Q&A: Menopause symptoms result in adverse work outcomes, missed workdays

Key takeaways :

• Nearly 14% of women reported at least one adverse work outcome due to menopause symptoms.
• Researchers estimated an annual loss of $1.8 billion in lost work time in the U.S. due to menopause symptoms.

Menopause symptoms can negatively affect work outcomes, highlighting the need for improved medical therapies and a more supportive workplace environment, according to researchers involved in a large cross-sectional Mayo Clinic study.

The researchers invited 4,440 women aged 45 to 60 years (mean age, 53.9 years) who received primary care at one of four Mayo Clinic sites to participate in a survey study. All participants reported current employment; 93% of participants self-identified as white, 76.5% said they were married and 59.3% reported education level as college graduate or higher.

The primary outcome was self-reported adverse work outcomes related to menopause symptoms with menopause symptoms assessed by the Menopause Rating Scale.

Mean total Menopause Rating Scale was 12.1 in the cohort, which signified moderate menopause symptom burden. In total, 13.4% of women reported at least one adverse work outcome related to menopause symptoms, and 10.9% reported missing days of work due to menopause symptoms in the previous 12 months, with a median of three days missed.

Researchers observed increased odds of reporting adverse work outcomes related to menopause symptoms as menopause symptom severity increased. Women in the highest Menopause Rating Scale score quartile were 15.6 times more likely to experience an adverse work outcome compared with women in the lowest quartile (P < .001).

In addition, based on missed workdays related to menopause symptoms, researchers estimated an annual loss of $1.8 billion in the U.S.

Healio spoke with lead author Stephanie Faubion, MD, MBA, medical director for the North American Menopause Society, director of the Mayo Clinic Center for Women’s Health, and a Healio | Women’s Health & OB/GYN Peer Perspective Board Member about menopause symptoms’ real-world impact on women in the workplace.

Healio: Which menopause symptoms do women report as substantially affecting their work productivity and absenteeism and why?

Faubion: Women were sent a menopause questionnaire which we analyzed by total and symptom domain scores. The three different domains within the total menopause symptom score were all individually associated with adverse work outcomes. The three domains are somatic symptoms, which include hot flashes, night sweats and sleep disturbances; psychological symptoms, which include anxiety, irritability and depressed mood; and genitourinary symptoms, which include vaginal dryness, sexual problems and bladder problems. The domains scores were all individually associated with adverse work outcomes, but the one that was the strongest, and that seemed to be driving it the most, was the psychological symptom domain. Mood symptoms are one of the more common menopause symptoms. We know from other studies that poor mood can adversely impact women and men in the workplace. That’s why we have mental health resources at work. So, this is not that surprising, but it was interesting to see as it relates to menopause symptoms in the workplace.

Healio: Are different groups of women affected more than others; for example, by ethnic group or job type?

Faubion: We didn’t look at job type in this study. We know from previous research that it probably doesn’t matter what type of work a woman is doing, and that makes sense, especially if you think of the psychological symptom domain driving it. Women in the C-suite can be just as impacted by mood symptoms as women working physical labor jobs.

We did a small subgroup analysis on racial and ethnic differences in our study.  Although no major conclusions can be drawn from it because the number of minority women was small, we did see racial and ethnic differences with Black women being about 3 times more likely and Hispanic women being about 1.6 times more likely than white women to have an adverse work outcome due to menopause symptoms.  This requires additional study to confirm the findings and to determine the factors that may be influencing this.

Healio: Women may fear some discrimination in the workplace as they age. Might they be reluctant to disclose to their employer when menopause symptoms affect their work? Should they disclose this information?

Faubion: I don’t think we should force women to disclose their menopause status because they may feel that they’re at risk for discrimination. That’s a legitimate concern. But women should be able to access resources confidentially, just like they do now. For example, with mental health concerns, they can access resources with or without notifying their managers or supervisors. We need to be cognizant that women may or may not want to have open conversations about menopause in the workplace.  Some women may want to discuss the impact of their menopause symptoms at work, so we need to be prepared. And we need to train managers and supervisors to have sensitive conversations with women about menopause.

Healio: What would you recommend employers do to better support women with menopause in the workplace?

Faubion: This probably requires a multipronged approach. Employers need to be educated about the impact of menopause on their workforce and what that’s doing to their bottom line, but they also need to implement required education and training modules for managers and supervisors. Also, women need to be educated. Women don’t always recognize all the symptoms that can occur necessarily relate to menopause.  We need to educate women about menopause, including what the symptoms are, how they might impact them, including in the workplace, and about the resources available to them. Women also need access to competent menopause care, and that may or may not be with employee health doctors. Employee health doctors typically aren’t educated on menopause management. We need to be educating those employee health providers on what to look for and where they can refer women who would benefit from menopause care.

Healio: Is there anything else you would like to add?

Faubion: This has further-reaching consequences and implications. Women may not only be struggling in the workplace, but they also may not be taking a promotion, may have taken a lesser job, may not have put their name in the hat for a job, or may even be getting out of the workforce earlier. It really speaks to the fact that women may be opting out of the leadership pipeline, and that could be one of the reasons we don’t have as many women as men in the C-suite.  It also has implications for women’s financial security in retirement.

For more information:

Stephanie Faubion, MD, MBA, can be reached at faubion.stephanie@mayo.edu.

References:

• Faubion S, et al. Mayo Clinic. 2023;doi:10.1016/j.mayocp.2023.02.025.
• Furst J. Mayo Clinic study puts price tag on cost of menopause symptoms for women in the workplace. Mayo Clinic News Network. newsnetwork.mayoclinic.org/discussion/mayo-clinic-study-puts-price-tag-on-cost-of-menopause-symptoms-for-women-in-the-workplace/. Published April 26, 2023. Accessed April 27, 2023.