Menopause, an occupational hazard?

Posted by Liz on Mar 30, 2012 in aging, women's health, work | 1 comment

Two years ago, I wrote about a UK-based study examining the challenges that women face while working through the transition. Among working women surveyed, a majority reported that the primary factors affecting their ability to function in their job were menopausal-related fatigue and insomnia. During an email exchange, the study’s author noted that “evidence suggests that some women do experience a lot of difficulty – largely tiredness – much of which can be resolved with sensible line management and flexible work. ” However, “as with any other long-term health condition, employees should feel empowered to discuss health conditions with their line manager/supervisor,  otherwise the latter are not in a position to help.” Not soon after, I wrote about a study examining how menopause affects occupational health specifically, with study findings showing that total work ability scores declined by almost a half a point for every one point on the total symptoms scale score.

Importantly, these results have finally been published and appear  in the March issue of Menopause. 

Let’s step back a moment.

If you are unfamiliar with the term “work ability,” it refers to a concept “built upon the balance between a person’s resources and her work demands” and can be used to “predict future impairment and duration of sickness absence.” Within the confines of this definition, it’s no surprise that by and large, women have higher raters of sickness absence than men; just look at the multitasker caretakers in your own circle of friends! Moreover, women that are in the age range most commonly associated with perimenopause and menopause, i.e. 44 to 60, also reportedly have the highest incidence of absence from work, begging the question, is menopause playing a role?

In case you missed the first post on this study, women were asked questions about individual and lifestyle factors that might influence work ability, e.g. BMI, physical activity, smoking status and education. Additionally, menopausal symptoms were measured and analyzed using a scientific scale, and a tool – the Work Ability Index – was employed to evaluate how well the 208 women participating in the study were able to currently perform work. The latter tool focused on work ability compared to best of a lifetime or current demands, impairment due to illness, how often they took sick days over a year’s time and what life was like in general, both at work and at home.

Overall, menopausal symptoms were negatively associated with work ability, in particular, physical symptoms (body aches, joint pain, numbness, feeling dizzy/faint),  psychological effects (irritability, feeling blue, anxiety, depression) and education level.  Moreover, both physical and psychological symptoms accounted for as much as 36.5% of the different results in work ability among women. Yet, vasomotor symptoms — hot flashes and night sweats — appeared to have little influence on the ability to work, most likely because in this particular set of women, vasomotor symptoms were reported as existing but not (yet) bothersome.

What was lacking in this particular assessment were women who worked outside health and social service industries, who might be engaged in jobs that are less strenuous and physically challenging. Indeed, even in the earlier study, the women were mostly civil servants, i.e. police officers. The researchers note that the group of women they followed may have also had easier access to self help and lifestyle interventions because of their occupational backgrounds, which could have also influenced outcomes. Still, it seems that on some level, symptoms influence work ability and contribute to absence from work. More troubling is the fact that it is well known that women who work appear to have better menopause quality of life.

In essence, we define ourselves, at least in part, by our work. And when we suffer, our work suffers. How do we bridge the gap between work, life and demands of the transition if those demands impact our quality of life in ways that we might not have previously considered? I don’t have any answers.  Do you?