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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. The impact is especially severe for women with lower socioeconomic status. 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.