Julian Hannush: Welcome to Health Unscripted, brought to you by the Cigna Group, a podcast featuring real, raw conversations with some of the most knowledgeable experts in the healthcare industry. Episode of the Health Unscripted Podcast. I'm Eva Borden and I am the Chief Product Officer for U.S. Employer of Cigna Healthcare. And I am joined by not just a colleague, but also a friend, Wendy Sherry, who is the CEO of Global Health Benefits for International Health for Cigna. And I'm so pleased to be having this conversation today about a really important topic about women's health. As we know, women make up about half of the global workforce. And there are topics specific to women's health that we don't tend to talk about, particularly that there's 47 million women right now who are entering menopause annually. And when we think about this number, and this is at a global level, not just a US. So part of the importance, Wendy, of meeting with you today is to talk about this isn't just a US problem. This is something that is universal to all women. And so I wanted to have a chance to just talk with you about your perspective, not just from the US, but globally, what does this mean? So if we know that 80% of women experience symptoms during perimenopause, that includes hot flashes, sleep disruptions, mood changes, brain fog, memory lapses, headaches, just this whole myriad of things, which I would say as a as a woman in and around that age, I can appreciate the very much the reality of what this looks like. As well as forty-seven percent of menopausal and post-menopausal women say that their symptoms have actually disrupted their work and really interrupted how they're showing up in the workplace. Can you talk about some of the hidden impacts that employers may or may not see? Absolutely. Anita, it is so wonderful to be with you today. As you said, we've known each other for a long time, colleagues, friends, and I'm thrilled to be approaching and talking about this important topic with you. So you use the word hidden impact, and I think hidden is the key word there, because very often these symptoms that, as you said, half of our workforce will go through are often concealed. So women silently often suffer through things that again, all of their female colleagues will at some point in their life, if they're fortunate to get to this phase of their life, will experience. So it's things like brain fog. So not being able to remember something, or just again, not clicking ⁓ mentally in the moment of what's going on. Things like, you know, anxiety and stress, those are all some of the hidden impacts that have very real impacts to that employee and their ability to conduct their roles, their jobs. To help their employer achieve their overall objectives, mission, et cetera. So these hidden impacts very often will lead to employee dissatisfaction, will certainly again, impact how individuals are performing each and every day, their productivity and their vitality. So again, these hidden impacts are really quite real and quite impactful. One of the elements of ⁓ Perimenopause and menopause, Wendy, that we think about is, you know, you talk a lot about these symptoms that can manifest physically. And there's not just elements of potentially embarrassment, concern, questioning that women can have about themselves, but it also can bring up elements of anxiety or depression, ⁓ in ways that it's i as I think about so I've had our behavioral health business for a period of time. And when I think about the importance of that and we talk about the mind-body connection. There's a really important component of this mind, body, hormonal connection that women go through. And so when we think about it from an employer's point of view, what are the things that you would flag for employers to say, hey, we really think you should be mindful of this if we think if you want to keep women in the workforce longer, if you want to be aware and understanding what's going on? Like, what would you flag? And could you also bring in a little bit of Not just for the employer world, but also from the ⁓ the global world too, when I think about the the two areas that you could tend to focus on. Yeah, there's there's so much in in what you said. And I think one of the important points you just made is that mind-body connection. So when we think about menopause, it really does impact both the body and the mind, right? The anxiety piece we talked about, the stress. The brain fog, those are all mind type of things that impact physical outcomes, impacts how again people show up at work. So employers need to be cognizant that when they are bringing forward solutions to help women going through perimenopause and menopause, that they're thinking about it through the lens of the mind and the body and ensuring that employers and the programs that they're offering. do include the important aspects of mental health. And you you made the comment a moment ago around how should we think about this from a global landscape. Well, you know, I think that you would agree with me. We've made tremendous strides on in a US world, US, you know, US-based world around destigmatizing mental health, right? And and every day people are talking about the importance of getting the help people need. access has become much greater through lots of ⁓ great work. But sometimes in other parts of the world, that stigma is still there. Again, barriers are being broken down every single day and progress is being made around improving mental health and mental health awareness and access across the globe. But if I'm being honest, there are cultures where it is still a little bit behind where we are from a US perspective. So Again, something that employers need to keep in mind is that the importance of the connection between mind and the body, make sure mental health is part of it, but also be culturally sensitive because not all cultures embrace mental health, mental health awareness the way that we do here in the US. You bring up something that's really interesting. And I think there's a lot of connection between the concept of mental health as well as these symptoms and what women go through through perimenopause and menopause. And both of them are really relate to creating visibility on what's happening, that these things are real, and then what to do about them. It was probably five or six years ago. I was in a professional setting talking about, I believe it was at the business group on health, and they were talking about menopause. And it was really interesting because of the employers that were there, they said when we just started the conversation, they got more engagement. through those conversations than they had seen in almost anything else. And it was really highlighting this need, this need for support, the need for care. So in mental health, I can think about ways that we've helped provide support. But what would you say is important, particularly if we think about two thirds of women who are between 40 and 65 want some type of menopause benefit? What are the types of benefits that we should be thinking about providing? So we've talked about mental health therapy, what that could look like. What some of the corresponding pieces for menopause? Yeah, it's a great question because it is a multi-dimensional ⁓ solution, if you will. So you said it, right? Mental health is certainly a key component, but there's also prescription health care benefits. So if you think about things like hormonal hor hormone replacement therapy, ⁓ important that that becomes a core aspect of the offering. And then even providing access to specialists. So often Women don't have access to specialists in their communities. So I know that one of the things that we do is we offer options for virtual specialists. So making sure that there are, again, great access to doctors and specialists in the field of menopause and perimenopause. And then in addition, it is a very confusing time for women. We talk about menopause and perimenopause. It's a undereducated topic, right? Many people just aren't aware that that these symptoms are actually connected to perimenopause and menopause. And then once they figure it out, they're like, okay, where do I go to get help? So it's a little bit of a complex and often confusing journey. So being able to off offer support systems, navigation systems to help people through that journey. So on the global health benefits side, as an example, we're partnering with Carrot Fertility. As a way to help individuals navigate through these complex journeys. And as I said a moment ago, also recognizing that there could be cultural or even regulatory differences in different countries. So having companies like Carrot help our customers navigate through these journeys in ways that are culturally relevant, also ensure that they have the right access to the care and the providers. wherever they are around the globe. So those are just a couple of examples that really speak to the holistic approach as it relates to providing benefit solutions for menopause and perimenopause. And as they think about this journey, so it it's really interesting. I think there's so many parts of what women go through, what men go through, and then what we oftentimes whether through partnerships, colleagues, whatever, just these ex these different types of experiences that we have. When you think about employers who would say, but what's in it for me? Like, why should I invest in this? Why does this matter? Does this really impact my workforce? What's the reasoning behind why this type of an investment should be had potentially in in place of other things or even in alongside of other things? Like, what would be the reasoning why? It's our people that help us to achieve our mission. Our financial objectives help serve our clients and customers. So, with that in mind, you need your employees to be their best selves. It goes back to our mission of improving health and vitality. So, what's in it for an employer is better outcomes, better ability for them to achieve their mission, better ability for them to serve their clients and customers, better ability for them to achieve their financial outcomes. Because at the end of the day, when people show up as their best selves, you're gonna have way higher employee satisfaction, way higher engagement. And as a result, you are 100% going to have better outcomes and performance. I think too, Wendy, about retaining women in the workforce, particularly as they go through these stages of understanding, ⁓ a discomfort and not knowing whether it be brain fog or other pieces. I think personally I I can I can truly picture sitting in a conference room where it just behap so happened that in this particular event it was predominantly wet men. And I kept having hot flashes and I felt so silly taking my jacket off, putting it back on, taking it off and putting it back on. And not necessarily I don't know that I fully understood what was going through what was going on with me, let alone my colleagues. ⁓ and I feel like now that the conversation is becoming A little bit more normalized, not nearly as far as we made in mental health, but it's actually starting to be normalized. What advice would you give women who are experiencing these symptoms? What advice, what would you say to them to help manage? I still want to be an active contributing part of the workforce. I want to show up. I want to do well. What would be the things that you would encourage them to be thinking about and doing? So first and foremost, this is just a natural part of life and we all go through it. I absolutely remember those moments that you've just described, getting ready for a big presentation, because that's always when it hits you the most. And that hot flash is there. And you are the first thought you have is embarrassment. I'm embarrassed. ⁓ and then you start losing your confidence. And then of course you're not at your best self. So just having that moment of, okay, this is what's going on. This is normal, and I am clearly not alone. In what's going on. I think that just would help to ground people in that moment. But then more broadly, advocating for yourself, being open with, hey, I need to take a half a day off because I'm having some more severe symptoms at the moment, or I need to work from home, or I could use a fan in my office, whatever it is that you might need to be able to show up at work as your best self. you should feel confident in your ability to ask for those things. And again, knowing that you're not alone. And I could not be more excited about the fact that we are having all of these conversations around this important topic. Because I will tell you, when I was going through the heat of it, pun intended, we were not having these conversations. So hopefully by having these conversations, we're normalizing it. We're breaking down the stig stigma and giving women much more confidence in their ability to advocate for what they need to be successful. I really appreciate how you frame that because when I think about what employers are faced with, you want women to show up being confident in their professional selves. So they're making the best choices for the company and not spending mental calories focused on things that quite frankly, like you said, it's normal. If you are a woman, this will happen to you. So any last comments before we ⁓ end this time together? You raise another important point. So I will just hit on on the notion of the timing when all of this happens, right? So perimenopause, menopause occurs when women are in the strides, like they are growing their careers. And if women and employers are not careful, they have the potential of losing high potential women. Because they again don't feel comfortable, don't have the support they need. So it is another important watch item. Just the timing of when all this happens is when people are really growing their careers. So like I said, I couldn't be more thrilled that we're really having these conversations, that more and more employers every day are offering these benefits or expanding their benefit packages so that the women that come behind us. It'll be a lot better for them than it was for us. Wendy, thank you so much for this time. I continue to be inspired by you, your leadership. I particularly appreciate that you ⁓ alongside of Signar are tackling this topic, not just for those in the US, but also globally, because as you said, that takes a lot of effort to be culturally sensitive and mindful. So thank you for your leadership position, both professionally and personally. Thank you for listening to this episode of Health Unscripted brought to you by the Signer Group. 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