The Four Ms: What Women's Health Really Costs Women's Finances.

Published: 2025

What is the impact of women's health on their finances?

It is a question we need to ask more often — because the answers reveal systemic gaps hiding in plain sight.

Much of the financial inclusion work I have done over the years considers how different life events shape financial wellbeing. But there is a growing recognition — one I have been arguing for consistently — that health-specific factors play just as critical a role in women's financial outcomes as the more commonly discussed drivers like the pay gap. And they interact with those drivers in ways that compound over a lifetime.

I think about it through four Ms.

Menstruation

Menstrual health conditions — from severe period pain to endometriosis, fibroids, and PMDD — affect a significant proportion of women throughout their working lives. The economic cost to the UK of absenteeism due to severe period pain and heavy periods alongside endometriosis, fibroids, and ovarian cysts is estimated at nearly £11 billion per year.

Behind that aggregate number sit individual financial consequences: missed work days, reduced performance during symptomatic days, out-of-pocket costs for pain management and treatment, and — for those with diagnosed conditions navigating inflexible workplaces — career decisions shaped by health rather than ambition.

Maternity and Motherhood

Maternity, and the broader caregiving expectations that follow, remain among the largest single drivers of the gender wealth gap. Career pauses reduce earnings directly. Part-time working patterns — disproportionately taken up by mothers — reduce them further. Career breaks women take to care for their families amount to an average of £39,000 in lost pension savings, and unpaid leave that is not covered by voluntary National Insurance contributions can compromise State Pension entitlement, which requires 35 qualifying years.

Caregiving does not end with early childhood. Women disproportionately carry eldercare responsibilities too — a second wave of career interruption that arrives just as many women are reaching their peak earning years.

Menopause

Approximately 60,000 women in the UK are not in employment because of menopause symptoms, with a direct economic impact of around £1.5 billion per year. Women leaving the workforce during perimenopause and menopause exit at what should be their highest-earning, highest-contributing years — the years that disproportionately determine final pension outcomes.

The workplace conversation on menopause has improved in recent years, but support remains inconsistent, and the financial planning conversation has barely started. A career interruption at 50 has fundamentally different retirement consequences than one at 30, and almost no financial products or guidance address this directly.

Marriage — and Divorce

The fourth M is the one least discussed in health terms but deeply connected to the others. Marriage shapes financial structures — whose career takes priority, whose pension contributions continue, whose name is on which assets. Divorce reveals those structures, often brutally. Pensions are among the most commonly overlooked assets in divorce settlements, and women — who typically have smaller pots and interrupted contribution histories thanks to the other three Ms — are disproportionately harmed when they are ignored.

Why this is a design problem

Each of these four Ms brings physical and emotional challenges. Each also brings economic ones: career pauses, reduced income, increased care responsibilities, medical expenses, and exclusion from long-term financial planning that assumes an uninterrupted, full-time working life.

And yet most financial products and systems do not take these realities into account. The default customer for whom pensions, savings products, and financial guidance were designed did not menstruate, did not take maternity leave, did not go through menopause, and did not face the asymmetric financial consequences of divorce.

If we want genuinely inclusive financial solutions, we have to design with these lived experiences in mind. That means recognising health as a financial determinant — not a separate wellbeing topic, but a core input to financial outcomes. It means creating products that flex with life stages rather than penalising deviation from an uninterrupted career. And it means reframing financial wellbeing through a gender-aware lens — not as a special interest add-on, but as accuracy about how half the customer base actually lives.

Closing the women's health gap could boost the global economy by at least $1 trillion annually by 2040. The financial services industry is sitting on one of the largest levers for that change — the design of the products that shape women's financial lives.

I would love for women's health to be more central in the financial inclusion conversation. The evidence is there. The opportunity is there. What is needed now is for the industry to treat it with the seriousness it deserves.