohibit discrimination on that basis and provide reasonable accommodations — schedule flexibility, temperature or workspace adjustments, restroom access, and similar changes — when symptoms “substantially interfere” with a worker’s ability to do her job, provided she asks and the accommodation doesn’t create undue hardship for the employer.
Two details make it distinctive beyond the accommodation itself. Coverage isn’t tied to pregnancy or childbirth, which is where a lot of existing protections in this space stop — it applies to the symptoms on their own terms, at any stage of the transition. And unlike the federal Pregnant Workers Fairness Act, which only applies at 15 or more employees, Philadelphia’s ordinance sets no minimum employer size at all. Employment-law commentary has called it the first ordinance of its kind in a major US city — first city, not first jurisdiction; Rhode Island got there first.
It’s Not Stopping at Two
What makes this worth writing about rather than filing away as one city’s news is that it’s a pattern, not an event. Virginia’s legislature has moved on similar language this year, and industry legal trackers report bills covering menstrual, perimenopause or menopause workplace protections pending in California, Illinois, New Jersey, New York, Connecticut, Maryland and Pennsylvania — ranging from accommodation mandates to paid leave for medical care. None of those have become law as of this writing, and pending is not passed; several could stall or be amended beyond recognition, the way legislation usually does. But two jurisdictions with a working accommodation requirement already on the books, and roughly half a dozen more actively drafting one, is a direction, not a coincidence.
None of this is legal advice, and PeriFlow doesn’t advise on employment matters. Whether any of these laws currently reach you, what “substantially interfere” would mean for your specific job, and how to actually raise an accommodation request are all questions for an employment lawyer or your own HR department — not a blog post, and not an app. What’s worth taking from this section is simpler: the idea that perimenopause symptoms are a legitimate, accommodation-worthy workplace issue — not just something to push through quietly and alone — now has real legal footing in more than one place, and the reasoning behind it doesn’t stop at a state line.
This Isn’t Only a Legal Story
The strongest argument for taking any of this seriously didn’t come out of a legislature at all. It came out of a study published this month in Climacteric, and it has nothing to do with US employment law.
Researchers pooled data on 1,478 women aged 40 to 54 across 12 Latin American countries, sorting them into four groups by age and menstrual pattern: regular cycles at 40–44 (the reference group), regular cycles at 45–49, irregular cycles at 45–49 — perimenopause, in other words — and no periods for at least a year at 50–54. The rate of severe symptoms rose steadily across those groups, from 18.3% in the reference group to 50.6% among the postmenopausal women. But the detail that matters most for a workplace conversation is what had already happened before menopause: women with irregular cycles had nearly three times the odds of severe symptoms (odds ratio 2.97) and roughly twice the odds of lower job satisfaction (odds ratio 2.01), compared with the regular-cycle reference group — while their periods were still, technically, happening.
The paper’s own framing is worth repeating directly: symptom burden and its effect on work “emerge before menopause,” which the authors argue should push clinical attention earlier rather than waiting for a diagnosis that, for a lot of women, is itself years away. This is a study of women who’ve never heard of Rhode Island’s law or Philadelphia’s ordinance, in twelve countries with completely different employment systems, arriving independently at the same underlying fact American legislators are only now catching up to: the perimenopausal years, not just the postmenopausal ones, are when work starts to suffer.
Why So Few Women Know
The awareness figure — 7% — isn’t just low. It fell from where it stood a year earlier, in the same annual survey, at a moment when public conversation about perimenopause has arguably never been louder. That gap is the part worth sitting with. Visibility and awareness aren’t the same thing, and one can rise while the other falls.
Some of the gap is structural — Rhode Island’s law is only a year old, and Philadelphia’s doesn’t take effect until 2027, so most of the women it will eventually cover have had nothing yet to be aware of. But the deeper pattern points somewhere more familiar than a knowledge gap: hiding symptoms at work rather than raising them (27%, rising to 30% among women in their forties), and absorbing a real income hit instead. It’s close to the same reflex that shows up in exam rooms — weighing whether naming what’s happening will be believed, taken seriously, or held against you, and often deciding silence is the safer bet. A right nobody mentions doesn’t change that calculation on its own. It just sits there, unused, while the people who’d benefit most from it keep paying the cost quietly.
What a Dated Record Actually Changes
None of this is a reason to build a case, or to walk into a conversation with HR armed for a fight. But there’s a pattern that shows up everywhere perimenopause meets an institution that runs on specifics rather than feelings: a vague complaint gets a vague response, and a dated one doesn’t.
“I’ve been really foggy and exhausted at work lately” is a feeling. “This has been happening most afternoons for six weeks, and it’s worse in the ten days before my period” is a pattern — the same kind of specificity that makes a doctor’s appointment go somewhere instead of ending in “let’s keep an eye on it.” Whether the eventual conversation is with a manager, HR, or a doctor whose note you’d bring to either, the version of you who shows up with dates is having a fundamentally different conversation than the version who shows up with “I’ve just been feeling off.” That holds even if you never say the word “accommodation” at all — most women who track brain fog or exhaustion are doing it for their own clarity first, and that clarity happens to travel well beyond the reason they started.
This is, in a smaller and far less dramatic way, the same thing a dated symptom record does for a clinical appointment: it turns “I don’t really know when this started” into something a specific person can actually act on. What it isn’t is a document built for an employer, and PeriFlow doesn’t produce one — an accommodation request, like any employment matter, needs to go through the right channel with the right person, not a printout designed for an entirely different conversation.
Know your phase. Nourish your body. Feel like yourself again.
PeriFlow tracks your perimenopause cycle — even when it’s irregular — and tells you exactly what to eat, when to fast, and how to move, adapted to the phase you’re actually in. Free 7-day trial.
Whether or not a law like Rhode Island’s or Philadelphia’s ever reaches where you live, the research underneath both of them isn’t going away: symptom burden, and its cost at work, start well before menopause for most women who experience it at all. Knowing that on your own terms — with dates, not guesses — is worth doing regardless of what the law does or doesn’t yet say where you are.
Suggested internal links: /blog/perimenopause-doctor-appointment-what-to-bring, /blog/perimenopause-exhaustion, /blog/perimenopause-brain-fog, /blog/perimenopause-hot-flashes, /perimenopause-symptoms
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