Elsevier

Maturitas

Volume 85, March 2016, Pages 88-95
Maturitas

Review article
Menopause in the workplace: What employers should be doing

https://doi.org/10.1016/j.maturitas.2015.12.006Get rights and content

Abstract

Large numbers of women transition through menopause whilst in paid employment. Symptoms associated with menopause may cause difficulties for working women, especially if untreated, yet employers are practically silent on this potentially costly issue. This review summarises existing research on the underexplored topic of menopause in the workplace, and synthesises recommendations for employers. Longstanding scholarly interest in the relationship between employment status and symptom reporting typically (but not consistently) shows that women in paid employment (and in specific occupations) report fewer and less severe symptoms than those who are unemployed. Recent studies more systematically focused on the effects of menopausal symptoms on work are typically cross-sectional self-report surveys, with a small number of qualitative studies. Though several papers established that vasomotor (and associated) symptoms have a negative impact on women’s productivity, capacity to work and work experience, this is not a uniform finding. Psychological and other somatic symptoms associated with menopause can have a relatively greater negative influence. Physical (e.g., workplace temperature and design) and psychosocial (e.g., work stress, perceptions of control/autonomy) workplace factors have been found to influence the relationship between symptoms and work. Principal recommendations for employers to best support menopausal women as part of a holistic approach to employee health and well-being include risk assessments to make suitable adjustments to the physical and psychosocial work environment, provision of information and support, and training for line managers. Limitations of prior studies, and directions for future research are presented.

Introduction

Reflecting the increased participation of women and the aging profile of labor markets in many industrialized nations, a growing number of women aged 45 years and over have taken up paid employment over the past two decades [1], [2].1 This trend is likely to continue as national governments and employers tackle the challenges of an aging population by seeking to retain and increase the number of mature-aged women at work [3]. In consonance with these demographic and economic imperatives, a large and, in some nations, ever-growing number of women are transitioning through menopause whilst in employment [4], with the majority of women symptomatic between 45 and 55 years, and some likely to exhibit certain symptoms beyond [5]. However, the many specific and interconnected health, lifestyle, aging and work-related concerns of women aged 45 years plus (including menopause) which can influence women’s participation in paid employment, and engagement and performance whilst at work, are often overlooked. In most of the literature to date, ‘work’ has not been the primary focus of interest, sometimes even only as a single item on a survey [6]. This oversight is potentially costly for employers. In one study of 252,000 symptomatic employees, the incremental direct and indirect costs of their untreated vasomotor symptoms (VMS) for employers amounted to circa USD $370,000,000 over one year [7]. Despite the clear and significant business case for ‘managing’ menopause, organisations have been slow to respond. A survey of 500 UK health and safety representatives conducted for the UK’s Trades Union Congress (Paul, 2003) [4] found that only 1 in 5 employers provided information about menopause to employees; a mere 2% covered it as part of their health and safety provision.

This review summarizes the existing literature on menopause in the workplace. It pays particular attention to how menopausal symptoms affect and are affected by a woman’s working status, as well as key physical and psychosocial work-related factors that may exacerbate or ameliorate symptom experience. The review synthesises recommendations for employers on what they could best do to support employees going through menopause, notes limitations in existing studies, and concludes with directions for future research.

Section snippets

Search strategy

We conducted an initial search using the Ovid MEDLINE database from the fields of medicine/nursing/health sciences (no time range limits) using the keyword combinations: menopause/work (693 citations); menopause/employment (138 citations); and menopause/productivity (18 citations). Scrutiny of these references highlighted that ‘work’ was typically used as a synonym for efficacy (e.g., in relation to menopause treatments), or in a general sense, rather than to specifically refer to the workplace

Results

In most studies to date, ‘work’ has typically not been the primary focus of interest, often only included as a single survey item [6] (usually as the sociodemographic variable ‘employment status’) and tested for its potential association with symptom reporting (see Section 3.1 below). However, there is a trend over the last decade or so towards studies that place a primary and more systematic focus on menopause in the workplace. These recent studies (2000–2015) offer more detailed quantitative

Conclusion

It is only in recent years that peri-menopausal and post-menopausal women’s experiences in the context of paid employment have been systematically researched. The literature summarized above suggests that vasomotor, psychological and somatic menopausal symptoms can create difficulties for some women at work, and that physical (notably the temperature and spatial layout of the working environment) and psychosocial (notably work stress and job control/autonomy) facets of the working environment

Contributors

Professor Gavin Jack* declares that he helped conceive the form of the review, designed and participated in the literature search, wrote an initial draft of the paper and contributed to the final draft, and has seen and approved the final version.

Associate Professor Kathleen Riach declares that she helped conceive the form of the review, participated in the literature search, contributed to the final draft, and has seen and approved the final version.

Ms Emily Bariola declares that she helped

Conflicts of interest

None.

Funding

None.

Provenance and peer review

Commissioned; externally peer reviewed.

References (81)

  • D.A. Lawlor et al.

    The association of socio-economic position across the life course and age at menopause: the British Women’s Heart and Health Study

    BJOG

    (2003)
  • B. Cassou et al.

    Risk factors of early menopause in two generations of gainfully employed French women

    Maturitas

    (1997)
  • G.W. Tang

    The climacteric of Chinese factory workers

    Maturitas

    (1994)
  • A.C. Sasser et al.

    Economic burden of osteoporosis, breast cancer, and cardiovascular disease among postmenopausal women in an employed population

    Women’s Health Issues

    (2005)
  • A. Griffiths et al.

    Menopause and work: an electronic survey of employees’ attitudes in the UK

    Maturitas

    (2013)
  • R.A. Hammam et al.

    Menopause and work—the experience of middle-aged female teaching staff in an Egyptian governmental faculty of medicine

    Maturitas

    (2012)
  • G. Mishra et al.

    Perceived change in quality of life during the menopause

    Soc. Sci. Med.

    (2006)
  • N.S. Ghosheh Jr., S. Lee, D. McCann, Conditions of Work and Employment for Older Workers in Industrialized Countries:...
  • S. Payne et al.

    Older women, work and health

    Occup. Med.

    (2010)
  • J. Tilly et al.

    Older Women Matter: Harnessing the Talents of Australia’s Older Female Workforce

    (2013)
  • J. Paul. Health and Safety and The Menopause: Working through the Change. Trades Union Congress [TUC], London, 2003...
  • M. Geukes et al.

    The impact of menopausal symptoms on work ability

    Menopause

    (2012)
  • P. Sarrel et al.

    Incremental direct and indirect costs of untreated vasomotor symptoms

    Menopause

    (2015)
  • K.A. Frey

    Middle-aged women’s experience and perceptions of menopause

    Women & Health

    (1981)
  • C.M. Obermeyer et al.

    Symptoms, menopause status, and country differences: a comparative analysis from DAMES

    Menopause

    (2007)
  • M. Abedzadeh-Kalahroudi et al.

    Prevalence and severity of menopausal symptoms and related factors among women 40–60 years in Kashan, Iran

    Nurs. Midwifery Stud.

    (2012)
  • A. Huseth-Zosel et al.

    Socioeconomic differences in the menopausal experience of Chinese women

    Post Reprod. Health

    (2014)
  • C. Chung

    Sense of coherence, self-care, and self-actualizing behaviors of Korean menopausal women

    Dissertation Abstr. Int. B: Sci. Eng.

    (2000)
  • D. Anderson et al.

    Relationship between psychosocial factors and health behaviours for women experiencing menopause

    Int. J. Nurs. Pract.

    (2002)
  • I. Loutfy et al.

    Women’s perception and experience of menopause: a community-based study in Alexandria, Egypt

    East Mediterr. Health J.

    (2006)
  • G.A. Jassim et al.

    Knowledge of Bahraini women about the menopause and hormone therapy: implications for health-care policy

    Climacteric

    (2009)
  • E.B. Gold et al.

    Factors associated with age at natural menopause in a multiethnic sample of midlife women

    Am. J. Epidemiol.

    (2001)
  • S.L. Johnston

    Menopause in Blackfeet women—a life span perspective?

    Coll. Antropol.

    (2003)
  • A.P. Ortiz et al.

    Age at natural menopause and factors associated with menopause status among Puerto Rican women aged 40–59 years, living in Puerto Rico

    Menopause

    (2006)
  • F. Sarac et al.

    Early menopause association with employment, smoking, divorced marital status and low leptin levels

    Gynecol. Endocrinol.

    (2011)
  • H. Fallahzadeh

    Quality of life after the menopause in Iran: a population study

    Qual. Life Res.

    (2010)
  • E. Stefanopoulou et al.

    IMS study of climate, altitude, temperature and vasomotor symptoms in the United Arab Emirates

    Climacteric

    (2014)
  • C.E. Szoeke et al.

    The relationship of reports of aches and joint pains to the menopausal transition: a longitudinal study

    Climacteric

    (2008)
  • J.M. Alquaiz et al.

    Determinants of severity of menopausal symptoms among Saudi women in Riyadh city

    Climacteric

    (2014)
  • F. Jin et al.

    Knowledge and attitudes towards menopause and hormone replacement therapy in Chinese women

    Gynecol. Obstet. Invest.

    (2015)
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    Dr Schapper died in September 2014. She was an Honorary Researcher in the Department of Management, La Trobe Business School, La Trobe University, Bundoora, VIC 3086, Australia.

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