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COLLEEN: Welcome back to hot flashes and cool topics. Today, we have Asima Ahmad on, Co-Founder and the Chief Medical officer of Carrot Fertility. Yes, it is fertility but so much more. Welcome to the show.

DR. AHMAD: Carrot helps women on all hormonal health journeys, which include menopause for women and low testosterone from men. And we do this with the goal, also being a reduction in healthcare costs and improving clinical outcomes. So at this time, we’re working with over 1 ,000 customers across every industry that you could possibly imagine in over 170 countries, and we cover millions of lives globally.
And we have a very extensive network, actually, over 11 ,000 eligible clinics, agencies, pharmacies, legal service partners, and experts around the world. So the largest network of its kind, because we want to make sure that our members are able to receive the care that they need in the most efficient way possible. So get the right care at the right time.

BRIDGETT: Do you work with insurance companies?

DR. AHMAD: Yeah, we work with health plans and health systems. So sometimes if an insurance company wants to do like, you know, like a kind of like a carve out fertility benefit, we can work with them as well. But most of our customers, I would say, would be employers.

BRIDGETT: Yeah, I know, Colleen, you brought this up off air before we came on about women and when they’re going into menopause.
Sometimes they’re putting off having children if they want to have children. And they’re coming into maybe right off of their perimenopause, pregnant menopause. Yes, like they’re coming off of maternity leave and then they’re entering perimenopause or there are in it and they’re pregnant, just like you said. What services can be provided for women in that situation?

DR. AHMAD: So I think before I jump into that, I think you brought up a really interesting point in that the timing of when people are having babies is at a later age or, you know, and we’re seeing that. We’re seeing that globally. We’re definitely seeing that in the U .S. And what that means is that they may be at a point where they’re having a child where they are perimenopausal. They may have started perimenopause and had a child or maybe that might start a little bit later. So the thing that we do at care fertility is when we think about fertility and lifelong hormonal health, we think of all of this as a continuum. It’s not like a single point in time. It doesn’t mean that, you know, you’re 20, you’re going to have a baby. Then, you know, you’re 45 to 50. You’re going to go through menopause. It’s basically that no matter what age or stage of life you’re at, we’re there to support you. Because in some cases, and this is a great example, people will go through perimenopause or menopause early. They’ll have early ovarian aging or premature ovarian failure or primary insuffciency. So where they, an example is like undergo or go to become menopausal before the age of 40. And so some of these people will become menopausal first and then get pregnant afterwards. And that could be using donor egg or eggs that they previously froze. And then after they go through that stage and they’re pregnant, so they have support through pregnancy and getting prepared to going back to work, and then they’re menopausal again. So that’s why when we think of it, we think of it as a continuum. We’re not like, okay, it has to be this stage first or that stage next. And that way the support is very comprehensive. It’s very fluid. It doesn’t seem disconnected. It’s all just available whenever that person needs out. It’s also interesting because from some of the research that I’ve seen, menopausal women are the fastest growing category in the workforce. So this is something that is going to become more and more an issue for corporations. And it would really be incumbent to the corporations to say, what’s out there, what do women need and how can we best protect and encourage productivity at the same time?
COLLEEN: So you’ve done some surveys. And what have you found have been some of the modifications that companies can make to benefit menopausal women?

DR. AHMAD: So I’ll talk a little bit about that, but I’ll also tell you how they feel about it. So when we surveyed these women, the majority of them did not have benefits in place to support menopause. So just 24% say that their employer has any sort of menopause benefit in place. And of that 24%, only 9 % said that it was significant. And there were so many, 60% said that If they had a really comprehensive menopause benefit in place, it would have improved their job satisfaction. And so it’s not going to be like a one solution works for everybody. I think it depends on what your employees need, but it’s important to have different options in place. So the way that we do it at a carrot is that members have access to like an unlimited access to online evidence -based education. They have the ability to talk to experts 24 -7. And then, you know, sometimes it’s like 2 a .m. when you have the availability to speak to someone. So they have the unlimited access to that. And that could be through video, chat, text, whatever works for them. There’s a virtual community. So they have the group support. And I think one of the biggest things is specialized network that we have are providers. Because what you hear quite often from women going through perimenopause and menopause is that it took them several providers. They went through several providers before they found the right person. It’s not usually like, oh, I met the, you know, the doctor and it was the first doctor that I met with and I was great. So it helps connect them and match them with a provider that would best fit their needs, which you think is very valuable. And also there’s the financial benefit. So people or even other treatments that might not be covered through their traditional insurance.
COLLEEN: How would a company, or how do you get the message out to companies that care fertility is available for menopause and the workplace care? So this is where I think that I tell people that anyone can make a difference because for many of our customers,
we’ll find that it was that one person that went to HR and said, you know what, like, whether it was menopause or whether it was like pregnancy benefits or fertility, like they had something that they needed, reached out. And because of them raising their voice, it was a benefit that was introduced. And it was then available to every one around them. So it helped not only them, but also their colleagues.
And so there is that power of the one voice. And I do want to encourage people to do that. But I understand that in many cases, it can be intimidating to be the only person going into that office and maybe you wanted to be a little bit more anonymous. So that’s where that it’s important to also reach out to ERGs and go, you know, there’s the power with numbers and you can also do that. And for someone, let’s say that doesn’t feel comfortable, whether it’s going alone or working with the ERG to go to HR, you can also go to the Carrot website and reach out to us and we like carrot the company can then reach out to your HR team and talk about the phone.
BRIDGETT: Okay. Yeah, that that always, I wondered how that worked because when I was going through perimenopause or menopause, I didn’t even think about asking the place, my employer, to have something there for me. What are some things that they do have that you have found that companies incorporate to help women in the workplace.

DR. AHMAD: Well, actually, I wanted to go back to the one thing that you mentioned was that you did not go and reach out. And I think that’s a really important point to head on in that though this is slowly changing over time, people still feel that there’s a lot of stigma on the topic of menopause. Like they don’t feel comfortable going to their employer and talking about it. Some of them feel that by bringing it up, that, and this is sometimes something that we see is that people may transfer their biases about, you know, like, you know, menopause occurs as you’re getting older. So they’ll link it to aging and they might transfer biases of aging onto colleagues. And so it’s not uncommon that people are reluctant to disclose this with their, you know, our team or bring it up as a topic. But I think that was really important that you mentioned that because that was also something that a lot of our respondents mentioned. They mentioned that they experienced because of these symptoms and in the situation where it might have been brought up ageism, about 47 % of them said that they experienced that. But yeah, in terms of like what employers can offer. Again, like I gave you some examples of what we’re offering through care of fertility benefits. But I think like there’s many different ways to do it. One, one is just like having leadership acknowledge it and maybe even share their experiences. I think that’s a great starting point because that helps again to reduce some stigma around the topic and having empathy around the topic around people who might be going through those symptoms really goes a long way. It sets the stage for what the culture should be in that company. And then the benefits is like the added part to it, right? So first, helping to create a culture where you’re providing support that there’s no stigma around the topic and then on top of it adding the benefits.

COLLEEN: One of the things when I was getting ready for this podcast I thought was interesting was that in February of 2024, the Equality and Human Rights Commission published new guidelines for menopause in the workplace. And those guidelines were like some of the things you were talking about, changes to a physical work environment, promoting flexibility, absences can be marked differently for menopause versus nonmenopause. As simple as if you have to wear a uniform, the uniform can be modified because a lot of women go through very heavy periods when they’re going through menopause and simple things that companies can do not to point someone out and say this person is getting older. They’re going through menopause, you know, red light over here. But to make it,

BRIDGETT: We’ve heard from so many women and doctors who have said tell the stories of women who quit their jobs because the menopause symptoms.

DR. AHMAD: It’s just a part of the offering that you have for employees in your company. And for example, the example that you used with the uniform being different, it could be somebody that’s peri metapause or menopausal who feels more comfortable. You say it could be somebody else. So it doesn’t really, you know, point out that person and make them stand out amongst the crowd. I think the other thing that you mentioned about like being able to take off time is that that is something that people have been doing over time. Like there were surveys, about 40 % of them said that they took off time when they were experiencing these symptoms. And about 70 % of them said that they took off about a week’s length of work, or like about 40 hours, so about a week, about 30 % of them said that they took around a month off altogether. And then of all those people that took off time, about close to 60 % said that they had to conceal the reason why they did that. So when you have something set in place where you’re able to take off time or, you know, when you were having those symptoms as you gave, you know, that example. I think that’s really, it’s a great way for companies to support individuals.

BRIDGETT: You know, I was reading the reports and the different things and that you also, or you, the reports mention how companies really lose a lot when they don’t have these benefits in place. Can you talk a little bit about what the loss to the company is when they don’t support women in menopause.
DR. AHMAD: So the Mayo Clinic had released data on American women that showed that menopause costs an estimated $1.8 billion in lost working time per year. So there’s that financial part. But if you think about it, many of these women who are going through this, right? Again, we talked a little bit about early menopause, but most of them are there are 40s, 50s, and 60s. So for many of them, they are at the height of their career. So by having an employee that is feeling symptoms of perimenopause or menopause that’s disruptive to their work, not only results in that financial piece, but like you could potentially lose an employee. A lot of and changed their, and the surveys shared that they changed their schedules about like, I think it was like 54 % of them, either changed their job altogether, went from full time to part time. And what you see is that if you offer support around this, around perimenopause and menopause, you help to retain those high level employees that you have. It’s going to cost you more if you lose that employee than if you put mechanisms in place to help to retain them. You’ll lose the experience and then women could lose their livelihood if they’re they feel like they’re missing this time off work. They’re putting their jobs in jeopardy and then their livelihood. And then that just snowballs into financial issues for women as well.

COLLEEN: One of the things that is interesting, I guess, to notice, you know, I was a young attorney in my 20s and back then, back in my day, we didn’t talk about getting pregnant. It just wasn’t a conversation he had. As a matter of fact,
my boss had a picture of a pregnant woman with an X across it, you know, like don’t smoke. Don’t get back in the day.

BRIDGETT: And he was a lawyer.

COLLEEN: He was the head of our department.
BRIDGETT: Doesn’t he know about that? Lawsuits.

COLLEEN: So when I got pregnant, I was terrified and they said, you know, don’t say anything for the first three months. I ended up spotting so I had to sit. And I ended up job sharing, which was very unique for the 90s. Well, since then, the conversation has opened up so much. And there’s so much more women are offered. Men are now offered paternity leave that we’re kind of, it’s now up to speed. Do you think the conversation on menopause is going to go in that direction as well, where it’s so women don’t want to talk about it right now, but as years go by and changes in our health care and hopefully women’s health becomes a priority that this will be a conversation that opens up possibilities for women?
DR. AHMAD: Well, I’m going to make sure that it does. way people treated they view it now in like number one you shouldn’t be getting pregnant okay number two you can and maybe you as a pregnant person can have time off but why would we give your partner time off and now the partner gets time off too i think yes it it may take a little bit of time i’m hoping it doesn’t but i do see a lot of changes already taking place even in the last few years around just the conversation around it in the workplace as well as like the support and the benefits that are are being integrated in it. It’s actually you know, as you said, Colleen, going forward with the talk of pregnancy, that that generation said, okay, let’s just move on with this. And I thought it was really interesting some of the things that took place what people in the survey said they wanted. And a big thing was flexibility. And can you talk about what flexibility might look like in a workplace? Yeah. So we had on some of those examples, right where flexibility might be so example um where someone let’s say they have to go into the office every day but they have the option of let’s say it’s just a bad day they’re feeling a lot you know maybe they’re having more hot flashes or just i just can’t concentrate i need to be in a different environment they have the option of working from home that’s something simple and honestly the world together we’ve gone through the pandemic we know that people can work remotely from home and still be productive. So that’s, I think, a great example of something that you could do. I mean, there’s obviously many other things, too, but I think that’s probably one of the best examples.

COLLEEN: They said the menopause room, too, or having a room, a special room. Yeah, there’s a company that has, have a room that I want to work for the company with the menopause room. Because they are so forward thinking and trailblazing that I just want to work for a company that would even consider doing that.
DR. AHMAD: Well, the way that I see it shaping out right now is that they’re connected. But in some cases, let’s say a company has something that they feel really works well for their employees for pregnancy.
And they’re like, well, we don’t want to change that. We have really great reviews from our employees. This works great for them. For them, maybe it might be a separate but in most cases I see that they’re they’re viewing it as like just like just like I said with like parrot is that it’s like a lifelong support or benefit offering that they have available and that and that and it’s important again to know that like it’s those those different journeys can overlap it’s not that one has to occur before the other and so having something in place that really really understands how all of them are interconnected and work together, create something that’s more fluid and comprehensive as opposed to maybe more fragmented.

COLLEEN: I’m curious what companies, what’s a typical reaction when a company is approached with this? You know. Yeah, does it depend on the size of the company? Like a small company, are they just amenable as a larger company?
DR. AHMAD: Yeah, actually it doesn’t matter what size the company is. That’s one of the things that we wanted to do when we started off carried is we wanted to make the benefit something that’s accessible for all size,
like different size companies. Because when a lot of these fertility benefits were becoming available, they were larger, much, much, much like these very large corporations and big, big companies. And so Because we’ve had a customer base that’s, you know, included very small -sized employers and, you know, very, very large ones, we’ve seen that across the board, there’s interest there. They all want to help in some way, shape, or form. And the thing that we try to do is to create that option of customization for our offerings in that sometimes the employer says that they want to offer a certain level of support, but maybe they can’t do the financial part yet. So they have the option to slowly add that on over time, which is, I think, really nice, because at least in that way, they’re starting to bring some level of support in. And as they have more resources available, can build on that over time.

BRIDGETT: Have you found, I know corporations, and I’m putting on my hat when I was a public school teacher. So I’m thinking about government jobs, things like that. Have you found they’re supportive as well or state or government jobs?
DR. AHMAD: Yes, they are. Again, you’re going to find that it’s not a one -size fits all, and the same thing goes with the response that you see from them, but their has been. I was thinking about my workplace situations and how that was such a, I remember just thinking, when is this bus going to stop? In the medical space, you know, medical space, we say, like, when we have a patient who can, so actually this is actually a perfect example. So when we do embryo transfers, we require the person to fill their bladder up. And there’s different situations like, you know, early pregnancy ultrasound. You want a full bladder to get the best imaging. And when one of those patients comes in and their bladder’s completely full and they look super comfortable we’re like you must be a nurse or you must be a teacher. You don’t have the ability to suddenly leave and be able to take care of yourself, whether that’s having a heavy flow period and being able to, you know, change your sanitary pad. But I think that There’s the flexibility piece that you brought up. But I think the other thing is, you know, when you had to send a note but with a student to like have a teacher stand in between the rooms to be on guard, the difference now is also that there’s much more technology and ability to reach someone quickly. So hopefully in this case, you might be able to just text someone and be like, right, that’s across the hall. And say, hey, I just have to like run down the hall.

BRIDGETT: Can you keep an eye in classroom for I yeah no that but I did I felt like gee I wish school systems had these things in place and I wish and I think too probably at the time I would have been embarrassed right bring this up yeah I’m hoping that’s changing it’s so complicated because when you’re younger and you’re trying to get pregnant you don’t have the stigma of the ageism like no one’s surprised when a 35 year old woman gets pregnant as an employee. But once you get to 50 and you’re talking about menopause, all of a sudden there’s that ageism stigma that is more complicated and would I think exacerbate the problem of not talking to your employees, employers, because they don’t want, you don’t want them to think that you’re aging out of your job. So hopefully, you know, there’s a lot of funding going into women’s health right now, which is great to see.
COLLEEN: What do you, what would you say the next two or three years with this women’s health initiative, the women’s health funding? What changes do you see coming on the horizon for menopause in the workplace?
DR. AHMAD: Well, two things. First, you mentioned the age of something. So that was something that we saw with our survey as well, that 47 % of them said that they experienced it and 44 said that they experienced it more than their male colleagues and women of color are more likely to experience it and receive criticism. So that was a really important point that you brought up. I do see things changing over time. I love seeing that there are these initiatives taking place that people are speaking about menopause, the importance of doing research in menopause, as well as just women’s health overall and that there’s funding and these initiatives in place towards it. When you think about how quickly we’ll see change, I think it will take a little bit of time. I think, like, when you think about research studies, it’s not that you, especially those really large, randomized controlled files, usually you don’t see the data immediately. So it may take a few years before they’re able to share that data and that might create change. But overall, I think that the fact that people are investing in this space is already showing that change will take place. And maybe that will be on the level of just like how people acknowledge it and handle it like when it comes to culture, whether that’s in the workplace or in other situations. But I’m very optimistic of what’s going to happen in the coming years around menopause and women’s home.

COLLEEN; Oh, that’s wonderful to hear because so are we. Yes. Dr. Asima, thank you so much for coming on. We will make sure to have care of fertility in the show notes. So if anyone wants the link, you can just go to our show notes and we will have those as well. Thank you for coming on and talking about menopause in the workplace. These conversations need to happen more frequently in larger communities so that we can kind of make it less stigmatized.
And it will be more, more women will come out and say, okay, I’m going through menopause. I’m still working. You need to help me get through this journey. So thank you so much for coming on.

DR. AHMAD: Oh,thank you so much for having me. It was great being able to chat with both of you today.

Dr. Asima Ahmad Shares the Best Tools for Menopause Support at Work

DR. ASIMA AHMAD: EPISODE LINK

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