Women, work and menopause
Authors:   , Geukes Marije 
Published: May 2024

Menopause, or the final menstrual period, occurs on average at age 51. In the years before and after the menopause, women may experience symptoms such as hot flushes, night sweats, heavy menstrual bleeding, mood swings, difficulty concentrating, muscle and joint pain, and urogenital symptoms. Some women experience few symptoms, but a proportion of women have severe symptoms that affect their quality of life. Women may also experience problems in the workplace, sometimes preventing them from performing their tasks at the same level.
The aims of this thesis were to find out whether there is an association between menopausal symptoms and work outcomes. To investigate whether healthcare providers are aware of a possible relationship between menopausal symptoms and work outcomes. Finally, to assess the effect of education about the climacteric on self-efficacy to work through the climacteric, experience of menopausal symptoms and work outcomes.
The general introduction of this thesis forms Chapter 1.
Chapter 2 analysed whether there was an association between menopausal symptoms and reduced work ability. A negative association was found between menopausal symptoms and work ability. Menopausal symptoms could predict a third of the variance in work ability in this group of women. Menopausal symptoms in the psychological and somatic domains were found to be particularly responsible for this. However, because of the cross-sectional design of the study, it is not possible to establish causality.
Chapter 3 compared the work ability of the group of women in Chapter 2 with that of a group of women with severe menopausal symptoms. Women with severe menopausal symptoms were 8.4 times more likely to report low work ability than women with mild symptoms. More than three-quarters of the women with severe menopausal symptoms had low work ability, putting them at risk of long-term sickness absence.
Chapter 4 describes a retrospective cohort study in which women with severe menopausal symptoms were followed over time from their first visit to a menopause clinic to a follow-up 3 to 9 months later. This chapter shows that treatment for menopausal symptoms is associated with an improvement in symptoms and is associated with an improvement in work ability. Improvement in depressive symptoms seems to be particularly important for this association.
A survey was conducted among Dutch occupational health physicians, the results of which are described in Chapter 5. This survey investigated beliefs, social norms and self-efficacy (belief in one's own abilities) regarding the recognition of menopausal symptoms and the relationship between menopausal symptoms and work among occupational health practitioners. Most occupational health physicians believe there is a link between menopausal symptoms and reduced work productivity or absenteeism. More than half of those surveyed find it difficult to assess the relationship between menopausal symptoms and work. Moreover, more than a third say they do not have enough knowledge to ask about menopausal symptoms, let alone discuss treatment recommendations. More than three-quarters of occupational health professionals say there is a need for a national guideline on menopause and work. In addition, 56% of occupational health professionals acknowledge that there is a taboo about discussing menopausal symptoms at work.
Chapter 6 describes the results of a workplace educational intervention on menopause on self-efficacy (belief in one’s own abilities) for working during the climacteric. This quasi-experimental study shows that female employees who received the educational intervention reported higher self-efficacy about working during the climacteric, were more knowledgeable about the menopausal transition and experienced less productivity loss due to menopausal symptoms than a control group of employees who did not receive the intervention.
The general discussion forms Chapter 7, where the implications for practice are outlined.