After 50, too many women reduce their working hours, become trapped in lower-quality jobs, or exit the labor market altogether. Part-time employment becomes more prevalent as women age. The gender gap widens. For women, this means lower lifetime earnings and significantly smaller pensions. Many are calling this phenomenon the “menopause penalty”—a midlife equivalent of the motherhood penalty. And indeed, research suggests that women’s earnings drop in the years following a menopause diagnosis.
But while menopause clearly plays a role, there is a risk in attributing these economic setbacks too narrowly to biology. Doing so not only oversimplifies women’s lived realities—it also medicalizes what are fundamentally social and organizational problems. Menopause matters. But it rarely acts alone.
A convergence of pressures and setbacks
Midlife is often the most demanding phase of women’s lives. Menopause tends to coincide with a series of other “life shocks” that disproportionately affect women. Caregiving responsibilities intensify: aging parents begin to need support, while many women are still helping children or even grandchildren. The “sandwich generation” is squeezed between upward and downward care.
Meanwhile, serious health risks increase—including breast cancer and chronic illness. Divorce is also common in midlife and comes with major financial and emotional consequences. The death of a parent is another major shock that frequently occurs in midlife and is largely invisible in workplace thinking—grief doesn’t fit into a few days of leave but often brings lasting exhaustion and difficulty concentrating.
Overlay all of this with growing exposure to ageism in the workplace and it becomes clear that menopause is rarely the only culprit. Yes, symptoms such as fatigue, hot flashes, or brain fog can make work harder to sustain. But menopause comes at a moment of cumulative strain. It does not create the inequalities. It amplifies those that already exist.
When work refuses to adapt
Many jobs are still designed for a worker who is endlessly available, physically resilient, emotionally stable, and largely free from caregiving responsibilities. Menopause symptoms collide with these unrealistic expectations.
Instead of redesigning work—adjusting schedules, reducing unnecessary presenteeism, offering autonomy, improving ergonomic conditions and workplaces, or recognizing fluctuating capacity—organizations implicitly ask women to adapt their bodies. And when they cannot, the “choices” available are reducing hours, stepping back from responsibility, refusing promotions, accepting less visible roles, or leaving work altogether.
From the outside, this looks like individual preference. That’s why the menopause penalty looks exactly like the motherhood penalty. Neither is caused simply by biology. Both result from the collision between life stages and rigid work systems built around male, uninterrupted career norms.
The penalty is also reinforced by stereotypes. Menopause is still associated with emotional volatility, decline, and loss of competence. Many women fear being perceived as less reliable or less ambitious. Some avoid high-visibility projects. Others turn down leadership roles or client-facing positions simply because they fear exposure. Menopause stereotypes are like sexism on steroids.
Economically, the menopause penalty represents a massive loss of human capital. Women in their late 40s, 50s, and early 60s often hold their highest levels of skill, institutional knowledge, and professional experience. When they reduce hours or leave work prematurely, organizations lose leadership potential, mentoring capacity, and expertise.
The danger of medicalizing inequality
There is an increasing push to frame menopause primarily as a health issue requiring medical solutions—more awareness campaigns, more diagnoses, more treatments.
Don’t get me wrong: better healthcare really does matter. Too many women suffer unnecessarily because of lack of information, poor medical support, or lingering fears around hormone therapies. For those with severe symptoms, treatment can be life-changing.
But there is a real risk in making menopause the central explanation for midlife economic inequality. When reduced earnings or stalled careers are blamed mainly on hormonal changes, it obscures the role of workplaces, the gendered division of unpaid work, insufficient care infrastructure, ageism, and broader social, political, and corporate issues.
It suggests that if women simply managed their symptoms better, the problem would disappear. We often medicalize social problems. For example, we prescribe antidepressants without addressing poverty, violence, overwork, or isolation.
Hormone therapy may ease hot flashes and prevent osteoporosis (and that’s a lot). But it won’t pay the rent, restart a stalled career, restore lost pension rights, or compensate for years of unpaid care work. Pills don’t fix ageism. They don’t erase structural inequality.
Let’s redesign work for long lives
1. Design work for sustainability. Most jobs are still built around an ideal worker who is always available, endlessly energetic, and free from responsibilities outside work. This model breaks down over long working lives. Companies should rethink workloads, hours, and performance expectations to allow for fluctuating capacity over time. Focusing on outputs rather than presence, reducing unnecessary urgency, and normalizing lower-intensity periods would make careers more sustainable.
2. Make flexibility the norm. When flexible working is treated as an exception, it carries invisible penalties (slower progression, reduced visibility). To avoid turning flexibility into a career trap, companies should offer autonomy over hours and location by default and ensure flexible workers are not sidelined.
3. Confront ageism head-on. Many midlife career setbacks for women are inseparable from age discrimination. Employers should track pay, promotions, and evaluations by age and gender, challenge stereotypes in leadership cultures, and ensure development opportunities exist throughout careers.
4. Recognize caregiving as a normal life-stage reality. Midlife is often when care responsibilities peak—for aging parents, ill relatives, or extended family—yet workplace policies remain focused on early parenthood. Companies should expand support to include eldercare flexibility. When caregiving is ignored or treated as a personal inconvenience, many women quietly reduce hours or exit.
5. Address menopause openly. Raising awareness and training managers can reduce stigma and improve support. But if rigid schedules, long hours, and unforgiving performance models remain, women are left to manage symptoms within broken systems. Menopause initiatives must go hand in hand with reforms in job design, flexibility, and inclusion—or risk becoming symbolic rather than effective.
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Hello and welcome to Modern CEO! I’m Stephanie Mehta, CEO and chief content officer of Mansueto Ventures. Each week this newsletter explores inclusive approaches to leadership drawn from conversations with executives and entrepreneurs, and from the pa…
Integrity, understood as a disposition to behave in prosocial, ethical, and principled ways rather than corrupt or self-serving ones, is among the strongest and most consistent predictors of job performance and leadership effectiveness. The reason is far from mysterious. Leadership, whatever its context, is a collective enterprise. No meaningful goal, from building empires to running companies, has ever been achieved alone.
Across history, not just in humans but also other animals, cooperation has depended less on raw power than on trust. Ancient trading societies flourished precisely because reputation constrained behavior: merchants in Phoenician city-states, medieval guilds, and Silk Road networks relied on repeated interactions and informal enforcement mechanisms to ensure that partners honored their commitments. Those who cheated were excluded, not merely judged. Trust, in effect, functioned as an early mechanism for coordination and enforcement.
The same logic applies in modern organizations. Teams perform better when members believe that leaders will act fairly, keep promises, and avoid exploiting asymmetries of information or power, or are so focused on their personal gain that they have little concern in harming the group. In line, research shows that leaders perceived as lacking integrity struggle to attract talent, elicit discretionary effort, or sustain collaboration over time. Conversely, leaders known for ethical consistency benefit from faster coordination, lower monitoring costs, and greater willingness among others to take risks on their behalf.
The cost of distrust
Given a choice, people prefer to collaborate with those they trust not because they are naïve, but because distrust is expensive. Working with unreliable or unethical partners increases the likelihood of failure, conflict, and reputational damage. In business, this may mean backing leaders who misrepresent performance or shift blame. In politics, it can mean empowering those who erode institutions for personal gain. In both cases, the costs are borne not only by the followers but by the system as a whole.
This is why chronic corruption is one of the most reliable markers of institutional breakdown. As documented year after year by Transparency International in its Corruption Perceptions Index, countries that score lowest on integrity and trust tend to share familiar pathologies: weak rule of law, politicized institutions, capital flight, and persistent underinvestment, generally caused by parasitic governments and destructive leadership. By contrast, countries that consistently rank at the top of integrity and trust measures benefit from stronger institutions, more predictable governance, and higher levels of social and economic cooperation. To be sure, these societies are not free of self-interest or ambition; rather, they have succeeded in aligning incentives so that ethical behavior is rewarded and corruption is costly, censoring selfish short-term individual gains in favor of collective long-term benefits.
Measuring integrity
So, how can we tell whether a person has integrity, or gauge someone’s moral reliability?
The question is especially consequential when applied to leaders, whose decisions shape the success, welfare, and future prospects of others. Fortunately, behavioral science offers several useful insights, even if it stops short of perfect certainty.
First, integrity is not directly observable. Unlike physical attributes such as height or hair color, it cannot be seen or measured at a glance. Instead, it is inferred or deducted from patterns of behavior, consistency over time, and alignment between words and deeds. Integrity is therefore an attribution rather than a trait we can observe directly, which makes assessment inherently probabilistic rather than definitive.
Second, short-term interactions are often misleading. Because appearing ethical brings clear benefits (trust, influence, reduced scrutiny, and access to resources) people are incentivized to signal integrity even when they lack it. This helps explain why superficially ethical environments can sometimes attract parasitic actors who exploit the goodwill and assumptions of others. In contrast, in persistently corrupt settings, distrust becomes the default, and even well-intentioned individuals are treated with suspicion. Context shapes both behavior and perception.
A parallel and increasingly robust line of evidence comes from research on the so-called “dark traits”, narcissism, psychopathy, and Machiavellianism. Although conceptually distinct, these traits share a common core of low empathy, emotional coldness, and a tendency to instrumentalize others. From an integrity standpoint, this combination is toxic. Individuals high on these traits are less constrained by guilt or concern for others, more willing to bend or ignore rules, and more likely to justify unethical behavior as necessary, deserved, or clever rather than wrong.
Psychopathy is most directly linked to callousness and fearlessness, reducing sensitivity to punishment and moral emotion. Machiavellianism predicts strategic deception, cynicism about human motives, and a belief that ends justify means. Narcissism, especially in its more grandiose forms, adds entitlement and moral exceptionalism, the belief that normal rules apply to others but not to oneself. Together, these traits reliably predict counterproductive work behaviors, ethical transgressions, and integrity failures, particularly in roles that confer power, discretion, and weak oversight. Crucially, this is not because such individuals lack intelligence or self-control, but because their motivational architecture is misaligned with prosocial norms. Where integrity depends on empathy, respect for authority, and an internalized concern for collective outcomes, dark traits tilt decision making toward self-interest, dominance, and short term gain, making them among the strongest dispositional red flags for integrity risk in organizational life.
Third, while integrity cannot be measured perfectly, it can be assessed meaningfully. Research shows that peer ratings are among the most reliable indicators, precisely because integrity is reputational: it reveals itself in how people behave when others depend on them. Longitudinal data, such as 360-degree feedback, is especially informative. Personality traits like conscientiousness, altruism, and self-control (including the capacity to self-edit) also predict ethical conduct, as does past behavior. Self-reports are often dismissed, but well-designed measures still differentiate reliably between individuals with higher and lower integrity. Track records matter, even if they do not render anyone immune to temptation. As Warren Buffett famously observed, reputation takes a lifetime to build and a moment to destroy.
Finally, the environment matters. Ethical failures are not only the result of “bad apples,” but also of “rotten barrels.” Weak governance, misaligned incentives, and tolerance for small transgressions can erode integrity even among otherwise decent individuals, while well-designed systems can reinforce ethical behavior by making misconduct costly and transparency unavoidable.
Sapping growth
Taken together, these points suggest that integrity is neither inscrutable nor guaranteed. Whether in governments, firms, or teams, integrity functions as an enabling condition for coordination and progress. When trust erodes, actors devote more effort to monitoring, hedging, and self-protection, leaving less energy for innovation or growth. In this sense, integrity is not merely a moral ideal, but a form of social infrastructure: largely invisible when it works, and painfully obvious when it does not.
Below, Brad Stulberg shares five key insights from his new book, The Way of Excellence: A Guide to True Greatness and Deep Satisfaction in a Chaotic World.
Brad is on faculty at the University of Michigan. He is a performance coach and regular…
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