Dr Ginni Mansberg on why perimenopause is a leadership issue
Dr Ginni Mansberg is an Australian GP, author and broadcaster who has explained complex medicine on Channel Seven's Sunrise since 2008, and is co-founder of the evidence-based skincare company ESK. Her position is that perimenopause is an organisational problem, not only a private medical one: roughly 10 per cent of women leave the workforce during their peak earning and leadership years, a further 14 per cent reduce their hours, 8 per cent decline a promotion or request a demotion, and 80 per cent report lower productivity. The driver is hormonal instability, which Mansberg calls the hormonal trampoline, producing disrupted sleep in about 75 per cent of women, a diagnosable mood disorder in one in three, and a persistent sense of not feeling like yourself. For chief executives, the takeaway is that this attrition is being recorded as personal choice when it is in fact an avoidable loss of senior capability, and midlife is the window where intervention delivers the highest return.
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The need-to-know:
Never drop a day. Reducing to 0.8 FTE almost never reduces the workload, because the missing 20 per cent is rarely backfilled, so the outcome is a 20 per cent cut to pay and superannuation while carrying full-time delivery.
The only safe sentence a colleague can say is "I feel like you're not yourself. How can I help?" Naming perimenopause or offering three quick solutions removes control from someone already feeling out of control, while an open question leaves the next move with her and lets you route her to internal resources rather than acting as her doctor.
The binding constraint on a new partnership is rarely capital. It is manpower and the CEO's attention. ESK now requires evidence that a partner will carry real risk, because a distracted chief executive drops balls in the main revenue channel while chasing an unproven market.
Let’s go a little further
Ginni Mansberg has spent close to two decades doing something most clinicians never manage: compressing complex medicine into ninety seconds of live television without losing the accuracy. Her path there was unplanned. She had children young, concluded that neither nannies nor daycare would let her work, and started writing for medical trade publications from home. Her first book, Why Am I So Tired?, sold poorly, but it landed on the desk of an incoming editor at Women's Health. That produced a fifty-dollar monthly column, which produced a Sunrise segment when the network needed a woman to talk about the pill, which produced a broadcast career running from 2008 to today. Alongside general practice and a shelf of books including The M Word, Save Your Brain and The Women's Longevity Handbook, she and her husband Daniel built ESK, an evidence-based skincare business now trading in the UK, the US, South America, the Middle East and South Africa.
The insight in this conversation that should hold a chief executive's attention is about capacity rather than symptoms. Mansberg lays out what perimenopause costs an organisation, and the numbers describe senior attrition. Ten per cent of affected women leave the workforce entirely, usually in the years when their corporate knowledge and leadership reach are at their peak. Many do not leave permanently; they take a role well below their capability, absorb a 70 per cent cut to both pay and superannuation, and disappear from the leadership pipeline. Of those who stay, 14 per cent reduce hours, 8 per cent step away from promotion, and most report their output has fallen. She also makes the second-order point that gets missed entirely: a leader who is exhausted, irritable and unable to deliver to schedule pulls her whole team's performance down with her.
The moment that lands hardest is her instruction on reducing hours. "Please never drop a day." Her clinical experience is that the day comes off the payslip and the superannuation, but not off the workload, leaving the woman more stressed and materially poorer. It is a rare piece of health advice that is really a warning about financial independence, and she connects the two deliberately. The relationship between socioeconomic status and health outcomes is heavily evidenced. Keeping a woman earning and progressing is therefore an investment in her longevity, not only her balance sheet.
The leadership lesson runs against most managerial instinct. Mansberg is blunt that the urge to diagnose and solve is the wrong urge, whether you are a partner at home or a colleague at work. Someone in perimenopause is experiencing a loss of control. Arriving with three fixes and a suggested day off takes more control away. Anything beginning with "you should" fails. What works is a question, and then the willingness to sit in the answer. At work, the boundary is even tighter: notice, ask once, and route her to the resources your organisation should already have. Do not be her doctor, her therapist, or the arbiter of her team relationships.
The same capacity logic governs how Mansberg and Daniel run ESK, and this is where the CEO application becomes concrete. Their constraint is not capital and not supply. It is manpower and the founder's attention. So when a new market or channel presents itself, the test is whether the counterparty will put its own risk and effort on the table, or whether it expects ESK to do the work and clip the ticket. They have walked away from markets, including India, on that basis. Her advice to earlier-stage operators is sharper still: if you cannot afford to be distracted, do not enter the partnership. Build your own capacity, exhaust the channel that is already working, and let the shiny opportunity wait a year. Interest from a credible partner arrives as validation after a long stretch of hard graft, which is precisely what makes it so easy to say yes to at the wrong moment.
Both halves of this conversation ask the same question of a leader. What does this actually cost in attention, and who is carrying the risk? Applied to a partnership, it prevents an expensive distraction. Applied to a senior woman quietly reducing her scope, it reframes a resignation letter as an operating decision your organisation made by default.
If one of your strongest leaders scaled back this quarter, would your organisation record it as her personal choice, or as a cost you chose to absorb without ever pricing it?
Question for you
If you have watched a capable woman on your leadership team narrow her own scope in the past year, what did you assume about why, and who on your team would you trust to have asked her about it? Phil reads every email.
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