Employment conditions and work-related stressors are associated with menopausal symptom reporting among perimenopausal and postmenopausal women

Psychological and physical stress response and incidence of irregular menstruation in female university employees: a retrospective cohort study

Background This study aimed to assess a clinical relevance of three-dimensional occupational stress (job stressor score [A score], psychological and physical stress response score [B score], and social support for workers score [C score]) of the Brief Job Stress Questionnaire (BJSQ) in the national stress check program in Japan to irregular menstruation.Methods The present retrospective cohort study included 2,078 female employees aged 19-45 years who had both annual health checkups and the BJSQ between April 2019 and March 2022 in a national university in Japan. The outcome was self-reported irregular menstruation measured at annual health checkups until March 2023. A dose-dependent association between BJSQ scores and incidence of irregular menstruation was examined using Cox proportional hazards models to calculate multivariable-adjusted hazard ratios (HRs) of four quantile (0-49% [Q0-49], 50-74% [Q50-74], 75-89% [Q75-89], and 90-100% [Q90-100]) of the BJSQ scores.Results During 2.0 years of the median observational period, 257 (12.4%) women reported irregular menstruation. B score, not A or C scores, was identified as a significant predictor of irregular menstruation (adjusted HR [95% confidence interval] of A, B, and C scores per 1 standard deviation: 1.06 [0.89-1.27], 1.35 [1.15-1.57], and 0.93 [0.80-1.08], respectively). Women with higher B score had a significantly higher risk of irregular menstruation in a dose-dependent manner (adjusted HR [95% confidence interval] of Q0-49, Q50-74, Q75-89, and Q90-100: 1.00 [reference], 1.38 [1.00-1.90], 1.48 [1.00-2.18], and 2.18 [1.38-3.43], respectively).Conclusions Psychological and physical stress response predicted irregular menstruation.

Associations of menopausal symptoms with job-related stress and social support in Japanese school teachers

OBJECTIVES

Being a school teacher is highly stressful. This study aimed to clarify the prevalence of menopausal symptoms and explore the association between these symptoms and job-related stress among Japanese school teachers.

STUDY DESIGN

A cross-sectional study was conducted among randomly selected elementary and junior high school teachers in Japan. Data from 284 teachers aged 45-60 years were analyzed.

MAIN OUTCOME MEASURES

Menopausal symptoms were measured using the Greene Climacteric Scale, and the Brief Job Stress Questionnaire was used to assess job stressors, social support, and job/family satisfaction. Associations between scores on the Greene Climacteric Scale and on the Brief Job Stress Questionnaire, and demographic information were analyzed.

RESULTS

The most common menopausal symptom was "feeling tired or lacking in energy" (reported by 94.4 % of respondents). The total intensity of menopausal, psychological, and somatic symptoms was significantly correlated with the total level of job stress. Moderate correlations were found between depressive symptoms and job stress regarding suitable jobs, job control, and rewarding jobs, while weak correlations were evident between depressive symptoms and job stress regarding quantitative job overload, interpersonal conflict, and poor physical environment. Higher levels of perceived support from supervisors or co-workers and job satisfaction were associated with less severe psychological and somatic symptoms.

CONCLUSIONS

Most middle-aged school teachers felt tired or lacking in energy. Higher job-related stress and lower levels of support from supervisors or co-workers were correlated with more severe menopausal symptoms. A supportive work environment and stress management are essential for such teachers.

Association of psychosocial factors at work with fertility and menstrual disorders: A systematic review

OBJECTIVES

This systematic review aimed to assess the association between psychosocial factors in the workplace and menstrual abnormalities or fertility, focusing on literature implementing a prospective cohort design.

METHODS

We searched MEDLINE, EMBASE, PsycINFO, PsycARTICLES, and Japan Medical Abstracts Society electronic databases for studies published from inception to February 26, 2020, and updated the search in PubMed on May 29, 2024. Inclusion criteria were (P) adult female workers (over 18 years old), (E) presence of adverse psychosocial factors at work, (C) absence of adverse psychosocial factors at work, and (O) any menstrual cycle disorders, menstrual-related symptoms, or fertility issues. Prospective cohort studies were included. The included studies were summarized descriptively.

RESULTS

Database searching yielded 14,238 abstracts, with nine studies meeting the inclusion criteria. Outcomes included fertility (n = 5), irregular menstrual cycle (n = 1), early menopause (n = 1), endometriosis (n = 1), and serum hormones (n = 1). Study findings included that women with high job demands and low job control were less likely to conceive, and working over 40 h per week and frequent heavy lifting, and rotating night shift work increased the risk of earlier menopause. Studies on night shift/rotating work and fertility outcomes showed no significant differences.

CONCLUSION

This review underscores the insufficient high-level evidence regarding the association of psychosocial factors at work with fertility and menstrual disorders, emphasizing the necessity for future well-designed studies.

Association Between Menopausal Symptoms and Work-Related Factors Among Female Workers in Japan: A Cross-Sectional Study

OBJECTIVE

Although menopausal symptoms are an important issue for female workers, their association with work-related factors is not well studied. Here, we explored the association between work-related factors and menopausal symptoms in Japan.

METHODS

A cross-sectional study was conducted in 2023 among all 1465 female employees of a large Japanese company. Associations between occupational factors and moderate or severe menopausal symptoms, as measured by the Menopause Rating Scale (MRS), were examined using logistic regression analysis.

RESULTS

Several workplace-related factors were significantly associated with moderate or severe menopausal symptoms, including company support and the number of night shifts. A marginally significant association was also seen for commuting time.

CONCLUSIONS

Workplace menopause interventions for the factors identified in this study may satisfy unmet needs.

Menopause and the workplace: consensus recommendations from The Menopause Society

ABSTRACT

Menopause is a natural life transition experienced by half the world's population. Women aged 50 years and older are the fastest growing demographic group in many countries, making essential contributions to the workforce. Although menopause is a universal and natural life transition, the symptom experience is highly variable among women. Some women may experience few or no symptoms, whereas others may be bothered by moderate to severe symptoms for a decade or longer, which can adversely affect quality of life, relationships, job satisfaction, and career advancement. Indeed, menopause symptoms, including vasomotor and genitourinary symptoms, as well as sleep and mood disturbances are associated with multiple adverse work outcomes. Studies to date have demonstrated that these adverse work outcomes related to menopause symptoms include a compromised ability to work, reduced work productivity, absenteeism, and even loss of employment or an early exit from the workforce. Further, the relationship between menopause symptoms and work may be bidirectional, with certain aspects of the work environment being linked with a greater menopause symptom burden, such as insufficient restroom facilities, unpredictable or long work hours, the inability to take breaks, and confined or crowded workspaces. Thus, workplace solutions may need to be tailored based on women's individual needs, the work environment, and the type of work.The Menopause Society, in conjunction with an expert panel of medical and legal experts and women's health advocates, has developed a set of consensus recommendations that challenges employers to create a menopause-supportive workplace for their employees. These recommendations include, among other things, suggestions for employers to review policies and healthcare plans and benefits and to consider flexibility and accommodations that may be needed for some women with menopause symptoms. Guidance for women with menopause symptoms that affect them at work in terms of understanding their resources and empowering them to be self-advocates are also provided, as well as recommendations for what occupational health professionals should know and do for women with bothersome menopause symptoms in the workplace.

The impact of a specialist-led digital health application on menopause symptoms in the workplace: A single-arm, longitudinal evaluation

OBJECTIVES

The aim of the study was to evaluate the change in menopause symptoms and work impairment among a cohort of UK working women who utilised an employer-provided digital menopause health application offering education and personalised support.

STUDY DESIGN

We adopted a retrospective, single-arm, longitudinal approach by analysing data from 11,870 users of the Peppy Health menopause application. Users reported their menopause symptoms and work impairment on day 0 and after 90 and 180 days of application use.

MAIN OUTCOME MEASURES

Menopause symptoms were measured by the Menopause Rating Scale, while work impairment was measured by a single question.

RESULTS

A significant decrease in the severity of menopause symptoms was observed in users across menopause stages, except for premenopausal users who saw lower severity and no change over time. Improvement in menopause symptoms was positively associated with the degree of application engagement. Work impairment also significantly reduced over time for menopausal users, and a significant association was observed between a reduction in menopause symptoms and a decline in work impairment.

CONCLUSIONS

Our findings show that engaging with a digital menopause application is associated with an improvement in menopause symptoms, which lends initial support for the use of personalised digital solutions to help working women through the menopause transition.

Menopause in the workplace: Challenges, impact, and next steps

INTRODUCTION

Menopause is a natural part of a woman's life that coincides with a time when many women play significant roles in the workforce. Menopause symptoms, such as hot flashes, fatigue, and difficulty with concentration and memory, can have a negative effect on work productivity and efficiency.

OBJECTIVES

This paper summarizes the impact of menopause in the workplace, with an emphasis on the impact of symptoms on employed women and how the workplace influences their experiences. It highlights economic implications, promotes awareness, and suggests potential next steps.

METHODS

A search for papers was conducted between August and November 2023 in the PubMed and Medline databases. Papers were selected based on personal experience and interpretation of the findings. Recommendations for managing menopause symptoms in the workplace and guidance on an optimal workplace intervention strategy were provided.

RESULTS

Women experiencing severe menopause symptoms are more likely to report adverse work outcomes, including absenteeism and job-related decisions such as quitting, retiring early, or declining promotions than women experiencing few symptoms. Factors such as a lack of awareness about menopause, inflexible work conditions, and high-stress jobs can exacerbate the severity of these symptoms. Additionally, unaddressed menopause symptoms contribute to both direct and indirect economic costs, including medical resource utilization and lost work productivity, resulting in a substantial economic burden.

CONCLUSION

Menopause symptoms impair women's work experiences and productivity. In addition to dismantling the stigma associated with menopause, it is critical to create and implement menopause workplace policies and interventions aimed at supporting women in this universal life stage.

Navigating menopause at work: a preliminary study about challenges and support systems

OBJECTIVE

Women's increasing workforce participation necessitates understanding unique life phases like menopause for enhanced workplace inclusivity. This research investigates the challenges and needs of peri-menopausal women in work settings, using the Job Demands-Resources model as a foundation.

METHODS

A cross-sectional survey was administered to 351 working women aged 40 to 65 years in the United States. Hierarchical multiple regression models were employed to assess the relationship between the severity of menopausal symptoms, emotional exhaustion, work engagement, and turnover intentions.

RESULTS

Most of the respondents reported moderate (38.46%) to severe (35.9%) menopausal symptoms. Notably, 54% of the women were caregivers for children or adults. About 77.7% of participants reported work-related challenges due to menopause, with a perceived reduction in productivity (56.8%) being the most common issue. The severity of menopausal symptoms was found to significantly predict more emotional exhaustion ( P < 0.001), less work engagement ( P < 0.001), and greater turnover intentions ( P = 0.03). Concerns about being perceived as less capable in the workplace due to menopausal symptoms were reported by 51.2% of respondents. A striking gap exists between the workplace measures desired by women, such as formal menopause policies and managerial training (65.4%-68%), and their actual implementation (2%-6.3%).

CONCLUSIONS

This study reveals an exigent need for increased awareness and structural changes to support working women going through menopause. The findings have far-reaching implications for not just promoting gender equity and well-being but are also pivotal for maintaining a diversified, engaged, and effective workforce.

Policies, Guidelines, and Practices Supporting Women's Menstruation, Menstrual Disorders and Menopause at Work: A Critical Global Scoping Review

(1) Objectives: This paper presents a scoping review of global evidence relating to interventions (i.e., policies, practices, guidelines, and legislation) aimed at supporting women to manage menstruation, menstrual disorders, and menopause at work. (2) Methods: Databases including Medline (Ebsco), CINAHL (Ebsco), Scopus, Web of Science, APA PsychInfo (Ebsco), Humanities International Complete (Ebsco), Academic Search Premier (Ebsco), HeinOnline and OSH Update, and Google Scholar were searched in May 2022. (3) Results: Of 1181 unique articles screened, 66 articles are included. Less half of the articles (42%, 28/66) presented/reviewed an intervention related to women's workplace health. A total of 55 out of the 66 articles are set across 13 countries with the remaining 12 articles described as multi-country studies or reviews. Half of the articles presenting/reviewing an intervention were grey literature, with several undertaken in UK and EU member countries. Interventions focusing on supporting women with menopause at work were the most common (43%, 12/28), followed by menstruation (25%, 7/28) and menstrual disorders (7%, 2/28). Across the reviewed articles, recommendations were categorised as adjustments to the physical work environment, information and training needs, and policy and processes. Few articles explicitly presented or affirmed a design-process and/or evaluation tied to their intervention. In lieu of design-process, this review categorises the rationales driving the development of an intervention as: pronatalist, economic rationalism, gendered occupational health concern, cultural shift towards gender equity objectives, and efforts to reduced shame and stigma. (4) Conclusions: There is a growing body of evidence aimed at understanding women's experiences of managing their menstrual and reproductive health in the workplace and how this impacts their work/career trajectories. However, little research is explicitly concerned with exploring or understanding interventions, including their design or evaluation. Most articles report menopause guidelines and are typically confined to the UK and EU-member countries. Despite the prevalence of menstrual disorders (e.g., endometriosis and polycystic ovarian syndrome (PCOS)) there is limited literature focused on how women might be supported to manage symptoms associated with these conditions at work. Accordingly, future policies should consider how women can be better supported to manage menstruation and menstrual disorders at work and recognise the importance of co-design during policy development and post-intervention evaluation. Further research needs to be undertaken on the impact of workplace policies on both employers and employees.

An evaluation of demographic characteristics and workplace experiences of UK employees using an employer-provided menopause application

OBJECTIVES

The aim of the current study was to determine the demographic characteristics and workplace experiences of users of a menopause application in the UK.

STUDY DESIGN

A retrospective observational study of data extracted from the information submitted by 21,555 users of the Peppy Health menopause application during registration.

MAIN OUTCOMES MEASURES

Menopause symptoms were measured using the Menopause Rating Scale. The other questionnaire items assessed workplace impairment, work absence, thoughts about reducing hours or leaving work, feelings of support and disclosure confidence.

RESULTS

Users were predominately peri- and postmenopausal women between the ages of 40 and 60. The users reported menopause symptoms that were more severe than in the general population. Symptom severity was associated with work impairment and wanting to reduce hours worked or leave employment, and feeling supported was associated with less impairment.

CONCLUSIONS

The menopause application is reaching women in the workplace who are experiencing severe symptoms and who are likely to benefit from targeted support. Among the users of a menopause application, the presence of severe menopause symptoms can have a significantly negative effect on work and future participation in paid employment. The results also indicate the potential role of support to mitigate some of the negative impact.

Menopause-Biology, consequences, supportive care, and therapeutic options

Menopause is the cessation of ovarian function, with loss of reproductive hormone production and irreversible loss of fertility. It is a natural part of reproductive aging. The physiology of the menopause is complex and incompletely understood. Globally, menopause occurs around the age of 49 years, with geographic and ethnic variation. The hormonal changes of the menopause transition may result in both symptoms and long-term systemic effects, predominantly adverse effects on cardiometabolic and musculoskeletal health. The most effective treatment for bothersome menopausal symptoms is evidence-based, menopausal hormone therapy (MHT), which reduces bone loss and may have cardiometabolic benefits. Evidence-based non-hormonal interventions are also available for symptom relief. Treatment should be individualized with shared decision-making. Most MHT regimens are not regulator approved for perimenopausal women. Studies that include perimenopausal women are needed to determine the efficacy and safety of treatment options. Further research is crucial to improve menopause care, along with research to guide policy and clinical practice.

Effectiveness of workplace-based interventions to promote wellbeing among menopausal women: A systematic review

Menopausal symptoms are known to affect quality of life and work productivity. This systematic review aimed to describe the range and effectiveness of workplace-based interventions for menopause. MEDLINE, PubMed, Embase, CINAHL, Cochrane Library, Web of Science, PsycINFO, EconLit, and SCOPUS were searched from the inception until April 2022. Quantitative interventional studies evaluating physical/virtual workplace-based interventions aiming to improve well-being, work, and other outcomes, that involved women in menopausal transition, or their line managers/supervisors were eligible for inclusion. Two randomized controlled trials and three uncontrolled trials, comprising 293 women aged 40-60 years and 61, line managers/supervisors, were included in the review. Results were narratively synthesized due to the heterogeneity of interventions and outcomes and we found that only a limited range of interventions have been evaluated for their ability to support women going through menopausal transition in the workplace. Self-help cognitive behavioural therapy (CBT); Raja yoga; and health promotion (involving menopause consultations, work-life coaching and physical training) improved menopausal symptoms significantly. Self-help CBT was associated with a significant improvement in mental resources for work, presenteeism, and work and social adjustment. Awareness programs significantly improved knowledge and attitudes of both employees and line managers/supervisors about menopause. The interventions have mostly been evaluated in small studies with selected populations but have improved menopausal symptoms and work outcomes. A customizable menopause wellbeing intervention package incorporating these evidence-supported interventions should be developed and implemented on a wider scale within organizations alongside robust evaluation of its effectiveness.

Impact of Menopause Symptoms on Women in the Workplace

OBJECTIVE

To evaluate the impact of menopause symptoms on work outcomes and to assess the estimated economic impact.

PATIENTS AND METHODS

Women aged 45 to 60 years receiving primary care at 1 of the 4 Mayo Clinic sites were invited to participate in a survey study (Hormones and ExpeRiences of Aging) from March 1 through June 30, 2021. A total of 32,469 surveys were sent, with 5219 responses (16.1% response rate). Of the 5219 respondents, 4440 (85.1%) reported current employment information and were included in the study. The primary outcome was self-reported adverse work outcomes related to menopause symptoms assessed by the Menopause Rating Scale (MRS).

RESULTS

The mean age of the 4440 participants was 53.9±4.5 years, with the majority being White (4127 [93.0%]), married (3398 [76.5%]), and educated (2632 [59.3%] college graduate or higher); the mean total MRS score was 12.1, signifying moderate menopause symptom burden. Overall, 597 women (13.4%) reported at least one adverse work outcome due to menopause symptoms; 480 women (10.8%) reported missing work in the preceding 12 months (median, 3 days missed). The odds of reporting an adverse work outcome increased with increasing menopause symptom severity; women in the highest quartile of total MRS scores were 15.6 (95% CI, 10.7 to 22.7; P<.001) times more likely to have an adverse work outcome vs those in the first quartile. Based on workdays missed due to menopause symptoms, we estimate an annual loss of $1.8 billion in the United States.

CONCLUSION

This large cross-sectional study identified a major negative impact of menopause symptoms on work outcomes and the need to improve medical treatment for these women and make the workplace environment more supportive. Additional studies are needed to confirm these findings in larger and more diverse groups of women.

Women's Health and Working Life: A Scoping Review

Women's health matters for participation in working life. The objective of this study was to explore female physiology in a work-life context and to investigate possible associations between women's health, sickness absence and work ability. A scoping review was conducted to develop a systematic overview of the current research and to identify knowledge gaps. The search strategy was developed through a population, concept and context (PCC) model, and three areas of women's health were identified for investigation in the context of work. A total of 5798 articles were screened by title and abstract and 274 articles were screened by full text; 130 articles were included in the review. The material included research from 19 countries; the majority of the studies used quantitative methods. The results showed an impact on the occupational setting and an association between sickness absence, work ability and all three areas of women's health, but a holistic and overall perspective on female biology in the work context is missing. This review calls for more knowledge on health and work and possible gender differences in this regard. Women's health and working life involve a complex connection that has the potential to develop new knowledge.

Impact of Menopausal Symptoms on Work: Findings from Women in the Health and Employment after Fifty (HEAF) Study

Women make up a growing proportion of the workforce and therefore many women experience menopause while in paid employment. We explored the prevalence of menopausal symptoms, the relationship between symptoms and coping with work and the risk factors associated with struggling at work during the menopause. The Health and Employment After Fifty (HEAF) community-based cohort of people aged 50-64 years was incepted 2013-2014 to study health and work. In 2019, female participants were asked to complete a questionnaire about their menopausal symptoms, and effect of those symptoms on their ability to cope at work. 409 women were eligible for inclusion. The commonest symptoms were vasomotor (91.7%); trouble sleeping (68.2%); psychological (63.6%) and urinary (49.1%). The prevalence of reporting symptoms was similar no matter which type of occupation women were performing at the time. Around one-third of women reported moderate/severe difficulties coping at work because of menopausal symptoms. Risk factors for difficulties coping at work included: financial deprivation, poorer self-rated health, depression, and adverse psychosocial occupational factors but not physical demands. More awareness is needed amongst employers in all sectors but women with financial difficulties and those with jobs in which they feel insecure, unappreciated, or dissatisfied are at greatest risk.

The impact of workplace psychosocial factors on menstrual disorders and infertility: a protocol for a systematic review and meta-analysis

INTRODUCTION

Workplace environment, especially psychosocial factors at work such as job strain, workplace social support, and shift work, may affect the menstrual abnormalities and fertility of female workers. However, the association between psychosocial factors at work and menstrual abnormalities or fertility is not well understood. To address this relationship, we will conduct a systematic review and a meta-analysis of the literature that has utilized a longitudinal or prospective cohort design.

METHODS AND ANALYSIS

The inclusion criteria for this systematic review and meta-analysis are defined as follows: (P) adult female workers (over 18 years old), (E) the presence of adverse psychosocial factors at work, (C) the absence of adverse psychosocial factors at work, and (O) any menstrual cycle disorders, menstrual-related symptoms, or fertility. The MEDLINE, Embase, PsycINFO, PsycArticles, and Japan Medical Abstracts Society electronic databases will be used to search for published studies. The statistical synthesis of the studies included in the meta-analysis will be conducted to estimate pooled coefficients and 95% CIs. For the main analysis, we will synthesize measures of association between psychosocial factors at work and menstrual-related disorders/symptoms. At least three eligible studies will have to be gathered to conduct a meta-analysis; otherwise (i.e., if only one or two studies will be eligible and included), the results will be presented in a narrative table. We will use the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) to determine the quality of selected studies. To assess meta-bias, Egger's test, along with a funnel plot, will be used to check for publication bias. Lastly, we will examine heterogeneity using the χ² test with Cochran's Q statistic and I².

ETHICS AND DISSEMINATION

The results and findings will be submitted and published in a scientific peer-reviewed journal and will be disseminated broadly to researchers and policymakers interested in the translatability of scientific evidence into good practices.

SYSTEMATIC REVIEW REGISTRATION

The study protocol was registered at the UMIN registry (registration number: UMIN000039488). The registration date is on 14 Feb 2020. URL: https://upload.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000044704.

Menopause and work: A narrative literature review about menopause, work and health

BACKGROUND:

Menopause is part of working women’s lives. In Western countries, labour market patterns are changing rapidly: women’s labour participation has increased, the percentage of full-time working women is rising, and retirement age is increasing.

OBJECTIVE:

This narrative literature study aims to provide an insight in the state of the art in the literature about the relationship between menopause, work and health and to identify knowledge gaps as input for further research.

METHODS:

The search was conducted in PubMed, CINAHL, MEDLINE and ScienceDirect. The final set includes 36 academic articles, 27 additional articles related to the topic and 6 additional sources.

RESULTS:

Research on menopause, work and health is scarce. Results are grouped thematically as follows: Menopause and (1) a lack of recognising; (2) sickness absence and costs; (3) work ability; (4) job characteristics; (5) psychosocial and cultural factors; (6) health; (7) mental health, and (8) coping and interventions. Work ability of women with severe menopausal complaints may be negatively affected.

CONCLUSIONS:

Due to taboo, menopause remains unrecognised and unaddressed within an organisational context. New theoretical and methodological approaches towards research on menopause, work and health are required in order to match the variety of the work contexts world-wide.

A sex/age anomaly in thermal comfort observed in an office worker field study: A menopausal effect?

In a field study conducted in office settings in Sydney, Australia, background survey and right-here-right-now thermal comfort questionnaires were collected from a sample of office workers. Indoor environmental observations, including air temperature, mean radiant temperature, air velocity, and relative humidity, were also recorded and matched with each questionnaire according to the time and location. During exploratory data analyses, we observed that female subjects aged over 40 and 50 or younger registered significantly warmer sensations than other subjects, male and female, from other age ranges. To further explore this phenomenon, the sample of building occupants was classified into two groups-women of perimenopausal age (over 40 and 50 or younger) while the remaining respondents served as a reference group for comparison. Women in the perimenopausal age range demonstrated an increased perception of warmth (p < 0.01) and expressed thermal dissatisfaction more frequently (p < 0.01) than the reference group respondents who were exposed to the same indoor environmental conditions. Furthermore, women of perimenopausal age also expressed preference for cooler thermal environments, that is, lower air temperature (p < 0.01) and greater air movement (p<0.01) than the reference group, and their thermal neutrality (ie, the room temperature corresponding to a neutral thermal sensation) was approximately 2°C cooler than that of the reference group (20.7°C vs 22.4°C). A potential physiological explanation for the distinct thermal perception of women aged over 40 and 50 or younger observed in this study could stem from menopausal symptoms-the presence of hot flushes and dysregulation of the thermoregulatory system.

Work and health-related factors of presenteeism: a mediation analysis on the role of menopausal symptoms between job demands and presenteeism among a sample of social service women employees

Purpose

Building on prior studies on the role of health-related and job-related issues in affecting presenteeism, the present study tested a mediation model of the relationship between job demands and presenteeism by exploring the mediation effect of menopausal symptoms.

Design/methodology/approach

Data were collected through a self-report questionnaire involving social service menopausal employees (N = 204) from a public municipal organization. The survey was cross-sectional and non-randomized.

Findings

Results revealed that job demands, namely emotional, cognitive and physical demands, were significantly and positively associated with presenteeism. Furthermore, mediation analysis evidenced that physical job demands were also associated with higher levels of menopausal physical symptom bothersomeness, which in turn serves as a condition to increase the act of presenteeism.

Originality/value

The findings of this study widen the perspective on presenteeism research by evidencing the role of an overlooked health-related factor in relation to the act of presenteeism, that is the menopausal transition. Insights for the development of targeted preventive measures of the act of presenteeism and menopausal symptom management in the workplace may also be derived from these results.

Menopause and Sustainable Career Outcomes: A Science Mapping Approach

This paper provides a systematic review of the phenomenon of menopause at the workplace from a sustainable career perspective, by highlighting its major themes along with the evolution and tendencies observed in this field. A conceptual science mapping analysis based on co-word bibliographic networks was developed, using the SciMAT tool. From 1992 to 2020, 185 documents were retrieved from the Web of Science. In the first analyzed time span (1992-2002), postmenopausal women, health, and risk factors appeared to be the motor themes (well-developed and important for the structure of the discipline under focus), and disorder was an emerging or disappearing theme in the phenomenon under research. In the second studied period (2003-2013), risk and health were motor themes, menopausal symptoms was a basic or transversal theme (important for the discipline but not well-developed), coronary heart disease was a specialized theme (well-developed but less important for the structure of the research field), and postmenopausal women was an emerging or disappearing theme (both weakly developed and marginal to the field). In the third studied period (2014-2020), menopause, breast cancer, and menopausal symptoms were motor themes, Anxiety was a specialized theme and risk and body mass index were emerging or disappearing themes. Sustainability of women's careers in the second half of life is of increasing importance given the increasing equal representation of men and women in working organizations, and the impact of the changing nature of work in the 21st century on older workers.

Climacteric symptoms more severe in 2010 than in 2000 - experience of Finnish women aged 52-56 years not now or previously on menopausal hormone therapy

OBJECTIVES

To analyze and compare the experience of climacteric symptoms and their associations with sociodemographic and health-related characteristics in two cohorts of Finnish women aged 52-56 years, born ten years apart and not now or previously on menopausal hormone therapy (MHT).

STUDY DESIGN

Nationwide population-based time-trend study with a large number of participants (n = 1986 + 1988).

MAIN OUTCOME MEASURES

The experience of climacteric symptoms was assessed by 12 commonly used menopause-related symptoms.

RESULTS

Women aged 52-56 experienced more moderate or severe symptoms and fewer mild symptoms in 2010 than in 2000. Being unemployed or inactive was associated with more severe symptoms (P = 0.007), but employment status had no effect on the relative odds estimates.

CONCLUSIONS

The influence of the birth cohort and time-period effects as well as work-related factors on the experience of climacteric symptoms in women not now or previously on MHT needs further research, particularly since the change in the experience of symptoms found in this study occurred within only ten years.

Menopause workplace policy: The way forward or backward?

Workplace policies regarding women's reproductive and menopausal health are garnering global attention. The peri- and post-menopause stages may be turbulent times for many women, with some experiencing debilitating symptoms and some none at all. While the symptoms of menopause should be recognised by employers due to their various impacts, the implementation of policies that pertain to all women can alienate older female workers by creating prejudice surrounding work capability. This piece identifies other avenues for the inclusion of menopausal symptoms through pre-existing policy and highlights the issues facing menopausal women in this current age.

Influence of Work on Andropause and Menopause: A Systematic Review

Aging is associated with gender-specific hormonal changes that progressively lead to gonadal insufficiency, a condition which characterizes a minority of men and all women. Work-related factors, such as stress and pollutant exposure, affect gonadal function and can interfere with reproduction in both genders. A systematic review of the PubMed, SCOPUS and EMBASE databases was conducted, according to the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) statement to investigate the effect of occupational factors on andropause and menopause. A total of 26 studies met the inclusion and exclusion criteria: 9 studies evaluated the effects of work on andropause symptoms, 8 studies examined its effects on age at menopause onset, and 9 studies addressed its effects on menopausal symptoms. Work-related factors, such as psychological stress, physical effort, and sleep disorders, showed a significant correlation with andropause manifestations, whereas age at menopause and severity of menopausal symptoms were both influenced by factors such as pesticide exposure, high job strain, and repetitive work. Since work accompanies men and women for most of their lives, it is essential to identify and prevent the risk factors that may affect reproductive health.

Do Menopausal Symptoms Affect the Relationship between Job Demands, Work Ability, and Exhaustion? Testing a Moderated Mediation Model in a Sample of Italian Administrative Employees

(1) Background: The increasing presence of employed women undergoing menopause has stimulated a growing corpus of research highlighting the complex relationship between menopause and work. Nevertheless, little is known regarding the mechanism by which menopause affects work ability and work-related well-being. In order to fill this gap in the literature, the present study examines whether and how menopausal symptoms affect the relationship between job demands, work ability, and exhaustion. (2) Method: In total, 1069 menopausal women, employed as administrative officers in a public organization, filled out a self-report questionnaire. A moderated mediation analysis was carried out using the latent moderated structural (LMS) equation. (3) Findings: The findings of this analysis indicate that the indirect effect of work ability on the relationship between job demands and exhaustion is influenced by the exacerbating effect of menopausal symptoms on the relationship between job demands and work ability. Moreover, the conditional effect confirmed that women with high menopausal symptoms receive more exposure to the negative effects of job demands on work ability compared to women with low menopausal symptoms. (4) Conclusion: The present findings may help in addressing interventions to prevent negative outcomes for menopausal women and their organizations.

Global consensus recommendations on menopause in the workplace: A European Menopause and Andropause Society (EMAS) position statement

INTRODUCTION

Worldwide, there are 657 million women aged 45-59 and around half contribute to the labor force during their menopausal years. There is a diversity of experience of menopause in the workplace. It is shaped not only by menopausal symptoms and context but also by the workplace environment. It affects quality of life, engagement, performance, motivation and relations with employers.

AIM

To provide recommendations for employers, managers, healthcare professionals and women to make the workplace environment more menopause supportive, and to improve women's wellbeing and their ability to remain in work.

MATERIALS AND METHODS

Literature review and consensus of expert opinion.

SUMMARY RECOMMENDATIONS

Workplace health and wellbeing frameworks and policies should incorporate menopausal health as part of the wider context of gender and age equality and reproductive and post-reproductive health. Workplaces should create an open, inclusive and supportive culture regarding menopause, involving, if available, occupational health professionals and human resource managers working together. Women should not be discriminated against, marginalized or dismissed because of menopausal symptoms. Health and allied health professionals should recognize that, for some women, menopausal symptoms can adversely affect the ability to work, which can lead to reduction of working hours, underemployment or unemployment, and consequently financial insecurity in later life.

Menopausal symptoms and work: a narrative review of women's experiences in casual, informal, or precarious jobs

Governments, employers, and trade unions are increasingly developing "menopause at work" policies for female staff. Many of the world's most marginalised women work, however, in more informal or insecure jobs, beyond the scope of such employment protections. This narrative review focuses upon the health impact of such casual work upon menopausal women, and specifically upon the menopausal symptoms they experience. Casual work, even in less-then-ideal conditions, is not inherently detrimental to the wellbeing of menopausal women; for many, work helps manage the social and emotional challenges of the menopause transition. Whereas women in higher status work tend to regard vasomotor symptoms as their main physical symptom, women in casual work report musculoskeletal pain as more problematic. Menopausal women in casual work describe high levels of anxiety, though tend to attribute this not to their work as much as their broader life stresses of lifelong poverty and ill-health, increasing caring responsibilities, and the intersectionally gendered ageism of the social gaze. Health and wellbeing at menopause is determined less by current working conditions than by the early life experiences (adverse childhood experiences, poor educational opportunities) predisposing women to poverty and casual work in adulthood. Approaches to supporting menopausal women in casual work must therefore also address the lifelong structural and systemic inequalities such women will have faced. In the era of COVID-19, with its devastating economic, social and health effects upon women and vulnerable groups, menopausal women in casual work are likely to face increased marginalisation and stress. Further research is need.

Relationship between number of menopausal symptoms and work performance in Japanese working women

OBJECTIVE

The presence of various menopausal symptoms could decrease work performance because symptom management strategies differ, and it is difficult to control all symptoms at work. The aim of this study was to examine the relationship between the number of menopausal symptoms experienced and work performance in working women.

METHODS

An online cross-sectional study was conducted with 599 working Japanese women aged 45 to 65 years. To represent work performance, absolute presenteeism was measured using the Japanese version of the World Health Organization and Work Performance Questionnaire short form, and menopausal symptoms were measured using the Greene Climacteric Scale. The total number of subscales on which a participant scored more than one point represented the number of menopausal symptoms.

RESULTS

Participants' mean age was 54.2 years, and 60.6% were postmenopausal. Their mean Greene Climacteric Scale score and mean absolute presenteeism score were 10.5 ± 10.6 and 61.7 ± 17.9, respectively. The proportions of participants who provided care for a family member, who had chronic disease, and who undertook regular exercise were significantly different among the four groups. After adjusting for other factors, absolute presenteeism was negatively correlated with the number of menopausal symptoms experienced (β = -0.13, P < 0.001).

CONCLUSIONS

Higher numbers of menopausal symptoms were correlated with lower work performance. The maintenance of health and the provision of appropriate working environments would help working women and improve work performance by reducing menopausal symptoms.

A daily study of stressors, continuously measured glucose, and diabetes symptoms in latinos with type 2 diabetes

This study examined whether daily stressors and continuously monitored glucose levels and glucose variability predict daily diabetes symptoms. Fifty Latinos with type 2 diabetes were randomized to either diabetes education (DE-only; N = 23) or DE plus stress management and relaxation training (DE + SMR; N = 32). After treatment, for 7 days they wore 'blinded' continuous glucose monitors and reported common stressors and diabetes symptoms twice daily. Between individuals, participants with more numerous overall stressors and more time in hyperglycemia reported higher symptoms. Within individuals, symptoms were higher during intervals of greater than usual stressors. Yet, diabetes symptoms did not covary with changes in glucose levels or glucose variability. The within-person stressor-symptom association was stronger among older individuals and non-significant for participants in DE + SMR condition. Diabetes symptoms were associated with recent stressor exposure, but not recent glucose level or changes in glucose. CLINICAL TRIAL NUMBER: ClinicalTrials.gov Identifier (No. NCT01578096).

Fostering Work Ability Among Menopausal Women. Does Any Work-Related Psychosocial Factor Help?

Introduction

Due to the aging workforce, it will become even more common for organizations to count, among their employees, women who are dealing with menopause. To date, no knowledge is available regarding the work ability among menopausal women. With this view, the aim of the present study was to identify work-related psychosocial factors associated with work ability in a sample of menopausal working women.

Methods

A self-report questionnaire was administered to 1069 menopausal women employed as administrative officers in the Italian public sector. The study design was cross-sectional.

Results

Work ability was found to be negatively associated with family–work conflict (β = −0.21, p = 0.0001) and positively associated with health-oriented organizational climate (β = 0.12, p = 0.0001), job autonomy (β = 0.08, p= 0.006), and skill discretion (β = 0.08, p= 0.048). Conversely, work ability did not show significant associations with job demands, flexible working hours, and social support.

Discussion

From a practical point of view, our study identifies various areas of intervention that could foster job sustainability during menopause. In particular, our findings suggest that, to improve women’s job sustainability across their entire work-life span, it may be crucial to develop organizational policies, training, and activities specifically dedicated to sustaining menopausal women’s well-being.

The relationship between menopausal symptoms and burnout. A cross-sectional study among nurses

Background

Despite the growing presence of menopausal women in workplaces, studies aimed at exploring the link between menopausal symptoms and job well-being are scarce. In the interest of addressing this gap, the present study aimed to explore whether menopausal symptoms might contribute to increased levels of burnout and whether this relationship can be moderated by social or personal resources.

Method

The study design was cross-sectional and non-randomized. Ninety-four menopausal nurses completed a self-report questionnaire including scales aimed at measuring menopausal symptoms, burnout, social (i.e., support from superiors and colleagues) and personal (i.e., self-efficacy, resilience, and optimism) resources. Moderated regression analyses were performed to test study hypotheses.

Results

Whereas menopausal symptoms were associated significantly with emotional exhaustion, no social or personal resources were found to moderate this relationship. Regarding depersonalization, our study indicated that it was affected by menopausal symptoms only among nurses who reported low social support (from superiors and colleagues), optimism, and resilience.

Conclusion

The present study highlights the importance of organizations that employ a growing number of menopausal women to seek solutions at the individual and social levels that help these women deal with their menopausal transition while working.

Self-help cognitive behavior therapy for working women with problematic hot flushes and night sweats (MENOS@Work): a multicenter randomized controlled trial

OBJECTIVE

The aim of the study was to examine the efficacy of an unguided, self-help cognitive behavior therapy (SH-CBT) booklet on hot flush and night sweat (HFNS) problem rating, delivered in a work setting.

METHODS

Women aged 45 to 60 years, having 10 or more problematic HFNS a week, were recruited to a multicenter randomized controlled trial, via the occupational health/human resources departments of eight organizations. Participants were 1:1 randomized to SH-CBT or no treatment waitlist control (NTWC). The primary outcome was HFNS problem rating; secondary outcomes included HFNS frequency, work and social adjustment, sleep, mood, beliefs and behaviors, and work-related variables (absence, performance, turnover intention, and work impairment due to presenteeism). Intention-to-treat analysis was used, and between-group differences estimated using linear mixed models.

RESULTS

A total of 124 women were randomly allocated to SH-CBT (n = 60) and NTWC (n = 64). 104 (84%) were assessed for primary outcome at 6 weeks and 102 (82%) at 20 weeks. SH-CBT significantly reduced HFNS problem rating at 6 weeks (SH-CBT vs NTWC adjusted mean difference, -1.49; 95% CI, -2.11 to -0.86; P < 0.001) and at 20 weeks (-1.09; 95% CI, -1.87 to -0.31; P < 0.01). SH-CBT also significantly reduced HFNS frequency, improved work and social adjustment; sleep, menopause beliefs, HFNS beliefs/behaviors at 6 and 20 weeks; improved wellbeing and somatic symptoms and reduced work impairment due to menopause-related presenteeism at 20 weeks, compared with the NTWC. There was no difference between groups in other work-related outcomes.

CONCLUSIONS

A brief, unguided SH-CBT booklet is a potentially effective management option for working women experiencing problematic HFNS.

Tackling the taboo: talking menopause-related problems at work

Purpose

Women are typically reluctant to disclose menopause-related problems that may affect their working lives to line managers. Consequently, support may not be offered nor potential solutions explored. The purpose of this paper is to examine how working menopausal women would prefer to have conversations about the menopause at work.

Design/methodology/approach

Using semi-structured telephone interviews working menopausal women (aged 45–60 years) were asked about their experiencing of talking about their menopause at work, and how helpful conversations might be initiated and conducted. Transcripts were analyzed thematically to identify factors that may facilitate or hinder such conversations.

Findings

Two themes emerged: first, organizational context. Facilitators included an open culture with friendly relationships, a knowledgeable and proactive manager, organization-wide awareness of the menopause and aging, and access to a nominated woman to discuss problems. Barriers included male-dominated workplaces, male line managers, fear of negative responses, stigma, discrimination, embarrassment or believing menopause is inappropriate to discuss at work; second, the nature of the discussion. Facilitators included managers demonstrating an understanding and acceptance of a woman’s experience, jointly seeking acceptable solutions, respecting privacy and confidentiality, and appropriate use of humor, as opposed to being dismissive and using inappropriate body language. Discussions with suitable persons at work were preferred and being prepared was advised. The women in the sample advised having discussions with appropriate persons and being prepared.

Practical implications

These findings could inform training programs, workplace policies and practice.

Originality/value

This study provides insights to help women and their managers discuss menopause-related difficulties at work and seek solutions together.

Sleep and Sleep Disorders in the Menopausal Transition

The menopausal transition is associated with an increase in insomnia symptoms, especially difficulty staying asleep, which negatively impacts quality of life. Vasomotor symptoms are a key component of sleep disruption. Findings from polysomnographic studies are less consistent in showing disrupted sleep in menopausal transition independent of aging; further prospective studies are needed. Hormone therapy alleviates subjective sleep disturbances, particularly if vasomotor symptoms are present. However, because of contraindications, other options should be considered. Further work is needed to develop preventive and treatment strategies for alleviating sleep disturbances to ensure better health, quality of life, and productivity in midlife women.

Risk Assessment: Factors Contributing to Discomfort for Menopausal Women in Workplace

The purpose of this study was to review the Factors contributing to discomfort for menopausal women in workplace and the perceived effects of working conditions on menopausal symptoms, and to produce recommendations for managers and women. This study was a review article. We searched PubMed and Science Direct for articles related to menopause and workplace. Keywords included: menopause AND workplace OR occupational health or menopausal women AND managers. Because we aimed to update the literature following the 2011 review of menopause and workplace, only English-language articles published between 2011 and 2017 were included. This review showed that how managers could be help and awareness and what should be done for menopausal women in workplace by risk assessment. Many risk factors are contributing to discomfort for menopausal women in workplace and managers should be assessed them. Managers should be aware that menopausal transition causes difficulty for some women at work, then occupational health and safety and health promotion policies will be increasingly important. It may help inform the development of tailored occupational health policies and programs that cater for the needs of women as they transition through menopause in the workplace.

What do working menopausal women want? A qualitative investigation into women's perspectives on employer and line manager support

OBJECTIVES

To explore women's perspectives on what employers and managers should and should not do in relation to women going through the menopause.

METHODS

An online questionnaire was used to collect qualitative data in a cross-sectional study of working women. Three open-ended questions asked peri- and post-menopausal women, aged 45-65 years: (i) what they thought employers could do, or should do, to help menopausal women who may be experiencing difficult menopausal symptoms at work; (ii) how managers should behave; and (iii) how managers should not behave towards women going through the menopause.

RESULTS

137 women responded to the open questions in the survey. An inductive thematic analysis was conducted and three overarching themes emerged. Theme 1 related to employer/manager awareness, specifically to knowledge about the menopause and awareness of how the physical work environment might impact on menopausal women. Theme 2 related to employer/manager communication skills and behaviors, specifically those considered helpful and desired and those considered unhelpful and undesired. Theme 3 described employer actions, involving staff training and raising awareness, and supportive policies such as those relating to sickness absence and flexible working hours.

CONCLUSIONS

The menopause can be difficult for some women to deal with at work, partly due to the working environment. To our knowledge, this is the first study to explore women's descriptions of how they would like to be treated by employers/managers, and what would be helpful and unhelpful. The results have clear implications for communication about menopause at work and for employer-level policy and practice.