For something that affects millions of women, perimenopause still isn’t the hot topic it should be. “The (M) Factor 2: Before the Pause” sets out to change that. 

“The (M) Factor 2” pulls back the curtain on perimenopause, a phase of life that can begin as early as a woman’s 30s and long before menopause is typically discussed. What starts as subtle symptoms like brain fog, anxiety and mood swings can quickly evolve into something more disruptive, from sleepless nights to intense physical changes.

The documentary covers many facets of perimenopause and its symptoms but makes one point extra clear: This is not a niche issue. It is a widespread health gap that has been ignored for far too long and its economic impact is staggering.

In Arizona, the economic impact of perimenopause and menopause is both significant and growing, as a large and increasing share of the state’s workforce is made up of women ages 45 to 60 navigating this life stage. National data suggests menopause-related symptoms drive at least $5.4 billion annually in lost productivity, along with billions more in healthcare costs — impacts that are reflected across states like Arizona with expanding, aging workforces. These symptoms can lead to missed workdays, reduced hours, lower productivity and even workforce exits, particularly in critical sectors such as healthcare and education that rely heavily on experienced female talent. As Arizona continues to grow and attract industries dependent on skilled labor, failing to address menopause-related challenges could strain talent pipelines, increase costs for employers and limit long-term economic competitiveness — making workplace support and policy solutions an increasingly urgent priority.

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Addressing the issue

That urgency carried into the film’s screening in Phoenix, where healthcare leaders, policymakers, and innovators gathered to continue the conversation. The event focused on what happens beyond awareness, including how healthcare systems, workplaces, and technology can better support women in midlife changes.

Speakers emphasized that the timing matters. Perimenopause often affects women during peak earning and leadership years, yet support has not kept pace. The result is missed diagnoses, workplace disruption, and billions in lost productivity. 

For Phoenix Mayor Kate Gallego, this isn’t just a personal conversation about women’s health. It’s a community one, and the issue comes down to access.

“When we fail to address women’s health, we hurt families, workplaces and entire communities,” she says, pointing to a system already under strain. With thousands of patients for every provider, getting answers, especially for something as misunderstood as perimenopause, can feel nearly impossible.

That gap, she suggests, is exactly where the problem grows. When women can’t access care, they’re more likely to go undiagnosed, unsupported, and unheard. In Phoenix, efforts are underway to change that, from expanding medical education to investing in women-focused health innovation.

What was once considered a private issue is now being recognized as a broader economic and public health concern.

Using AI to bridge the gap

Susan Sly appears in the documentary as an AI ethicist and founder and CEO of The Pause Technologies. Her perspective connects women’s health gaps with the data and technology shaping modern care.

“I am grateful to be featured in this film addressing why we cannot build trustworthy AI on faulty or incomplete data,” she says. “When women are underrepresented in the datasets driving healthcare innovation, the technology itself becomes biased by design.”

The Pause Technologies platform focuses on helping women track symptoms and better understand patterns in their health, leveraging artificial intelligence to help bridge the gap in care. Sly’s own story reflects what so many women experience but rarely talk about.

“For 13 years, I suffered… I was sweating all the time. I wasn’t sleeping. I had brain fog. I couldn’t function and I was still expected to show up and perform. One doctor told me it was all in my head.”

That disconnect between what women feel and what the system recognizes is a thread that runs throughout the film. And it’s not just about discomfort. As Sly points out, the consequences can be serious:

“Eighty percent of women are symptomatic,” she says. “Women are leaving the workplace in droves because of lack of support.”

The issue is especially pronounced for women of color, who have historically been left out of the data shaping modern healthcare.

By the end, “The (M) Factor 2” feels less like a documentary and more like a wake-up call. One that asks why something so common has been ignored for so long. The film is currently available to stream through PBS and local PBS stations. 

Economic impact of menopause and perimenopause

RAND, a research organization that develops solutions to public policy challenges, conducted a study on the economic impact of menopause in the United States. Here are six takeaways:

• A massive portion of the workforce is affected: Women ages 45-60 make up to 30% of the U.S. labor force, meaning menopause is not a niche issue — it’s a major workforce reality.

• Productivity losses are significant — and growing: Menopause-related symptoms drive at least $5.4 billion annually in lost productivity, with impacts from missed workdays, reduced hours and layoffs.

• The true economic cost is much higher: The $5.4 billion estimate excludes indirect costs like missed promotions, early retirement and career changes, meaning the real economic impact is likely far greater.

• Healthcare costs add a massive burden: Direct medical expenses tied to menopause symptoms total nearly $25 billion annually, underscoring the scale of its financial impact on individuals and the system.

• Key industries are especially vulnerable: Sectors like healthcare and education, which rely heavily on experienced female workers, face some of the highest economic losses — amplifying existing staffing challenges.

• The impact will intensify without action: As more women remain in the workforce longer, menopause-related economic pressures are expected to increase through 2050, making workplace support and policy solutions increasingly urgent.

What leaders need to know about menopause and perimenopause

According to research from RAND, which develops solutions to public policy challenges, here is what business leaders need to know about menopause and perimenopause:

• This is a workforce issue, not a niche issue: Up to one-third of working women are in the menopausal transition — many in peak leadership and high-skill roles.

• It’s already costing your business: Menopause-related symptoms drive billions in lost productivity through absenteeism, presenteeism and turnover.

• Your top talent is at risk: Many women reduce hours, pass on promotions or leave the workforce entirely due to unmanaged symptoms.

• Healthcare costs are significant: Menopause-related medical expenses add tens of billions annually, impacting both employers and employees.

• Certain industries face greater exposure: Healthcare, education and other female-dominated sectors are especially vulnerable to talent shortages.

• Support is a competitive advantage: Companies that offer flexibility, benefits and awareness programs will retain talent and outperform peers.

• The problem is growing: As more women work later in life, the economic and talent impact will intensify without proactive action.