Podcast Summary

My So-Called Midlife with Reshma Saujani

Episode: What Is the Menopause Penalty? with Petra Persson
Date: August 27, 2025
Host: Reshma Saujani (B)
Guest: Dr. Petra Persson (D), Stanford Economist

Overview

In this episode, Reshma Saujani sits down with Dr. Petra Persson, a Stanford economist, to discuss the rarely addressed economic penalty women face during menopause, dubbed the "menopause penalty." The conversation covers Dr. Persson’s seminal research using Scandinavian data to reveal the financial cost of menopause on women’s careers, parallels with the "child penalty," and the role of policy and culture in shaping gendered outcomes. The discussion also delves into the successes and cultural shifts following paternity leave reforms in Sweden, exploring how policy and social expectations interact, and what lessons the U.S. can draw.

Main Discussion Points & Insights

1. Midlife Reflections: “Whirlwind” and Peace (05:25–06:01)

• Dr. Persson describes her midlife as a “whirlwind,” balancing life as a researcher and a mother to three young children, yet surprisingly, it’s also brought her “more peace of mind.”
  • Quote: “My midlife mindset is that my best years are now, but they sort of run by way too quickly.” (D, 05:55)

2. Lessons from Sweden: Paternity Leave Shaping Culture (06:35–19:03)

• History and Policy Design:

  • Sweden's shift from a maternity to parental leave system (1974) initially failed to engage fathers.
  • “Use it or lose it” reforms starting in 1995 began reserving leave specifically for fathers, or the family lost that portion.

• Cultural Shift:

  • Early on, dads taking leave were called “velour dads”—seen as soft—but over generations, the norm changed.
  • Today, it’s considered uncool in Sweden not to take leave.
  • Quote: “By now, completely shifted ... in my generation in Sweden, it is fairly uncool to not take any paternity leave at all.” (D, 13:00)

• Norms & Spillover Effects:

  • When one dad took leave, others (colleagues, friends) followed, showing policy’s power to influence workplace culture.
  • U.S. lags behind, with stigma and lack of policy preventing similar shifts.
  • Quote: “Policy drives norms and it’s a slow process … but if we use policy to coordinate a lot of dads to take more leave, then it will snowball.” (D, 17:00)

• Intergenerational Shifts:

  • Men benchmark themselves against their fathers’ (much smaller) contributions to caregiving, explaining some marital friction.
  • Quote: “Men are often benchmarking themselves based upon what the amount of care their fathers did. And so they're like, what are you talking about? ... For them it's more than their dads did.” (B, 17:31)

3. The Menopause Penalty: Research & Revelations (24:20–39:37)

• Defining the Menopause Penalty:

  • Existing research on the “child penalty” for women is extensive; little addresses menopause’s economic impact.
  • Dr. Persson’s study traces women in Norway and Sweden who sought medical care for menopause symptoms (ages 45–55).
  • Finding: Women with menopause-related care visits earn 10% less four years later than their peers.
  • Quote: “[Women] who visit a healthcare provider with a menopause related symptom are earning 10% less four years later.” (D, 27:54)

• Mechanisms:

  • Some women reduce work hours or leave the workforce due to symptoms.
  • Disability insurance claims spike after a menopause diagnosis.
  • Symptoms like hot flashes, sleep disturbances, cognitive issues significantly impact work capacity.

• Who’s Affected:

  • The study focuses on ages 45–55, i.e., typical onset.
  • Early menopause (before 45) may incur even greater losses.

4. Policy Implications: What Can Be Done? (31:33–36:12)

• Supportive Measures:

  • Flexible work arrangements, mental health services, and on-the-job accommodations can help.
  • Dr. Persson argues that there’s an economic rationale—businesses benefit by retaining experienced women through temporary symptoms.
  • Quote: “It's not just a nice thing for these women … there is an economic rationale for doing so.” (D, 31:59)

• Government’s Role:

  • Policy currently supports parents and workers with short-term health drops; menopause deserves similar attention.

• Chronic Penalties & Hope:

  • Despite persistent problems like the “child penalty,” there’s hope—more women over age 50 are staying in the workforce, driving employment growth in many countries.
  • Quote: “One striking trend … is the growing presence of what we call older women who remain actively engaged in the workforce.” (D, 34:22)

5. The Power of Awareness: Media and Education (36:12–39:37)

• Natural Experiment:
  • In 2018, a primetime TV series on menopause in Sweden led to:
    • An immediate surge in Google searches and gynecologist visits for menopause issues.
    • Sustained increases in women receiving hormone therapy (HRT).
  • Impact: Women (especially those without a college degree) who accessed more information and care had lower economic losses associated with menopause.
  • Quote: “Awareness around and increased access to menopause-related healthcare can lower the economic losses.” (D, 39:19)

6. Destigmatizing Menopause: The Importance of Talking Openly (43:04–46:35)

• Current Silence:

  • Despite increasing celebrity awareness and podcasts, menopause is still under-discussed. Over half of UK women polled didn’t understand their symptoms when experiencing them (University College London).
  • Contrast: Society prepares for puberty with open discussion and support for all; menopause lacks such infrastructure.
  • Quote: “I feel more prepared for my child entering the teenage years than for my own menopause.” (D, 45:04)

• Cultural Framing:

  • Puberty framed as aspirational (and happens to boys and girls), but menopause is framed with shame.
  • Opportunity: Normalize and even celebrate postmenopausal wellbeing—many women thrive afterward.

7. Research Reception & What’s Next (40:32–46:35)

• Positive Reception:

  • Dr. Persson notes enthusiasm from colleagues and relevance to men (many have partners experiencing menopause).

• Future Projects:

  • Planning to study the menopause penalty in other countries and contexts, to see how policies and cultures change outcomes.
  • Reshma suggests also exploring the “midlife penalty,” reflecting broader age-related biases for women at work.

Memorable Quotes & Timestamps

• “Culture eats policy for breakfast every time.” (B, 04:14)
• “My midlife mindset is that my best years are now, but they sort of run by way too quickly.” (D, 05:55)
• “It is fairly uncool to not take any paternity leave at all [in Sweden].” (D, 13:00)
• “Policy drives norms and it’s a slow process. ... If we use policy to coordinate a lot of dads, then it will snowball.” (D, 17:00)
• “[Women] who visit a healthcare provider with a menopause-related symptom are earning 10% less four years later.” (D, 27:54)
• “There is an economic rationale for [menopause accommodations].” (D, 31:59)
• “More than half of the women who had gone through menopause felt that they didn’t know what was happening when it happened to them.” (D, 44:10)
• “I feel more prepared for my child entering the teenage years than for my own menopause.” (D, 45:04)

Key Timestamps

• 05:25 – Reshma prompts Petra for her one-word midlife summary (“whirlwind”)
• 08:06 – Sweden’s parental leave policy genesis and culture shift
• 09:25 – “Use it or lose it” paternity leave reform
• 13:00 – Cultural transformation on fatherhood in Sweden
• 24:20 – Introduction of the “menopause penalty” concept
• 27:54 – 10% earning drop for menopausal women established
• 31:33 – Policy implications and the need for workplace flexibility
• 36:12 – Swedish TV “information shock” and improvement in care-seeking
• 43:04 – Destigmatizing the menopause conversation and societal comparisons with puberty
• 45:04 – “I feel more prepared for my child entering the teenage years than for my own menopause.”
• 46:12 – Framing menopause as aspirational, potential for positive narratives

Tone & Style

The conversation is intimate, frank, and occasionally humorous. Reshma frequently refers to personal and relatable anecdotes, balancing the academic subject matter with warmth, curiosity, and advocacy for cultural change. Dr. Persson’s style is precise yet accessible, underpinning economic research with everyday examples and cultural commentary.

Conclusion

This episode spotlights the overlooked financial repercussions of menopause for women, reframing it as a critical public policy issue with life-long implications. It highlights the interplay between culture and policy—both in supporting families through parenthood and in addressing age- and gender-driven penalties at work. A recurring takeaway: talking about menopause, improving access to care, and thoughtful policy interventions are vital for empowering women during midlife and beyond.