Yvonne Heimann [00:00:00]
I want you to think about the last time you walked into a room and forgot why you were there. Or you were in the middle of a sentence and the word just disappeared. Maybe you chalked it up to stress, to being too busy, to not sleeping enough, and part of you believed that because the alternative felt too scary to say it out loud. I'm Yvonne Heimann, and this is She Is A Leader. The show for women who are done building someone else's dream and are ready to build their own on their own terms. Today's guest left a career in finance at Goldman Sachs to become a functional medicine physician because she kept watching high-performing women just disappear from leadership and she finally figured out why. Her name is Dr. Manna Semby. She is a menopause society certified practitioner. The creator of the Periomenopause Broken Rung Framework. And she has a book coming out that I think is going to change how we talk about women in leadership forever. Here's what I need you to know before we even start. What you have been feeling is not burnout, it's not weakness, it's not you losing your edge.
It's your brain going through one of the most significant changes of your life. At the exact moment your career demands the most from you. By the end of this conversation, you're going to have a name for it, a framework for it, and you are going to know exactly what to do about it. Stay with me, as this is important, and I am really excited to have Dr. Manna with me today.
Yvonne Heimann [00:01:50]
Without being diagnosed, but simply by the symptoms, I'm in the middle of my perimenopause too, so my god, lady. Why are we just starting to talk about this?
Manna Semby [00:02:03]
Well, thank you, Yvi. I'm so glad to be having this conversation today. It's a good question. In the last two, three, four years, certainly we've begun to talk about menopause and certainly also perimenopause, but for the longest time we didn't because it was culturally just not okay to talk about these things. There was, there has been a big shroud of privacy, of taboo nature, of.
"Manage this thing in the four walls of your own home, but don't talk about it in the public square", so to speak. And now I feel that for the last I would say several years, many women are stepping forward and talking about menopause as a real physiological change that every woman experiences in their life, and not talking about it is.
You know, it makes some people uncomfortable when we talk about this, right? But if we don't, that is to our detriment. If we don't talk about it, we don't raise awareness, we don't get the resources we need, we don't get the help we need, and as a result, we can we are never able to catch up. So it is not a surprise to me that the when the Gen X woman came of age.
Right. The Gen X woman comes of age during the time when she's going through perimenopause and menopause and the world of AI and the world of technological advances. I think that this is a genie that cannot be put back in the bottle. It's out, it's going to be heard, it's going to get its say, and it's going to make the change that all women need across the whole world. So finally, thank goodness we're talking about it.
Yvonne Heimann [00:03:52]
And then. And I was laughing over here. As I always tell you, my my lovely listeners, if you're just listening, Yvi's faces on the YouTube videos of the podcast episodes are hilarious. So you just missed me kind of giggling behind the scenes. Because I grew up with the only phones on the block and remembering to call the operator because I grew up in East Germany.
I remember switching from a pop mache car in East Germany to actual cars, to self-driving cars, to the internet, to phones I can carry everywhere, to they suddenly don't have any buttons anymore, to now AI and all of these. And I'm looking back and I'm like, how often have I reinvented myself? How often have I seen a new world? And my god, even just my growth in asking for what I want or what I need. Because I was raised with you don't ask, you just serve, you just give. You are that that old picture of mom is taking care of everybody, right? So when you were talk the Gen X and growing up and all the changes we've seen and all the things, and honestly, I don't even know if I follow it, fall into Gen X or millennial. I never know. I'm somewhere in that age range.
And when you were talking about all of this, I'm like, I'm just sitting here giggling. I'm like, yeah, it's going to be interesting at some point talking to my nephew and my nieces of yeah, this is what life used to look like. And I don't even feel that old yet. It's an interesting age to be in, isn't it?
Manna Semby [00:05:30]
Yes, well you it is, and you know there are plenty of young mothers that are perimenopausal and have just given birth or have toddlers. So this is by no means an uncommon situation because women are having children later. Perimenopause in some women starts earlier, so the two things can combine. And during perimenopause, our hormones are all over the place. So if somebody thinks they cannot get pregnant,
That's not that's not really the thing. So you can definitely, definitely be perimenopausal and get pregnant, carry a whole pregnancy and be the mother of very young children and be completely exhausted.
Yvonne Heimann [00:06:05]
I feel you so much on that one. I'm literally in my journey of getting all of the blood panels taken care of and figuring getting data, getting data to what I'm seeing and what I'm feeling. And I would love for you to tell me about the women who sit across from you. The high achiever who comes in convinced she's just burned out or just losing, losing her mind, what's actually happening to her?
Manna Semby [00:06:34]
Yeah. Yes. I will tell you only just this morning, this woman reaches out to me and says, I'm in my early fifties. I've reached out to my doctor to ask for either hormones or an antidepressant. I am so exhausted and I don't feel like I feel like I'm losing myself was are her exact words. So this woman, she is.
She's an ABA therapist, you know, one of those therapies that you do with young children that have autism. And I've known her for decades and and I see that all the time. I hear from women who are on the verge of quitting their jobs because they feel they cannot perform at the same level anymore. I hear from women who are taking a pay cut and cut in hours, reducing their hours so they can continue to do the job yet also have time to take care of themselves.
I hear from women who are not able to get the care that they need from their doctors. So it's really all about like something has happened and I don't have the language to explain it. And I am not finding the help that I need. Not from my doctor, not from my employer, not from my family. Nobody can tell me what's going on and I don't know what to do.
Yvonne Heimann [00:07:51]
Oh my god, yes. It's I look at even just the energy level for me, right? Not yes, throughout the circle, energy levels change, cool, awesome. And I also feel like I can't work a normal workday where it's like by one or two p.m. I often just completely burned out. Or it's this.
An emotion coming up, no matter if it's if it's a positive or a negative emotion, that just pops out of me and I can see it. It's like looking at myself from the outside, and I can see it, and I know this is not how I want to act right now, and there is nothing I can do. And I'm like, oh my God. Fortunately enough, I have learned to communicate or step away.
Step away. I know what's happening right now. I do not want to have this conversation with you. Step away. But it's this, yeah, I'm not myself anymore. I often, when I get into those low moments where I cannot control my own emotions, my own body, and I'm like just feeling like completely losing control. The other half of myself looks at me and is like,
You're an autopilot. What's happening? We know this is not what you want to do, and there is nothing I can do about it.
Manna Semby [00:09:18]
Yes. So the two things that really need to be paid a lot of attention to. One is this concept of burnout. You know, we know that sixty percent of senior women in corporations are burnt out. But we don't ask where this burnout is coming from. And my guess is if we ask these women where is the burnout coming from, what life stage are you in, I would I would bet you that at least half of them. It is through menopause. Okay, we don't ask. Women in their 40s and 50s at work, 60% of them are burnt out. We do not ask where is this coming from. Also, the more senior a woman, the less likely she is going to talk about menopause at work because it is still a stigma, it is still taboo, especially in the corporate world, right? Because the any progress that this particular woman or any woman has made has been so hard won.
That you don't want to give the hint of a doubt to somebody who is in a position to promote you or not, for you to give them any ammunition to think she might not be able to perform. She is doubting herself. So women are not going to talk about it. We also don't ask about it because then it's going to be like, okay, we asked, they told us, now we don't know what to do. Right? That's one thing. And the second thing that you are telling me about is this mood changes.
With the menopausal transition. This is a very common, very common occurrence. Many women will notice that they can have emotions like sudden anger, rage, frustration, tears that they're not able to control.
Yvonne Heimann [00:11:04]
Oh the tears. Yeah.
Manna Semby [00:11:07]
These any of these emotions can come up suddenly at a time when it is most inconvenient to you. And yet you have to either step away or educate your team, like I'm gonna need a minute or two. And so what is happening, what is really happening, and what we need women to understand is that your brain is changing. Your brain is changing in a very big way, and until and unless all women know about it.
We will just be caught off guard with what is happening to me. Right? More than anything, the menopausal transition is a brain event. We have been told that it is just the end of reproduction, you cannot have babies anymore, now you're getting older. All of that is, yes, incidental to the change that is happening in the brain.
Yvonne Heimann [00:12:00]
It's just a physical manifestation of how it shows up outside of us. Mm-hmm.
Manna Semby [00:12:02]
It is a it is one of the manifestations, right? Right. So our brain, the areas of the brain which are most responsible for decision making, executive function, risk taking, mood stability, all of those areas have a many, many receptors for estrogen and progesterone. When those begin, when the supply of those hormones begin becomes less freely available. It becomes lesser than usual. When it becomes more unreliable, it fluctuates a lot first in perimenopause and then in menopause it completely goes down to zero. When this begins to happen, these areas of the brain that are so important for work, for balance, for judgment, for you know, balancing all these things that we do.
That's why things become a challenge. And if we don't understand what's happening, then we are just trying to chase our tail. Like what's going on? Let me just catch a break.
Yvonne Heimann [00:13:12]
Yeah, I'm like the the positive advantages of it is I definitely give less fucks at this point. So there is positive positivity in those changes too.
Manna Semby [00:13:22]
There there is that. There is that. I, you know, there is this thing about Dr. Lisa Moscone has talked about it, I think, that women, this is a way, this is a rite of passage where you s develop, you learn to develop more empathy for yourself. Something that you that women often don't do through their younger years, right? Because they're always caretaking of others.
And finally at this point it's like, no more. I'm gonna take care of myself. And high time.
Yvonne Heimann [00:13:54]
Less fucks given. Yeah, and it's like even without the the medical knowledge behind it and everything, it's it makes sense, right? We are the one supposed to, I'm not, but a lot of other women bearing the child, and the child needs to care and needs to be taken care of to survive. So naturally, it makes complete sense for me in nature that we do have a hormone build and our bodies and our mind works accordingly. So it always did make sense to me. I love, however, also how you make the connection not just for us as women and in our personal life, you also make the connection again in leadership and work. And you call it the perimenopause broken rung. So I would love for you to walk me through that moment when you realize this is not just a health issue, but it's actually a leadership pipeline issue. How walk me through this.
Manna Semby [00:15:01]
So my first career was at Goldman Sachs and I was there in my twenties and my thirties. And what I used to see was like, okay, there's plenty of women here in the 20s and 30s, but somehow in the 40s and 50s, there's not that many. And certainly in late 50s and 60s, hardly any woman. I'm like, where are they going? What are they doing? Where are these women? And when I became a doctor, I found that they are all sitting.
In my waiting room and other doctors' waiting rooms, basically asking, what is going on? I cannot perform at the same level anymore. I feel I am going to make a mistake. I'm gonna have some judgment call that is gonna go wrong, and I just don't trust my ability to function in the same way anymore. Now notice nothing wrong has happened yet. They're just anticipating, they're just anticipating something is gonna go wrong because they don't have that internal confidence anymore. Because yes, they are losing words here and there.
They are taking two or three times or four times as long to read and understand material that they were able to do effortlessly before. So they are translating correctly that something has changed and they want to be able to undo that change or fix it, and but they don't know how to, right? So that's when I when I made the switch already from one career to the next, and I realized okay, this is where the women are sitting. And by no means am I saying, that we are still at only 29% of leaders that are women, all because of menopause. But I think this is a very big contributor to the fact that we don't have enough women leaders today. We are still far from 50-50 women representation in leadership. So the idea of the broken rung, this is a concept that was introduced by McKinsey and Lean Inn.
Manna Semby [00:16:55]
And what they said is that we used to have this idea of the glass ceiling in the 80s and the 90s, right? We've had that, okay, women can progress in careers in corporations to a certain level, but no further. And then when they actually did the research, they found that actually it's not that you can live reach to a certain point and then finally you can't ascend anymore. They found that the ladder, if you want to use that metaphor.
The ladder of career advancement for women is broken at the very first rung.
Meaning men and women start their careers in equal numbers, more or less, okay. But right from the first promotion onwards, for every 100 men that make the promotion, only 90 women make it. So right at the first promotion to manager, there is a difference. Fewer women get that promotion. And then at each successive rung, it's fewer and fewer and fewer and fewer.
Such that by the time we get to the top rung, it's only about 20 to 30% of women in leadership. And my idea is of the perimenopause broken rung, that in addition to all the rungs that we have already documented that are broken, which are things like lack of sponsorship, lack of mentorship, the bias that still continues, the microaggressions that still are there, there is this other giant broken rung that is faced by women just when they're getting to those really senior positions, right? In the four in your 40s, often women are getting to that senior vice president level or managing director level, right? Those promotions. And at the same time, this big physiological change is happening in their bodies and brains, right? So just noticing that these two stages.
Like one of career advancement and the other one of change in the body and the brain, they are coinciding. And how many women are not able to achieve their professional goals because of the change in their body and their inability to receive the support that could help them. So we see a big decrease or a lack of increase. Is the right way to say it. We lack of increase, a sustainable increase in the number of women in leadership.
Yvonne Heimann [00:19:30]
Now, I know you don't believe the answer is just more resilience training or another DEI program or anything. What do you believe could be the solution for this? What what can we do?
Manna Semby [00:19:47]
Right. So I think DEI programs are very helpful in the sense that there needs to be more education. If you can educate, okay, we say that okay, corporations don't know about this or men don't know about this. Even women don't know about menopause. We have not been taught about menopause, right? Our school didn't tell us, our schools taught us about pregnancy and puberty, but not perimenopause. Our doctors don't didn't know about perimenopause.
You know, our mothers didn't talk to us. My mother didn't talk to me about menopause. So we end up in our 40s and 50s not knowing what to expect. So education is definitely number one. And then the other thing that companies can do, there's already some EAPs, there are already benefits, there are already plenty of things in place, infrastructure-wise, already. What companies need to see is what can, what already exists that can be used and offered to women. Most workplaces have flexible work policies. So offering what kind of flexibility can you do, great. But it's really the need of the hour is education and removing the stigma that is with menopause. Right? It's like removing the stigma, and all of that is going to need a really something that is difficult to do, but it's called culture change.
Right. We need to stop thinking of this thing as like this negative burden that somehow, you know, keeps women down. Yes, it's a thing women go through, but if we provide the right support, they can do whatever they have been doing and continue to do that.
Yvonne Heimann [00:21:26]
So what does it look like on the other side of this? What does it look like when we get to experience to actually hear, here's what's happening to you, here's what you can do. What shifts? What does that look like?
Manna Semby [00:21:45]
So in all the organizations that I have been speaking at, or any conferences that I've been speaking at, you will be so amazed to know how many women come up to me and tell me "I was going to quit because I thought I was burnt out and I couldn't do it anymore, but now I know what help I need to go get and I'm gonna get it, and I'm not gonna quit this company that I've been working at for twenty-nine years". You know, I was this close to quitting. So, the number one thing that I want to tell women is like on the other side of this. Let's say if every woman and every man and every organization has the right education. And my thought is if they have the right education, then they will have the support structure, the infrastructure. At least the companies that really care about retaining women. There are some companies today that are not caring, and so be it. That's their decision, that's their prerogative. But for the companies that care.
To just see what already exists in their support structures, in their benefits, and see what can be done. And for HR and managers to know that when a woman appears to be struggling in midlife and she hasn't come and said anything to you that I'm going through menopause, do not give her a performance improvement plan. You know, it's called a PIP plan. Like, do not write her up for like disengagement, low morale, low motivation, without finding out what's really going on and how you can help. Right? The woman is probably not going to raise her hand and ask for help because of the cultural situation that we are in, that women, you know, are still blacklisted if they talk about this. So if you have a woman that has been a strong performer but suddenly seems to be struggling or quieter than before.
Figure out a way to have a conversation. Figure out sent your HR or whoever it is, and then provide the support that is needed, that she needs. Okay. And then you will notice a real difference in your attention, in your morale, in your productivity, in your profitability. And you will become one of those model organizations that people really want to work at.
Yvonne Heimann [00:23:59]
Dr. Manna, thank you. These conversations just they need to happen, right? And they need to continuously happen. And for everybody listening, here's your one. No, actually, I got two action items for you today. Educate yourself and check what resources are available to you. Some of which are, by the way, in the description. And think of one woman in your life who has been seemingly quietly pushing through.
Who you have watched dim a little and just assumed it might been stress or age or live. Send her this episode right now, right before you close this app. She has been waiting for somebody to give her the language for what she's feeling. You just found it, now pass it on. And links to Dr. Manna's work and her book are all in the show notes. You know how that goes. And I will see you next week. Doctor Manna, thanks so much for having these conversations and coming on to She Is A Leader. Thank you.
Manna Semby [00:25:06]
Thank you, Yvi. It was a pleasure talking to you.