The motherhood penalty is well-documented, but what happens at the other end of the reproductive spectrum? Menopause—a transition often marked by debilitating physical and psychological symptoms—also entails substantial costs. Using population-wide Norwegian and Swedish data and quasi-experimental methods, we show that a menopause diagnosis leads to lasting drops in earnings and employment, alongside greater reliance on social transfers. Increasing access to menopause-related health care can help offset these losses. Our findings reveal the hidden economic toll of menopause and the potential gains from better support policies.