Menopause and Night Shift: Why Nurses Say One Day Off Isn’t Enough

If you have worked night shift long enough, you already know that sometimes one day off barely gives you enough time to recover before you’re right back at the bedside. Now throw in fatigue, interrupted sleep, brain fog, and unpredictable periods, and it’s not hard to understand why menopause can make an already demanding schedule even more challenging.

For many nurses, perimenopause and menopause happen right in the middle of their careers, when they’ve spent years building their clinical experience and are often the ones everyone else turns to for help. Yet, for something that affects so many women, we really don’t talk about it much in nursing. After more than 25 years in this profession, I can tell you that we’re pretty good at pushing through just about anything, but that doesn’t mean we should have to.

A study published in the Journal of Advanced Nursing took a closer look at what nurses experience while working through menopause. Researchers in Finland, led by a team at the University of Turku, surveyed 3,487 female registered nurses aged 45 and older and interviewed 23 nurses about how menopause affected their work. The survey was distributed through a Finnish healthcare trade union newsletter, so respondents were self-selected rather than a random sample. The study was published online in August 2025 and appeared in the journal’s May 2026 print issue.

What stood out was how much nurses struggled with recovery after night shifts, managing symptoms while caring for patients, and getting the support they needed from their employers. And while the research was conducted in Finland, I think a lot of nurses here in the U.S. will recognize some of these same challenges.

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What the Research Found About Nurses and Menopause

The nurses surveyed had an average age of 54, and many reported health concerns that could affect their overall well-being and daily lives. Fatigue and sleep disturbances were among the most common complaints, but researchers also found high rates of musculoskeletal pain, headaches, and other symptoms.

Among the 3,487 nurses surveyed:

• 78% reported neck or shoulder pain
• 76% reported general fatigue
• 69% reported headaches or eye pain
• 69% reported lower-body muscle pain
• 67% reported sleep disturbances
• 59% reported back pain
• 19% reported symptoms of depression or anxiety

Nearly 45% of participants rated their overall health as less than good, which is concerning when you consider the physical and mental demands of nursing. However, there’s an important distinction here. The survey looked at general health problems among nurses aged 45 and older, so we can’t assume menopause was responsible for all of these symptoms.

The researchers followed up with 23 nurses to better understand their experiences with menopause at work. Those interviews provided more insight into the challenges they were facing, particularly when it came to night shifts, recovering between shifts, and managing symptoms while taking care of patients.

Anyone who’s spent time working nights knows how difficult it can be to get good sleep during the day. Between family responsibilities, appointments, sunlight coming through the windows, and the rest of the world going about their day, sometimes getting a solid stretch of sleep feels nearly impossible. Add menopause-related sleep disturbances to that, and you’re dealing with another challenge altogether.

In the study, nurses described needing significantly more time to recover after working nights than their schedules allowed. Some said they had a harder time sleeping during the day as they got older, while others felt that even a full day off wasn’t enough to feel rested before returning to work. And when you’re already starting your next shift exhausted, it’s easy to see how that can become a cycle.

Interestingly, nurses who were able to temporarily stop working nights during menopause described that change as beneficial to their well-being. Unfortunately, not everyone had that option. Some nurses had managers who were willing to work with them, while others said they were promised scheduling adjustments that never actually happened.

Of course, we all know that changing your schedule in nursing isn’t always as simple as asking. Staffing needs, seniority, unit policies, and available positions can all play a role, especially in hospitals that are already struggling to keep shifts covered. But I do think it’s worth asking whether there’s a better way to support experienced nurses who may need some flexibility during this stage of life.

Previous research has also looked at the relationship between night shifts and menopause. A 2019 study published in Human Reproduction involving more than 80,000 U.S. nurses found an association between long-term rotating night shift work and a modestly earlier onset of menopause, particularly among women predisposed to menopause before age 45. That doesn’t mean night shift directly causes early menopause, but it does suggest there’s more to learn about how shift work affects women’s health over time.

Hot Flashes, Brain Fog, and Trying to Get Through a Shift

One thing that makes managing menopause at work particularly challenging for nurses is that we don’t always have the luxury of stepping away when we need to. You can’t just leave your patients whenever you’re having a hot flash, need to use the restroom, or aren’t feeling your best. Depending on your assignment and staffing, you may not even get a proper lunch break, much less the opportunity to deal with symptoms as they come up.

The nurses interviewed described several challenges that made their shifts more difficult. And if you’ve spent any time working at the bedside, you can probably relate to at least a few of them.

When Even a Bathroom Break Becomes a Challenge

For nurses dealing with heavy or unpredictable bleeding during perimenopause, something as simple as finding time to use the restroom can become a major source of stress. Some described constantly worrying about when they’d get their next break and whether they’d have enough time to manage their symptoms.

Most bedside nurses know what it’s like to work an entire shift barely finding time to drink water, eat lunch, or use the bathroom. Now imagine adding heavy bleeding to that equation, especially when you’re responsible for multiple patients and can’t always step away.

Hot Flashes Don’t Wait for a Convenient Time

Hot flashes were another challenge nurses described. Some felt embarrassed by excessive sweating, while others started bringing extra clothing to work because they knew they might need to change during their shift.

And depending on where you work, the environment can make things even worse. Between moving patients, running around a busy unit, and wearing layers of protective equipment, nursing isn’t exactly a job where you can just turn down the thermostat or step outside to cool off.

Brain Fog in a Job That Requires You to Be Sharp

This was one of the findings that really caught my attention because of how much concentration nursing requires. Nurses described forgetfulness, difficulty focusing, and feeling less mentally sharp than they were used to. Some began writing everything down or relying more heavily on checklists to make sure they weren’t missing anything important.

Think about everything we’re responsible for during a shift. Medications, assessments, recognizing changes in patient conditions, communicating with providers, and making decisions that can directly affect patient safety. There’s a lot happening at once, and very little room for error.

Some nurses also worried about making mistakes, which only added to their stress. It’s important to point out that the study did not establish an increase in actual clinical errors related to menopause. What it documented was how these nurses perceived changes in their concentration and how those concerns affected their confidence at work.

One part of this research that really resonated with me was how many nurses continued working even when they weren’t feeling well. Some described pushing through their shifts because calling out sick wasn’t something they wanted to do, and several later questioned why they hadn’t just stayed home to rest.

I think most of us understand that mentality because we’ve probably done it ourselves at some point in our careers. We know what happens when someone calls in, especially when the unit is already short-staffed. Our coworkers end up taking on more responsibility, assignments get shuffled around, and there’s often that feeling of guilt about leaving everyone else to pick up the slack.

But somewhere along the way, we’ve gotten so used to putting everyone else’s needs ahead of our own that we sometimes forget we’re allowed to take care of ourselves, too. Just because we can push through a shift doesn’t necessarily mean it’s the best thing for our health.

Researchers refer to working despite health problems as presenteeism, and it’s not something unique to nursing. A 2023 Mayo Clinic study involving 4,440 employed U.S. women between the ages of 45 and 60 found that 13.4% reported at least one negative work outcome related to menopause symptoms, while 10.8% reported missing work because of symptoms during the previous year.

The researchers estimated that menopause-related missed workdays accounted for approximately $1.8 billion in annual economic losses in the United States. Although that study wasn’t specific to nurses, it does show that menopause can have a meaningful impact on women in the workforce, and it’s something employers should be paying attention to.

We’re healthcare professionals. We educate patients about their health every day, understand how hormones affect the body, and encourage people to speak up when something doesn’t feel right. Yet somehow, menopause can still be an uncomfortable topic in our own workplaces, which is pretty ironic when you think about it.

Nurses interviewed for the study described feeling that menopause was misunderstood, dismissed, or sometimes even mocked by coworkers. Some were uncomfortable discussing symptoms with male managers, while others said getting support depended largely on who their manager was and the culture of their particular unit.

Participants also described occupational health services as offering limited support, with some saying it could take months to get an appointment. For a profession built around healthcare, you’d think we’d be doing a better job of recognizing and supporting the health needs of our own workforce.

One positive finding was how much nurses valued having coworkers who understood what they were going through. Whether it was sharing advice, offering encouragement, or simply being able to laugh about something with another nurse who was experiencing the same thing, that peer support made a difference. And if there’s one thing I’ve learned throughout my nursing career, it’s that sometimes another nurse who understands exactly what you’re dealing with can make a difficult day a little easier.

The researchers concluded that menopause and its effects on nursing work remain under-recognized by leadership and occupational health services. They recommended several ways employers could better support nurses, particularly those experiencing symptoms that interfere with their work.

Their recommendations included:

• More flexible scheduling: Allowing nurses to temporarily reduce or avoid night shifts when symptoms become difficult to manage.
• Individualized shift planning: Considering employees’ health needs while maintaining fair and consistent scheduling practices.
• Modified duties or part-time options: Offering temporary adjustments when symptoms make certain responsibilities more challenging.
• Better menopause education: Helping managers and coworkers understand common symptoms and how they may affect employees.
• Improved occupational health resources: Making menopause-related guidance and support easier to access.
• A more supportive workplace culture: Creating an environment where nurses feel comfortable discussing health concerns without embarrassment or fear of being judged.

I realize that implementing some of these changes isn’t always easy, especially in hospitals already dealing with staffing shortages and tight schedules. But I also think we need to look at the bigger picture and consider what happens when experienced nurses feel they can no longer manage the demands of their jobs.

According to the National Council of State Boards of Nursing’s 2024 National Nursing Workforce Survey, the median age of registered nurses in the United States increased from 46 in 2022 to 50 in 2024. That’s a substantial portion of our workforce approaching, experiencing, or having already gone through the menopause transition.

And we’re talking about nurses who often have decades of clinical experience, the ones serving as charge nurses, preceptors, mentors, and resources for newer staff. Losing that experience affects more than just staffing numbers, so finding ways to support nurses throughout every stage of their careers should be part of the conversation about retention.

While the study focused on nurses’ experiences rather than evaluating specific treatments, there are a few things worth considering if you’re dealing with menopause symptoms while continuing to work nights.

• Pay attention to your sleep and recovery. If you’re consistently struggling to recover between shifts or noticing changes in your sleep, don’t automatically assume it’s just part of getting older. Sleep disturbances can have several causes, and your healthcare provider can help determine whether menopause or something else may be contributing.
• Don’t feel like you have to suffer through symptoms. There are hormonal and nonhormonal treatment options available for certain menopause symptoms, and what works for one person may not be appropriate for another. Having a conversation with your healthcare provider can help you understand your options and decide what makes sense for your health.
• Consider whether your current schedule is still working for you. Maybe you’ve worked nights for years and never had an issue, but now you’re finding it harder to recover between shifts. That doesn’t mean you can’t continue working nights, but it may be worth exploring whether a different schedule or temporary adjustment would help.
• Don’t ignore symptoms that deserve medical attention. Heavy or unusual bleeding, persistent fatigue, and changes in concentration shouldn’t automatically be dismissed as menopause. Just like we’d tell our patients, it’s important to have symptoms evaluated rather than assuming we know what’s causing them.

It’s also worth remembering that menopause looks different for everyone. Some nurses experience relatively mild symptoms and continue working without major changes, while others have symptoms that significantly affect their daily lives. There’s no reason to compare experiences or assume everyone should be able to manage symptoms the same way.

After more than two decades in nursing, one thing I’ve learned is that we’re really good at taking care of everyone else while putting ourselves at the bottom of the list. We’re used to adapting, pushing through, and telling ourselves we’ll get some rest when things slow down, even though we all know how rarely that actually happens in healthcare.

But our bodies change, our needs change, and what worked for us earlier in our careers may not always work the same way years later. That doesn’t make us any less capable, and it certainly doesn’t take away from the experience and knowledge we’ve spent years building.

I don’t think the takeaway from this research is that menopause makes nurses less capable or that nurses going through menopause shouldn’t work nights. It’s that we need to do a better job of recognizing that nurses have health needs of their own, and those needs deserve the same consideration we encourage our patients to give theirs.

We’ve spent our careers showing up for everyone else. I think it’s reasonable to expect our workplaces to show up for us, too.

🤔 For nurses navigating perimenopause or menopause, has working night shift changed how your body recovers? And if so, what do you wish your coworkers or hospital leadership understood?

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